The Order of St. John

Barry Glenn, MD, Board-Certified Ophthalmologist and Fellow, American Academy of Ophthalmology

In the summer of 2008 my wife Nancy and I spent three months at the St John of Jerusalem Eye Hospital. I had retired recently from the practice of ophthalmology in College Station, Texas, after 32 years, with a total of 40 years in medicine. Through a mutual friends of ours who is a member of The Order of St John, we were encouraged to consider volunteering humanitarian medical work at the Hospital. We coordinated our time of service with the Medical Director of the St John of Jerusalem Eye Hospital. She suggested the best time to volunteer at the Hospital would be July-September 2008.

I helped each weekday in the outpatient clinic. The clinics and Hospital treat all incoming patients with medical and surgical eye diseases. Patient fees are based on the patient’s ability to pay and without regard to ethnicity or religious preferences. The most common diseases seen are cataracts, glaucoma, and diabetic retinopathy.

In the operating room (“theatre” in British terms), I observed surgeons using state-of-the-art equipment donated by various individual supporters of the Order’s work. These excellent surgeons would not be able to utilize their skills for patient benefit without this first-class equipment. All the surgeons appreciate the Order’s contributions in this vital area of the hospital’s mission. When appropriate, I gave input based on my practice experiences to the surgeons and the OR staff.

In addition to the clinic and operating theatre help and observation, I presented PowerPoint lectures on Basic and Clinical Sciences from our American Academy of Ophthalmology to the four residents-in-training to help them prepare for their board examinations. Dr. Nicholas Sargent, Consulting Ophthalmologist and Medical Education Director, frequently asked visiting doctors to give lectures to residents and medical staff on ophthalmic topics of the lecturer’s choice. I was privileged to present talks based on material provided by the Academy to the residents and medical staff.

What a thrilling and unique experience for Nancy and me to serve in such a special land and with such special people! During our time in Jerusalem we felt even safer than in many American cities. I encourage qualified graduating fellows and full-time practicing ophthalmologists to consider volunteering to help for one, two, or more weeks at St John of Jerusalem Eye Hospital. Retired ophthalmologists could serve even longer. Just possibly, you will be more blessed than the people you came to serve!

The experiences of Barry and Nancy Glenn at St John of Jerusalem Eye Hospital during the summer of 2008. This account is from Barry’s perspective on volunteering, assisting, observing, and teaching in the clinical arena at the Hospital. Subsequently, Nancy became a member of The Order of St John in November 2008.

James Lehmann, MD, MStJ, Cornea Specialist

Dr. James Lehmann with a patient at the St. John of Jerusalem Eye Hospital

San Antonio, TX -- For two months during the summer of 2006, I worked as a visiting surgeon at The St. John of Jerusalem Eye Hospital. Until retirement, most American ophthalmologists do not have the time to work abroad for more than a week; however, I had several months free between working with ORBIS International, a nonprofit organization fighting blindness in developing countries, and embarking on more specialty training in the US. Dr. James McCulley, the Chair of Ophthalmology at UT Southwestern at Dallas and a Member of the Order of St John, encouraged me to visit the Hospital during my break.

Consequently, I spent that summer at SJEH working in the clinics, performing surgeries, teaching residents, and participating in outreach programs in the West Bank. That experience led me to become a Member of the Order of St John and compelled me to make two more trips to the Hospital.

What is unique about The St. John of Jerusalem Eye Hospital? Why does it have such a profound effect on visitors? First, the hospital is a great place to work. It is efficient and equipped with modern surgical equipment and facilities. For a year before my time at the Hospital, I worked with ORBIS International across Africa, Asia, and South America. I saw intelligent, skilled doctors frustrated by the lack of medicine, equipment, and infrastructure.

This is not the case at The St. John of Jerusalem Eye Hospital. From the beautiful operating microscopes and new anesthesia machines in the operating rooms, to the disciplined, intelligent nursing staff on the wards, to the well-stocked pharmacy -- the quality of care is first rate! Simply put, it is a first world hospital in a developing world environment.

Secondly, the Hospital is located in the Sheikh Jarrah neighborhood in East Jerusalem, a mile from the Old City, and is surrounded by churches, hotels, and consulates. The magic and beauty of Jerusalem intoxicates its visitors. A wonderful climate, friendly people, and grateful patients -- these things overcome one’s fears and prejudices.

Since my visit in 2006, I have returned twice, transporting tissue from the US for corneal transplantation. There is no eye bank in Israel or Palestine, and there is no cornea specialist at The St. John of Jerusalem Eye Hospital. During each visit, I bring 10-12 corneas, and work with residents and staff on pre-selected patients, performing transplants to restore sight to patients with severe corneal pathology such as keratoconus, traumatic scars, and burns.

If I could manage to go more often, I would. Each visit I meet new faces -- residents, nurses, staff and patients -- but the feeling in the Hospital is the same. The staff’s morale and sense of purpose are enduring. Each day, the Hospital staff, representing three great religions, truly lives our motto, “in the Service of Humanity.”

Miracles and Reality: Volunteering at the Hospital

Adventure and opportunity travel hand in hand, and my experience with the Hospital supports that. Ten years ago, I stated in my Order membership application that I wanted to serve as a volunteer anesthetist. That dream was realized in October 2003 when I accompanied Dr. Robert Della Rocca and his ophthalmic team to Jerusalem. I have continued to volunteer for seven years, witnessing not only miracles of sight regained, but also areas of urgent need.

I am amazed (as visitors always are) at the Hospital’s delivery of superb ophthalmic care under hugely trying circumstances. As an anesthetist, I was impressed by the diversity and care of cases performed under general and regional anesthetics across a spectrum of age groups. I assisted the late Dr. Ibrahim Salaweh, who for nearly a decade served as the Hospital's chief of anesthetics, bringing great expertise in managing adult and pediatric cases. His colleague and friend, Dr. Issa Abu Sada, continues to share this talent. Their dedication to safe anesthesia delivery has been exemplary.

One area of particular interest to me is the Hospital’s continued ability to manage and safely secure patients with difficult airway structures. AsOxford Professor Robert MacIntosh said, "The three requirements for good anesthetic are 1.) a good airway 2.) a good airway and 3.) a good airway." Dr. Salaweh's great desire was for the completion of the Hospital’s “Difficult Airway Cart”, a wheeled metal chest holding a variety of devices for managing and safely securing a less than classically structured airway. A key element is a fiberoptic intubating bronchoscope, which is critical when anesthetists are presented unexpectedly with difficult airway architecture. In 2004, Dr. Salaweh told me that the only items the cart lacked were two of these -- adult and pediatric.

Together with other colleagues in Texas, I am helping to raise funds toward the purchase of the two scopes. I act in loving memory of Dr. Salaweh, whose face, voice and clinical abilities all miss at the Hospital, and with whom I was privileged to work.

Anna Armstrong, MD, DStJ

Dr. Armstrong Assists with a procedure