I’m a Trauma Surgeon in Israel. In My Hospital, We Are in This Together.

https://www.nytimes.com/2021/05/18/opinion/israel-palestinians-conflict-injuries-hospital.html

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HOLON, Israel — Late in the evening on Tuesday, I was working in my office in Wolfson Medical Center, the hospital where I am the director of trauma surgery. The sun had set and suddenly the sirens started blaring from every corner of Tel Aviv, warning of rockets headed our way.

Our hospital is on the southern edge of the city, in a working-class neighborhood filled with Jews and Arabs, recent immigrants from sub-Saharan Africa and the countries of the former Soviet Union. From the hospital’s intercom came a calm, programmed voice: “Red alert,” it said. “Please move away from the windows and into a protected area as soon as possible.”

I ran down the internal stairway to the emergency room and waited. Moments later I heard booms — some sounded distant, others sounded like they were right over our heads, a result of Israel’s Iron Dome antimissile system exploding rockets in the sky.

After a while, things were quiet again. I walked outside to the entrance where the ambulances are. Medics — most of them volunteers, some as young as 15 — were running to their ambulances and speeding off; they wore bulletproof vests and helmets. One told me that a bus in a nearby neighborhood had been hit. There were casualties. The hospital staff knew that we had only minutes to prepare for the influx.

Doctors, nurses, radiologist technicians, transport techs, the blood bank and social workers were called to the emergency room. The operating rooms were notified. Within an hour, more than 40 patients had arrived. Four were in critical condition; three needed emergency surgery. For the next few hours, the entire hospital worked to evaluate and treat the wounded. People cleaned wounds, set fractures, did whatever was necessary.

At 3 a.m., I left the operating room and went back to the emergency room. Everything had returned more or less to normal. As the sun rose, our trauma team rounded on our patients. I was called urgently back to the operating room because one patient was still bleeding. Once I finished treating her, I was ready to sleep on the couch in my office for a few hours. Maybe I would even shave. (A colleague in the gynecology department had found me a razor.) But first it was time for a debriefing: The whole staff gathered to discuss what we would do differently, and how to improve our performance the next time there was a mass casualty incident.

As I looked around at my colleagues, I couldn’t help but notice the diversity of our team. From the trauma center to the inpatient ward to the operating rooms, this was a team of Arabs, Jews, Muslims, Christians and Druze (and I’m sure a few others).

In parallel with the rising conflict with Gaza last week, tension rose between Jewish and Arab citizens of Israel. There have been violent riots, with Jewish extremists pulling Arabs from their cars and Arabs doing the same to their Jewish neighbors. Businesses and homes have been destroyed. The police have used more violence to control the violence.

We have been treating the people injured in those clashes, too. The groups fighting each other on the streets were suddenly confined together inside the walls of our emergency room. As they arrived, one would wear the religious Jewish undergarment, the next would be an Arab. One of our Arab nurses would thoroughly treat a Jewish wounded woman; a Jewish intern examined a young Arab man who had been injured by a rubber bullet to the chest. An Arab specialist checked the wounds of a Jewish man who had been beaten, and the Jewish cleaning lady helped an Arab man put on his hospital gown. A Jewish nurse cleaned the blood off the forehead of an Arab boy.

To help with the influx of patients one of our Arab residents had driven to the hospital from Lod, a city that has seen some of the worst communal violence in recent days with buildings burned, windows smashed and hundreds of people injured. That resident had risked his own life — he could have been attacked by extremists as he drove through the streets — to help treat whatever patient was put in front of him. The next day in Lod, his wife’s car was set on fire.

Wolfson Medical Center is not the biggest hospital in Israel. It lacks funds, and its exterior probably has not been painted for 40 years. But to me it represents everything that is beautiful and possible with this place. Before, during and after this current disaster we are the hospital for one of the most diverse, elderly and neglected populations in Israel. We train residents from all over the world (especially Africa and Latin America), and Palestinian residents from the West Bank and Gaza. The concepts of free, accessible medicine — socialized medicine — and of serving a needy community with the highest standard of care are as essential to this place as its concrete walls.

In two and a half days last week, we received more than 100 people wounded from missiles, falling shrapnel or the violence on the streets. I have no idea what this week will bring; whatever it is, I cannot be proud enough of the team here, which is constantly ready to come into work at any hour, willing to sacrifice themselves to help, to do whatever is needed.

In the coming days, years and decades, I hope that what is happening now under the roof of this hospital — the selflessness, the lack of ego, the teamwork and diversity and mutual respect — can be a model for this entire country, for our entire region. If neighbors and communities can’t work together, can’t get along in the way that I see every night in our hospital, I worry that we are guaranteeing that the suffering across this country will only get worse. If we do come together, as we do inside our walls, it will be a beautiful thing.

In the early hours of Thursday morning, I asked one of our best nurses, a Druze man from a village in the Golan Heights, for a cigarette. I allow myself one a year and this felt like the right moment. He rolled it for me and we stepped outside into the parking lot, together, to enjoy a moment of quiet. And peace.

Adam Lee Goldstein is the director of trauma surgery at Wolfson Medical Center in Holon, Israel.

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