Tales From Inside an Israeli ER
WHY YOU SHOULD CARE
Because like much in life, death is nothing like it is on television.
By Matthew Stein
In this occasional series, OZY takes to streets and neighborhoods across the globe to ask a simple question: “How was your day?”
Dr. Ofer Merin, Shaare Zedek Hospital
I’m a morning person. I wake up at 5 a.m. and start my day with a 10K run. It’s good physical exercise, but for me, it’s more mental — I run to clear my brain. I’m at the hospital by 7 a.m., and my time is divided between my responsibilities as the hospital’s deputy director, director of the trauma unit and my work as a cardiac surgeon.
My work involves long hours, but that’s the life I chose. People tend to take a step back and work less as they get older, but in my case, it’s probably the opposite. My wife works with tourism and many of her clients are in North America, so she’s quite busy as well, often until late in the evening. I think having a spouse who’s also a hard worker is a good prescription for a long marriage because there’s no time to fight.
Today Trump is in Jerusalem, so I didn’t run. On special days or in times of tension, I need to be available very quickly. About a year ago, Jerusalem had an eight- to 10-month period when every other day there were stabbings, and Shaare Zedek’s trauma unit treated more than half the country’s terror victims. During this time I didn’t leave the city; I was always 15 minutes away from the hospital.
Today Trump is in Jerusalem, so I didn’t run. On special days or in times of tension, I need to be available very quickly.
Israel has been putting a lot of energy into making sure hospitals have a strict plan to receive mass casualties. At least once a year, I’ll drill our staff to ensure everyone knows their position and what to do when a suicide bomb explodes and 100 victims are coming in. This is a huge load on any emergency room; you need to understand the flow, have the right priorities and know how to deal with those patients who are already in the hospital.
From a purely medical point of view, treating terror victims is no different than other patients, but there are differences. First, terror victims come to the hospital in a much more critical condition, which means treatment is more urgent. People involved in such incidents also have a higher chance of developing PTSD.
To make things more complicated, in many of these incidents, we had to treat the terrorist alongside the victims. Sometimes, if their condition is more critical, we’ll operate on the terrorist first. We’re extremely strict with treating patients as patients without judging them, but explaining this to the victims and their families is not easy.
We’re also strict on debriefing medical and mental issues. We let the staff share their emotions, talk about what they did and how they felt. This is a very important part. You have to look carefully at your staff to make sure no one is getting overwhelmed. Dealing with trauma is unique in that within seconds, it takes you from your daily routine into a difficult medical situation. Families place their loved ones in your hands. You follow up with them day and night, quickly develop interconnections and almost become part of the family.
For the last 15 years I’ve also worked as the commander of the Israeli Defense Forces (IDF) field hospital. Israel is deeply involved in confronting national disasters in the world. We have one of the largest and strongest emergency medicine teams, and we’re recognized by the WHO as the only team with a level 3 rating, which is the highest level. I’m responsible for preparing this unit for whatever civil or military issues we’ll confront.
On every mission we bring 100 tons of medical equipment and we’re able to deploy very quickly — usually within six to eight hours from the time we land. We’re very self-sufficient — we bring our own sleeping bags, tents, food and water.
The biggest challenge of working in these areas is how to adjust the treatment. You can’t copy and paste from your homeland because there’s always a lack of resources. You don’t have the same imaging, labs or blood units. Sometimes the operation room is too busy, and if you operate on one person, another will die. You can’t hold patients for the same amount of time or send them to rehab because often, there is no rehab.
- Matthew Stein, OZY Author Contact Matthew Stein