I felt like the angel of death last year at Mount Meron when the annual Lag B’Omer festival turned into a disaster – a crowd crush caused by inadequate infrastructure killed 45 people, some of them children.
I was supposed to leave the mountain and the festival at 12 a.m. when my shift ended. I am the deputy head of United Hatzalah’s Medical Department and a paramedic, and at the time I was in charge of the medical treatments given on the mountain during the celebration. We always have a member of the medical department present at the festival in order to oversee the two medical clinics that the organization operates as well as the eight to 15 teams of volunteers active at any given time. My job was to make sure proper treatments were given to those who needed them and coordinate any and all medical needs with our dispatch center and other medical organizations. This included everything from making sure medical supplies were available to treatment or transport of patients.
I didn’t leave at midnight. Instead, I stayed to talk with some of my fellow responders to see how they were holding up on one of the most active nights of the year. Just before 1 a.m., the tragedy began to unfold and I was right in the middle of it.
First, a call went out that a balcony had collapsed. We didn’t quite know what had happened, but we ran to the location indicated. I found a man lying on the floor, and together with other first responders, began to perform CPR. Someone came up to me and asked why I was performing CPR. This was a mass casualty incident (MCI), they said, and as one of the highest-ranking medical personnel present, I had to manage the scene itself. I looked a few meters further down the path, and that is when I saw multiple teams performing CPR on multiple casualties. Then I understood the magnitude of what was taking place. It wasn’t a collapsed balcony, but a crush – a major MCI.
I couldn’t perform CPR on each and every victim. That wasn’t my job at that moment. I switched to MCI protocol and began to check the victims who were receiving CPR. I started to declare people dead. It was very loud, and per MCI protocols I checked pulses for 20 seconds each, not the usual 10. I checked the pupils of each individual multiple times to make sure there was no response. This was to make sure the person was actually deceased and had no pulse, because during an MCI, you can miss signs of life due to the noise or chaos at the scene.
That is how I passed through the crowd: Declaring people dead right and left. Sometimes I even declared a person dead multiple times, because when one team stopped performing CPR and left the body, another team would come and resume CPR, not knowing the person had already been declared dead.
I remember the vast number of volunteers that gathered and the huge amount of medical supplies that were used and then simply strewn on the ground with no time to clean them up. CPR was being performed at multiple locations a few meters away from where the tragedy took place – was taking place – including inside the clinic of United Hatzalah. Some victims were further away on pathways that had been cleared for the purpose. Over the course of a short period of time, I declared more than 30 people dead.
At some point, we collected all of the bodies of the deceased in the lower parking lot. At that point, I helped bring a few more bodies down from our clinic. Then a doctor from one of the ambulance teams again pronounced the death of those I had already declared deceased.
Once the incident was over, the injured had been transported and the deceased properly taken care of – as much as was possible at the scene – I went to work at my other job as director of the Psychotrauma and Crisis Response Unit. Throughout the evening, members of our unit who were at the mountain were providing psychological care and emotional stabilization for the eyewitnesses and survivors – those who made it, but were traumatized by witnessing the horror of the evening.
After everyone else was cleared off the mountain, we held a debriefing circle for the responders themselves. I went out into the forest and the area around the mountain and collected all of the volunteers who had gone off to cry by themselves. I brought them back so that we could cry together and, through this, begin the process of healing. For some of us, this would be a process that would take time. Some of the volunteers took months to fully recuperate from the experience. Some of them still haven’t. Our unit tried to help them all through a group meeting that night at the mountain, phone calls throughout the next day before Shabbat and then 15 group meetings in different locations around the country on Saturday night.
Wherever the volunteers were located, that is where we had highly trained personnel from the unit performing debriefing circles and group therapy, not just for United Hatzalah volunteers, but all first responders.
In one instance, I brought a responder to the mountain eight months after the incident to heal. She hadn’t been sleeping for the entirety of the time since the tragedy. I went with her to visit the mountain and told her, here you tried to save lives.
Shortly after the incident, I felt a lot of anger, even rage. I didn’t sign up to be the angel of death, to pronounce the deaths of more than 30 people who went to celebrate a holiday. I had my own personal crisis. I changed my job and lessened my responsibilities by becoming deputy head instead of head of the medical department, so I could spend less time in the field. I wrote protocols to help the organization handle MCIs better and respond faster. Now we train all volunteers in MCI protocols and have spent the last year doing so.
A year later, I’ve managed to make my peace with what happened. I still feel like I was the angel of death that night, but I know in retrospect that I acted according to protocol, and the work I did perhaps saved others who might have met a different fate had I acted differently. Perhaps even the angel of death has a purpose. Perhaps even the angel of death can save lives.
Avi Marcus is the deputy head of the medical department at United Hatzalah of Israel.