Dr. Michael Fuenfer on left; Israeli pediatric surgeon on right.

A local surgeon describes rushing to Israel to help during the war

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A local surgeon describes rushing to Israel to help during the war

Dr. Michael Fuenfer on left; Israeli pediatric surgeon on right.

Fearing a war on three fronts, the Israeli Ministry of Health solicited medical volunteers from around the world willing to provide medical assistance if needed. I spoke with two American physicians who had just returned to the United States after volunteering in Israel, and both described it as an exceedingly rewarding experience. As a former U.S. Army Green Beret officer, trained as a general and pediatric surgeon with additional certification in critical care surgery, and having served two tours as a trauma surgeon at a combat support hospital in Afghanistan, I felt that I possessed the requisite experience, skill, and background to be an asset to Israel during wartime. Officials from the Ministry of Health agreed, issued me a temporary medical license and invited me to serve at the Galilee Medical Center (GMC) in Nahariya.

Upon arrival in Israel, I boarded a train north for the two-hour journey to Nahariya. As the conductor walked down the aisle, I noticed a 9 mm semiautomatic pistol tucked reassuringly into his back pocket.

Welcome to Israel.

Military service is compulsory for the majority of Israelis when they turn 18. Men are required to serve on active duty for 32 months and women 24. After this period, they remain in the reserve, subject to being called up to their units until the age of 40.

But in this time of national emergency, many mobilized soldiers appear much older. In the weeks following the Oct. 7 attack, over 360,000 Israel Defense Force reservists’ peacetime lives were put on hold so they could defend the country.

At each station, the train platforms were crowded with young Israelis clad in olive drab fatigues, combat boots, and overloaded rucksacks en route to their assigned units.

Unlike the case in most countries, when Israel goes to war, everyone goes to war: the CEOs of companies, lawyers, students, rabbis, scientists, teachers, engineers, mechanics, shopkeepers, salesmen, and doctors – especially the doctors. The Galilee Medical Center is situated only a few miles from the border with Lebanon, a 22-second Hezbollah rocket flight away.

During the 2006 Lebanon War, Hezbollah fired 3,970 rockets into northern Israel in the course of a month, killing 43 Israeli civilians. One of those rockets exploded in the ophthalmology clinic at the GMC. There were no casualties in the hospital, but this provided the impetus to convert the underground floors into wards capable of providing patient care in case of future emergencies.

At the GMC, all patients – including children in the Neonatal and Pediatric Intensive Care units – were transported to the subterranean maze of corridors and rooms transformed into wards, protected by blast-proof doors and reinforced walls. In the silent, gloomy, darkness of the deserted above-ground portion of the children’s hospital, patient rooms and cribs were empty and toys in the playroom carefully packed away, while crayon drawings and colorful paintings made by small fingers still adorned the walls.

The makeshift underground wards are crowded, poorly ventilated, and not designed for patient comfort. But for now, that’s the way it is, and the doctors, nurses, and patients are adapting. Due to limitations on space and resources, each morning ambulances transport the less seriously ill to other medical facilities. One of the largest of these is the Rambam Medical Center in Haifa, where a massive, purpose-built underground hospital is capable of accommodating more than 2,000 patients.

Many hospital staff doctors throughout Israel are reservists and quite a few from the GMC were mobilized to their IDF medical units, leaving some departments – including pediatrics – short-staffed. Several attending physicians had been working continuously without a day off for over four months, and although the physical and mental strain was evident, morale remains high, and an atmosphere of camaraderie fostered by shared sacrifice and a commitment to patient care predominated. The medical staff, residents, and medical students were fluent in English, but the majority of patients and parents were not. As someone not fluent in conversational Hebrew, the language barrier and the electronic medical record system served as obstacles to a certain extent, but other medical staff members were readily available to serve as translators.

The population of northern Israel is diverse, comprised of Muslims, Jews, Christians, and Druze who have been living and working together in peace for generations. This was clearly evident among the staff of the GMC. In the operating room, the surgeons were speaking Hebrew, the anesthesiologists were conversing in Russian, and nurses conducting conversations in a language that I was unable to identify. The hospital director is a Christian Arab. Peaceful coexistence is an attainable goal when all parties commit to it.

During my time at the GMC, fortunately there were not many seriously injured casualties admitted, so what I saw were primarily run-of-the-mill civilian-type accidents. Most of the kibbutzim near the border were evacuated in the days following the Oct. 7 attacks as a precaution. The principle reason that I and my predecessors were invited to Israel was to orient us to the hospital and the medical staff members in our specialties, and to assess our individual capabilities.

In the unpredictable nature of the current threats to Israel, military strategists believe that attacks by Hezbollah on northern Israel will result in a mass casualty scenario that will overwhelm the limited remaining hospital staff. When and if that happens, there will not be time to orient medical volunteers, and those of us who spent time at specific hospitals would be called upon to return on short notice, which we are all willing to do. That was the situation during my time at the GMC, which is probably different than that of Israeli hospitals closer to Gaza, and the front line of combat operations.

It was my privilege to be given the opportunity to contribute in some small way to the care of children caught up in this terrible conflict. Θ

Dr. Michael Fuenfer is a pediatric and general surgeon based in Newburyport.

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