(Writing this sleep deprived, at 4am during a 24-hour on-call, and still jet-lagged, so apologies for the telegraph-like speech and poor writing. Probably also a bit long)
First day in the hospital (Monday) was a nice easing in. Got to meet the anaesthesia department who were extremely welcoming.
Dr Duvdevani, the department chair, his deputy, and a total of 10 other anaesthetists had stayed overnight in the hospital as in-house on-calls, in case the inevitable ground invasion started along with flood of casualties, but thankfully things remained quiet. Those 12 in-house on-calls, got reduced to 8 on the following nights.
It turned out that the department chair is married to a good friend of my parents-in-law, which made for a nice personal connection.
All elective surgery since the big attack a week earlier had been cancelled, so there was actually relatively little work to be done by anaesthetists. That day they started one elective OR (skin cancer removal - yes, that is considered elective for medics).
We were visited by 3 paramedics and one doctor/officer from an elite military unit (not sure I’m supposed to name the unit), who came to get practice with intubations and airway management. This is very standard in Israeli hospitals, and I have personally trained several when I was in Hadassah (including Sayeret Matkal, Mista’arvim, Maglan, etc., as well as civilian paramedics) They need to be able to deal with medical emergencies as paramedics and army doctors, and Operating Rooms are a safe controlled place to learn. Although this time, with this war, their training felt to me a little more immediately urgent. Sadly with the lack of elective surgery they only got to help with one intubation.
I went and spend the rest of the day getting to know the ICU team, who were also very welcoming.
The ICU had gone though a lot of flux: On Black Saturday it got completely emptied, discharging patients to wards, that usually wouldn’t be sent out. It was immediately filled and overwhelmed with trauma cases as the hospital got inundated.
Then over the intervening week, most of those had gradually been discharged to the wards, so we were left with 5 patients, all but one of whom were injured in the initial Hamas attack. We are now working hard to keep beds empty, as a safety margin for when the war gets worse.
So when I got to the ICU, it was relatively calm, but they mentioned that one doctor was off in Miluim (emergency army service), and wasn’t answering his phone, and another one would be one of the 8 on-call anaesthetists that night, so couldn’t cover the on-call the following night. At the end of the Dr Jacobson (the ICU head of department) jokingly mentioned that I might be asked to do an on-call and I said “maybe, let’s see?”. At the end of the day things seemed to have gone well, and I asked if I could do it. He checked with the deputy medical director of the hospital (who happened to walk by that moment), got her "OK", and that was that.
During that day, Avigdor Lieberman came to visit the ICU. I kind of recognised him in the corridor but for a moment wasn’t sure from where, and did my usual head-bob of “I know you” acknowledgement when I'm not sure. He nodded back as if he knew me, but looked a bit puzzled too. He of course is a big-deal opposition politician, former minister of defence and minister of treasury, surrounded by body guards, and I realised I had never seen him before except on TV. He certainly had no idea who I was..
On the way home from work I stopped off at a supermarket from pita and humus for dinner. Whilst at the self-service checkout, a cashier called out “there’s a siren. Everyone follow me”. We all went quickly to the back office behind the store room and waited until we heard the explosions plus a few minutes, and then I headed back to finish the checking out. The machine didn’t even lose the items I’d already scanned, and just popped up the “are you done or would you like to continue message”.
On the way out I got to speak to a friend who lives here, and got the warmest, kindest message that really made me feel tearful. I’m really embarrassed to say this (but I will as I’m sleep deprived), but he told me that when he heard I was coming over, he decided to see what he can do to volunteer, and so he cleaned out his family home, and invited a family from Ashkelon to move in until the fighting was over. I honestly still can’t believe he felt that, because working here really isn’t any harder than the usual clinical days on any ICU, and I absolutely feel that just his action made this whole trip worthwhile. Separately, my mum has contacted the local hospital in Netanya, and has started volunteering there in a medical capacity. I’m honestly overwhelmed by how volunteerism seems to be feeding on itself throughout this. Almost like a snowball, with people helping each other.
After that I went home to a house lent to me by friends of the my parents who are currently in Jerusalem. The place is beautiful, and <10 minutes from the hospital, with a small bomb shelter inside it, so is perfect. I had a bite to eat and went to bed.
Sleep was fitful, but no sirens woke me. Just jet lug. Headed a number of booms of distant explosions, and briefly worried why I hadn’t heard an air raid siren, but realised that it was just very precise and only sounded in areas likely to be hit.
Woke in the morning to shower, drive to work, and get started on 24-hour ICU on-call.
On the way found driving to be an odd experience: you keep trying to spot placed you can park and run for cover in 30 seconds. It adds a little stress the usual defensive driving of looking out for cars trying to do stupid things, and is not something I usually have to think about.
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