July 23

Sheikh Salah Schehade and his family were killed lat night in an attack by Zahal. Dalia Rabin Philosof quit her position in the Defense Miistry in frustration over this government. 2 terrorists trying to infiltrate were also killed. While this was happening we were sitting on a balcony in Yaffo watching the Arab families bathing and cooling down at the beach.

The scene was overwhelmingly pastoral. Women in traditional robes, with long white veils, holding the hands of tiny children in shorts. Here and there a dog, a horse, a few cats, wandering in and out among the people. The sound of the sea and a few random words.

And we are talking politics, theoretically, analytically, totally unaware of what is happening in Gaza.

When are we supposed to have elections? When do we get to chose a parliament?

Nobody in the group knows. As if we have accepted the fate of having totally incompetent leaders as a life sentence.

Who would want to be in a government like this? A government fascinated only with violence and trivia and self perpetuation. The best don't lack conviction, but have given up - Dalia Rabin is only one of those who have thrown up their hands in frustration - not at the political situation but at the way this government is not coping with it. This one wants to go to London to be an ambassador, that one has become a talk show host...

The best are not allowed to function and therefore must go elsewhere to do some good.

In order for us to have a good wall that goes in the right places and is accompanied by a meaningful settlement, we've got to have elections now. Just like we keep telling the Palestinians they need elections now.

For example: a law passed in the Knesset today makes it legal for religious students in Yeshivot to stay out of the army. One of the reasons it was passed was because Sharon got the Arabs to vote for it...

How do you get yourself into a situation when Muslims are deciding the fate of Yeshiva students?

Later, that same day: It begins to become clear that although Israel was very happy with killing Sala Schade we weren't counting on all the others too. Miscalculation about the civilian damage, we're saying. We apologize, about the 8 kids, hang our heads, say if we had known this one ton bomb would cause such damage we wouldn't have done it. We say we had cancelled previous planned attacks on his life because there were others around. All this is very nice. Still still, I was watching little children play last night. Children like that dead today.

July 24

The television today is full of the loss of life in Gaza yesterday. Today is Tu B'Av, the Jewish equivalent of Valentines Day, and it seems to be totally forgotten in the wake of such a tragedy.

Certainly some of the tumult is because of the terrible fear of reprisals, but more is the even more terrible guilt and shame we feel.

During the Gulf War, when the Americans threaded a 'smart bomb' into one of Sadam's headquarters that turned out to be an air-raid shelter for civilians, and hundreds of innocent citizens were killed, I had a similar reaction. Except I don't expect such moral considerations from other countries. I do expect it from Israel.

Schehade was an enemy and was responsible for many human bombs that killed many many people. There is no doubt that in his killing many deaths were prevented in Israel. But couldn't we have found a more humane way of killing him?

Maybe not -

This came from the Chicago Tribune last week, July 14, 2002, via Naomi Regan

This came from the Chicago Tribune last week, July 14, 2002, via Naomi Regan.

A doctor's story: Awaiting the wounded

By Dr. Avraham Rivkind. Dr. Avraham Rivkind is head of the department of
general surgery and the trauma unit at Hadassah University Hospital in
Jerusalem


When a human bomb goes off in Jerusalem, I know within seconds. I wear two
beepers and a cell phone, even to bed. Nearly always, driving my own car, I
can beat the first ambulances to the hospital, even if I'm asleep when the
first call comes.

The sirens blare as ambulance after ambulance pulls up in front of the main
square of Hadassah University Hospital. I wait outside, with dread in my
heart. As the doors swing open, my greatest fear is that one of my own four
children or my next-door neighbor's will be lying there among the terror
victims, so many of whom are only kids.

Our enemies choose their targets to maim our youngsters. They strike at
pizza parlors, school buses, frozen-yogurt kiosks. The medics make their
own quick decisions in the field: The worst patients are brought to Hadassah
Hospital, the only Level I trauma center from the Jordan Valley to
Beersheba. I'm in charge of that unit.
>
My first job is triage, instantly evaluating which treatment each patient
is to receive: being hurried onto the trauma table with a dozen top medical
experts surrounding him, wheeled away to surgery or brought to the regular
emergency room for care.
>
I listen to the reports of medics, I look at the patients, and I touch
them.
>
My medical training in Israel and the United States, years of experience,
intuition and sometimes help from the Almighty--something we're not
embarrassed to talk about in Jerusalem--help me make these life-and-death
decisions.
>
The medical challenges are daunting.

Victims with blast injuries can seem perfect on the outside but may be
burning up inside. Several weeks ago, I kneeled over a beautiful young woman
named Shiri
Nagari in the hospital parking lot. I asked her how she was feeling, and she
answered that she was OK. But I felt that something was wrong.
>
She was slowing down. I ordered immediate intubation to create an airway.
Some of my colleagues thought we needed to spend time on the patients with
more visible wounds. But her chest X-ray confirmed my hunch: a white
butterfly on the black background.
>
Shiri's lungs had exploded.
>
The same loud wave of air that smashes your eardrums can compress the
air in your lungs and send it to destroy the organs in your abdominal
cavity. Three concussive waves do lethal damage when a bomb explodes
in an enclosed area.
>
We rushed Shiri to our trauma operating room, always left empty for
emergencies, and opened her up: blood in her chest and abdomen, a
liver torn apart. No matter how much blood we pumped in, she couldn't
survive.
>
I'm 52, and like most Israelis I serve in the army too. I have seen my
share of tank injuries, unrelenting cancers and traffic accidents.

Shiri's death was the first time I ever cried at losing a patient.

I dread telling the patient's parents, but that is also part of my
job. Even less dire pronouncements are tough. Recently, after a
terrorist attack in the open-air market in Jerusalem, I had to inform
a victim's wife that we had amputated his leg. His wife flew into a
rage. That's an anger I'm familiar with. I'm always coping with my own
anger that we can't pull off a miracle for each patient.
>
Concussive injuries are only part of the damage caused by urban bombings.

We have been treating damage to the brain, lungs, bones and heart
caused by nails, bolts and ball bearings packed into the high-velocity
bombs.

Adi Hudja, only 14, had more than 40 metal objects in her legs from the
suicide bombings on Ben Yehuda Street last December.
>
She was bleeding uncontrollably from her wounds. On the spot, we came
up with the idea of trying a coagulant for hemophiliacs still not
approved by the U.S. Food and Drug Administration, certainly not
approved for trauma. It costs $10,000 for a small bottle, but it
worked.
>
Six months later, she's coming for therapy three times a week in
Hadassah's Mt. Scopus Rehab Center, and she's learning to walk. Next
year, maybe she'll be able to go back to school too. She's the same
age as one of my daughters.

Clock is ticking

No matter the sophistication of medical care, speed counts. Most of
the thousands of procedures we surgeons in my department do each year
are elective, but trauma is different. Our chief trauma nurse, Etti
Ben Yaakov, always talks about the "golden hour" we have to save our
patients' lives.

She's right.

The clock is ticking from the obscene sound of the blast. In the trauma
center, I am assisted by a remarkable team of doctors, nurses and
technicians. Suicide-blast victims almost all need multidisciplinary
care.

We need to figure out who's going first: the neurosurgeon, the vascular
surgeon, the general surgeon, the orthopedic surgeon, the facial surgeon?
Even in the middle of the night, doctors and nurses and technicians and
cleaning staff arrive at the hospital without even being called.

Who will do the anesthesia? Hands fly up: Our entire operating room
staff is ready for an unscheduled shift.

Every decision I make is informed by my core belief that every patient
wants to live. Sometimes this credo forces me to try so-called heroic
surgery when everything seems lost.

In October 2000, Shimon Ohana, an 18-year-old border police officer,
was declared dead in the field. But I asked the ambulance driver to
bring him to the hospital. Some decisions are hard to make in the
field. I uncovered him, we opened his chest cavity and began to work.
He came back to life but remained in a coma for 17 days.

At last, he woke up.

Today, he is a fully functioning young man who trains dogs and loves
computers. He lives in Beersheba, but he often comes to Hadassah Hospital
for follow-up care or to encourage our other patients. I can't resist
hugging him: He's my continued reminder that we can't give up hope.

Everyone treated equally

The lines of ambulances, inevitably, bring a fair percentage of Arab
patients.

We can't tell whether they are perpetrators or victims. Even if we
could, it wouldn't matter: Everyone who enters the Hadassah Hospital
courtyard is treated equally.

And yes, I have operated on terrorists.

Once, I was awakened at 2 a.m. on the Sabbath to do emergency surgery
on a terrorist who had been injured while he was being apprehended. I
had seen the grisly results of his bus bombings.

More than any other question, friends and visitors and even patients
want to know how I feel using my medical training to save the lives of
these mass murderers.

Because I'm a doctor, a believing Jew, a human being, I would never
allow a patient to die whom I could save. But this saving of life is
more than my medical requirements: It's a mission.

By fixing the holes in their chests and bellies, I'm making a
statement that I'm not like those forces of darkness that want to
engulf this country in blood.

Do they understand? I haven't the slightest doubt that they do. They
thank me. They look at me differently. I and my people are no longer
the demons of their ugly propaganda. And they suddenly comprehend what
the American women of Hadassah who established our hospital and most
of the hospitals and clinics in this land with no regard for race or
creed understood 90 years ago.

The Hadassah motto is taken from the prophet Jeremiah who cried for the
"healing of my people."

The healing of all peoples is the only way to rescue the future of this
region.

July 25

People keeping asking each other if it is possible that the Israeli government bombed Schehade and the innocent civilians around him on purpose so that the tentative peace gestures of the Hamas wouldn't continue - that perhaps we don't want peace. I don't think so. But I do believe that old distinction between smart and wise. Smart people can get out of situations that wise people don't get themselves into.

We aren't wise.

And we aren't smart all the time either.

The wave of revenge attacks began immediately. Just this morning 2 people were killed. A number of attacks have been prevented by the arrest of terrorists on their ways to attacks.

How can we expect anything else? As we keep saying to each other in the family, how can you have a country if you don't have borders or a constitution?

I want borders. I want a constitution, an enforcable constitution.

Almost as much, I want elections.

As my mother used to tell me, I'm allowed to want.

Yesterday, at the Ministry of Defence, the protesters were holding up signs that seem ageless, recycling phrases from the War in Lebanon - like "How Many People Have You Killed Today?" - something that used to be addressed to Arik Sharon but is now to Fuad. But in an original take-off of Lystistrata, the "Kvisa Shchora" gay and lesbian group (translation: "black sheep" or "dirty laundry") announced "We won't sleep with soldiers."

Who says war dulls originality?

And now Fuad says that Schehade was on his way to a mega-attack with a one ton bomb. Immediately. The size of his bomb and the size of ours are identical - This sounds even more creative than "Kvisa Schora." But time will tell. In the past impossible stories have proven true in this country.

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