- Monday 7th February 2011 – My Final Shift
After spending ten days sick in bed, I was excited to be able to make it in for one last shift.
When I arrived at the station, it was full of people I’d never seen. This threw me a bit, as I’d enjoyed becoming a part of the Haifa station and looked forward to seeing all the familiar faces of people I now call friends. Then I realised, however, that while that station is like a big extended family, it maintains its vibrancy due to the new volunteers who come through regularly.
I’d arranged to do my last shift with Pninit who has had a big impact on me. While I love many of the drivers and have learnt a lot from everyone, I did my first “solo” shift with Pninit and that day, which remains one of the most challenging and rewarding, was a turning point for me. I started to see that I could do what needed to be done and that it wasn’t totally ridiculous for me to be racing around in an ambulance. I think that it may have taken a lot longer for this to happen if it wasn’t for Pninit, who taught me so well that day. that it allowed me to act with confidence. She also made it clear that I was her teammate and, thus, she was relying on me and trusted me to have her back. She demonstrated this in her actions and this really made me step up to the challenge. I thus thought it fitting to do my last shift with her.
As there were so many volunteers at the station, I had a large team today. In addition to Pninit and me, there were also two new volunteers – one doing his first-ever shift and the other only his second. This actually turned out to be quite significant on my last day, as it allowed me to see how things had come full circle. I realised, with a bit of a shock, that I was now the one showing the newbies what to do, explaining things to them and making sure they were all right. Yet it felt like only yesterday that I was in their position!
I also realised how things had changed when one of the volunteers took me aside after one of our cases and said to me that he was a bit in shock by everything and couldn’t understand how Pninit and I could act so calmly. I remember feeling exactly the same way on my first shift. I just couldn’t understand how, for example, we had just attended a failed CPR and then everyone was discussing what they were going to have for lunch. I was thus really stunned today to realise that, in such a short time, I’d learnt how to detach. This upset me a little bit, but I know that I couldn’t have survived these last few weeks if I hadn’t mastered this. It’s a skill that is as necessary as knowing how to use the equipment and it’s up to each person to deal with this in their own time and in their own way.
This quite possibly accounts for all the craziness that I’ve encountered at MADA, not to mention this “blog”!
My team was stationed at the “Nosh” post, so I had only minutes to say my goodbyes at the station. This probably worked out for the best – less time to dwell and be sad!
Our first call was a simple case of an older Russian man who had a temperature and insisted on going to hospital rather than see his GP as we suggested. Actually, the patient didn’t insist on anything. He actually didn’t get to say a word. Instead his wife answered for him – everything from his name to how he was feeling. I also mention that the patient was Russian, because it seems to me that we get a lot of Russian patients who think that a slight temperature means certain death. They might not bat an eyelid when they have a big gaping head-wound, but a 38 degree temperature and they’re hysterical! Pninit, whose husband is Russian and has worked for MDA for many years, confirmed my theory on this.
Our second call came through on the beeper as a CPR. As I turned around to tell the other volunteers to double glove, I saw a mix of fear and excitement in their eyes, which I’m sure was mirrored in mine, regardless of all the shifts I’d done. When we reached the apartment, we heard the tell-tale, loud gurgling, breathing noises of someone with pulmonary oedema. This allowed us to relax a little, as it meant that the patient was breathing and wouldn’t require CPR just yet. However, the patient was unresponsive and showing signs of sepsis. The patient was in a bad way and ended up requiring CPR in the MICU.
But what really stood out in this case was the behaviour of the patient’s spouse and carer. Generally, when we arrive at a scene, the relatives and carers are eager to explain to us about the patient and what had happened. In this case, the husband and carer vaguely pointed us in the direction of the patient and went to make themselves a cup of tea in the kitchen. I virtually had to drag the carer into the room to help us and to give us the necessary information. Then, when Pninit went to talk to the husband about his wife’s condition, he told her that he hadn’t called the ambulance for his wife. He called for himself as he was feeling like he had the flu and said that he wanted someone to treat him. Pninit (no doubt doing her best to hide her shock) patiently explained to him that his wife’s condition was life-threatening and that we’d need to treat her first. Later, when we were about to rush the barely conscious patient to hospital, we asked the husband if he’d like to come with his wife. He replied that, no, he would not like to come as he was feeling a little ill and wanted to know when we would be back to check on him.
This was definitely one of the strangest experiences I’ve had on shift. It would have been hilarious if it wasn’t so clearly obvious that the patient was unlikely to survive the day.
Our final call came around midday and lasted until the end of shift – three hours later.
It was one of the saddest and definitely the longest call I’ve had. We arrived at an apartment to find a locksmith trying to open the door. We ascertained, from the social workers on-scene, that the elderly occupant of the apartment had fallen during the night and was unable to get up to open the door. The initial concern was obviously to make sure the patient was conscious and, after a chat through the door, we waited for the locksmith to finish his work. With multiple locks, this ended up taking close to an hour. We suggested calling the fire department, but this is very expensive for the owner of the door and the social workers said that they preferred to let the locksmith finish his work. As the patient was not in a life-threatening state, we agreed to wait.
During this time, we got the patient’s background from the social workers. In her eighties, the patient was a Holocaust survivor, who had escaped to Israel with her brother, where they lived together until his death a few years ago. Neither married and both spent their lives essentially afraid of the world. The social workers had been working with the patient for a number of years but, as she mostly refused to leave her apartment or let anyone in, there was little they could do to help – except for phone calls and visits spent talking through the door.
When I heard this, I was really saddened and thought how awful life must be for the patient. However, what I imagined, could not have prepared me for the reality of this person’s life.
When we finally gained access to the apartment, we found the patient on the floor, sitting in her own urine. She looked so little and vulnerable that my heart broke. Worse though, was the state of the apartment, which was absolutely filthy. When Pninit asked us to get her some water and something sweet, we were faced with an empty kitchen and one single cup that was so covered in grime, it was impossible to wash clean.
The patient was distressed at having so many people in her house and refused to go to hospital. As she clearly had a fractured leg and possibly hip, it was impossible for us to leave her there. However, we are unable to force anyone to go to hospital if they don’t want to.
Thus began nearly two hours of us and the social workers trying to persuade the patient that she must go to hospital and promising her that someone would be with her every step of the way. She was just so terrified of leaving her home and of the hospital that she was hysterical. She begged us to leave her there, but with her medical condition and her appalling living conditions, I honestly believe that if we hadn’t finally persuaded her to go to hospital, I and probably everyone else in the room, would have gone against the law and taken her to get help against her wishes. After everything that this lady survived, it is just so wrong that she should spend the last of her days living that way. After being reassured by the social workers that now that she was out of her house, she could get the care she needed, we left our patient with the capable hospital staff and hoped that someone would find a way to return some much deserved dignity to this survivor’s life.
After shift, I went with Pninit to visit the Krayot station, which is around twenty minutes outside Haifa. Pninit had spent most of her years with MDA working out of the Krayot station before coming to Haifa so, when I told her that I wanted to visit the station, as it is Australian-sponsored, she said she’d be honoured to give me a tour and introduce me to the personnel there. Pninit had often spoken about the fantastic youth volunteers who work out of the Krayot station and arranged for some of them to come in to meet me.
I was again left in awe by just how amazing the youth volunteers are. Most were not on shift and had come in especially, giving up their own social time to welcome me to the station. As I met each one and had a chat with them, it was easy to forget that the average age of the group was 16 years old. They are all so competent, professional and passionate about the work they do with MDA. It’s also great to see the bond that they have with each other.
They explained that they didn’t know each other before starting at MDA and now they are all extremely close. They were an amazing bunch and I could easily understand why Pninit is so proud of them – they deserve much respect and praise, though they would surely tell you otherwise.
On my bus ride back from the Krayot station, I heard an ambulance siren and caught myself trying to see who the team was. It was then that I realised that I’d become part of the MADA family. While two months ago, an ambulance hurtling down the streets of Haifa wouldn’t be something I that I’d notice, today, I can make out a siren from a mile away and feel a sense of pride and connection to each ambulance that I see. Before this experience, I never imagined that I could be linked to a place and its people in such an intense way.
Always finding ways to make Israel part of my life, I’ve studied here, worked here and lived here in various capacities. I thought that I knew Israel well and considered myself highly connected to her. However, my time with MADA has allowed me to see places that I’d never seen before and meet people I would never have had the chance to meet. It’s been incredible to be invited into the homes of people from all the socio-economic, cultural and religious backgrounds that Israel has to offer. It’s also been amazing to realise that none of these differences matter when someone’s life is at risk.
I feel humbled that I was given the chance to be part of so many people’s lives and that they trusted me to help them in their time of need. I am thankful to MDA for giving me the skills necessary to help these people and I’m proud of myself for taking on the challenge.
In my work back in Australia, I often found myself telling people that the MDA Volunteer Program is a “real, life-changing experience”. I can now say, from my own, personal experience, that it IS this and SO MUCH MORE. It’s been an amazing couple of months and, quite simply, I’m sad that it’s over. I’ve caught the MDA bug, but I’m not looking for a cure!
Thank you to all the amazing people at the Haifa station for helping to make my experience the rich one that it was. Thanks also to everyone at Magen David Adom and Israel Experience who are involved in running the program and, finally, thanks to Andrew from the MDA Victoria office for so speedily uploading all my stories and photos onto this website!
- Thursday 3rd February 2011
Unfortunately, I’ve been sick at home for the past week.
Today, I received this amazing story from Sergio, the volunteer from Mexico. (That’s him in the pic with me.)
He had a successful CPR! Given that I’ve written plenty about all the failed CPR’s that I attended, I thought it would be nice to share a case with a rare positive outcome.
So, here’s another piece from Sergio ….. enjoy the success!
My Successful CPR
by Sergio Leventhal (Mexico City, 19 years old)
It was about 7:00am when I changed drivers. I was supposed to be with Eran, but I ended up with Pninit. A few hours went by while I sat watching MTV in the waiting room, when suddenly I heard – “Pninit you cave a call”.
At that moment, I ran to ambulance number 45, I got in and, when Pninit announced that she was there, they told her where we were headed and what we were going to do. The only thing I heard was “CPR”. I started shaking, so I asked Pninit if it was true that we were headed to do a CPR and, when she confirmed it to me, a big mass of natural adrenaline came through my body. It was my first CPR. Sharon had already attended four, sadly, none of them were successful.
On the way to the scene, I started to understand that this could be the first dead body I got to see in MDA. I knew that most CPR cases are not successful, because I know that to reanimate a human heart is almost impossible. As soon as Pninit saw how nervous I was, she told me to calm down and that if I was nervous the patient would die. Because of that, I automatically stopped shaking.
We got to the place and ran to the apartment. When we got there, we saw three people from the NATAN and a private doctor (apparently she called us). One guy from the NATAN was in charge of the breathing, one was in charge of compression and the last one was in charge of all the medicine and adrenaline shots. Because there was so much work to be done and there were not enough people to do it all, they called us.
By the time I entered the apartment (the patient was lying at the entrance door), I was instructed to leave the AMBU bag on the floor and to hand Pninit our oxygen tank. As soon as I did that, the guy who was doing the compressions was asked to stop so that I could continue. When I heard those words, I got really nervous. I’d never been that nervous in my life – a patient’s life was in my hands!
So I started the compressions, but I forgot to count them. I did as many as I thought were enough and let the paramedic give two breathings and then he said, “remember to count your compressions”. So I started counting them and whenever I reached 30 compressions, I would stop and let the paramedic give the 2 breaths. There was a moment when I gave the 30 compressions, but because the paramedic was connecting the breathing machine to the oxygen, he didn’t give the patient the 2 breaths, So I continued with compressions and, by that time, I was instructed that now I didn’t need to count the compressions.
The patient was already intubated and the compressions would not affect the breathing. A few minutes went by when, suddenly, the paramedic asked me to stop the compressions. He wanted to check if there was any pulse on the patient. By that time, I was observing the monitor. Suddenly I saw that it began registering heartbeats while I was not doing compressions.
At that moment, the paramedic looked at me and said, “look what you did!” I turned the other way and the guy who had done the compressions before me said “Congratulations!”. I looked at Pninit – she was so proud. I almost started crying because the patient came back from death after MY compressions!
After some minutes, we lowered the patient into the ambulance. The NATAN took him to the hospital and Pninit took me to celebrate what had just happened. We went to a store at a gas station and, on the way there, I called my Mom, although in Mexico was 2:00am! She was so happy! We got to the store and Pninit told the cashier lady what we had just done. She told me “you are a hero!”.
Those words have marked me forever. I can conclude that, on February the 3rd 2011, with the help of everyone in the NATAN and Pninit, WE saved a life!
- Day 25 – Sunday 30th January 2011
As I’m sick and didn’t go in to the station this morning, I’d like to share with you, instead, a piece written by Sergio Leventhal about his first day on shift. Sergio is an overseas volunteer from Mexico and I previously, briefly wrote about his somewhat shocking introduction to MDA. Here is his full story.
My First Day at MDA
by Sergio Leventhal (Mexico City, 19 years old)
Who could ever imagine that, at 6:30am on your first day at MDA (when the human body isn’t yet functioning at full capacity and when you still don’t react with a 100% confidence), you’d be attending a “mass casualty event”?! (This is an event where there are more people injured and in need of help than there are volunteers and paramedics).
I, at least, never imagined that this would happen to me but, unfortunately, this was my welcoming to MDA. I arrived at the central base in Haifa and just when I crossed the door to enter, one of the drivers came running asking who could go with him, saying that there had been an accident on the freeway and that there were a lot of injured people.
The words “mass casualty event” never went through my mind. I just assumed it would be a bad accident. As thoughts raced through my head, part of me was saying, “Don’t go, you’re not experienced enough!”, but another part of me was saying, “You should go – this is not so common, don’t let this opportunity pass by”.
A couple of minutes went by and, from the three of us who were there at the moment, just one had offered to go so that left just two of us – me and another volunteer who was about my age. We started discussing who should go but, with no time to spare, I decided to go and quickly hopped into ambulance number 57.
As soon as we closed the doors, the driver said, “You guys are lucky. The event we’re going to is a mass casualty event”. At that moment my heart went crazy! I knew what was waiting for us. When we finally got to the accident (we were the fifth ambulance), we took out a backboard and the typical stretcher, while the driver ran out to help an army officer who had some facial injuries. The driver then told me to take another woman, who had an injured leg, to the ambulance. But when I got there, I saw that two MDA blood bank workers (who were hurt in the accident) were already inside the ambulance.
I really didn’t know what to do, but then the driver came with the injured officer and asked the woman with the injured leg to hop off because the other two women looked worse. He carried the officer in to the ambulance, closed the door and off we went to Bnei Zion hospital.
On the way there, I didn’t know what to do! I was so nervous. So I looked at the driver and he said, “NEVER look at me – your patient is in the back with you – clean her wounds.” I didn’t know with what, so I took the bag with all the bandages, took out some gauze and a special disinfectant liquid and started cleaning her face, while my partner was checking all of the patients’ vital signs.
When we arrived, the driver told my partner to register the patients, but because he didn’t speak very good Hebrew, he asked me to do it. I’d never done that, but with the help of the nurse and her patience, I made it. When I finished registering them, the driver came to us and thanked us very much for helping him.
For a long moment, I felt a big satisfaction! On my first day, I did something that not everybody can do.
- Day 24 – Thursday 27th January 2011
Today, I brought Australia Day to MDA Haifa! Due to logistical reasons, I had to postpone celebrations by a day, but armed with a big Aussie flag, vegemite sandwiches, chocolate crackles and other bits and pieces, I did my best to bring a bit of Aussie spirit to the station. The choccy crackles were a hit, the vegemite sandwiches less so. Actually, as expected, almost everyone thought I was trying to poison them with my little spread-filled triangles and no attempts were even made to politely hide their disgust! This of course made for some funny photos and led to an even greater appreciation of my chocolate crackles! I’ve spent quite a few Australia Days in Israel and I always really enjoy sharing them with the people around me.
With a fun start to the morning, I went on to have a pretty busy shift with my team, Mahoul – the driver and Sergio – another volunteer from Mexico.
Two cases stood out for me.
The first was a patient in his nineties who had been suffering from chest pains but, despite his advanced years and a possible cardiac incident, was the best patient I’ve ever had. He was an absolute gem and left us all smiling.
The second case was an elderly patient with severe pneumonia. We’d been called to transfer him from his care facility to the hospital. He was unresponsive though, thankfully, breathing. He was in really bad shape and had us extremely worried the whole way to the hospital. You really can experience the whole gamut of emotions in one shift in this line of work.
Having felt a bit off this morning, I finished the shift “sick as a dog”. Hoping I don’t end up “sick as a pig” – lots of swine flu going around at the moment.
- Day 23 – Wednesday 26th January 2011
You really do see some strange human behaviour in this job. Today, we got called to the scene of a car accident. A plain-clothes policeman had already secured the site and the injured driver was sitting on the side of the road. While the rest of my team went to get the necessary equipment and ascertain exactly what had happened, I stayed with the patient to make sure they didn’t move.
Now, before I tell you the next part of the story, it’s important that you fully understand the scene.
There is a big white ambulance with lights flashing parked next to the smashed vehicle. There are ambulance staff racing around doing their work – and me, in full uniform, sitting next to the patient, talking to them and taking their pulse. With all of this in mind, I have to ask – does it not seem a tad strange that a pedestrian, walking by, decides to come over to my patient, ask them what happened and offer to help them stand up????
At first, I thought that perhaps I was invisible, but not being on the thin side, I was fairly certain that this was not the case. Then I thought that, maybe, the passer-by was a doctor, for surely that could be the only explanation as to why someone would be offering assistance to a patient already in the care of the ambulance service. But alas, this was not the case as when I asked the lady who she was, she sharply replied that she was “just trying to help” and stormed off in an angry huff.
This left me absolutely dumbfounded, though when I later told my team what had happened, they didn’t seem too surprised, saying that Israelis often like to help in an almost intrusive manner. So to the pedestrian who offered my patient help this morning – thanks for caring, but next time it may be wise to consult with ambulance staff on scene before attempting to make a car-crash patient with a possible broken spine stand up. Furthermore, please don’t take it personally when said ambulance staff politely ask you to step away from the patient.
It was a bit of a slow shift today, with only this and one other call. But in big news, for the first time in my volunteering history, I used the toilet at “Banats” without getting a call!
My team was really fun and I had some good chats with Dima, the national service girl I was working with, who is Druze, though many people don’t realise it. I was also treated to some musical talent as my driver, Ohad, had been a contestant on “Cohav Nolad”, the Israeli version of “Australian Idol”. When I asked him what he was doing working for MDA when a singing career is at his fingertips, he replied with a sentence I’ve heard many times in my month of volunteering – “working for MDA is an addiction, no matter what happens, you just can’t give it up!”.
I’m really starting to understand this, I can’t imagine what life’s going to be like very soon when I finish up here and don’t get to do shifts anymore. I’ve caught the MADA bug!
- Day 22 – Tuesday 25th January 2011
It seems that I spoke too soon. My first call today was to a CPR. It was not successful.
Although I had been to three other CPR cases in the past month, this one was different as it was the first time my ambulance was first on scene. This meant that I actually got to partake in all aspects of the CPR process from start to finish.
We worked on the patient for quite a while before an MICU became available and joined us. I really thought that there might be a chance of getting a positive outcome, as the patient was still warm when we reached the house. Sadly, we didn’t even get a shockable heart rhythm. At least the patient was in their nineties and hopefully had lived a full life.
On the plus side, I finally got to work with Noa, one of the national service girls who has helped me out at the station since day one. (That’s her far-right with Raily and Dima).
- Day 21 – Monday 24th January 2011
RECIPE FOR A GOOD SHIFT
- 1 beautiful, sunny day
- Being at favourite post “Banats”
- 1 driver (Kobi) with many years’ experience
- 1 pocket-rocket of a youth volunteer (Oriya)
- MP3 player-full of good songs brought in by driver
- Not having to lift too many patients
- Getting another team of strapping fellows to assist in carrying
the one patient who needed to be carried down five flights of stairs
- Spending as little time as possible in emergency room
- Being able to find beds for the patients
- “Thank you’s” from all patients
- 1 Australian movie (“Heat”) playing on daytime TV
- 1.Mix all ingredients together.
- 2.Make sure to spread calls fairly evenly over shift.
- 3.Try to avoid irate drivers, mad dogs, and fully- chained
prisoners having a smoke outside emergency.
- 4.Top with ending shift at a location 10 min by bus
rather than 40 min by bus from home.
Best served fresh, daily.
- Day 20 – Sunday 23rd January 2011
As previously mentioned, I’ve started each week on shift with a failed CPR and was feeling very much like bad luck. It didn’t help, therefore, that mid-way through today’s shift, we got a call to a CPR case. The whole way there, I just couldn’t believe that, yet again, I was starting my week with a CPR. All reason was very close to being lost as I realised that four weeks in a row seemed much less like a coincidence and a whole lot more like a pattern.
As we bundled up the stairs, it was thus a HUGE relief to hear our patient babbling. He wasn’t coherent and he wasn’t in very good shape, but he WAS alive and he stayed that way. This made me happy for him and happy for me – I can now dispel any thoughts of a “start of week CPR curse”!
I was teamed up today with Pninit (the driver – in the pic with me), who I really enjoy working with, and Yonatan, a volunteer medic who I had not worked with previously but got along well with. We were stationed at the ‘Nosh’ post (in the Nave Sha’anan neighbourhood), which I hadn’t worked out of before so I was excited to see what it was like. I had been told that Nosh was renowned for being a hectic and while we got off to a bit of a slow start today, once we had our first call, we never made it back to the post.
I didn’t mind the hour off at the start of the shift, because on the way Pninit stopped at “Abu Shaker”, which everyone at the station kept telling me makes the best hummus in Israel and Pninit wasn’t letting me leave without trying it. Despite a bit of initial resistance from my stomach at having to deal with hummus and its accompaniments at 7.30 in the morning, I must admit that it was very good hummus and I’m sure I’ll have to make at least another visit before I head back to Australia.
Apart from a regular ambulance, Nosh also has a MICU stationed there during the week and today it just happened to be a MICU donated by Australia (Perth). I thus made its team (made up of Shustock – the driver and Karen – the Paramedic) pose for photos and tell me all about their time at MDA.
All of our calls were fairly standard, but what really stood out for me today was how full all the hospitals are. I’ve been noticing for a while that the emergency rooms are overflowing, but today we had no beds into which to put our patients and had to go scouring the hospital to find ones we could use so that we could get our stretcher back and go to our next call. It was a bit of a fight, as ambulance team after ambulance team looked for beds for their patients. It isn’t a good time to be sick in Haifa and the poor hospital staff are stretched so thin. The nurses even went on strike last week, as they found themselves without the staff and resources to give adequate care to the huge number of patients coming in every day.
I also must make a quick mention of two things that made me laugh today (the type of laughing you do when thealternative is to cry
The first was our encounter with a gentleman driver who abused us when we asked him not to block in our ambulance (the spot was no- parking anyway). He continued to toot his horn and curse as we loaded our patient into the ambulance – clearly, we were greatly inconveniencing him in his quest to get a parking ticket.
Secondly, on return to the station, we found that the hose we use to clean the ambulances after a shift wasn’t working and, after trying different approaches (and getting wet in the process), we found ourselves washing the ambulance with an empty water-cooler bottle. It’s definitely a skill for MDA personnel to be able to think outside the box, but this is probably not a case in which they should need to.
- Day 19 – Thursday 20th January 2011
Two words – “helicopter transfer”.
A few years ago, Magen David Adom reached an agreement with a European company that would allow for two MDA helicopters to operate in Israel, one in the North and one in the South. Unfortunately, the costs were too high to maintain both and so, today, only one chopper is active – working to save the lives of those in hard-to-reach places and in extreme medical emergencies.
Today, I got to see this helicopter in action.
As the chopper doesn’t have a stretcher and the Rambam helipad is not directly connected to the emergency room, it’s necessary for an ambulance to meet the helicopter and transfer the patient to A&E. With the helipad occupying a nice piece of oceanfront real estate and beautiful, clear blue skies, we had a nice little wait in the sun until we heard the tell-tale sound of chopper blades.
At this point, Kobe (our driver) ushered us all back into the ambulance so that we wouldn’t get blown over when the chopper landed. There were a lot of people involved in the transfer, so the other volunteers and I were instructed to help the helicopter paramedic put his equipment in our ambulance – and then stand back and take photos (the chopper is still a bit of a novelty).
It was all very quick and, within minutes, the patient was being looked after by the emergency room staff and the helicopter flew off into the day, to await its next call.
Today’s shift really was quite different. In addition to meeting the helicopter, my team (which included Sergio – a new overseas volunteer from Mexico, Kobe – the driver, and Oriya – a youth volunteer with the day off from school) also provided medical support at a Tu Bishvat event. We were also representing Magen David Adom at the event as it was a tree-planting ceremony in memory of the victims of the recent Carmel fires.
It was really touching to see all the school kids and emergency service personnel come together to celebrate and commemorate and to mark a day which holds particular significance for the people of the Carmel this year. I also got to plant my first tree. Given the amount of time I’ve spent in Israel and the number of programs I’ve been on here, I was surprised to realise that I had never done this before. It thus meant a lot to me to be able to plant my first tree, while representing MDA and, having been here for the fires, the experience was particularly special.
Throw in a couple of patients (including one with the strangest vomit I’ve ever seen), a driver swap (shout out to Pninit!) and beautiful weather (may Winter not come until I leave) and I had a fun and varied day – a good way to end the week.
- Day 18 – Wednesday 19th January 2011
Today, I was stationed at “Tira”. This, as I may have mentioned, is the slowest of the posts.
I think I was put there because I did evening shift yesterday and they wanted to let me rest. Rest is what I did. Rest is all I did.
Oh, and I watched the movie “300″ which my driver brought with him. Is it weird that, in all the blood and guts scenes, all I was thinking was – “how would I bandage that?” ???
- Day 17 – Tuesday 18th January 2011
I had my first “baby unresponsive” call today. I was a nervous wreck the whole way to the house. Thankfully, when we arrived, we found a one year old with a pulse and breathing. Suffering from a bad flu and with a very high temperature, the parents had been unable to wake the child and were understandably hysterical. We raced the little girl to hospital and, by the time we left the children’s emergency ward, she was crying. In this case, a crying baby made me very, very happy.
Getting up at 11:00am, instead of 5:00am, also made me very, very happy! I’d long wanted to do an evening shift to see if the pace was different and what it was like working at night. This shift is usually reserved for the youth volunteers who come after a full day at school and do shift until 11:00pm.
Today though, there was a big party for all the MDA youth volunteers in Israel, so my offer to do the shift was happily accepted. It’s really nice to see that MDA does something for its volunteers and the ones I’d a chat with were all really excited to catch up with close friends and make new ones from all over the country.
I was stationed at the “Banats” (B’nai Zion Hospital) post with my driver Kobe. I’m sure that he must hold the record for the fastest evacuation of patients from arrival on-scene to hospital. With 18 years’ experience at MDA, you can really tell that he works on well-honed instincts.
We ended up having four calls, which I was told was a lot for a night shift at Banats. True to form, one of these calls came as I was visiting the ladies’!
Our first call was to the aforementioned baby, followed by a woman having an asthma attack, a man with chest pains and an elderly lady with a host of problems. The last call was in a religious neighbourhood and around 50 children suddenly appeared in the street to see what was going on. They were very cute and were arguing amongst themselves as to who would ask me what was going on.
I spent much of my night between patients trying to choose between hanging around the overcrowded, flu-plagued emergency rooms of various hospitals or passive smoking at least two packs outside said hospitals. I know that, in general, Israelis smoke a lot, but I really feel like a disproportionate amount of medical personnel here have heavy smoking habits. I can literally count on one hand the number of people I’ve met at the station who don’t smoke and still have fingers left over. I’m also pretty sure there are more Emergency Room staff smoking outside at any given time than there are working inside. I know that these are stressful jobs, but I still find it strange that so many health professionals are such heavy smokers. Hope I can kick my passive smoking habit when I get home.
- Day 16 – Monday 17th January 2011
I had zero calls today – I hope this means that the people of Haifa are healthy!
- Day 15 – Sunday 16th January 2011
This is the third time in a row that I’ve started my week with a failed CPR. If I was more superstitious, I’d think I was bad luck. In reality, I know that CPR is, more often than not, unsuccessful, but we do it in the hope of getting one of those rarer, positive outcomes. I really hope that I get to see one of those.
Today’s shift started with a bit of commotion as there was a big traffic incident involving a bus and a number of cars, twenty minutes before the start of the morning shift. This meant that the teams from night shift were at the accident and so could not hand- over to the morning shift and some of the morning shift, who had arrived at the station early, were also out at the scene.
This included Sergio, a new volunteer from Mexico, who just happened to arrive early for his first-ever shift and ended up at a mass casualty incident! Having finished his training course just last week and barely having seen the back of an ambulance, he was, understandably, a little shaken up on his return.
I arrived a few minutes after the call, so that I didn’t get to go. However, I was invited to do my shift on the “Natan” (MICU – Mobile Intensive Care Unit). The MICU differs from a regular ambulance in that it offers Advanced Life Support, meaning that it’s stocked with drugs and equipment needed for many life-saving procedures done in the field and is staffed by a driver, paramedic and doctor (and sometimes an extra medic or volunteer). In short, there’s a lot more going on in a MICU and the care that can be given is much more advanced.
I was thus torn between the excitement of getting to work on the Natan, having seen it in action at many of my previous calls, and fear that I wouldn’t be able to do something they needed me to do (this is a fear I have every shift, but was multiplied by a thousand as I thought about a shift on the Natan). In the end, excitement won out and I was reassured knowing that I’d be working with a highly-skilled and professional team.
I had worked with both the paramedic (Offer) and the driver (Shlomi) on previous shifts (that’s them in the pic right) and it was really interesting to see them working on the Natan. While I’d held them both in high regard before, seeing them work on the MICU today really reinforced my respect for their skill and professionalism. They also had a good working dynamic and have such different traits that they make for a good team.
As I’d never been on the Natan, I’d never worked directly with Claudia (the doctor), though I’d seen her at previous calls. Originally from Russia, where she had also worked as a doctor on ambulances following years as a paediatrician, Claudia recently decided to join the MDA team. I’dd a good chat with her about the differences in health care and emergency services in Russia and Israel and she was nice enough to talk me through all of the medical conditions and procedures that we came across – although admittedly some of it went a little over my head.
The big difference with having a doctor on scene is that they can call time of death. For example, if a regular ambulance has a failed CPR case, and there is no available Natan (there is generally only one that works out of the Haifa station), the ambulance has to transfer the patient to hospital to call time of death. Apart from this, it is the paramedic who is in charge, as they’re the ones who’ve specialised in pre-hospital emergency medicine.
We had three calls today, which is a little quiet, but each call on the Natan is a lot more intense and protracted. Our first call was to a patient who had gone to their local doctor with chest pain. With the ECG showing the possibility of something starting, the doctor had called for the Natan to transfer the patient to hospital. The advantage of this was that Offer was able to organise for the patient to be admitted immediately into the cardiac unit, rather than go through the emergency department. This could potentially have saved the patient’s life.
At the hospital, I got to see one of the MICU’s donated by Australia, which works out of the Australian-funded station in Yokneam. I’m always proud to see our little kangaroos darting around the country!
The second call was to transfer a patient from one hospital to another. Having done many patient-transfers on the regular ambulance, I thought it would be a breeze. I was wrong. The patient was in a particularly precarious state, having suffered a bleed in the brain and had also been intubated. This meant it took quite a while to get the patient unhooked from all the hospital equipment and hooked up to ours. The doctors at the hospital were also supposed to have put the patient to sleep in preparation for the transferm, but he kept waking up and struggling against the treatment. No-one could really understand why, with all the drugs the patient had been given, they were still not sedated properly. However, once the patient was in the back of the ambulance, Offer saw that the catheter put in by the hospital staff had been put into a vein that wasn’t suitable and thus the patient had not properly been receiving the sedation. Shlomi opened up another vein and, this time, Offer managed to put the patient under, making things a lot less traumatic for both patient and ambulance-team alike.
Not wanting to risk losing access to the vein again, it was my responsibility to hold the patient’s arm straight. This, admittedly, sounds very simple. However, nearly twenty minutes of holding dead weight (even if it was just an arm), whilst bent over in an awkward position and trying not to fall over as the ambulance hurtled down the bumpy roads, was actually hard work. By the time we reached the hospital, I was sweatier than after one of my aerobics classes at the gym!
What I really noticed about working on the Natan is that there are a lot more people doing a lot more things. There is also a lot more time spent treating the patient inside the Natan, unlike the regular ambulances which treat on-scene and then transfer. Quite a few times, it felt like a big game of “Twister”, as people climbed over people to do what they needed to do. At one point, I found myself reaching between someone’s legs and over someone else’s lap to hold the patient’s hand still, while simultaneously holding the patient’s legs down and trying to stay out of the way – all without falling flat on my face!
Our final call was outside of our region to the Gilboa region. It was a fair drive and, when we arrived on scene, the regular ambulance was well in the midst of CPR. There was a doctor on-scene and we learnt that the patient’s workmates had also started basic CPR before the ambulance had arrived. Offer intubated the patient to assist their breathing and we continued CPR. Unfortunately, the long period of CPR yielded no response and Claudia had to call time of death. At 55 years old, with no history of heart problems, it was understandable that the patient’s spouse could not comprehend their death. As I saw the patient lying amongst crates of parts and surrounded by workmates, I realised that this person had gone to work like every other morning, without any reason to think that they would not be making it home that night. Although I’d attended two other failed CPR cases, this was my first time seeing a hysterical relative. When told of the news, the patient’s spouse lay screaming on top of their deceased partner, unable to understand that their other half was now gone.
I’m not ashamed to say that this left me feeling really sad, but at least I’m sure that the patient received the best possible care and that many people had done all that they could. Unfortunately, sometimes the best is just not enough.
- Day 14 – Thursday 13th January 2011
Although most of the people at the station have been great, there are one or two, as you would expect in a large organisation, who are not as nice. Unfortunately, I had to deal with one of these less-than-pleasant people this morning, so my day got off to a crappy start. Once I was out on the road with my driver though, everything was fine.
Today, I was assigned to work with George (he of massive moustache fame, as you may recall) and our first job was an “outside transfer”. It means that we had to transfer a patient from a hospital in Haifa, to a hospital in another region – in this case, Petach Tikvah. As our patient had to be constantly connected to oxygen, we were able to make it an urgent call and bypass the awful peak hour traffic heading towards Tel Aviv. I felt really sorry for the patient’s wife as she was sick herself and threw up the entire trip.
After some confusion at the hospital as to who the patient was and if he was supposed to be there (which I have, by now, come to expect), we were finally able to head back. On our way out, we met some of the local MDA teams. It was nice to realise that I now have a bond with complete strangers working all over the country.
We’d just made it back to Haifa, when we received another call. It ended up being another transfer – this time from hospital to home. George renamed us the “ambulance transfer service”. The case ended up being enjoyable as the patient was a chatty young mother who had broken her leg and was heading back home. Having been in an ambulance five times in the last two weeks, she declared herself a “frequent flyer” and, I must admit, it was more relaxing having a patient who knew what to expect.
At 2.30pm (half an hour before the end of shift), we received a call to the Krayot (about 20 mins outside of Haifa) and thus any thoughts of going home on time were dashed. The address was extremely difficult to locate as the GPS wouldn’t recognise it and the signage in the area was poor. The family wasn’t impressed with our response time and I suppose, to them, their house is very simple to find because, well, they know where it is . . . .
The patient was in a lot of pain (no doubt adding to the family’s distress) as they had been constipated for three weeks, unable to get anything in or out. We loaded the patient into the ambulance and they were so lovely, constantly thanking me for my help. We also bonded over the slightly scary ride to the hospital!
- Day 13 – Wednesday 12th January 2011
Today, the Haifa station was in a flurry as final preparations were made for the dedication ceremony of a new MICU (Mobile Intensive Care Unit) in the name of Ahuva Tomer z”l. Ahuva was the Haifa Police Chief who was killed in the recent Carmel fires.
The MICU was donated by the MDA Friends Society of France and is the first of 45 ambulances which will hopefully be bought by the various Friends Societies around the world in honour of each of the 45 victims of the fires.
It was a very touching ceremony, attended by Ahuva’s family, representatives of the police, the President of the French Friends Society and the Director-General of MDA. Also present were many of the paramedics, drivers and volunteers who had treated people during the fires (including Ilia, with whom I worked yesterday and who, I found out, had been part of the team who treated Ahuva on scene).
Ahuva’s partner is taking court action against the government for negligence and has been a very public voice of late so there was a lot of media interest.
However, the focus was really on the way in which Ahuva helped people and how apt it was to have a MICU donated in her name, which will continue that help.
Apart from the ceremony, I only had two simple calls today. My team actually had three calls, but I missed one to go to the dedication. I ended up being very glad that I missed the call as I found out it was a corpse transfer.
I also have to mention that I’ve been very touched by the concern many MDA people have shown, having seen the awful situation in Queensland on the news. Although most Israelis find it hard to even fathom the expanse of land that has flood in, there is much support here and we’re all hoping that the situation improves soon.
- Day 12 – Tuesday 11th January 2011
I really should’ve guessed that after being part of a team of three yesterday and getting hardly any calls that today, alone with my driver, I’d have a packed day. Our first call came ten minutes after our shift started and we didn’t see the station again until fifteen minutes before the end of shift.
My driver today was Ilia (pic left) who, at 23, is one of the younger drivers at the station. With his “baby face” and happy-go- lucky, slightly loopy personality, I wasn’t sure what I was getting myself into. However, within minutes of reaching our first patient, it became very clear to me that I was working alongside a confident professional. With each new call, I could see that despite a penchant for busting out Michael Jackson dance moves and goofing around between calls, having grown up in the “MDA family”, Ilia’s years on the job were evident in the experienced way he handled each patient. It also struck me that, in addition to doing his job well, Ilia was able to connect with the patients in a real and natural way that went beyond good bedside manner.
Ilia also speaks Russian, which made my shift today totally different from all the others. All of a sudden, we no longer needed to use creative hand gestures to get medical histories and patient details, and the patients’ families looked a lot less confused and a lot more relaxed. I also admit that I really didn’t mind Ilia’s preference for not asking female crew members to carry the patients. Although I know that if need be, I can manage, it really isn’t my “strong” point. (Sorry, couldn’t resist!).
All of our six calls were quite interesting in one way or another. The first call was to a collapsed, elderly patient who had been found on the floor. How the patient got to be in the state that they were in was quite possibly due to more sinister reasons than the family gave, but that was not our concern at the time. What was our concern was that the patient had an extremely slow pulse and felt like an ice-block. When I first saw the patient, I was a little taken aback as they were little more than skin and bones. With such precarious vital signs, it was necessary for us to call the MICU to transport the patient and I helped Ilia prepare an IV while we waited. During my time with the patient, they did not lose consciousness at any point, so I was later a little shocked to learn that the MICU team was forced to do CPR on the patient and that all revival attempts were unsuccessful.
Our second call was to a traffic accident, which ended up being minor, but was made interesting by the fact that, with the banked- up traffic, we weren’t able to get the ambulance close to the scene. So we had to hike down the road with all our equipment to get to the patient. It was also my hardest handover ever, as the woman had no identification on her and could not remember her ID number. This meant that the hospital wouldn’t start her file, which meant that we couldn’t leave. Eventually, after I’d used the “I’m a foreigner, take pity on me card”, the lady dealing with admissions sorted it out and our patient was able to get the care she needed.
Our third call was to a 92 year old patient. I heard the daughter speak in English and later, after a good chat with the patient’s spouse, I found out that the family was originally from Zambia. There were a couple of interesting things about this call. Firstly, the daughter was a nurse, which was handy and also meant a lot less explaining. Secondly, the patient wanted to die and did not want to go to hospital. The daughter had also made the very hard decision that the patient had suffered enough and let us know that, if it came down to it, there was a DNR (do not resuscitate) order in place. At first, the patient was in a really bad way and, as we waited for the MICU to arrive, everyone in the room held their breath a few times as it seemed we would soon be witnessing the end of a life. I really didn’t know how I would feel about watching someone pass, without any attempt to help them. But, luckily, I didn’t have to deal with that today as the patient’s condition improved slightly and the MICU evacuated them to hospital.
What was really touching was that the patient’s Filipino carer was so concerned for her ward and it was clear that she was part of the family. Foreign workers, doing this type of work, are often viewed in a negative light in Israel, so that it was nice to see a relationship based on mutual care and respect.
Our fourth call was to an elderly lady who was writhing around on her bed yelling that she was not well. Ilia quickly recognised that she had worked herself into a panicked state and, with a flair that would make a trained psychologist proud, he had our patient calmly sitting in a chair, telling us her life-story within minutes. The patient and her husband were such a lovely, cute couple who had been together since they were teenagers and had come to Israel after World War II. By the time we left the patient in hospital, we’d seen photos of all the grandkids, witnessed a rare case of enduring love and been invited for Shabbat dinner.
Our last two calls were fairly simple. One was a patient transfer from hospital to an aged care facility and stood out because the family of a patient, who had been left in the hospital hallway due to a shortage of rooms, was extremely grateful to see us take away our patient. Our final call was to a patient who had suffered a “hypo” (hypoglycaemia or low blood sugar) outside a store. As it was a fairly busy shopping area, there were many concerned members of the public on hand to offer their two cents’ worth and, for some reason, a few were upset with us due, from what I could understand, to our “slow” response time. In reality, we reached the scene within minutes of the call to 101 being made. I hear it is well- known that people often feel like an hour has gone by waiting for an ambulance, when it has actually only been minutes. In the end, the patient refused to let us treat them on scene or take them to hospital so, unable to force treatment, we left – which left some of the crowd quite confused. Whilst we prefer to take all our patients to hospital, just in case, from observing and talking to the patient, it was quite clear that they had been given a dose of sugar and were no longer in a “hypo” state.
- Day 11 – Monday 10th January 2011
Today was one of my slowest days thus far but, thanks to a great team and a couple of interesting cases, I ended up enjoying the shift.
When I was assigned a shift at “Tira” this morning, I knew that I’d probably have a lot of time to twiddle my thumbs today. Although I’d never been there, I’d heard that the post at Tirat Ha Carmel (one of the three smaller posts in the Haifa area), was notorious for being the quietest and that shifts there were best – if you had lots of reading/TV/sleep to catch up on. Still, I was excited to be going to a place I hadn’t been to before and working with a driver with whom I hadn’t yet worked.
From the minute he said “good morning”, I could see that Shlomi (pic below), my driver for today, could best be described as having a “fiery” personality – but in a good way. I was pleasantly surprised to see someone who, while projecting such a loud confidence, also shows true kindness and patience. I think it is this combination which makes him so suited to his job. He also left me in hysterics most of the shift, although his driving left my stomach sitting in my throat most of the time. I also found out that Shlomi had evacuated one of the fire fighters from the recent Carmel fires and, while the fire fighter sadly succumbed to his injuries in hospital, Shlomi’s actions, as well as those who worked with him, allowed a pregnant wife the opportunity to say goodbye to her husband. There were many families who did not get this chance.
As I was in Haifa at the time of the fires and witnessed the panic and devastation, I have felt really honoured to meet and be working alongside many of the MDA personnel who put their own lives at risk to help others affected by that awful situation.
Also, on the ambulance with me was Raily (in the pic with Shlomi), who I’d learnt a lot from on one of my earlier shifts. With a bit more free time between shifts and further distance from the hospitals, I got to have some good chats and learnt that Raily had started at MDA at age 15 as a youth volunteer. Although she has completed almost a year of her national service at MDA, she still wants to do her army service next year. She is hoping to become an army paramedic before, hopefully, realising her dream of being a cardiac surgeon. She is equally determined as she is talented so I believe that she will reach her goals. I couldn’t help but be impressed by her ambition.
Before I started volunteering, I assumed that the focus of my experience would be the patients. However, I have found that getting to know the people at the station has been equally important and special. From the paid workers to the volunteers, everyone has a story and there is great variety in the walks of life from which people come. This makes the station extremely vibrant, yet there is also a sense of cohesiveness and community as everyone is united by the work they do and, as many put it, “the MDA bug”!
We ended up getting three calls today which, as I was informed, is two more than usual on shift in Tira!
To be honest, I’ve been sitting here for the past half an hour trying to remember what the first call was. I now recall and am happy to be able to inform you (and thus not totally disrespect my patient), that it was a call to a shopping centre, where an employee was unable to move due to back pain. We evacuated the patient to hospital and I spent the whole ride cringing in sympathy as the bumpy roads here are not fun for people in pain.
Our second call was to the local bus company, where one of their employees had slipped and fallen down the stairs. This meant that I got to see my first backboard in action (you would understand my excitement over this if you had done the training course and spent hours practising back-boarding). It was also my first time dealing with a patient absolutely howling in pain. Again, the roads in Haifa were not our patient’s friend and, this time, I wasn’t just cringing, but letting out my own little howls with the patient as I could almost feel their pain with each bump.
Our third and final call was outside of our region (the Carmel region) to a moshav in the Sharon region. (I’ll admit, it took me a minute to realise people were not talking to me but rather about the area.) After a bit of a drive, and some not too fantastic directions from the patient’s family, we arrived at the scene, which turned out to be a beautiful, sprawling house, the type which is not very common in the sea of apartments that make up Israel. The call had come across as a case involving violence, so I was interested to see what it would be like attending a call with possible police involvement. Unlike in some countries, the police in Israel do not attend ambulance calls unless specifically requested. The police in this case had been called before us, and it soon became clear that we were on the scene of a dispute between neighbours that had become physical.
Our patient claimed that, during an argument, his neighbour set his dog loose on him and then proceeded to bang him over the head with a rock. Luckily for our patient (and probably the neighbour), the dog bite had barely pierced the skin and the rock to the head had left just a few scratches. None of the injuries required treatment on scene, however, it is procedure for all dog bite cases, that the patient be taken to hospital for treatment against rabies and that the case be reported to the health ministry. The long ride to the hospital was made pleasant by the patient being a nice, chatty type, who was in good spirits despite the day’s events.
- Day 10 – Sunday 9th January 2011
I didn’t have shift today, as I went to Jerusalem for the dedication of the YMDA first-responder motorbike. Having been involved with Young Magen David Adom (YMDA) for the past two years, I was extremely honoured to be able to attend the dedication. The ceremony was held in front of the 70 participants of the current overseas volunteer training course, as well as some volunteer program alumni. (The arrow’s pointing at me in the crowd – just in case you couldn’t find me there.)
It was fun going back to the hostel where I had spent 10 intense days learning skills to prepare me for my volunteering period and it was great to catch up with my instructors, Boaz and Lauren, (in the pic) who worked hard to prepare me and my classmates for our ambulance adventure. I also got to meet two volunteers – one from the USA and one from Mexico, who will be joining me at the Haifa station next week.
Of the crowd that was there, I managed to find two more Aussies, Joseph from Sydney and Tom from Brisbane, who helped me “unveil” the bike (pic left). It was an extremely proud moment for me to represent YMDA and see how the hard work of many, as well as the support of the younger members of our community, could assist MDA in its life-saving work.
(Not even a “suspicious object scare” and the ensuing hour and a half long wait at the Jerusalem bus station on my way home could ruin the special events of today!)
- Day 9 – Thursday 6th January 2011
Today was one of my hardest, yet most rewarding days on shift so far.
When we were assigned our drivers, I was really excited to be working with Pninit (that’s her in the pic), one of the female drivers at the Haifa station. While there are many female drivers working out of the Jerusalem station, there are only two in Haifa and I was curious to see if there are any differences in the way a female driver operates. I was, however, a lot less excited and a lot more nervous when told that, because there was a shortage of volunteers this morning, each ambulance would be staffed by two people instead of three, meaning I would be working alone with the driver.
Whilst I recognised that this would be a great opportunity for me to learn a lot, I also knew that, with not many shifts under my belt, if my driver did not have the patience to teach me, I would end up being more of a hindrance than a help. Luckily, Pninit ended up being extremely patient and more than willing to teach me. She considers the volunteers to be a great asset to MDA and so feels it is necessary to invest in them. With this attitude, I could not have asked for a better driver for my first “solo” shift.
We hadn’t even finished checking our ambulance, when we received our first call (this did not help with my nerves). We didn’t see the station for the rest of the shift with five calls, all male patients, all requiring to be lifted. I’m sure that I will be feeling muscles I didn’t know existed this weekend.
Three of the cases stood out for me. The first was a male who had fainted outside a corner store. He stuck out because he looked suspiciously like he’d escaped from a hospital recently, with a hospital tag still on and also smelling suspiciously like he’d gone straight to a pub. He was in a very sad state and I spent the ride to the hospital trying to get him to stop crying long enough for him to give me his medical history. More worrying was that between unloading him from the ambulance and getting him to a bed in the A&E, he “passed out” at least three times. Whether he was faking the loss of consciousness or it was alcohol-related was unclear, but if he was faking it, he had a pretty high pain threshold as Pninit gave him some pretty hard trap pinches before he came around. (Pinching the trapezius muscle is used to see if a patient is responsive to pain when determining their level of consciousness).
The second patient who really made an impact on me was a double leg amputee. We were called because a wound in his arm that he’d recently had treated had burst open and was bleeding heavily. I realised that this was actually my first time dealing with any sort of blood on a patient (no fainting on my behalf, luckily!). After Pninit showed me how to bandage the arm correctly, we were then faced with getting our patient to the ambulance. We managed the internal stairs without a hitch, but when we reached the front yard, the patient’s relatives suggested we take the garden path rather than go down the stairs. This ended up being a massive mistake. The path was long and uphill and took us twice as long and about five times the energy to get the patient up the path than it would have going down the stairs.
We finally managed to get the patient into the ambulance (with me looking like a beetroot). Pninit gave me instructions to check the bandaging and to make sure that the wound had not bled through. I soon realised, however, that this would be a secondary concern as the ambulance ride itself was causing the patient much more distress than did his arm. Although he appeared to be quite a tough guy, I quickly understood that with no legs and only one functioning arm, bumping around in the back of an ambulance (thanks to the Haifa municipality for the great roads) would be quite an ordeal. So I spent the next twenty minutes “bear hugging” the patient to make him feel stable, while trying very hard not to topple over myself. I was also really hoping that I would regain the feeling in my arm as the patient was gripping onto me so tightly. Although it was extremely uncomfortable for me, I knew that I had done more in that moment to help a patient than in everything I had done so far. The gratitude in the patient’s eyes made everything worth it and I’m sure it is one of the moments I will remember most clearly when this experience is over.
Our final patient was supposed to be a simple transfer from one hospital to another. A few complications made the process a little more difficult than it should have been, but what really struck me about this patient was that (a) he had no pants and (b) that his story was extremely sad. In his early thirties, he’d been working construction, when an elderly driver lost control of his car and ran him down. He had sustained severe injuries to his legs and had spent the past three months in hospital with a long, uncertain road ahead. What was particularly sad was that he was supposed to be getting married next month.
So today was long, today was hard, but today I learnt a lot from my driver and got to really connect with my patients.
Now, I desperately need a hot bath . . . .
- Day 8 – Wednesday 5th January 2011
I didn’t have shift today, because I went to meet with the AUJS LDP group to the MDA Blood Services in Tel Aviv. They were a great group of both Australians and South Africans.
We given a tour of MDA’s Blood Services, led by its Director, Professor Eilat Shinar, who explained all the processes. Some even decided to donate blood.
- Day 7 – Tuesday 4th January 2011
I think I’ve found a cheap, risk free alternative to Botox – wearing a youth volunteer shirt. Ever since I arrived at the station, everyone I’ve met has been shocked to learn how old I am. Most think I’m still in my late teens, with the oldest guess being 24. I put this down to the fact that the overseas volunteers wear the same shirts as the youth volunteers, but I’m still claiming the compliment!
I was supposed to work at one of the smaller posts today, but I really wanted to be at the main station to say goodbye to Haneen (she’s the one above me in the pic), one of the National Service girls who had completed her two years of service at the station.
Haneen made sure that I found my way around the station from day one, so I was really happy when I was told I could stay at the main station. I had originally thought that Haneen was Druze, but I found out that she is actually Bedouin, which was very interesting as I have not had much contact with Bedouins in Israel. Haneen intends to study nursing at university next year and when I asked her what she thought of her time at MDA, she said that she had really enjoyed it and it meant a lot to her, but that she would absolutely not miss the 5:00am starts and intends to sleep in for the foreseeable future!
Two of Haneen’s friends, Maisa and Saril, who usually work out of the station in Hosefiya, came to do shifts in Haifa today. (That’s Saril, Maisa, Hila, Haneen and Angelo in the pic) It was fun hanging out and having a good laugh between calls. It is beautiful to see the strength of the friendships that form at the station and which will no doubt last a lifetime.
Hila agreed to take me under her wing again today and, together with Yonatan, our driver, we trudged around Haifa in the rain getting people to hospital. I triumphantly managed to take the BP and pulse of our various patients and learnt how to start a patient’s file at the hospital, despite not being able to read Hebrew particularly well.
The call that stuck out most today was the first. Yet again, it wasn’t for any medical reason that the call made an impact but rather, it was my first experience of an unimpressed relative. Although the patient did not require urgent transportation to hospital, his daughter was irate at the time it was taking us to get to the hospital (thanks to the ever-present road works in Haifa) and abused the driver for not going faster. I suppose that people expect a ride in an ambulance to include sirens and lights and high-speed driving, but this has a risk associated with it, both for those inside the ambulance as well as those on the road. It should only used when absolutely necessary.
Also, I had a pretty amusing and shocking encounter with an elderly lady, who flatly refused to vacate the elevator so that we could get to an urgent patient, claiming she was old and unable to wait for the next one. She seemed to have enough energy to yell and shake her finger at us and could easily have sat on one of the nearby seats with her carer, but she insisted on staying in the elevator. In a huff, she finally agreed to exit the elevator when we tried to get in with all our equipment as she felt “squashed”.
You see some interesting human behaviour in this job . . . .
- Day 6 – Monday 3rd January 2011
Luckily, I didn’t start the New Year with a contagious disease. However, I apparently ate something bad over the weekend and spent yesterday over a toilet rather than over a patient – a very annoying way to start 2011 and a new week on shift.
Thankfully, I was well enough to make it to the station today and was excited to get to work with Hila who, as I have previously mentioned, is a total crack-up! (That’s Hila on the left in the pic, with Tal and Raily) She is also very good at her job, so I knew I was in for a good day. I also got a great driver, Tal or “Shustock” as everyone calls him, who is possibly one of the tallest people in Israel and attracts attention wherever he goes!
Stationed at the main station, we received our first call early on. When I asked Shustock what we were attending, he said “a guy with sore balls”. I assumed that he was joking until we got to the apartment and found a guy in bed, writhing in extreme pain, as his wife looked on a little bemused (in my opinion) and his two cute kids ran around getting ready for school. Jokes aside, the situation was quite serious and there was a good chance the patient could have lost consciousness from the pain. We quickly evacuated him to hospital. This case was a major victory for me as, on Hila’s insistence, I took the patient’s blood pressure – and I actually heard it! I felt a little bad getting so excited when the patient was in so much pain, but I was very relieved to finally be able to do it. Now I’m hoping that it just wasn’t a lucky break!
We didn’t make it back to the station before being called to a CPR. When we arrived, we found the patient, in their early fifties, unconscious on the bathroom floor. We managed to move the patient out into another room and were given a little surprise along the way when a prosthetic leg popped off mid-move. The MICU had arrived straight after us, so there ended up being seven people working on the patient. After finally getting a medical history (which took some time due to a language barrier and the fact that one of the patient’s relatives locked themselves in a room when we arrived and refused to come out), there was still no obvious cause for the collapse. With seven MDA personnel, including a doctor and paramedic, I didn’t do much except pass equipment and hold the IV, but I really got a good lesson in performing CPR – my first from start to finish. Unfortunately, despite the team’s best efforts, the doctor declared the patient dead after a protracted period of CPR.
This is my second time attending a failed CPR in as many weeks and I’m really hoping I don’t start every new week on shift like this. I think that a lack of an obvious reason for the patient’s collapse, combined with his young age, left everyone feeling off and I overheard the paramedic say that last week he had three successful CPR cases, all on elderly sick patients. Yet today’s, seemingly, healthy and young patient had died. I suppose people in this line of work see many surprising and inexplicable things. Unfortunately they are not all positive.
After a bit of a break, we got called out to a supermarket, where an elderly patient had fainted and had hit his head. Despite insisting all was well, when the patient dropped the water bottle he was holding as we spoke to him, Shustock declared that all was not well and we rushed the patient to hospital. This was my first experience of ambulance crew and doctors not getting along so well as the doctors refused to listen to the handover information and recommendation that the driver gave them. In the end, the patient ended up being placed in the ICU … where we had put him in the first place.
The day ended with two “false starts” as we raced to one call (with some pretty impressive driving form Shustock) only to find that our patient was already being loaded into another ambulance and then another call where we were sent to back up another ambulance, but on arrival it turned out that the patients were only lightly injured and we weren’t needed.
I have to say, we really didn’t mind as this call came ten minutes before the end of shift.
- Day 5 – Thursday 30th December 2010
I’m not going to lie – hurtling down the street against the direction of traffic with sirens blaring is FUN! Especially when you have a driver named George, whose personality is almost as big as his giant moustache! Less fun is getting a call telling you that the patient you just attended to has something contagious and airborne.
Today, I was again assigned to “Banats” or the MDA post at the Bnai Zion Hospital. I like shifts there, so I was happy. I met my team, which consisted of George (that’s him on the left with his impressive moustache) and Tim (on the right), who is completing his national service at MDA. I had seen “Timmy” around the station often, as he is in charge of re-stocking the storeroom – so he is a good guy to know. Most impressive, however, is that Tim, who has family in New Zealand, likes Vegemite! I nearly fell off my chair when I found this out, as I have honestly never met someone, who is not Australian, who likes Vegemite. Most Israelis or non-Aussies, who I get to try the stuff, think that I am trying to poison them. I thus considered Tim a champion from the start and promised to bring him some Vegemite from my stash.
We had quite a busy shift. I don’t know what it is about the Banats toilets, but there is always a call when I am visiting them!
There were three standout cases today. The first was a patient with a fractured arm – pretty standard, except that there were at least 10 family members all standing around screaming and hysterical. A family member then tried to give George a tip for our services, but he of course refused. Didn’t stop us from having a good chat about what we would have done with the money though!
The second case wasn’t actually one we attended, but I heard about it over the radio and feel it deserves a mention. An Egged bus driver had a heart attack while driving a bus full of people. Although he unfortunately did not make it, in a heroic act, he managed to pull the bus over, thus averting a mass casualty incident and saving countless lives.
The third case was our final call for the day and also the longest I have attended thus far. After receiving information that the patient was unconscious, we prepared ourselves for a possible lengthy CPR, only to arrive and find the patient sitting up and talking. We were met at the scene by a first-responder, who had been in the area and it soon became apparent that although conscious, the patient was not in a good way. Suffering from a severe case of hypoglycaemia, the patient was confused and combative and not particularly easy to work on. It didn’t help that the lady who let us in didn’t speak much Hebrew other than to repeatedly tell us that she wasn’t related to the patient and had no idea about them – all the while packing a bag of their clothes and sporadically bursting into tears.
It was my job to try and get information out of this lady, calm her down and keep her out of the way. Every time I thought I was having some success with this, she would again start screaming in Russian and crying. In the end, using my most impressive miming skills and encouraging squeezes of the hand, I managed to get the lady to wait in the ambulance.
We were able to get the patient out of their apartment and into our ambulance just as they lost consciousness. With the patient unresponsive to the “Glucogel” and sugary water we had given, we were glad to see the “Natan” (Mobile Intensive Care Unit) pull up because they are able to administer drugs necessary to reverse the effects of a “hypo”. After treating the patient on scene, the MICU evacuated them to hospital and we raced off back to the station, eager for an on-time clock off from shift. This plan fell to the wayside, when we received a call from the MICU to let us know that they had discovered that the patient had a contagious disease!
Some commotion ensued and, amongst it all, I found myself a little confused as to whether I needed to be worried or not. After helping to douse everything in alcohol, all seemed fine and I went home, though I did make a call to Aryeh Kaufman (head of the overseas volunteer program), just to check up on the disease and make sure I didn’t need to take any precautions.
So, I had quite an eventful day with George, Tim and Ambulance 47 and, due in large part to a lack of elevators in apartments in Haifa, I got home today stuffed, in desperate need of a long hot shower, and acutely aware that some sessions at the gym working on my upper body strength would be desperately in order
if only I wasn’t so pooped!
- Day 4 – Tuesday 28th December 2010
I have been hearing for quite a while now that the people in MDA are crazy. I am starting to see that there is quite a lot of supporting evidence for this statement. For example, today, my driver, craving a hamburger, stopped to talk to a truck full of cows. Not to the driver
to the cows
(Sorry Offer, I couldn’t resist!). I don’t blame him though, after only four simple shifts, I can already understand how years of dealing with Israeli roads, sick patients and
Israelis, leads to a need for comic relief. Thus, although when it comes down to it, the work is serious, there is a lot of mucking about also. I never thought, when I started the volunteer program, that I would spend a good part of my day laughing my head off. Then again, you don’t need a background in psychology to understand the necessity behind the frivolity.
Stationed at the main station, my driver today was Offer (not the same one as yesterday), who is a paramedic and the MDA spokesperson for in the region. The team was completed by Raily, who has been volunteering for MDA since she was 15 years old and is now doing her national service at the station. They were a great team to work with and their years of experience were evident. I was really impressed by their knowledge and professionalism, especially as they are both quite young. I was also very grateful for their patience and willingness to teach me.
Without any MICU’s attending our cases, we transferred all of our patients to hospital today and I am starting to become familiar with the admin staff at each one. Fortunately, my reading and writing skills in Hebrew are not very advanced and I get to miss out on all the fun paperwork!
I also had my first AIDS patient today who was suffering from drug- induced hallucinations. Happily for everyone involved, the voices in the patient’s head were those of his wife and children and not something more sinister.
I spent most of my downtime at the station subjecting people to blood pressure tests as I still struggle to hear anything. Of the 20 or so tests that I did, I only managed to get a reading for myself and one other person. One nice guy even ran laps around the station so I could hear a higher BP but, unfortunately, I couldn’t hear a thing. Not being able to do something so simple makes me feel really stupid, but I can’t make myself hear sounds, so I will just have to keep trying until I do!
I met lots of the youth volunteers who do the afternoon shift. They were all excited as most would be spending the afternoon on shift at either a local festival or a football match. They are really cute kids, though I am always impressed by how “grown up” they can be when on the ambulance.
No shift tomorrow as I have a Bat Mitzvah in the family, which will be really special as the Bat Mitzvah girl has an aggressive form of cancer and was not expected to reach this milestone.
So I’m off for now – back for a 5:00am start on Thursday!
- Day 3 – Monday 27th December 2010
Today, I remembered that 5:00am is not my favourite time to start the day. This is a feeling I am sure will repeat itself many times in the next month! However, spurred on by the promise of a day filled with new experiences, I actually made it to the station with time to spare.
My team today included Offer, a driver who exuded a certain cool mixed with a little crazy, no doubt due to his many years on the job and having seen it all “more than once” (as he put it).
The other volunteer was Angelo (in the pic), who is completing his national service at MDA. Angelo was the first person I met at the station and had shown me around when I admitted to being lost. I hadn’t seen him at the station since, as he had been on break celebrating Christmas. Coming from a Christian Arab family with roots in Haifa stretching back many generations, Angelo is extremely proud of his city and proud that he can help those in need. With less than a year left of his service, he is torn between continuing on at MDA and starting his university degree. Hopefully, he finds a way to do both as his passion for MDA is obvious.
Of the various calls that we had today, two stood out. The first was just a patient transfer, but it was my first repeat-patient. I knew, coming into this, that working on an ambulance would mean usually seeing a patient once and not really knowing what became of them. So I really enjoyed seeing my patient from yesterday especially, as in this case, his condition had improved.
The second call was a suspected CVA (stroke) at the markets. It wasn’t so much the patient that stood out so much as situation that occurred once the patient was in the ambulance. I know that everyone knows that Israelis drive like maniacs and that moving for an ambulance is a foreign concept, but today was exceptionally startling.
Question: When you see an ambulance with lights flashing reversing up a narrow street, do you:
(a) Reverse back down the road or at least stop?
(b) Drive towards the ambulance at full speed hoping to make it through the remaining gap?
For those of you who picked (a), I recommend not attempting to drive next time you are in Israel as it seems that Israeli drivers think (b) is the most correct response. This reaffirmed my belief that the drivers are the true heroes of Magen David Adom!
I also got to meet more of the Haifa team today, especially those doing their national service, who do morning shift six days a week. I am sure that I will mention them all at some point as they are all exceptional people, but today it was Hila (in the pic above with Angelo), who really caught my attention. With a massive personality, an infectious laugh and a constant stream of jokes, she is loved by everyone and is truly the life of the station.
- Day 2 – Sunday 26th December 2010
Had a bit of a “boys and their toys” day today. Arrived this morning and was told I would be based out of the main station. My ambulance team consisted of a driver and a medic in his last stages of training to be a driver. This lead to some “mostly healthy” competition as the trainee tried to prove what he knew and the trainer tried to assert his authority. Although a largely, light- hearted clash of testosterone, it quickly became apparent to me that I lacked a necessary appendage to play the game and would be best keeping my head down and waiting for instruction. I thus spent most of my shift either highly amused or shaking my head, but I was actually able to learn a lot as the driver-in-training explained each of his actions out loud.
Our first call was a patient transfer, which provided for a fairly relaxing start. This was followed by a more intense call, largely due to the fact that we had to manoeuvre the ambulance up a fairly precarious hill and the patient (a suspected overdose) was hard to reach. A few more calls rounded out my second day on shift and, as I took the bus home, I realised that I was already starting to feel at ease with everything.
I am really looking forward to fully integrating into the station in the coming weeks and am excited to see who I will meet tomorrow.
- Day 1 – Thursday 23rd December 2010
I saw my first real-life dead body today. Five hours into my first shift, the day after I finished my training. When they say the Ambulance Volunteer Program is real – they mean it.
Part of my role with MDA Victoria has been to promote the Ambulance Volunteer Program in memory of Yochai Porat, who was passionate about bringing young people to Israel to make a difference and experience the real Israel on the basic level of humanity that binds us. Yochai (z”l) was killed during reserve duty as he rushed to the aid of injured soldiers but his dream lives on with hundreds of people from all over the world coming to Israel to volunteer for Magen David Adom.
I decided that, although at age 27, I would be one of the older participants on the program, I wanted to experience the program first hand, both to help me better promote it and to add to my “tapestry of life”.
Yesterday, I finished the 10 day training course which all volunteers must pass in order to work on an ambulance. I was part of a very cute group made up of Canadians, Americans and Brits. We were a relatively small group so we finished the material with a couple of days to spare which allowed us to cover some extra topics, like childbirth (complete with a fake baby and ‘vagina doll’ as the boys put it) and we also got to sit in on the Shlav Bet’s IV class. Overall, it was an intense yet fun 10 days and we were all sad that it was over but excited to start our volunteering.
We all left Jerusalem for the cities we would be stationed in and with family and a place to stay, I was placed in Haifa. A few hours after I got back, I received a call telling me to be at the main station at 6.50am for my first shift. I very nervously prepared my uniform and bag ready for a rushed early start. I arrived at the station early, eager not to be late for my first shift as we had been warned that the “ambulance will not wait.”
I had no idea where to go but luckily I met another volunteer who was nice enough to show me around. He introduced me to some of the other volunteers, mostly national service girls and then I was assigned to an ambulance. Each regular ambulance generally has a driver/medic and two volunteers. The other volunteer on my ambulance was a young girl named Iris (that’s her in the pic with me on the right) – who at 16 is still in school and is one of the many dedicated youth volunteers. As she showed me how to check the ambulance before a shift, I was in awe seeing this young girl acting with such professionalism and confidence. If I hadn’t overheard her saying she had the day off from school, I would never have guessed how young she was. It made me think of what my friends and I did with a day off at her age and it definitely didn’t involve saving lives!
After we checked the equipment I met Ofir, our driver (that’s him, standing next to Iris by our ambulance). At first, he was a little intimidating and I was a bit worried having heard stories of a few not so pleasant drivers. But it turns out he’s just not really a morning person and, after he got his morning coffee, he turned out to be a really nice guy who patiently answered all my questions and dutifully put on the siren for my first call!
Haifa has a main station and three smaller posts throughout the city and we were sent to Bnai Zion Hospital. Then began the wait. In most stations, except for perhaps Jerusalem and Tel Aviv, which are fairly chaotic, part of the job involves getting used to switching from “chilling” to “on” at any given moment.
My first call came as Iris and I went to get milk and bread from the hospital kitchen. Being quite far from the ambulance, we broke into a light sprint, attempting not to alarm anyone, though I did notice quite a few bemused faces as people watched two girls bundling down the corridors juggling milk and bread! On board the ambulance, excitement soon turned to disappointment as half way there we were told we were no longer needed.
My first real call came when I was mid-pee, which was fairly amusing and a situation I am told I will have to get used to! For the sake of patient confidentiality, I won’t go into too many details, but we arrived to find a patient with a severe wrist fracture, an injury I had sustained myself and could relate to. After stabilising the break, we took the patient to the hospital and I was introduced to the amazing amount of paperwork that goes along with every ambulance call!
We didn’t make it back to the station before receiving our next call. The energy on the ambulance increased as we got news that it was a CPR case. I was instructed to put on double gloves and make sure the AED was ready. We would be meeting a private ambulance team which was already on scene and had called for assistance. When we arrived, I at first thought the patient was a child because all I could see were two small feet poking out of the bedroom door. When I got closer, I realised the patient was not a child but rather very elderly. Unfortunately, the patient did not survive. I was extremely surprised by how calm I was considering this was my first time seeing a dead body. I felt as if my emotions had switched off and all that was left was my brain – examining the situation and calculating what I needed to do. It felt very strange as throughout the training I had tried to imagine how I would respond to situations and I thought I’d be a little more hysterical and useless. I think it definitely helped that the patient had been very ill and although distraught, the family was at peace with the situation. Obviously a more traumatic case may cause me to react differently but it definitely gave me confidence to know that when it comes down to it, I can overcome any excitement and nervousness and do what is necessary.
We ended our shift with a pulmonary oedema case and thus I finished my first shift with a good cross-section of things I had learnt in training. I really felt that things had come full circle as suddenly I understood things that for the past 10 days had only been theoretical and dependent on my imagination. I know that it was only my first day and that I will face many challenges in the next two months, but for now at least I feel like I can do this and I’m looking forward to my next shift on Sunday!
and I now carry rubber gloves in my pocket – a sure sign that I am now a true first responder!