Area doctors are on call - for war
Posted on 11/17/2002 5:16:25 AM PST by MeekOneGOP
Area doctors are on call - for war
8 volunteer physicians would serve in Israel if conflict intensifies
11/17/2002
Against the backdrop of unending Middle Eastern tensions, of terrorist attacks and military retaliation, a group of North Texas volunteers prepares for war.
And if the conflict escalates that far, these volunteers - eight doctors from the Dallas-Fort Worth area - promise to be in Israel within 72 hours, stationed a few miles from a hostile border, at a hospital possibly overwhelmed with casualties.
"Would I be scared? I'm sure I would be once I got there," said Dallas neuroradiologist Andrew Tievsky. "But even if there was active [weapons] fire going on, it wouldn't dissuade me from going."
The doctors, part of a group from the central United States, would replace Israeli physicians called to active military duty. And though the Americans would work at a civilian hospital, the dangers are inescapable.
"This is in a very critical area, near the border with Lebanon in western Galilee, where they'd expect the first line of attack from Lebanon and Syria," said Sandy Bidner, a Dallas orthopedic surgeon.
"They expect substantial casualties there if it comes to war."
"If you stand on an upper floor of the hospital, you can see a ridge in the distance, maybe four miles or so, and that's Lebanon," Dr. Tievsky said. "It's one thing to read about it, but to be there and see it, that's different. It's shorter than my commuting distance to work."
Surrounded by countries it considers hostile, and with Iraq looming just to the east, Israel has long prepared for attacks. In a visit to the hospital two weeks ago, the American doctors saw just how serious those preparations are.
The hospital is built with thick reinforced concrete, and the operating-room suite is shielded from conventional explosives by an 18-inch concrete shell, said Daniel Karin, a Dallas anesthesiologist.
"It's also shielded from poison gas and from biological warfare agents by dedicated, filtered airflow systems," he said. "And entry is possible only through a series of doors that create an airlock similar to that found on a submarine.
"That's the good news. The bad news is that this is the only hospital in Israel protected in this way because it is the only hospital considered to be in the battle zone."
And the portions of the hospital perched above ground are only a part of the complex. Deep, deep in the ground are hospital wards, treatment areas and support facilities that more than double the size of the hospital, from 600 beds - 300 of them for surgical patients - to 1,400 beds, 1,100 for surgical patients.
"There are seven wards beneath the main hospital," Dr. Karin said, "and these would be filled with trauma patients."
During their visit, the doctors studied the facilities and the procedures used, helped in the operating rooms and watched one of the hospital's regular disaster-training sessions - this one in chemical warfare, with 500 patients flooding the hospital.
"It was very overwhelming to us," Dr. Bidner said. "We're standing on the roof watching this military exercise and they're bringing in bodies in ambulances, and I'm thinking, 'We don't do any of this at home.' "
Dr. Karin in particular learned his role could be much different from anything he does in Dallas.
"In the disaster drill, I learned that anesthesiologists are much more involved than I had realized," he said. "The principal cause of death in nerve-gas poisoning is respiratory. The anesthesiologist must don full chemical warfare protection so that he can intubate victims as they arrive, before they can be detoxified.
"Doing an intubation with gas mask and heavy protective gloves is quite difficult."
Language differences could also cause problems without an interpreter, Dr. Karin said.
"I've learned to say 'This will sting a little' and 'Take a deep breath' and 'Do you have pain?' " he said. "Beyond that, I'm in trouble.
"Most of the nurses speak broken English - except when you really need something from the workroom and don't know how to ask for it."
Beyond that, though, much of what the doctors saw seemed intimately familiar, though they found some considerable differences, too, Dr. Bidner said.
"It's very interesting there, because it's state-of-the-art, and then again it isn't," he said. "They've just done this fabulous $25 million expansion, but they don't have an MRI machine in the hospital."
There is one CT scanner, Dr. Tievsky said, about 10 years old and due to be replaced. But a comparably sized hospital in the United States probably would have two or three.
The doctors, especially the younger ones, are well-trained, and Israeli doctors in general "do a better job of preoperative preparation of their patients," Dr. Karin said.
"They see much of what I do as 'defensive medicine' and pooh-pooh it as unnecessary expense."
All in all, though, "I don't think the doctor-to-doctor adjustment will be a problem," Dr. Bidner said.
The idea of American doctors volunteering to help Israel in times of war isn't a new one, Dr. Tievsky said. He saw it firsthand in 1967, during the Six-Day War.
"I was a college student, working in my father's radiology office, and we were listening to the dispatches on the radio constantly," he said. "We went out to lunch one day and ran into a [general practitioner] in solo practice who was packing his bags and dropping his practice to go to Israel to help out.
"That really made an impression on me."
The Dallas doctors who have volunteered their time are Jewish, and they're all part of a program coordinated by Jewish Federations in the United States and officials in Israel.
"The whole of the U.S. is linked with the whole of Israel in terms of industrial, educational, agricultural and medical exchanges," Dr. Bidner said, "and we're part of what we call the central region - 13 cities in the middle part of the U.S."
The region is affiliated with western Galilee in Israel, and that's where the emergency team would go, he said.
And the doctors hope the team grows beyond any specific religious designation.
"I think that's one of the things that has energized us," Dr. Bidner said. "We're finding that it's not just Jewish doctors, but Jewish and Christian doctors alike who have gotten very interested in the Middle East in the last year or two."
"There are a lot of non-Jewish doctors and a lot of mainstream Americans as well who support Israel," Dr. Tievsky said. "I think, if given the opportunity, people would be glad to help on a personal basis."
For American Jews, though, the bonds run very deep, he said.
"That has to do with the 4,000-year heritage of this land being our homeland," Dr. Tievsky said. "And that's reinforced by modern history, by the birth of Israel and the Holocaust and the survivors going to Israel in the '40s and '50s.
"And then there was the huge Russian population that has moved there in the last 10 or 15 years.
"It is our homeland," he said, "and that's a strong and deep bond."
E-mail myoung@dallasnews.com
Someone is going to an awful lot of trouble it seems...
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