October 7 in Hadassah Ein Kerem
Trauma surgeon on local visit tells his story
October 7 started like any other day for Oded Cohen Arazi.
“I remember waking up at home,” in Jerusalem, “very early on Shabbat morning, because my wife’s phone kept beeping.
“She kept getting messages from her family in the south.
“And then we opened the TV and we started seeing pictures. Already, at 6 a.m., there was video of soldiers being taken into Gaza. My kids woke up at 8, when the first sirens went off.
“They already were in their shelter room, because that’s their bedroom, so we closed the steel window and the door.
“We actually heard the Iron Dome explode over Jerusalem. I’ve never heard it before. Jerusalem had never really been targeted before.”
The family thought the threat was over, so they went out, “and then there was another siren, and then another,” he said. “We went back in.
“And then, at about 9:30, we decided to go to work.”
The next decision was who would go. Dr. Cohen Arazi is a trauma surgeon; his wife, Noya Cohen Arazi, is an intensive-care nurse. They both work at Hadassah Ein Kerem hospital, and they have three children — a 5-year-old and 3-year-old twins. (Now, “there’s another one in the oven,” Dr. Cohen Arazi said; Ms. Cohen Arazi is pregnant.) Only one of them could go.
They decided that it would be Oded.
What was it like?
Dr. Cohen Arazi — who was in New Jersey last week on a speaking tour arranged by Hadassah, and who talked to me in Short Hills — began with a description of the massacre.
“It isn’t like anything we’d ever experienced before,” he said. “I don’t think there has been any equivalent in the modern world, in the West. Nothing comes near it in the percentage of the population killed, the systematic killing of people in their homes. The people who were killed weren’t in the army. The attack wasn’t against the army.
“Entering a small kibbutz, taking it over, and then firing from cars; raping and torturing and murdering.
“Going to the Nova festival, with several thousand people there partying, and just shooting everybody. This is not something you’d expect in a Western society. It’s not something that can happen when you just go to a party. You expect to have a good time at the party, and then to go home.”
The attack is correctly compared to September 11 because “it was just people doing normal things in their own regular lives,” he continued. It was less like Pearl Harbor, which also was a surprise, because “the Japanese attacked for no reason, but they attacked a Navy base.
“It’s hard for Americans to imagine it. It was an attack out of the blue.
“And the brutality of it was off the scale. The only thing comparable to it as pure evil is what the Nazis did.”
But the world is different than it was when the Nazis were in power. “Unlike then, now we have an army, and we can defend ourselves,” Dr. Cohen Arazi said.
That background is very important, but it’s also to a large extent beside the point, he continued. “A good thing about being a doctor is that I leave all politics outside the door. I am a doctor, not a policeman. When someone comes in the door, we treat them. We treat everyone, with no questions asked. What happens to them afterward is for other people to decide.”
On October 7, Dr. Cohen Arazi said, “the soldiers on the ground fought like lions. They found soldiers with empty magazines next to them. They fought to the last bullet. Eventually some of them died.”
He was in his trauma unit, which “usually treats injuries from car crashes and accidents and attacks from blunt instruments, or 80-year-olds who fall off ladders, when you look at them and wonder, ‘You’re 80 years old! Why are you on a ladder at 4 in the morning in the first place?’
“So it was a big shift from blunt injuries to soldiers coming in with shrapnel wounds, leg injuries, gunshot wounds.
“That day we started getting casualties. Every time a chopper landed, it probably looked chaotic to someone from the outside. Every bed had someone in it. Specialists from all the departments came to evaluate patients.”
Some of the soldiers were in bad shape, he said. Often, it took hours for some of them to be rescued. Once they were in helicopters, though, Israel’s small size worked to their benefit. No part of the country is too far from a major hospital; Dr. Cohen Arazi, in Jerusalem, is only about 15 minutes from the border with Gaza.
“There are two ways to do it,” he said. “Scoop and run or stay and play. We do scoop and run; you do what you can right away, and then you get them to a hospital as soon as you can. There is no point staying on the ground, because you are delaying the treatment that we offer in the hospital, and that treatment is better.”
Reports say that about 370 of the 1,200 people Hamas and the freelance murderers who accompanied them slaughtered on October 7 were members of the Israeli military.
First responders put tourniquets on wounds, Dr. Cohen Arazi said. “A tourniquet is lifesaving, but within an hour you should be in a hospital, where a doctor can open it and do surgery. But it often took about eight hours. That’s a long time. The tissue doesn’t like it, especially the muscles; the cells begin to die, and the nerves start not to work.”
Ein Kerem saved not only most of the soldiers, but most of their limbs as well. “We had a soldier who had tourniquets on both his legs and the upper limbs,” Barbara Sofer, Hadassah’s Israel director of public relations, who accompanied Dr. Cohen Arazi, said.
(Although this is a story about Dr. Cohen Arazi and Ein Kerem’s trauma department, Ms. Sofer, a Connecticut Yankee who made aliyah, deserves her own story; to meet her is to know that. It would be a good one.)
“It was a long treatment, about three weeks in the ICU, dialysis, another month in the hospital and then a long rehabilitation,” Ms. Sofer said. “Then later, I saw him dancing. It was one of the most emotional moments I’ve ever had. There he was.” He’d been injured twice, she added; first he was hit with shrapnel, and after he recovered, he went back to the front to continue to fight.
“We have very low amputation rates,” Dr. Cohen Arazi said; the hospital has both highly skilled health-care providers and cutting-edge technology.
Dr. Cohen Arazi, who is 44, told a bit of his own story. It is hard for someone who never considered medical school to understand what might draw a medical student to such a specialty as trauma surgery, and Dr. Cohen Arazi tried to explain it.
Like his parents, he was born in Jerusalem; his mother’s parents went to Mandatory Palestine, as he punctiliously put it, when they were babies, from Morocco, and his father’s parents went there from Syria and Egypt. His mother was born in 1943 and his father in 1932, well before the State of Israel was established.
His high school required a year of public service, and he chose to work with first responders. “My desire to be a doctor began when I was 15 and first went on an ambulance,” he said. “I started volunteering in the MDA” — the Magen David Adom, the Israeli Red Cross-equivalent. After his IDF stint — he was in intelligence — Dr. Cohen Arazi went to Tel Aviv University, and then to medical school in Hungary.
His first love was trauma surgery, but for 18 months he did organ transplants. “It’s amazing,” he said. “You take a person with complete liver failure, for example. He’s basically dead, with not one but two legs in the coffin. And then you get a new liver, and he is back on his feet. He is alive. He is living. That had a tremendous effect on me.”
Remember, both Ms. Sofer and Dr. Cohn Arazi said, in Israel, the only precondition for getting a new organ is that you be Israeli. It doesn’t matter what kind of Israeli — Jew, Muslim, Christian, Arab, Druze, Ethiopian, Sephardi, Ashkenazi — as long as you are a citizen, and you qualify medically. That’s it.
“About two and a half years ago, I started doing trauma again, and I never looked back,” Dr. Cohen Arazi said. “It is an amazing job.” Hadassah sees patients from before their arrival in the emergency room through to their exit from long-term rehabilitation. It’s thrilling to see, he said.
How does he do the kind of work he does? How can he see what he sees and make sense of it? “When a patient comes in, you treat them according to the protocol,” he said. That means that you have no room for emotion. “First things first,” he said. “You look and see what the patient needs, and you do it.
“That was put to the test for me in January,” he continued. “My nephew was a soldier, called to the reserves. He came into my trauma unit. He was the last of five soldiers out of the chopper. I didn’t know that he was coming, and when he got to the door, I asked him, ‘What are you doing here?’
“He was completely calm. He was wearing sunglasses. Everyone comes in with earplugs, because of the noise in the helicopter, but he was the only one wearing sunglasses. ‘I’m here for a family reunion,’ he said.
“That was a very challenging time. I had to call my brother and tell him. I had to call my mom and tell her that her first grandchild was injured.
“When you have five soldiers in the trauma unit, and you are responsible for all of them, and four of them you’d never met before that day, and one you have known all his life — when you are examining him, you have to completely separate yourself from everything. The whole idea is that you have to stop thinking about who he is, because that doesn’t serve him. What does serve him is identifying everything that is wrong.
“Then you can remember who he is.”
His nephew is okay now, Dr. Cohen Arazi said. “He had three weeks of hospitalization, and then three months of rehabilitation. He still walks with a cane — but he is walking and having fun. He has hope.”
Rehabilitation is hugely important, he added. Over the last decade or so, the medical world’s understanding of that truth has matured, and so has the treatment of people who need both physical and emotional care if they are to return to their lives. “People are much more sophisticated about dealing with it now,” Ms. Sofer said.
The war has changed some things in the hospital, Dr. Cohen Arazi said. Many of the surgeons and other specialists are also reservists, so they’re out with their units.
The workload has become even more intense. He remembers the day when he was leaving to go home, exhausted and ready to be out of the hospital, after having told his wife that he was on his way. “I am going down the hill to my car,” he said. “I see my car, less than 20 meters away. And then I hear a toot toot toot from my phone, and then I get a trauma message, so I call Noya, and I say, ‘I’ll be delayed.’
“But it’s not a nuisance. It’s good. Eventually they” — the wounded soldiers — “will go home. They are all worth it. They did everything for us, so we now are doing what we can to help them.”
And the war also has changed his understanding of the generation of young adults who are facing this fight with Hamas. “Everything bad that we said about this generation” — everything dismissive, anything about their lack of care or desire to step up when necessary — was wrong,” he said. “We were wrong.”
Dr. Cohen Arazi has a story in his family about the desire to protect the State of Israel. It’s a desire that connects generations.
He tells the story of his father’s sister, his aunt Shula Cohen-Kishik. “They had a big family,” Dr. Cohen Arazi said. “Thirteen brothers and sisters. Shula was one of the oldest, either the second or the third, and my father was the 11th.
“She was born in Argentina, grew up in Palestine, and was married to Joseph Kishik, a rich merchant in Beirut,” he continued. “They lived in the Jewish quarter there, and they had seven children — one of their sons, Itzhak Levanon, was Israel’s ambassador to Egypt, and the last of them passed away just this year, at 90-somethng.
“It was a very different time then in Lebanon. A much more luxurious time. Lebanon was a very Western country until 1981, when its civil war began. Beirut was called the Paris of the Middle East; people walked around looking elegant. Looking like they could be in any European capital.
“Shula and her husband were in Lebanon in 1948, when the United Nations decided that Palestine would be split and Israel would become a state. She smuggled thousands of Jews to Israel if they couldn’t get there legally. She was in charge of making sure that everything happened the way it was supposed to. She’d walk the convoy almost to the border, to make sure that it could get through safely.”
The Middle East is a small place. Word gets around quickly, and all the Jews who wanted to get to Israel made their way to Ms. Cohen-Kishik. “There were almost no Jews left to smuggle into the country,” he said; next, “she was recruited by Mossad, and she gave them important information.” She lived in Beirut and worked for the Israeli spy agency for decades; she was caught and imprisoned in 1952, and then she was released.
But then, in 1961, she was caught again. “I heard that this is what happened — my father told me this, and now of course I can’t ask him anymore — that Mossad took out the main witness against her,” Dr. Cohen Arazi said.
“The interrogations weren’t easy. She was tortured. One thing that I learned when I was in intelligence is that everyone who is tortured speaks.
“She was sentenced to death, but eventually it was reduced to life in prison. That part wasn’t that hard — she still had some friends there, although a lot of people hated her. She was released in 1967, after the Six-Day War, in a prisoner exchange.”
Ms. Cohen-Kishik was 16 when she married and 27 when she began to work for the Mossad. She lived until 2017, dying at 100. “She was the first woman Israel publicly acknowledged as a spy,” Dr. Cohen Arazi said.
“I knew her for many years.
“In 2007, she lit a torch on Yom Ha’Atzmaut,” he continued. To understate, that is a major big deal. A huge honor. “I was there when she lit it.
“Back then, it was one person per torch, and there was a big thing that you had to say. A lot of people tried to memorize it and say it by heart, but they couldn’t.
“She did.
“When you see the video, you can see her daughter, my cousin, standing in the back, going through it sentence by sentence, to see if she had it right. And Shula remembered everything. She knew the whole thing by heart. She didn’t say any wrong words.
“You can’t be a spy — and for many many years she was a successful one — without remembering everything. You have to remember all the lies you’ve told, and who you told them to. You have to remember all the details.
“When I interrogated people, part of my job was to look for small details. That’s how you catch a liar. My aunt had a very long memory. She remembered everything.”
A trauma surgeon also must have the capacity for detail, the instinct for precision, and the ability to put aside emotion but retain the capacity to care deeply.
Dr. Cohen Arazi has that, and so do the other healthcare providers who have kept Israeli soldiers and civilians alive during this war. And if they are anything like Dr. Cohen Arazi, they all long to go back to the time when their main concern was car crashes and 80-year-olds falling off ladders.
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