With new simulation program, IDF doctors train to save real lives
Amid a relentless wave of Palestinian terror and violence, the army’s West Bank medics are utilizing a state-of-the-art hospital center to hone their skills
Judah Ari Gross is The Times of Israel's religions and Diaspora affairs correspondent.
Three people were injured in a shooting attack, two of them seriously, inside Tel Hashomer Hospital near Tel Aviv on Thursday morning. In the room next door, two people were stabbed.
The “people,” however, were plastic dummies — dolls that mimic the circulatory and respiratory systems of human beings. And they weren’t actually shot and stabbed, but they acted like they had been.
In order to train its doctors, paramedics and medics for emergency combat scenarios, the IDF started using the Medical Simulation Center at Ramat Gan’s Tel Hashomer Hospital in October — as an ongoing Palestinian terror wave gathered pace. Through the center, which goes by the abbreviation MSR for the Hebrew Mercaz l’Simulatzia Refu’it, army medical personnel practice triage and first aid in real-life scenarios, but without the real-life casualties, Col. Dr. Hagay Frenkel, chief medical officer of the IDF’s Central Command, said.
Tall and commanding, with a Marine Corps-style “high and tight” haircut, Frenkel helped develop the army’s program and oversaw Thursday’s exercise.
The IDF has other training facilities, including a state-of-the-art center at Ir Habahadim — the army’s “city” of training bases — in the Negev desert. But none compares to the MSR at Tel Hashomer, Frenkel said.
In the MSR, sound systems provide realistic effects — a helicopter flying overhead, explosions — and multiple cameras installed in the training rooms allow the medical teams to review their exercise to find how they can improve, Frenkel said. (The sound system can also be used to play music at the end of an exercise; after Thursday’s, it was “Adventure of a lifetime” by Coldplay.)
Last month in his Jerusalem office, Frenkel showed The Times of Israel a text message he had received — proof of the MSR’s efficacy, he said — from a combat medic in the Central Command thanking him for the training program, and telling him that she had successfully used one of the intubation techniques she had learned in Tel Hashomer while deployed in the West Bank.
Getting better all the time
The combination of the MSR training and on-the-job experience gained in the past four and a half months of increased violence in the West Bank have improved the capabilities of the Central Command’s Medical Corps, Frenkel said.
“We’re better than we were on October 1,” he said.
It is difficult to numerically measure Frenkel’s claims of improvement, as a whole host of factors can impact an attack victim’s chances of survival — including severity of the wounds, response time, and distance from a hospital. There are some cases where even if a person were injured in the middle of an operating room, medical personnel still wouldn’t be able to save them.
“But I investigate every time there is an event in which someone could be saved,” Frenkel said. “Are we perfect? No, we’re not perfect. But we’re okay,” he said.
Too much experience
The IDF’s doctors and medics have unfortunately had plenty of opportunities for real-life training, with hundreds of people injured on both the Israeli and Palestinian sides in recent months.
As part of the IDF Medical Corps’s oath, soldiers are required to provide treatment for victims and attackers alike. “I swear on this day to give a helping hand to every injured and every sick… if it is a friend or an enemy, and to every person as a human being,” the oath reads.
The IDF, along with the civilian Magen David Adom ambulance service, has faced criticism for this practice of treating assailants, even from within its own ranks.
“In the Medical Corps, no one put a question mark on whether we need to do that. But in the army in general, is there an argument? Yes,” an army official admitted, though he called the discussion on the topic, “healthy.”
Regardless of the criticism, the officer said, “we teach people to treat based on the severity of the victims’ injuries, not their religion.”
Some Palestinians and left-wing groups, meanwhile, have accused the army of responding too slowly to Arabs wounded while attacking, or believed to be attacking, IDF troops.
‘We teach people to treat based on the severity of the victims’ injuries, not their religion’
Any delays in treatment, an IDF officer responded, come from the medical teams waiting for the all-clear from the troops on the scene. During the second intifada, terrorists would sometimes use secondary explosive devices to kill emergency responders. As a result, medical teams today have to be more cautious when approaching even apparently disarmed and disabled attackers, the officer noted.
The IDF has indisputably treated numerous Palestinians who were injured when attacking soldiers and civilians. In October, an army doctor used a new and expensive dried plasma treatment to save the life of an Arab man who was injured near the Tapuah Junction in the northern West Bank while trying to stab a soldier.
A much-needed refresher course
Dr. Amit Alfassi, a captain in the reserves, and his team of four medics came to the Medical Simulation Center on Thursday, taking a break from a larger exercise for the Hetzei Ha-Esh Reserves Brigade in the Tzeelim army base in southern Israel.
While the rest of the Hetzei Ha-Esh Reserves Brigade trekked through the mud and dirt of the northern Negev, Alfassi and about a dozen other IDF medical personnel worked in the relative comfort of the sprawling Tel Hashomer campus to hone their professional skills. The reservists are called in to train about once a year, Frenkel said, but this was their first time in the MSR.
The Central Command’s medical personnel train with the center three times a month. The doctors and medics travel to Tel Hashomer twice a month, while the MSR staff brings its equipment to the command for in situ training once a month.
For doctors and paramedics, who work in medicine on a constant basis in civilian life, these training exercises are helpful refreshers on the finer points of combat medicine.
In civilian life, Alfassi, a father of three daughters, works as a doctor in family medicine clinics in the northern city of Nahariya and the surrounding communities. For him, these exercises provide the opportunity to be again familiarized with the demands of working in a combat team and with the latest in emergency medicine.
But for the regular combat medics these drills are vital, as only a small fraction work in a medical profession after the army, Frenkel said.
“We encourage them to volunteer with Magen David Adom,” Frenkel said, referring to the Israeli ambulance service. “But we can’t force them.”
And if volunteering with MDA was required, he added, “we wouldn’t have any medics.”
‘I think he’ll make it’
At the MSR on Thursday, Alfassi’s team arrived to the scene of what was supposed to represent a shooting attack with three victims.
Before entering the room, his team had divvied up tasks and prepared their equipment — something that would normally be done during the ride to an attack scene, Alfassi said.
After a brief moment of “not confusion, but, you know, a second to figure out what needs to be done,” the team set to work, Alfassi said.
The MSR’s operators, one army officer and a civilian, monitored the team’s progress from a control room and added the special effects designed to make the exercise more realistic.
“Leave me alone! Leave me alone!” one of the operators shouted into the microphone to mimic an uncooperative patient.
Alfassi and his team of four medics treated the three patients, giving intravenous fluids and medications to two of them who were seriously wounded.
Gunshot wounds, he said, are particularly difficult because it’s nearly impossible to know in the field the extent of the internal injuries the patient has suffered.
Alfassi and his team stopped the bleeding, which is the main immediate threat to life, and mostly stabilized the patients. “The team worked well,” he said afterwards.
One of the victims would still need to have his chest drained by the medical team on the imaginary helicopter that arrived to take them away, Alfassi said. “It’ll be close,” he said, “but I think they’ll make it.”
