Since the massacre on October 7, 2023, there have been misconceptions of Israel as a country and of the medical consequences of the terrorist attack. There have been charges against Israel of “colonization” and “genocide.” These accusations are accompanied by a rise in antisemitism in our communities, universities, and medicine.
As physicians recently returned from a medical mission sponsored by the American Healthcare Professionals and Friends for Medicine in Israel (APF), we feel compelled to reframe the narrative from a medical viewpoint.
In Israel, health care is centrally managed by the Ministry of Health (MOH) in coordination with the Home Front Command (HFC). Together, they manage national medical resources and prepare for mass casualties while making the Israeli health care system one of the best in the world.
On October 7, 2023, the health care system in Israel was overwhelmed despite a constant state of preparedness for mass trauma. At all times, 28 hospitals are on constant alert, can accommodate a 20 percent surge above average capacity, and can function without power for 72 hours. The scale of the massacre, which included 1500 people killed, 1500 people wounded, and 239 hostages taken, ensured that everyone in Israel and many in the Jewish Diaspora were connected to someone affected. The massacre involved 45 towns in Israel, including multiple Kibbutzim and military sites.
At Barzilai Medical Center, a hospital close to the Nova Festival, 250 casualties were seen on 10/7. Emergency room sites were added to the parking lot at Rambam Medical Center.
When Hamas or Palestinian civilians are wounded, hospitals in Israel treat them the same as they would Jewish and Arab Israelis. In fact, Soroka Medical Center in Be’er Sheva was established in 1959 for all of the people of the South, Arabs and Jews alike. At Soroka, the first casualties of 10/7 arrived at 7:37 a.m. By 9:00 a.m., 60 casualties were treated in the emergency room. At noon, 280 casualties were seen. Within hours of the attack, additional volunteers arrived, and 190 hospital patients were discharged to accommodate the incoming casualties. Within 24 hours, there were 674 casualties. Time magazine has reported on Soroka Medical Center’s heroic efforts.
During a mass casualty event, the hospital does not rely on electronic medical records but instead utilizes hand-written notes in case of a cyberattack. While caring for patients, the hospital simultaneously initiated a process to connect patients with their families. Using smartphone pictures from families, eventually, 100 percent of the patients brought in were united with their loved ones. Sadly, two of the hospital’s beloved physicians were killed during this war, Dr. Daniel Levy and Dr. Eitan Menachem Naaman. A memorial in the lobby displays the photos of nurses and other staff tragically killed.
In order to try to save as many people as possible, Magan David Adom (MDA) deployed early on 10/7 to the frontlines. Ambulance drivers and patients on board were shot at and hit with RPGs. These burned-out and bullet-ridden ambulances are now at the Nova Site Memorial Car Graveyard. Amit Mann, a beautiful 22-year-old paramedic and singer who was destined for medical school, was killed on 10/7 while actively caring for victims at an MDA clinic.
At Sheba Medical Center in Tel Aviv, one of the top medical centers in the world, we met with physicians, patients, and families. A young mother, who sustained 60 percent burns on her body, saved her husband and two-year-old daughter by running into the fire away from terrorists determined to take them as hostages. Many victims of 10/7 who have lost limbs are still being treated and rehabilitated at Sheba.
Regarding those who could not be saved, Dr. Chen Kugel, head of the Israeli National Center for Forensic Medicine, and his team successfully identified 98 percent of bodies and parts brought to their facility after 10/7. These victims’ bodies were often burned and fused together, only to be identified by radiographic techniques. Many had multiple causes of death. Dr. Kugel submitted his historical data to the Lancet.
Despite so much loss and medical casualties, the people of Israel remain resilient. Although a study from Columbia University shows that anxiety, depression, and posttraumatic stress disorder have significantly increased since 10/7, PTSD is still not as prevalent as expected. This is likely due to the resilience of the Israeli people, but also that the war is ongoing. In the North, rockets are being fired at Israel by Hezbollah daily, and people have been displaced from their homes. Most recently, 12 children were killed 12 children were killed on a soccer field during an air strike.
Perhaps the most salient aspect of the mission was learning that the resilient Israeli people feel isolated and misunderstood by the world right now. Israelis who have lived through multiple wars have never experienced anything like this. The people of Israel, the hostages and their families, and the injured are being revictimized by the damaging misinformation on social and news media.
It is true and tragic that civilian lives on both sides have been lost, another source of trauma for people who value life. However, misquoting the number of deaths in Gaza, as in a recent Lancet article, is an example of the current antisemitic climate in the medical literature. To minimize civilian causalities, IDF soldiers (average age, 20) warn the Palestinian people days before entering an area so that civilians can evacuate before combat begins. A recent New York Times article illustrates how the Hamas army hides behind civilians, often in plain clothes.
As physicians, we take an oath to “First, do no harm.” We believe that Israel, although resilient, is struggling for survival and that they are being revictimized by propaganda and misinformation. The most hopeful message we carry with us is from an IDF General, a first responder at the Nova Festival who said, “We need a ‘Marshall Plan’ for Gaza to help the Palestinian people.” Our hope is that a greater understanding of the situation will help bring healing and peace.
Karen B. Rosenbaum is a forensic psychiatrist. Frank Rosinia is an anesthesiologist.
