"Hi.  אני ד"ר עלמאן רופאה מארה"ב ובאתי להתנדב לשבועיים. האם אתה מדבר אנגלית?  I'm Dr. Ellman, a doctor from the United States and I have come to volunteer for 2 weeks.  Do you speak English?"  That was how I introduced myself to every patient over the two weeks at the end of June that I spent at Schneider Children's Hospital in Petach Tikvah on a medical mission from JOWMA.  And every time, this simple statement was met with a very grateful smile and a feeling of love and support that was actually visible.

To give you some background, I am a Pediatric Emergency Physician in Orlando.  I am originally from Brooklyn, where I went to Shulamith for 15 years.  I then went to Princeton, followed by Einstein.  I did my residency in pediatrics at, then, Schneider Children's Hospital of the LIJ system (now Cohen's of Northwell).  I then moved with my husband and our one year old to Orlando in order to do my PEM fellowship at Arnold Palmer Children's Hospital.  That was 14 years, 4 more children, B"H, and one high school (Yeshiva of Central Florida) ago.  

As with so many of you, things had settled into a routine until October 7th.  After the horrific attacks on our people that day, I found myself struggling to find a way to help from afar.  Like thousands of others, I signed up with the Israel Ministry of Health and anywhere else that said it could help facilitate medical missions to Israel.  Since Israel is a country of reservists, it was clear that there would be medical needs throughout the country, both for the military and civilians.  I knew that I would not be able to help with the IDF, but was hoping I could help to fill the resulting gaps, wherever they might be.

As I was waiting to be called upon, I was in touch with other physicians who were organizing medical supplies for Israel in the tristate area.  I brought this idea to the Florida Physician group where others were able to work out the logistics of getting supplies to Israel.  I organized the Central Florida effort.  I found that the hospital systems and local physicians were eager to help and with the help of Yeshiva of Central Florida, who funded the trucks, I was able to send 5 truckloads of medical supplies to South Florida for shipment to Israel.

Being able to send the supplies allowed me to feel useful and like I was doing something to help with the war effort.  But as I told a reporter who interviewed me at the time, I was still really hoping to be able to go to Israel to help directly.  And I almost had my chance in October.  I was told that there was a joint JOWMA/EVP mission leaving in a couple of days.  I told them to count me in, but there was just a small detail of an expired passport.  I made two trips to Miami in between night shifts, slept on the plane and the train, cried to the security officer, and eventually got my passport but it was too late for that trip.

For months after, I continued to hope for a way to go help.  I spoke with MDA but they didn't really need pediatricians.  I filled out paperwork with Ziv hospital in Tzfat but never heard back.  And I looked into giving trauma lectures at Ichilov but nothing came of it.  And I drove Dr. Mira Ostrow crazy with my frequent messages.

Finally, around April I had my chance.  JOWMA told me that Schneider Children's was looking for help.  I started to make trades with my colleagues to go in May, but was then told that June would be better.  While the trades proved harder to make than I expected (and left my boss a bit frustrated), I was able to clear two weeks.  And I am so glad.

I took the train to Miami early on Sunday morning and then took the shuttle to the airport.  When I told the shuttle driver that I was going to volunteer in Israel, he was touched and said he would not charge me the $10.  That attitude of appreciation would be something I would see constantly over the next two weeks.  

I finally arrived in Tel Aviv early Monday morning and spent the next 12 hours at the hospital.  The first day involved a lot of settling in and learning the ropes. To help me get acclimated, I was initially paired with Dr Dennis Scolnik, the former director at Sick Kids in Toronto who has recently made Aliyah and came out of retirement after October 7h to volunteer at Schneider's for months now. 

The overall culture in the ED in Israel is similar to America.  But there are some big differences.  The first thing I noticed is that our HIPAA laws obviously don't exist in the same way in Israel.  This has both pros and cons, as families were constantly standing at the desk and interrupting medical conversations. The flow in the ED is also very different, with the parents expected to advocate and fend for their children in more ways than in my ED in Orlando.  But the medicine is the same and the team helped me to quickly become comfortable in the department.  

On my first day, there was a girl with Down's Syndrome who had presented for shortness of breath.  I had helped in her care and she was still working pretty hard at shift change, and so I stayed to help with her.  I suggested that we put her on high flow vapotherm and she responded very well.  I noticed that staying past shift change seemed to be helpful and very appreciated, and so I tried to do that on most of my days.

Due to some technical glitches, I did not yet have my housing set for the first night.  When Dr Gal Altberg, the evening attending, heard that, she immediately told me to stay at her house.  I felt very welcomed and it was a clear reminder of why I was there in the first place - we are one family.

While I was slightly limited in having only a temporary Israeli Medical license, I was able to easily find my place with the team.  I became responsible for the stagerim, or interns.  They would present their patients to me and I was able to guide the management and teach them (and they helped me translate).  I gave many impromptu lectures on pediatric emergency medicine, as I had more time than the regular attendings.  I also took over some of the more time consuming procedures. 

During one shift, an IDF soldier in uniform and his wife had brought in their daughter for stitches.  I tried to express my gratitude for what he is doing to protect our people and our land, but he kept thanking me for coming to volunteer.  The father also tried to make the daughter feel better by telling her that she would get to be stitched up by an "American doctor."  While it did make her smile, I have no doubt that the skills of my Israeli counterparts are just as good.

I was very impressed with the level of knowledge of the stagerim and residents and it was truly a pleasure to practice alongside them.  When we had an unresponsive teenager brought in, the energy and flow in the resuscitation room were identical to my ED, except for the language.  One thing that was different was that bedside ultrasound is used much more routinely than in my own department.  I got to be on the receiving end of some education, as well!

I also had the opportunity to catch up with Dr Yehuda Sabiner, a close family friend.  He is finishing his pediatric residency after initially going to medical school through the IDF.  I was able to hear about some of his 6 months in Gaza as a doctor with the medical corps.  He focused on the huge importance of having blood in the field and how life saving that was.  He was also the first to tell me a line I then heard repeated two more times.  "Salt water is for pasta!"  They do not give lactated ringer for traumatic injury, but go straight to blood.

On my second to last day in Israel, Dr Ron Berant presented me with a Schneider sweatshirt as a token of appreciation.  He then invited me to join most of the team at the Israel Association of  Emergency Medicine annual conference that happened to be the next day.  This turned out to be incredibly fortuitous for me.  For my last night in Israel, I was again invited to stay with one of the attendings, this time Dr Lisa Amir, one of our own special JOWMA members.  And the next morning we headed to the conference.

The focus of the first half of the conference was October 7th.  They had members of the IDF medical corps, MDA, United Hatzalah, and the directors of the three major ERs present from their point of view.  They focused on the successes and failures of that day.  It was fascinating to hear from each of them.  These organizations are all specialists in Disaster Medicine and MCI and it was incredible (and heartbreaking) to hear some of what they went through and how many people they were able to save.

While the trip was primarily focused on helping in the ED, I did find time at night to do many other things that I was hoping to accomplish.  Despite nearly 80 hours of medicine over my 11 days, I was also able to help pack boots, tie tzitzit, go to an army BBQ, visit wounded soldiers, and go on a bear witness tour to Nova with a survivor.  I was also incredibly fortunate to hear Einav Danino speak about her son Ori who is still being held hostage.  She is an amazing example of emunah.  I also went to a hafrashat challah event with Yelena Trufanov.  This was extremely emotional as it was both a Seudat Hoda'ah for her own release from Hamas and a zechut for her son Sasha, who is still being held.

All in all, the trip was incredibly special for me, as I really got to feel that I was doing my small part to help make a difference.  Throughout my time there I got a better sense of why my coming was so useful.  The doctors there have a hard time admitting it, but they can use help.  After October 7th most of the attendings were not available due to miluim or other pressing needs around the country - for example, Dr Amir went to Eilat for several weeks to help them deal with the influx of patients due to the displacement of Israelis around the country.  In addition to losing so many attendings, 20% of the residents were called to miluim.  Imagine trying to run your hospital with 20% less residents!! 

They finally got back up to 60% of the attendings being present around April.  However, while most of the team is now back, 30% are still called intermittently to miluim.  And even the staff who were not directly in Gaza, were almost all affected by a spouse or child being called up.  Many have been taking care of generations of their family while also taking on added shifts to cover for their colleagues. Being stretched so thin has left a mark and everyone is tired, though they do their very best not to show it.  I am grateful to JOWMA and all the other organizations who have tried to help fill this void.

While I went to Israel to do a small part to help, I think I actually came out way ahead.  As a friend of mine remarked when I told her all about my trip, "it sounds like you really got so much out of this trip."  I really did and I just hope I gave back a fraction of what I gained.  Thank you, JOWMA!