One of the bullets had penetrated behind his left ear and was sticking halfway out of his left eye. He also had bullet holes in his left chest and abdomen. When the paramedics arrived there was no pulse, so they immediately started chest compressions, intubated him, and brought him as fast as they could to our trauma center. He arrived still without a palpable pulse or any signs of life. My resident quickly began to open his chest and perform an emergency thoracotomy. I arrived minutes after the patient, biking directly into the trauma bay on my classic Cinelli fixed-gear (which is my most loyal and reliable partner). 

We opened the left chest and found it full of blood. We clamped the aorta, then opened the pericardium, and I began compressing the heart between the palms of my hands. Blood units were pushed into him and there were a few glimmering moments of hope as his heart's irregular flutter strengthened a bit, but it quickly faded despite maximum resuscitation. Statistically there was less than a 1% chance that he would survive. He probably had significant brain injury together with the blood loss. The damage was beyond salvageable. 

I talked to his family, saying how sorry I am to his aunt, cousin, brother, and ex-wife (with whom he has a young daughter). His mother was on vacation abroad. Severe trauma is immediately most traumatic for the family and friends, as the victims’ path to understanding and realization are usually more prolonged. The lives of those close to the patients are also suddenly, and sometimes drastically, changed. They were obviously heartbroken. I laid my hand on the backs of the men as I walked out, again saying how sorry I was, even though my team had given their absolute best effort. 

An Unpredictable Attack

It was past midnight and I was walking home, rolling my bike with my right hand and talking on my phone to my parents with my left. (I was taking advantage of the late night to talk to my parents at a reasonable hour at their east coast time). An electric bicycle rider rode quickly by me in the opposite direction, muttered a profanity at me, and went on, annoyed at something, I guess. I kept walking and talking, enjoying the silent debriefing of the quiet cool spring night after a couple of hours of blood, noise, and eventual death. Suddenly something hit my left shoulder from behind, knocking my phone and helmet to the ground. I saw that same biker speed on forward and away. 

This brought me back to my lacrosse days; it felt like one of those nice hits from one of my muscled foes at some arch-enemy high school. The blood was not yet fully dry on my black Blundstones from the night's trauma, and for some reason (or no reason) a complete stranger wanted to physically harm me. Unlike high school rivals based on mascots, history, and legends, this was an unpredictable hit solely due to my mere existence at a certain place and time. 

With the blood still wet on my boots, my first thought was ”What is the point?” Jewish or Arab, I don’t know what he was or what he thought I was. Maybe it was just man versus man, with no religion or ethnicity involved. I don’t know. But this is what came to mind because in the last weeks all we have heard about, and felt, are shootings, violence, and hate messages going back and forth. During this recent trivector of Passover, Good Friday, and Ramadan, the Path to Freedom, Resurrection, and Reflection all seem to be leading to lost hope, unnecessary death, and destruction of any last bit of humanity and civility we have left.

Why Care About Others?

Any healthcare worker has a front row seat to see, and feel, the fragile balance between life and death, to smell and hear the end of a life or the hope for a few more joyful moments. And we have all read editorials over and over again focusing on our region, demanding change in some witty and intelligent way. Yet again, as the days pass, we are stuck under the same gravitational pull of violence, oppression, and resentment. 

So what is the point? What is the point of caring? Of being married to my work? To try to care and do good with actions more than words. What is the point of thinking about wanting to be more with my two children than actually being with them? What is the point of endlessly asking (practically begging) for donations for specific projects that bring Israeli and Palestinian surgeons together, instead of working in a private hospital? As my senses are surrounded by life and death every day, what is the point of thinking beyond the patient in front of me? Past the hours I get paid for? 

What is the point of being idealistic (or maybe it's more naive and egotistical) and thinking that there is hope, that there is an opportunity to change, to operate together. That we can create a peaceful reality, in which the moments of life are dominated by laughter, friendship, respect, trust, good food, and mornings at the Tel Aviv beach followed by dinners under the moon in Gaza (for everyone!) If not for me and some crazy interesting date (I’m divorced (twice), hopefully at least for my children. 

So I will tell you the point. The point is that this peaceful equilibrium can happen and will happen. As the ground appears to be crumbling at an astounding rate below our bare feet, this is when our actions will shine. This is when we (the masses, not the politicians) need to make individual relationships, small partnerships, to begin to work together on common interests. Help each other succeed. Meet each other's families, eat together. Operate together, shoulder to shoulder or across from each other, together trying to save the one person in front of us.

These individual relationships are what will change policy, are what will rise beyond religion, dogma, and history. These individual relationships based on respect are what we have to build.  If we do not do this now, all of our lives will end prematurely. If not physically, then emotionally, as we will miss out on the pleasures and gifts that this beautiful and short life have to offer. So with our children by our sides, as the blood finally dries on my shoes, please help me move forward together, now, because this is what we all deserve, and what needs to happen.