What Boston hospitals learned from Israel


Minutes after a terrorist attack killed three at the finish line of the Boston Marathon, doctors and nurses at the city’s hospitals faced a harrowing scene — severed limbs, burned bodies, shrapnel buried in skin.

For Boston doctors, the challenge presented by last week’s bombing was unprecedented — but they were prepared.

Many of the city’s hospitals have doctors with actual battlefield experience. Others have trauma experience from deployments on humanitarian missions, like the one that followed the Haitian earthquake, and have learned from presentations by veterans of other terror attacks like the one at a movie theater in Colorado.

But they have benefited as well from the expertise developed by Israeli physicians over decades of treating victims of terrorist attacks — expertise that Israel has shared with scores of doctors and hospitals around the world. Eight years ago, four Israeli doctors and a staff of nurses spent two days at Massachusetts General Hospital teaching hospital staff the methods pioneered in Israel.

According to the New Yorker magazine, every Boston patient who reached the hospital alive has survived.

“We had periods where every week we had an attack,” said Dror Soffer, director of the trauma division at the Tel Aviv Medical Center, who participated in the delegation. “It becomes your routine.”

Techniques that were “routine” in Israel by 2005, and helped save lives in Boston last week, began evolving in the 1990s, when Israel experienced a spate of bus bombings. Israeli doctors “rewrote the bible of blast trauma,” said Avi Rivkind, the director of surgery at Jerusalem’s Hadassah Medical Center, where 60 percent of Israeli victims have been treated.

Much of what Israel has learned about treating attack victims was done on the fly. In 1996, a 19-year-old soldier arrived at the Hadassah hospital following a bus bombing with severe injuries to her chest and esophagus. Doctors put chest drains on her lungs and performed endoscopies twice a day to stop the bleeding. Both techniques are now regular practices.

“We were sure she was going to die, and she survived,” Rivkind said.

Rivkind is an internationally recognized expert in terror medicine and widely considered one of the great brains behind Israeli innovations that have been adopted around the world.

Trained at Hebrew University, the Hadassah Medical Center and the Institute for Emergency Medical Services Systems in Baltimore, he has contributed to several volumes on trauma surgery and post-attack care, and authored a number of seminal medical studies. Rivkind was the personal physician for the late Israeli President Ezer Weizman, helped care for Ariel Sharon when the prime minister fell into a coma following a stroke, and has performed near-miraculous feats, once reviving a soldier shot in the heart who had been pronounced dead in the field.

But not everything Rivkind has learned about treating attack victims comes from a story with a happy ending. In 2002, Shiri Nagari was rushed to Hadassah after a bus bombing. She appeared to have escaped largely unharmed, but 45 minutes later she was dead. It was, Rivkind later wrote, the first time he ever cried after losing a patient.

“She seemed fine and talked with us,” he said. “You can be very injured inside, and outside you look completely pristine.”

Organizing the emergency room, Rivkind said, is as important as treating patients correctly. During the second intifada, Hadassah developed what he called the “accordion method,” a method of moving patients through various stages of assessment with maximal efficiency. The process has since become standard in hospitals across Israel and around the world.

Task force to reassess Ashkelon ER move


Prime Minister Benjamin Netanyahu has ordered a task force to re-evaluate a Cabinet decision to relocate the planned construction of a reinforced emergency room in southern Israel.

Israel’s Cabinet approved by one vote on Sunday a plan to relocate Barzilai Medical Center’s planned underground secure emergency room to a site farther from the Ashkelon hospital because ancient graves were found on the site.

The task force, to be headed by the director-general of the Prime Minister’s Office, Eyal Gabai, was instructed to find a solution that would preserve the sanctity of the dead while ensuring the security of patients, according to Haaretz. Recommendations will be presented to Netanyahu after Passover.

Deputy Health Minister Yaacov Litzman, a haredi lawmaker from the United Torah Judaism party who heads the ministry from the No. 2 spot, initiated the change after the discovery of the bones on the site set aside for the new emergency room. Experts from the Israel Antiquities Authority have assured Litzman that the bones are pagan or Christian and may be moved, but Litzman insisted they are ancient Jewish gravesites.

The director-general of Israel’s Health Ministry, Dr. Eitan Hai-Am, resigned immediately after the vote.

The cost of moving the emergency room to a new site from its current planned site will cost an additional estimated $42.7 million. A private donor who had pledged more than $10 million for the original site is now reconsidering the donation, Haaretz reported.

An Affair to Remember: Hollywood and the Jews


Oscar night is almost upon us, and there is considerable talk (and pride) about three of the chief contenders — Halle Berry, Will Smith and Denzel Washington — all of whom are black. But don’t be fooled: Hollywood and the film industry is still primarily a Jewish story, no matter who deserves and carts off the evening’s prizes.

No one ever said the story itself — about American Jews and Hollywood — was not complex. Founded by East Coast Jewish immigrants at the turn of the 20th century, the movie industry had looked at first like a nickel-and-dime nickelodeon enterprise that catered to working-class American newcomers. By the time the movie entrepreneurs pulled up stakes and relocated to Los Angeles (roughly between 1907 and 1918) it was too late for the gentile business establishment to elbow its way to an insider’s place at the table.

By the 1930s, the industry was generating great profits, despite the Depression. It had also become highly personal for the Jewish moguls running Hollywood. There’s a story Neal Gabler recounts (in his book "An Empire of Their Own: How the Jews Invented Hollywood") about Louis B. Mayer, the head of Metro-Goldwyn-Mayer, holding movie star Mickey Rooney by the lapel and shaking him. Mayer was furious: "You’re Andy Hardy," he shouted. "You’re the United States. You’re the stars and stripes. Behave yourself. You’re a symbol."

Part of Mayer’s anger, of course, had to do with business. Rooney, still in his late teens, was the star of the "Andy Hardy" series of films, the No. 1 box office draw at MGM. Rooney’s escapades with women were liable to tarnish his image and send ratings down. But much of the anger also had to do with Mayer’s vision of America as an innocent, pure nation.

It mattered little that he was a ruthless studio head and businessman. The America he was projecting in films, and that he idealized, was a glorified land of promise and happy endings, of small-town family life brimming with virtue and filled with a mythic Western past. And it contained no Jews.

In the late 1930s, Mayer’s salary was the highest in the nation. However, he was still considered an outsider by the wealthy non-Jews of Los Angeles. He joined the Hillcrest Country Club, all of whose members were Jewish, because no other club would admit him.

Mayer and his fellow studio heads took this to heart. They bought into the rejection, viewing themselves as somehow socially inferior to the upper-class gentiles they longed to join. But in business, they prided themselves on being a step ahead, very much attuned to the popular culture. Except for the first talkie film, "The Jazz Singer," which was seen as a bold experimental gamble, Jews were considered bad for the box office and were excluded as characters in films and in the portraits of America that were projected, while Jewish actors were forced to Americanize their names.

When "Gentleman’s Agreement," a film dealing with anti-Semitism, was finally made after World War II, neither its producer, Darryl F. Zanuck, nor its director, Elia Kazan, was Jewish.

All that changed in the middle of the 20th century, both with the demise of the studio system and with the advent of television. Today, actors and actresses keep their own names, even when they sound Jewish (e.g. Alicia Silverstone, Adam Sandler, Richard Dreyfuss). Some, Gwyneth Paltrow for example, even make a point of extolling their Jewish heritage; in her case, on her father’s side of the family.

Many films today contain Jewish characters, often military officers, doctors, lawyers, judges and academics, as well as upper-middle class couples; some films have Jewish themes or central characters (e.g. "The Royal Tenenbaums" and "Schindler’s List") and three documentaries about Jews, produced by Rabbi Marvin Hier’s Museum of Tolerance, have won Academy Awards in the past six years.

It is no secret today that many agents, writers, entertainment lawyers and film producers are Jewish. British screenwriter William Cash lashed out at what he identified as "Jewish Hollywood" in the 1990s. He claimed that writers he knew attempted to pass as Jews hoping this would give them an inside edge. No one disputed the story, though most critics indicated that Jews and non-Jews competed on an equal playing field. It was craft and talent, not ethnicity, that secured a writing assignment.

Nevertheless, it has been this sense of a Jewish presence, a Jewish sensibility, within the popular culture that has helped reshape attitudes toward Jews in America. The themes of television’s sitcoms and dramas, while not Jewish, are often reflections of a modern, urban liberal point of view (think "The West Wing," "ER" and "Friends" today; "All in the Family," "Seinfeld" and "Brooklyn Bridge" in the past). It is no accident that Dan Quayle and Pat Buchanan attacked television and films for debasing our culture. Violence and sex made the headlines, but they believed the point of view they were assailing was one held by liberal and secular Democrats. Some Jews in Hollywood saw the attacks as thinly disguised anti-Semitism.

Buchanan and Quayle aside, it is interesting to chart the path that led to the turnabout in attitudes toward Jews in America, to analyze what caused the 180-degree turn that propelled Jews from being outsiders to insiders in America. There is certainly the Holocaust and the horror and guilt that accompanied it; the end of university quotas, both for students and professors; the emergence of Jews as lawyers in major firms and as law school deans in prominent universities. All of these played a role in admitting Jews to the American establishment.

But the imprint of culture — both popular and high culture — on a society that turns often to entertainment and art for both leisure and class status cannot be overestimated. During the second half of this century, we have seen the rise of Jewish writers in America — Saul Bellow, Arthur Miller, J.D. Salinger, Philip Roth, Cynthia Ozick and Rebecca Goldstein — all of whom have functioned as our nation’s Mark Twains and F. Scott Fitzgeralds, our successors to Ernest Hemingway and William Faulkner. We are, after all, a nation that proudly exports culture — along with Coca-Cola and jeans — to the rest of the world.

Domestically, the impact has led to a different outcome. Films and television have affected all Americans and, in the process, have helped integrate Jews into America. They have also introduced Jewish words, style and feelings into our national identity. Ironically, it is the last thing in the world that Mayer and the other Hollywood moguls desired. They wanted their America simple and small-town innocent — and without any tribal relatives.

Come Oscar night, we might recognize the unintended consequences of the world they helped create. We Jews are perhaps the greatest beneficiaries of the dream industry. And whether or not Washington, Judi Dench or Ron Howard are Oscar winners, it does not alter the profound role that Hollywood has played — and continues to play — in the lives of America’s Jews.