Rescue: heroism, innovation, horrors

October 7, Simchat Torah 5784, the tragic day that will live in infamy for the Jewish people, was also a day of incredible heroism.

The first line of heroes was undoubtedly the civilians and elite IDF units who courageously battled Hamas terrorists, many of whom made the ultimate sacrifice.

But there is a second line of heroes too, namely, the medics of United Hatzalah (UH), who ensured that hundreds of others were saved from making the ultimate sacrifice.

When my wife and I made aliyah seven years ago, our baby had a severe allergic reaction for the first time. United Hatzalah wasn’t on our radar screen. What was a traumatic taxi ride to the hospital could instead have been resolved in 90 seconds with a call to UH.

Thankfully, since 2016, UH’s ambucycle unit has grown by 40% and undergone a makeover into the ubiquitous bright orange color which is now a regular part of Israel’s landscape.

But UH’s story begins long before then — in 1989, to be precise — when a teenage Eli Beer smuggled illegal electronic equipment into Israel for the purpose of intercepting the radio signals of Magen David Adom (Israel’s Red Cross).

The story of UH’s growth is told in 90 Seconds (Artscroll), Beer’s gripping memoir. The trailblazing tale of how a middle school dropout became CEO of the largest independent, non-governmental EMS service in the world, responsible for a $50 million annual budget, is hard to put down.

The memoir kept me up into the wee hours of the night multiple times, despite knowing I faced unavoidable early alarm clocks (my children).

Lifesaving.” That is the answer most people would give if they had to sum up UH in one word. In fact, that ubiquitous bright orange color? I was sure it was marketing, part of a concerted effort the past few years to build a global brand and donor base. Wrong.

It was a safety measure recommended by an investigative committee after a volunteer’s white ambucycle slipped and was fatally hit by a car.

But a tour I received of UH’s Jerusalem headquarters led me to sum up UH with a different word: “innovation.”

This is the secret sauce of UH’s lifesaving efforts. The GPS technology that Uber used to revolutionize the world? It was first used by UH, before smartphones were even on the market.

An ATV vehicle for emergencies in the narrow, cobblestone alleyways of Jerusalem’s Old City? Invented by UH.

What gave Eli Beer the inspiration to create the famous ambucycle, which revolutionized medical first response across the globe? Witnessing a pizza delivery guy arrive quicker than the ambulance needed at that time.

“Innovation” is also code for “being one step ahead.” That is what made UH the primary lifesaving force in Israel on Oct. 7 and 8. After its rescue missions for the massive earthquake in Turkey, UH decided that significantly more supplies were needed to be prepared for a similar disaster in Israel, G-d forbid (more on that below).

Eli Beer never dreamed that UH would publish another full-length book less than a year after publishing his memoir, 90 Seconds. No doubt, he wishes that Angels in Orange was nothing but a dream — or nightmare — which we could still wake up from. But the barbarism of Oct. 7 was real. To the best of my knowledge, Angels in Orange is the first book recounting its horrors — and its heroism.

If 90 Seconds was the book I could not put down, Angels in Orange was the book I could hardly pick up. I got through about 15 minutes a day before throwing the book down in disgust at the unspeakable barbarism of the Hamas monsters.

But it is a critical book for every Jew. If you own a Holocaust memoir, you ought to own this, too. The book deserves its own review, but this article endeavors to convey some of the perspectives not yet told.

Moishe Paskesz is one of those volunteers whose story is not told in Angels in Orange, though it could have been a chapter unto itself.

First-hand account

We spoke on the phone one evening while Paskesz was zooming home from work on his ambucycle. Ambucycles, I learned, are only given to volunteers after they take a significant number of calls using their own vehicle. Unlike most UH volunteers, Paskesz was awake on Simchat Torah well before UH’s headquarters got its first call from the South. He was on call Friday night for UH’s Shabbat shift in his Jerusalem neighborhood, and 6:30 a.m. — the moments Hamas was invading Israel — found Paskesz somewhere quite eerie, in retrospect.

“The patient needed a certain medication, and where do you buy that on Shabbat morning? I went to East Jerusalem. I had no idea what was going on down south. I spent a good hour happily cruising the streets of East Jerusalem. Little did I know that if these people had any sympathy for their brethren down south, they could have just stabbed me or whatever. But what did I know?”

Paskesz went home to take a nap before hakafot, but “literally 30 seconds after my head hit the pillow, suddenly I hear a siren. I’m like, you gotta be kidding me.”

The sirens kept coming, and soon the UH dispatcher called all Jerusalem EMTs, saying there’s a war in the South.

“The last time such a call went out, in 2021,” Paskesz recalls, “it was a big nothing burger, so I didn’t give it much thought.”

A couple hours later, the dispatcher called for all ambulance drivers to go South, and when Paskesz got a personal phone call from Dr. Shlomo Gensler a short while after that, he realized something serious was going on. After a short conference with his wife and sweet six-year-old son — who told his father to “tell the people with boo-boos I wish them refuah sheleimah (a full recovery)” — he changed into weekday clothes and left.

Coming to terms with the magnitude of that day’s horrors was a multi-stage fight against the denial his brain kept trying to activate.

“Waiting outside for Dr. Gensler to pick me up, a non-religious neighbor shouted from his porch, ‘Are you crazy?’ and I replied, ‘Why? What’s the matter?’ ‘Because Hamas invaded Israel and already took 30 hostages!’ the neighbor yelled back.

“I jump in the ambulance with Dr. Gensler and ask what’s going on. We’re interrupted by a call Dr. Gensler takes involving a teenage girl whose father had both of his hands blown off and was bleeding to death. He was advising her what to do, and suddenly she asks, ‘You’re coming to us, right?’ Dr. Gensler hemmed and hawed and she exclaimed, ‘You’re not coming to us? You’re just wasting my time!’ She burst into tears and hung up.

“I turned to Dr. Gensler and said, ‘OK, but we’re on the way to save this guy, right?’ Dr. Gensler looked at me sadly and said, “No, this guy’s probably going to die.’ I said, ‘What do you mean?’”

Paskesz knew that sometimes a patient could not be helped because there wasn’t enough time. But here, they had the equipment, they had enough time, so what’s the problem? Dr. Gensler clued Paskesz in. “It’s a live-fire zone, active terrorists are on the loose, and we can’t reach these people holed up in their safe rooms.”

Paskesz couldn’t come to terms with the situation.

“I just went numb. My brain couldn’t process this. I said, ‘So what are we going for?’ Dr. Gensler said, ‘We’re going to save the people we can help.’ At that moment, I felt like my Shabbos and Yomtov (holiday) effectively ended. There would be no Kiddush, no Havdalah, no dancing with the Torah. Only saving lives.”

They arrived at Heletz Junction, by then UH’s de facto field headquarters, and found 10 ambulances lined up, waiting.

“My next inkling that it was a bigger disaster than I thought was when the operations manager started consulting on how many victims can fit into an ambulance, and someone said, ‘Maybe even eight.’

“I said, ‘eight? You’re gonna put eight patients into an ambulance?’ ‘No, no,’ came the response, ‘not patients. Dead bodies.’ This shook me even worse. I was like, ‘Why would you cram eight bodies into one ambulance when you have 10 ambulances here?’ One of them shook his head sadly and said, ‘Oh Paskesz, it seems you don’t yet understand the magnitude of what we’re dealing with here.’ And then another guy says, ‘Yeah, my friend was in the trauma room at Beilinson Hospital and said you literally cannot see the floor. It’s just a river of blood.’

“Then Gitty Beer (Eli Beer’s wife) showed up. She’d been driving an ambulance further South and reported that it’s basically like navigating a giant slalom course on the road. ‘You look around, there’s a dead child in the right lane, a dead soldier to the left, a police officer on the side, another soldier in the middle.’

“As I’m taking all this in, I’m slowly, slowly realizing that like, ‘we ain’t in Kansas anymore, Toto.’ But the human brain has a tremendous capacity for disbelief. And I was still like, ‘You know, there has to be some kind of mistake.’”

Finally, they were sent out on a mission, but what Paskesz saw next is too gruesome to put in print.

Since Oct. 7, despite involving myself in the war effort about as much as a civilian can, including a visit to a ravaged Kibbutz Nir Oz, I had had zero nightmares. That was, until the night after I interviewed Paskesz. What I heard next went somewhere deep in my psyche, and my sleep that night was punctuated by terrifying nightmares.

Coordinating with the IDF

The rest of Paskez’s story (excluding that most gruesome part) is told through the lens of his colleague Dr. Gensler, in chapter 16 of Angels in Orange.

But perhaps most noteworthy is that Paskesz went South at all.

EMT protocol is safety first, and paramedics are generally meant to wait until the danger passes before providing treatment.

Additionally, if a medic gets injured, it’s a double casualty — one more injured, and one less who can treat the injured. After a number of MDA medics were wounded or killed early on Oct. 7, MDA adhered to this protocol and forbade their medics from traveling to areas considered under fire. UH COO, Dovie Maisel, knowing full well the regular protocol, made the excruciatingly difficult decision to allow UH medics to operate under fire. It was risky, but no doubt saved hundreds of lives.

For a time, UH was viewed as a ragtag group of well intentioned but disruptive EMTs who circumvented government protocol. To understand more about how UH’s relationship with the IDF and government agencies informed its response on Oct. 7, I spoke with Maisel.

For decades, he told me, UH coordinated training exercises with various Israeli regional councils and municipalities. In 2017, though, UH was finally recognized by the Ministry of Public Security as an official emergency service.

This meant that UH is not just a nice, helpful organization, but a critical part of the response to a national disaster.

It also required the police to coordinate with UH in all drills and training exercises.

So when Oct. 7 hit, UH volunteers were prepared. In the Gaza border kibbutzim, they worked directly with the IDF, and in the Southern periphery towns, with the police. Both the police and IDF commended them for their professionalism under fire.

As the extreme scale of injured dawned on the IDF, it turned to UH for medical supplies. UH COO Dovie Maisel presumes that the IDF had supplies, but couldn’t source them quickly enough to where they were needed. UH, however, had its millions of dollars of equipment organized and easily accessible. Within 48 hours, UH’s warehouse was emptied.

A few days later, the IDF asked to borrow UH ambulances, which they did until late February. “Ask” is a nice word, because UH is required to comply as an official national emergency service. Does the government or IDF provide any compensation for using UH’s resources, I wonder?

“Nope, nothing,” is Maisel’s unequivocal answer. Thus, UH’s budget doubled from $50 million to $100 million in 48 hours.

Unnecessary Amputations

While MDA’s decision not to send its medics and ambulances South had sound logic, a different bureaucratic feud on Oct. 7 was borderline murderous and had no reasonable justification.

In December, while catching up with a family friend at a wedding, it came up that my friend’s son had been a part of UH’s helicopter unit on Simchat Torah. Our conversation ended when he commented, in a deeply bitter tone, “What idiots they (Ministry of Health) are.”

I hadn’t known UH had a helicopter unit, and for good reason. It was established less than a year prior, and not a moment too soon. On Oct. 7-8, both UH helicopters were in continuous use, evacuating the most grievously wounded IDF commandos to operating rooms in hospitals around the country (already by Simchat Torah morning, the surgical teams in Southern hospitals were worked beyond capacity). Until they weren’t.

Late Sunday morning, Oct. 8, a UH helicopter with two flight paramedics flew to Beersheba’s Soroka hospital to transport an officer from the Sayeret Matkal unit for emergency surgery in Meir Hospital in central Israel. Upon landing at Soroka, though, a representative from the Ministry of Health informed them that they didn’t have the proper permits.

The bitterness was still evident in all of the UH medics I spoke to about this, even months later, and why shouldn’t it be? As Yoni Rosenfeld noted, “You know how so many soldiers had arms or legs amputated? For some, that was completely avoidable.”

A primary reason for amputations on Oct. 7-8 was from tourniquets being applied for too long. The tourniquets are life-saving, but if left on too long, the limb must be amputated.

“Grounding our helicopters meant that dozens of soldiers only got operated on after it was too late to save their limbs.”

Since then, the Supreme Court has provisionally ruled in UH’s favor. The case is still pending.

Unity and Diversity

The organization’s name, United Hatzalah, is no coincidence. At a time that Israel holds out hope for our precious unity to remain strong, UH is doing the hard work to build the foundations of unity.

Its volunteers are 45% secular, 43% haredi or religious, and 12% Arab or non-Jewish. But it’s not just about the numbers. It’s about what UH does with the numbers. It’s about relationships. Mutual respect. Seeing the tzelem el-him — image of G-d inherent in every human — before race, ideology or religion.

As the head paramedic of UH’s Arabic volunteers, Ala Samara, a Christian Arab, told me, “For me, UH is family. UH always leaves me with a desire to give more.”

Samara, a paramedic and physician’s assistant in civilian life, sees a holy mission in saving lives, to the extent that lifesaving missions permeate his dreams.

Samara says that he does not experience racism in regular life, and never in the context of UH. In his time as a volunteer medic he did not receive cards or gifts around Christmas time, but once he suggested the idea to UH, it immediately adopted it.

Regarding the prospects of peace in Israel, Samara says, “As a kid, I went to sleep dreaming about peace. Today I also dream about peace. But I have no idea. The whole world is changing fast, I don’t know where things will go. But as I said, UH is family. It absolutely creates bridges between the different sectors of Israeli society.”

Samara concludes with a call for more attention to the Christian Arab community. “We’re a minority within a minority, we don’t make noise or cause problems. But we need more resources.”

I have nothing but praise for Angels in Orange. Surely, though, another signpost of Am Yisrael’s unity would be Artscroll releasing a book chronicling the heroism during this war of the “angels in olive green.”

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