Bamba !

No Comments

You know sometimes you get a feeling of impending doom, like something bad is about to transpire.

That’s not what happened that fateful Shabbat afternoon. On the contrary, driving to the address, I was ever so relaxed, and for good reason. The call was for an infant choking and statistically I was supposed to arrive to find relieved parents and a smiling baby – having already coughed out the foreign object.

I have responded to hundreds of “chokings” and thankfully the patient is mostly not choking once I arrive. The Heimlich is important and does save lives, but even a veteran EMT will have only experienced a handful of “the real thing” in his career. A complete airway obstruction is a rarity, thankfully.

Unit#22 was sitting behind me on my Ambucycle, getting an earful of how I desperately wanted to return to my wife’s London broil. We are neighbors and often respond together on Shabbat. I drive and he navigates, as would a wingman in the air force. I say navigate but I mean pray – both for the patient that we are about to greet and for us, that G-d take us to our destination safely.

And in case you were wondering, I am a stupendous pilot.

We were both mid-meal and looking forward to returning to our families with the good news that all was well. But thoughts of serenity flew out of the window visor, as we turned the corner. A handful of neighbors were manning the curb, screaming and waving hysterically. Screaming to the heavens and waving at us – His messengers.

Oops, pressure’s on – this is it – the real deal.

Huge adrenaline rush, quick revision of protocols, and five seconds later we land on location; #22 jumps off mid-park and runs gloriously to the rescue. I follow 15 seconds behind laden with my equipment and defibrillator, looking slightly less glamorous. People shove/point me in the direction of the apartment, but I don’t really need much guidance – #22’s blaring voice comes from the first floor and says, with absolute conviction;

“Shmeel – CPR on location – I need you NOW.”

This is where autopilot kicks in; when a medic’s mind makes split second decisions based on both training and experience.

I know it’s a respiratory arrest. I know it’s a baby. I know what I need to do.

I know what equipment I’ll need. I know what my job is and #22, far my senior, certainly knows his.

Almighty G-d – please, please help.

I run inside and in the doorway behold the scene in an instant. Baby is blue lying on the couch. My partner is doing compressions. Mum is sobbing violently. Granddad is saying Psalms. Grandma is screaming BAMBA! And Dad is nowhere to be seen.

I throw my stuff on the other side of the couch and take out my BVM (bag valve mask) or as we call it in the field, AMBU (Artificial Manual Breathing Unit). I’ll use this to force oxygen into the toddler’s lungs. I glance up at the child – I need to know what size ‘airway’ to use. An Oropharyngeal airway is a rigid plastic curved device, which, in laymen’s terms, ensures the airway remains unobstructed by the tongue. There are several sizes (color coded) depending on the size of the patient. In the classroom you measure this in slow motion, but now I instinctively reached for the black and insert it carefully into the two year olds mouth.

AMBU covers face and I squeeze a bag-full of O2 into her lungs.

On cue in run #74 and his ambulance team. He is a sweetheart and a solid professional to match; definitely someone you want around in an emergency. He too does an assessment and decides on the next two items on the ‘to-do’ list.

One: move this scene to somewhere less soft. A couch is no place for a CPR; it lessens the efficiency of the compressions. He chooses the dining room table, counts to three and all of us move in sync to the new venue. He wants to better position himself and so he jumps onto the table and kneels amongst Shabbat delicacies, with the baby’s head in between his legs. From this vantage point he can control the scene, his teammate’s actions and also manage the airway properly.

Two: he shouts for someone to connect defibrillator pads. There is hardly any room on her tiny body for the stickers. The AED does its automatic assessment and decides “No Shock Advised.” Bad News.

#22 continues compressions. #74 holds the mask with both hands snugly to the face and shouts commands. #44 looks for a vein to start a line. #76 prepares suction and its accessories. #18 breathes air into the lungs every few seconds. That’s me.

Three minutes pass although her mother later told us it felt like thirty. The baby moves. Or is it my imagination. Nope she moves again and this time tries to breathe as well. Cautious optimism now. Everyone continues what they’re doing but now in silence and in that complete silence we hear it, a squeal or perhaps a sob, doesn’t matter – there’s a pulse. She’s alive.

The Advanced Life Support team walk in and the baby starts crying weakly, though still with eyes closed and not completely conscious.

“The baby has a pulse and is breathing spontaneously,” Chief Paramedic bellows authoritatively, “What’s all the fuss about?”


Someone attaches an oxygen mask and the ALS team carry the patient to the ambulance for immediate transport. This seemed very much like a happy ending, but she wasn’t out of danger yet.

We stayed upstairs to pack up and offer a not so silent prayer that there would be no permanent brain damage and that Malka return to her absolute self.

He heard our prayer.

Sunday: Malka is discharged from the hospital and the family is reunited back home.

Monday: Malka is her normal bubbly self and does a photo shoot, to boot.

Tuesday: I get a ‘Thank You’ package that includes wine, treats, and a picture of a smiling Malka.

Wednesday: Extended family, friends, and EMTs are reunited at a gala event to recount, remember, and thank G-d for the Miracle.

The miracle of life.


Postscript: There aren’t enough words in any language, or any lexicon, to thank G-d for happy and healthy kids. If your kids are well and healthy but are screaming, fighting, jumping, and generally causing you to tear your hair out on a Shabbat afternoon. Take a deep breath and say;


And if you want to invite me for a Shabbat meal, by all means, but no Bamba please.

A Tale of Two Newborns

No Comments

They had entirely different responses, one sobbing quietly, the other remarkably calm – the mothers.

They were crying insistently and incessantly and with definite purpose – the patients.

The patients in both stories were newborns, one but a week old.

Brand new souls entrusted to brand new mothers.

New mothers who made good and sometimes preposterous decisions.

Decisions that would have unfortunate consequences.

Consequences that would involve – you guessed it – yours truly.


One would hope that the most serious calls would get the fastest response. But that’s not always the case. In fact in the forthcoming tales I was on scene in mere seconds, when the emergency was, well, not really an emergency.


Tale 1 – Good Judgment

I was literally sitting on my bike, talking on the phone, immediately outside the building wherein the emergency occurred. Lightning fast response, for an absolutely immaterial call. What a waste.

Murphy’s Law 1 – The Desperate and Needy 0


The beeper said:

2 Week old Baby – Miscellaneous medical problems – Ingrown Toenail.

I know – I did a double take as well – how could that possibly be true? Don’t ingrown toenails take weeks to develop and involve some fault on behalf of the subject, such as cutting too close?

I was on location before the mother had put down with Control.


Act One:

“Hello Madam – what seems to be the problem?” I asked the stoically calm Kimpeturin.

“My baby had an ingrown toenail – treated several days ago by a podiatrist – and is now behaving curiously,” was the ‘matter of fact’ response.

Still no wiser – neither about the toe nor about the baby.

I asked the same question again, phrased differently – and got the same response, phrased differently.


Act Two:

Do a once over of the infant.

Get a comprehensive medical history.

Procure a complete set of vitals.


This was sure to uncover the underlying problem. But – it didn’t.


Act Three:

Pretend you understand the whole situation.

Make believe everything is under control.

Get the baby to a hospital.


Worked like a charm.


I had now been on scene for about 3 minutes when Unit #22 joined the baby shower, bearing a heavy EMT knapsack, instead of gifts.

“What’s going on?” he asks, breathless from the 2 flights and his decade seniority.

“Her baby had an ingrown toenail – treated several days ago by a podiatrist – and is now behaving curiously,” I repeat verbatim, with a hundredth of a tinge of sarcasm in my voice. #22 immediately knows what I am insinuating and takes the mothers side.

I could sense the speech coming. My mentor had lectured me tens of times on this matter. And so it begins…

“A Mother always knows best. If a mother says that something is wrong with her child, you have to trust her unconditionally, irrespective of your clinical findings!”

Aye Aye Captain.

Ambulance comes, transports mum and child, and, if you must know, there was something awry with the baby and she spent several days in hospital recovering.

From what? Only Mum knows.


Tale 2 – Bad Judgment

No I don’t normally sit around on my bike, on my phone, waiting for calls, but;

I was literally sitting on my bike, talking on the phone, immediately outside the building wherein the emergency occurred. Lightning fast response, for an absolutely immaterial call. What a waste.

Murphy’s Law 2 – The Desperate and Needy 0

The Beeper said:

1 Week old Baby – Miscellaneous medical problems – Too Relaxed.

I know – I did a double take as well – how could that possibly be true? Don’t mothers hope and pray that they give birth to children who remain calm and relaxed and sleep through the night?

I jog to the door of the building and meet the mother in the hallway coming towards me from her apartment located at entrance level. She hands me the baby, as is the custom in times of panic, and for good measure yelped “Help!”

I do a one second observation. Infant Conscious – Yes. Infant Breathing – Yes. Great; let’s move to the couch in the house please, its pitch black in the hallway.


Act One:

“Hello Madam – what seems to be the problem?” I asked the uncontrollably hysterical mother.

“My baby was crying, and so I gave her a few drops of ‘RELAX’ to calm her down,” she said between sobs.


“And now she is too relaxed. Look at her, she is barely moving!”


Several Important Pointers:

  1. She was right – the baby was hardly moving. Not quite unconscious, but certainly dispirited.
  2. ‘RELAX’ is a herbal concoction so strong, it could make an elephant count sheep whilst lying wistfully on its back.
  3. The mother had given the newborn several drops of this innocent concoction in the hopes of having a quiet night.
  4. She would now not have a quiet night.
  5. I have a wild imagination, but could never ever make something like this up.


Act Two:

Do a once over of the infant.

Get a comprehensive medical history.

Procure a complete set of vitals.


Vitals were thankfully normal:

Pulse: 150

Sats: 97%

Respirations: 26

Blood Pressure: No chance on an arm that small


Act Three:

Baby is transported to hospital and makes complete recovery. No charges filed against the new mother. RELAX is pleased to learn that their product does indeed work, but adds a caution to the label:

“Not for use on Restless Newborns”

Always wanted to know how those absurd warnings get onto product labels?

Now you know!




Not all Mothers always know best – but mine certainly does. Happy 27th Birthday Mum!

Shooting at the Western Wall

No Comments

There is a simple, absolute rule that I have created for myself.

“Shmeel: Always take all your equipment.”


So that when you find yourself in the right place at the right time, you also have the right tools.

Let me qualify this though. It doesn’t mean that I need to carry around a defibrillator at my kid’s school graduation.


Take to Graduation List






That wouldn’t go down well with my wife, or my kids, or the school, or my self-image.

What it does mean is that:

  1. Always carry your communication devices on your person, so that you can be alerted to an emergency in your vicinity. It would be a shame to be shopping in Store #1, oblivious to someone dying in Store #2.
  2. When responding to an emergency, always take all your equipment. Don’t assume the EMT that arrived before you followed protocol, and don’t assume you won’t need that Burn cream. Because actually, you will.


But I find it hard to follow rules; even my own – which brings me to the beginning of my story.


I zip through the opening between the barriers and head towards Jerusalem’s Old City. Private cars are no longer allowed to enter the old city area and the municipality has set up a barrier that scans license plates and only opens for public transportation or emergency services. It’s a completely automated system and no amount of Israeli Chutzpah will help.

Authorized = Open Sesame.

Unauthorized = Shut as a clam

I whiz through the cobblestone streets – Jaffa Gate on my left and King David’s Tower on my right; my final destination is the Western Wall. Ambucycles are not allowed into the actual Kotel compound unless there is a medical emergency. So I park my bike in a dedicated but unofficial motorcycle parking area and dismount.

Security is tight at the entrance, not dissimilar to what you would find at an airport. Every entrance is manned by several armed guards and visitors need to pass through a metal detector, while their bags get a ride through an X-ray machine.

I beep whenever I go through the detector. Actually I don’t just beep, I chorus. The reason is simple – the extensive collection of electronic devices on my belt. I always seem to forget a radio, or beeper, or keys, or small change and make a fool of myself with a manual search.

Not this time. This time I would leave all my paraphernalia locked up under the seat of the bike and pass security, without a symphony.

“There won’t be an emergency in the next few minutes anyway, right?”


I make it to the wall and Pray. Several minutes pass and all is calm around me. It is early evening and the sun is setting swiftly. There is a cool breeze blowing and except for the birds chirping, men praying, and kids laughing, all is serene.


BOOM – First a quiet one and then,

BOOM – A louder one.


Most people run away from an explosion. We run towards it.


When I say ‘we’ I mean ‘I’ and when I say ‘I’ I mean ‘I would normally run towards the sound, IF I thought it was an emergency.

But I didn’t think it was an emergency. The absurd reality of a Jerusalemite’s existence lately, is that loud explosion type noises are part and parcel of daily life.


It might be the Iron Dome intercepting a Hamas missile.

It might be typical construction type sounds from one of the countless building sites.

It might even be fireworks emanating from E. Jerusalem celebrating the end of Ramadan.


“It’s certainly not an emergency, right?”


I end my prayers, take several steps backwards, and head towards the exit. The exit, however, is blocked by several burly guards.

“You ain’t going anywhere, brother!”

As it dawns on me that something is drastically wrong, a medic in uniform and carrying a backpack EMT kit brushes past me. The guards wave him through.

“I’m with him,” I blurt out, “I’m an Ambucycle medic!”

“And I’m Elvis Presley – Show me some ID,” came the cynical reply.

“I don’t have any. All my stuff is in the bike.” Even as the words came out, I knew it sounded meek.

“You ain’t going anywhere, brother!”

So I peek over the barricade and behold. A lady, covered from head to toe in ‘coverings’ is lying on the floor and about a dozen army / police / security stand around her. Something funky is definitely going on! I’m about to make another go at convincing my captors to let me free, when the all-clear is given and civilians are allowed to wander once more. I run towards the center of attention and glean the following from the EMS personnel on scene.

The lady, covered entirely with only her eyes showing, had attempted to bypass security and rush into the complex. An ever alert policeman noticed the breach and shouted for her to stop. She ignored the call and he fired a warning shot in the air. She continued walking, and fearing the worst he shot at her legs. The bullet grazed her foot and she fell to the floor. She was found not to be carrying any weapons, but the reason for her strange behavior was as yet unclear.

She was loaded into the waiting ambulance and sent to hospital with a police chaperon.


All’s well that ends well, but like I said at the start;


“Shmeel: Always take all your equipment.”


The Circus

No Comments

The United Nations (UN):

An international stage where the whole world hears you – but no one is listening.

Just saying.


The Red Crescent (RC):

Does a wonderful job of transporting people from A to B – but then so does a surfboard.

Just saying.


The Good Guys (US):

Helping those who need help – always. Period.


In a utopian world we would be looked up to and emulated.

In the real world we are criticized and ostracized.

Just saying.



Who can our antagonists turn to in their time of need?



The Circus – Act 1

We find ourselves treating and transporting patients who either do or do not hold Israeli citizenship and either do or do not agree with my right to exist. I’m not talking red white and blue “all talk and no play.” I’m talking about ‘patients’ who truly live their ideologies. I say live, but what I mean is die for their ideologies; and they hope to take as many innocents as possible with them, to the other side. Yes, it is often these exact persons that I risk my life to save.

A Circus indeed.

Essentially, all assistance given is gifted pro bono (unofficially). These people don’t pay; they don’t even pretend to intend to pay. Billing addresses aren’t provided, or don’t exist; either way, someone is losing out, and it ain’t the terrorist or his posse.


“Why do you do it?” you ask.

“You shouldn’t do it!” you exclaim.


You might be right. But selfless giving and indiscriminate kindness is in our blood, since Abraham’s times.

Others inherited other values.


“So there is no financial compensation, but how about plain, uncomplicated, absolutely gratis gratitude?”


No thanks from the subjects, nor recognition from the international community. Instead, we are vilified worldwide as occupiers, terrorizing the virtuous.


OK! Shmeel. Enough rhetoric. I’ve heard it all before.

You probably have; but have you raced, sirens blazing, to their rescue.

I have.


The Circus – Act 2

Recently there was a horrible motor vehicle accident, ‘on the other side’. They requested, nay, they begged for our help. We dispatched 3 Orange and 3 White ambulances. A true sacrifice, because this amounts to a dangerously large percentage of available ambulances during any one shift.


“Thank you so much” ?!?!



Instead, the State of Israel will suffer resentment, detestation and eventually protest. Deadly protest.

It didn’t take long.

The accident occurred at the SW checkpoint. Less than 24 hours later the “thank you” arrived, and I quote from mainstream media, Dozens protest violently against Israel at SW Checkpoint!”

“Protest altruism!” you gasp.

Yes! – How did you know? – Have you heard this story before?


The Circus – Act 3

Even the security of the attendant, during treatment, is not ensured. We are constantly bombarded and abused with verbal and even physical attacks.

In the ancient past, at the culmination of an unsuccessful CPR, our Medics were often threatened with their life, should they ‘refuse’ to bring back the departed. For this reason, amongst others, new protocol was introduced:

  1. When in a dangerous area, death is not declared on scene. In all instances, even in cases of totally dead patients (an ‘X’) and certainly in cases of partially dead patients (VF Cardiac Arrest) our teams are now instructed to initiate transport to a hospital where the family can be told, with a security presence, that the patient is no longer amongst the living.


  1. When there is a distress call in a dangerous area, our teams receive a police escort to the location. The cops remain during treatment, and escort us back out. Control synchronizes the response with the Blues, and a specific location or coordinate is designated as the meeting point. This spiel has, on occasion, delayed the medical response and that is unfortunate. Unfortunate for them, because they need help; and unfortunate for me, because I want to help.


But I didn’t create this reality. Terrorism did.



There is no conclusion.

This whole saga is still a work in progress and we wait, pray and hope for G-d’s mercy.

But I began this whole train of thought due to a beeper I received which said:

“Emergency Medical Event – E. Jerusalem”

These calls are normally signed off by the dispatcher as “Security Escort Necessary” – except on this occasion she mistakenly typed “A Coat is Necessary!”

Don’t know how much a coat is going to help.


Unless of course it’s bulletproof.