October 8, 2023, Sunday morning, 6 a.m. Ra’anana Israel. I leave home early for work at Sheba Medical Center in Tel Aviv. Important to get to the hospital early so I can donate blood. It’s what I can do. Grateful I’m type O. Universal donor.
I arrive, already hundreds of people waiting to donate blood. The room is quiet, the deafening silence of shock, anguish disbelief. I feel like a mediocre physician; I cannot help with the wounded and mutilated. I’m not a surgeon or orthopedic doctor or emergency physician. I’m not a pathologist who can help identify the unidentifiable. I’m just another physician, an oncologist, and today, following the events of the previous day, after my beloved people were brutally slaughtered, and with several family members, including my children, called up to the front, I’m not quite sure how to cope.
I have been an oncologist for almost 20 years, I have four children and a supportive husband. I’m aware that I can work under immense pressure, treating many patients and their family members and running a research lab. I’m a passionate physician and always loved being an oncologist. I have pondered humanity, personalities, connections between people, extending life, and dealing with end-of-life scenarios. These subjects are an integral part of being an oncologist. I have often spoken to my peers about them. Like most of you, I chose my profession and always felt that it was a good fit. But what does all that mean here, now?
It is Sunday morning. The beginning of the work week in Israel. I am seeing oncology patients. But not “as usual.” I’m having difficulty connecting with them and concentrating. Suddenly, advanced pancreatic cancer seems a trivial problem. I sit across from my patients and have flashbacks of the horrors perpetrated against human beings – children, the elderly, no one immune. I look at my patients’ CT scans and have flashbacks from news reports and inhumane videos shamelessly shared by the terrorist for the world to see. I cannot find my compassion, which was always near the surface, at hands’ reach. I have never felt at such a loss.
It is true, that at different times, we all have personal problems, loss of a loved one, issues with relationships, challenges with our children or elderly parents. These things impact us personally and professionally. This is different. Bigger than me and my emotions; it is universal. Brutal, intentional atrocities against humanity perpetrated on my fellow countrymen. How will I delve deep into myself and facilitate my reconnection with my patients and my compassionate healing side?
The medical system in Israel is harmonious, made up of staff from all backgrounds — Christians, Muslims and Jews — working together in respect and harmony in medical centers all around Israel. We continue to provide the most professional medical and humane supportive care to all the patients irrespective of the patients’ religion or nationality… and yet this conflict persists in trying to damage harmony.
Human-to-human interactions with others got me through the day. I opened myself up by sharing the struggle:
…with my colleagues. The head of our gastrointestinal unit decides, together with the psychologist, to have a debriefing meeting with the staff, as we all feel distracted and anxious. We meet. About 20 of us, nurses, secretaries, physicians, social workers, and psychologist. The staff start talking, discussing the horrific situation from their perspectives. I feel tears welling up in my eyes, I cannot take all this in. They all feel the same way, they all have family members called up to reserve duty, or a family member or friend missing or dead. We discuss the situation; there is deep connection between us all. I apologize and leave the room.
…with my patients. My 41-year-old female patient with advanced pancreatic cancer came into the clinic. She told me that her kibbutz was under siege that fatal day. She and her immediate family were not directly attacked. They are currently living as refugees in another city. Instead of discussing her advanced cancer and treatment, we discussed the situation. She has two young children. Her youngest is in fourth grade. One of her daughter’s best friends was abducted, the other murdered — identified only after several weeks, due to severe mutilation. Towards the end of our meeting, she said in a very small voice that perhaps it would have been better had she been taken hostage herself, instead of one of the other mothers who had much longer to live. I didn’t really know how to answer; a deep silence followed. But I must continue — and focus on her cancer and treatment.
…with a young wounded IDF soldier. I go to my office have a good cry, perform some work-related chores, anything to get my mind off the situation. I’m restless, so I go with a friend and colleague to get coffee. I notice a beautiful young soldier in a wheelchair, he could be my daughter’s age. His leg is bandaged up. “Hey, sweet soldier, can I buy you coffee?” He is surprised. I continue, “I’m a doctor here at the hospital; you look like my kid’s age. Can I get you a coffee?” “What doctor are you?” he asks. “Well, I’m not a real doctor. I can’t really help fix you now. I’m an oncologist.” “Wow,” he says. “My dad died when I was 14 from lymphoma — don’t say you’re not a real doctor. You fight every day to save lives and extend life. You are in a daily battle for life.” I inquired about his injury. “I’m in an elite commando unit… it was bad. We lost many soldiers trying to help the civilians. I have a bullet wound in my leg and my back.” As I’m about to leave, I turn to him and say, “I have one last request for you: Promise me one thing, please get emotional help. I’m sure you are traumatized, I wasn’t there and I am traumatized. Please don’t let this be like the Holocaust survivors who suppressed it all.” He looked at me with a twinkle in his eye and said, “Don’t you know our generation is different? I’m already getting therapy.”
…with a young Palestinian patient from Gaza. In September 2023, a 39-year-old man from Gaza, a father of three young children, was diagnosed with stage IV, gastric cancer. He suffered severe pain and weight loss. Following intake at our gastrointestinal unit at Sheba Medical Center, he rapidly initiated FOLFOX chemotherapy. His condition improved almost immediately. He stopped his analgesics and started to gain weight. It was clear that the treatment seemed very effective and we were all very optimistic and grateful. His fourth course of treatment ended October 7th, after which this Palestinian-born patient, raised in the Gaza Strip, had nowhere to go. He desperately wanted to continue treatment in Israel. Since the barbaric attack of October 7th, he has been staying in accommodations at the Sheba Hospital in Israel. He has received treatments per schedule, with response. Hundreds of other Palestinian patients, including children and cancer patients, are treated daily at various Israeli hospitals… What will happen to them?
These interactions, poignant and painful as they were also put wind into my weary and damaged sails. I thought back to a lecture I had recently given at the AACR Pancreatic Cancer Conference, before the attacks. I chose to end reflecting on humility, caring, and humanity with the following quote:
Inspire me with love for my art ….. In the sufferer let me see only the human being. Illumine my mind that it recognize what presents itself and that it may comprehend what is absent or hidden. Let it not fail to see what is visible, but do not permit it to arrogate to itself the power to see what cannot be seen, for delicate and indefinite are the bounds of the great art of caring for the lives of others … (Attributed to Maimonides (Rambam) a 12-century Jewish rabbi and physician)
Life, compassion, goodness and healing must continue to prevail.