Hadassah Medical Organization grapples with hundreds of wounded and a country with PTSD

Since the October 7 attacks on Israel and the onset of the Israel-Hamas war, hundreds of Israeli soldiers and civilians have been treated at the two Hadassah hospitals in Jerusalem.

But many Israelis, soldiers and civilians alike, are also dealing with another kind of problem, the psychological impact of the attacks and the war. There is hardly a person in Israel who has not been directly touched by the events, and post-traumatic stress disorder has skyrocketed around the country.

At the Hadassah hospitals, it is not only the patients who have been affected. Doctors, nurses, and administrative staff too have been called up for military reserve duty, have family members away on military duty, and have lost loved ones.

Felice Friedson of The Media Line spoke with Dr. Yoram Weiss, the director general of Hadassah Medical Organization, about how the organization is dealing with these complex issues.

Interview with Hadassah Director Dr. Yoram Weiss

TML: Dr. Yoram Weiss is the director general of Hadassah Medical Organization. You have been facing a huge amount of stress on the hospital in terms of the war going on between Israel and Hamas. Thank you for taking the time.

Dr. Weiss: It’s a pleasure. In the sense the events happened on the 7th of October, we have been focused on taking care of the wounded in our acute care facility, which is the tertiary hospital of Hadassah Ein Kerem, while preparing and augmenting our abilities to provide rehabilitation services in our other hospital, which is Hadassah Mount Scopus.

And I’m very proud to say that despite the war we were able to squeeze in and open a new rehabilitation hospital that we’re opening in Mount Scopus within the coming week. Instead of opening it in April [2024], we’ll be able to provide services in the new facility already at the beginning of January.

TML: What is the number of soldiers who have come through the hospitals since the beginning of the war?

Dr. Weiss: We have treated about 400 injured patients. Some of them are civilians that were brought to us and some of them are soldiers. And the treatment has been covered both for physical injuries, but some of them also required a lot of psychological support. And we’ve seen that especially with the civilians that were injured in the first days of the conflict, that came to Hadassah either immediately or later on.

There’s a lot of post-trauma that is developing in these patients, and that is another area that we unfortunately have experience with because of our experience with the Intifada. We had to spend a lot of time dedicating our workforce to address these issues, and also to support the community that was evacuated from the area around Gaza and brought to the kibbutzim and the settlements around Jerusalem supporting the people that are uprooted from their homes, both in the medical care, but also psychological care and PTSD.

TML: During the war, a lot of the more severe cases were going to hospitals like Sheba Medical Center and others [to] Barzilai [Hospital], but people do not understand, really until now, what the impact has been in terms of post-traumatic stress.

Can you elaborate a bit more on what you’re seeing, because you’re talking about those from October 7, people who have left the kibbutzim, who went through a lot. You’re talking about soldiers witnessing horrific things as well.

Dr. Weiss: I think that when it comes to post-trauma stress, the issue is especially with the civilians. It’s also somewhat with the soldiers, but especially where you see this in very acute form is in the civilians that were attacked on the 7th of October.

It presents itself either immediately, but in many cases, it presents itself later on. And we see it also significantly in the young people that were at the large party where many of their friends were slaughtered. And they end up arriving in our emergency room with severe post-traumatic stress disorder.

TML: Do you feel the country is equipped to handle it? Is there really a nation under stress?

Dr. Weiss: I think that in Israel we have the capacity to deal with it. We have a very strong psychiatric and psychological base to start with, with a lot of experience in the past, both clinical and research-wise. I think that we’ll have to dedicate a lot of efforts in this direction, so I would say that when the war has ended, there are two areas in medicine that Israel will have to increase its capacity. It’s first in post-trauma and psychological support, and psychiatric support. But I think also, where we’ll have to put a lot of emphasis [is] in increasing our capacity in rehabilitation, and here, really, the Hadassah Medical Organization, thanks to our supporters all around the world through the Hadassah Women’s Zionist Organization of America, is allowing us to really provide an amazing infrastructure to achieve just that.

TML: The post-traumatic stress, you just said how difficult it is in coming back. Is there a trigger that people can look for in noting that they have post-traumatic stress? There are civilians, as you say, that have post-traumatic stress and might not have even been there [but have it] just from seeing all of these photos.

Dr. Weiss: The answer is the fact that people will know about it, and the more we talk about it, this is the important thing. I think that it is important to portray post-traumatic stress disorder as something that can happen to any one of us, and to go and make people understand that if they will go and ask for support in treating that, we’ll be much better [off] than waiting with it. Because the more you wait with post-traumatic stress disorder the more it settles in and then it’s much [more] difficult to treat it.

I think the important thing is, and that’s why the discussion here in Israel which is very open currently about the issue of post-traumatic stress and the need for post-psychological support which you can read [about] in the newspapers and you hear [about] on TV. It’s extremely important, because it takes away this aura of [saying] I’m ashamed of having it. Well, guess what? Half the country is suffering from it. Either because they were there, either because they heard what happened, either because they had missile attacks over their heads for nearly two months. I think that’s very important.

TML: I want to look at the sector of the children of Israel. A lot of young kids are hearing things on radio, even if parents are trying to keep them away. A lot of young kids have fathers, particularly that are in the army. You can’t negate the stress on that sector as well. What do you think should be done here?

Dr. Weiss: We are aware of that. We have a child psychiatry department in Hadassah that has a lot of experience with that, and also with post-traumatic stress, as I mentioned, because of the Intifada. We have a lot of capabilities.

And the answer is yes, and there I would say, with children, our concern also is of another problem, and this is of eating disorders that can develop in children. I think, in children, the post-traumatic stress disorder can present itself as an eating disorder, and here parents need to be aware of that which can be another symptom of post-traumatic stress.

TML: Would you consider the patients that are here currently as [having] light to medium injuries? Or, are you getting any patients that have some of the very serious injuries?

Dr. Weiss: We’re getting all kinds of injuries. We treated, out of the people that were treated here, the 400-something people that were treated here, especially of the first day [of the war], but also going on, we’re receiving wounded with helicopters directly from the field, and some of them are seriously injured.

We have a lot of experience. Unfortunately, there is a team here of surgeons. We are a tertiary care hospital with a lot of experience from the Intifada and from other events in Jerusalem here in the area with trauma. We have treated a lot of severe cases; some with a lot of success and we’re very proud [of that]. And we prevented many amputations.

And we’re getting also a lot of secondary referrals from other hospitals to us. Some of the patients are being referred to us from other hospitals in Israel, because of our specialty.

TML: There’s a lot that has been floating in the press in terms of problems of vision from the war [as well as] problems with amputations. Are those the two areas [in which] you’re seeing many of the wounds? Are there other things that you’re seeing besides shrapnel [and] things of that ilk?

Dr. Weiss: First of all, it’s too early to say what is the pattern of this war, but it appears that because of the protective gear that soldiers have today, what we see today is a relatively higher number of eye injuries. We see a relatively higher number of limb injuries [as well], because these are areas that are not so protected, contrary to other [areas of the body]. That’s the reason that we see [injuries in those areas]. Because of that, however, the death toll is lower than in previous wars, because of the protective gear that they have.

What we see over the past few days also, because of the bombs that they’re using in Gaza, what we’re seeing is also shrapnel injuries, but these are usually affecting the limbs of these soldiers.

TML: Currently, how many soldiers are in the two hospitals?

Dr. Weiss: We currently have here in [Hadassah] Ein Kerem 17 soldiers that were admitted over the past week. And we have an additional 54 patients that are in rehab in the Mount Scopus [hospital].

TML: How many patients can you accommodate?

Dr. Weiss: Well, when it comes to acute care, we can accommodate a very large number. We are in [Hadassah] Ein Kerem, which is the tertiary care hospital, we are more than a 1,000-bed hospital, so we can accommodate as much as needed. In the [Hadassah] Mount Scopus, when it comes to the rehabilitation, we can accommodate an additional, within a week-and-a-half, I hope we’ll be able to accommodate an additional 30 patients. And add to that we also have the day care that can also accommodate a large number of patients that require rehabilitation.

Having said that, I hope that there won’t be so many people that will need it and that things come to stabilize.

TML: You have said that research is extremely important in maintaining a hospital and keeping it going. Is there special research that’s needed right now that’s different because of the war?

Dr. Weiss: No, I truly don’t think so. I think that the war is just a distraction of the regular work that is being done here, and the work that is being done in research. And I should say also, that’s part of us being Israelis. We have seen so many crises over the years.

We basically, in less than three weeks, decided to go back to our normal activity, to the normal research and development activity we have here, to the normal work. Yes, we had many physicians that were recruited into the army reserve [units]. It was a little bit difficult, but the activity was reduced to a minimum, and we’re very proud about that because the teams are very committed to provide the best medical care to their patients. And we’re doing that.

TML: Everybody in the State of Israel has had somebody that they either know, or second-removed know, who has been killed [by the events on October 7 and thereafter]. It’s no different here. You have photos in the hospital of those who were murdered or killed in the war. Can you touch on that a moment, on what is happening just internally on how people are feeling [and] how they work day-to-day because you’re here running the hospital and seeing and feeling what people are going through?

Dr. Weiss: There is no question that there’s a lot of stress that people undergo, and especially when people they know, their friends and relatives are killed, either on the 7th of October or in the ensuing activities that occurred. For me, personally, it’s very demanding, because I’m going to each one of our staff where a family member was killed and making it to come to their shiva and to visit them.

I think that it’s extremely important, and I think that it’s important of our organization to realize and to support these people, and we’re doing every effort to support them while we continue to do our regular work, and this is to provide medical care to any patient that needs it. And this includes Palestinians who come here and are being treated. You’ll see it when you go in the corridors, and you’ll see Arab physicians and nurses working here.

And we have Palestinian physicians who come here to work and to get their education here, and actually we’re very proud about that because I think that’s part of our mission. It’s to understand that not all Palestinians are terrorists, and we should try to create the bridges of peace that our organization is so committed to.

TML: Is the hospital in a situation where they have to treat terrorists today?

Dr. Weiss: I would say the following. We don’t have any terrorists [here] today. We see very few terrorists that we have to deal with, and until now, we didn’t have a problem with that. And I hope that it will continue.

TML: Dr. Weiss, can you share a little bit about your background in the army?

Dr. Weiss: No.

TML: Dr. Weiss, you have again restarted research [and] technology. What are the areas that you’re looking at today? Life does go on, hard to believe, and it’s important to discuss what is the hospital doing.

Dr. Weiss: I would say that it’s very difficult to say what the research that has been done here in the hospital because it’s an iceberg where anything that I will mention is just the tip of the iceberg of what we’re doing here. But I’ll give you an understanding, a hint of what we’re doing.

We have very strong translational research when it comes to stem cells and to very advanced CAR T[-cell] therapy. These are the two areas where we actually sold companies to large firms that are global companies. We are involved with very large pharmaceutical companies on the early diagnosis of cancer using DNA technology. We are very much involved in robotics, and we’re working with very large international companies on developing their robots here at Hadassah and also startups in robotics.

This is just the tip of the iceberg, but if you want really to go on the amount of research that is being done here at Hadassah, it will be interesting to see that about 55 of the competitive grants awarded by the Israeli government for medical research are being taken by researchers from Hadassah over the past three years.

TML: There was a lot of stress on hospitals, particularly in the beginning of the war as the reservists and soldiers were entering combat and hospitals were left without personnel. Has that changed? Have many doctors come from abroad to fill positions? Can you share a little bit about this?

Dr. Weiss: As the war started, we had about 15% of our physician workforce that were recruited to the army, and obviously this created a burden on those that were left, especially young physicians who had to do much more on calls. We tried to help them with that by taking senior physicians to take the place of the younger ones as much as we could. I’m not saying they didn’t work harder. They worked much harder; we appreciated it. And we showed the support, and it’s very important of us to thank those physicians that not only were in reserve [duty], but those that stayed here that worked very hard to fill the gaps that were left behind.

What we see now is that basically people are coming back slowly. We are very happy about that, but we realize that the conflict has not yet ended, and we’ll have to adapt as we go. And that’s part of being the director of a hospital at this time is to understand that we are working in a chaotic time and we have to take decisions day by day, and day by day our decisions may change.

TML: Dr. Weiss, there’s concern of a war breaking out with Lebanon and Israel. There’s grave concern in terms of what’s happening with the Red Sea. How does a hospital prepare? What are the steps a hospital needs to take if all of a sudden there are mass casualties?

Dr. Weiss: Well, unfortunately, I won’t be able to share with you all of what we’ve done, but we have prepared. We have increased our inventory to a higher inventory than we usually have, and the other thing is [that] we have prepared additional places for wounded, if needed. Hopefully, this effort, which was a very significant effort that we started on the day that the hostilities started, has been by now completed. I’m very proud about that, and I hope that this infrastructure that we’ve put in place will never be used. However, we are ready, and we’ll deal with it as it comes.

TML: What’s missing? What do you wake up in the morning and say, I don’t have this, I need it?

Dr. Weiss: When you deal with such an event, you realize how important it is to finish the projects that you started, and I would say that the two major projects that we would like to finish, which will increase our ability to deal with the future of events like that, is one, increasing the number of operating rooms that are in a protected zone, and secondly, finishing the rehabilitation infrastructure that we put in place in [Hadassah] Mount Scopus, which is extremely important, because after this event, and God forbid if there’s a war with Hizbullah and Iran, there will be even a larger number of people in Israel who will require rehabilitation. This is the part that is missing, and obviously, it is recruiting the physicians that will deal with that.

And I would like to thank also all of the international volunteers that came to Israel to support us. We didn’t ask for many to come. We had huge amounts of people that were begging us to invite them to come. We didn’t do that. We invited physicians and only those who were identified who their specialty can really complement the things we needed here at Hadassah.

But I really would like to thank all those that sent me letters and emails, and these are thousands [of people] who wanted to come here and to assist us. And we don’t take it for granted. We are very proud about that, and we thank them.

TML: Do you still need volunteers?

Dr. Weiss: We have some volunteers, but the number of volunteers we really need now is reduced, because we have a lot of the people that came back [from reserve duty]. But I think that what happened now is actually like a tradition. We will have volunteers that will continue to come, because they basically created here relations with the people in the hospital, and they will continue to come.

TML: Dr. Yoram Weiss, thank you so much for taking time with me here at The Media Line, and I wish for health here in this hospital and that maybe it quiets down a little bit.

Dr. Weiss: Thank you. Thank you very much. We really appreciate it.