Combat and medicine: How the IDF's Nahal brigade saves lives

It’s been six months since Lt. Tomer’s father told him to get ready. It was his day off from work as a paramedic with Magen David Adom (MDA), and he was at home with his parents on October 7, following the news. 

“You’re going to war,” his father, a retired career Israel Air Force (IAF) veteran said. “Get in touch with your reserve commander and ask him where you have to report. It’s happening now.”

“And he was actually right,” Tomer says.

Tomer, 22 of Ness Ziona, is one of three Nahal soldiers serving in the brigade’s medical unit, who spoke to The Jerusalem Post about their experiences in the Israel-Hamas War (Operation Swords of Iron). He’d recently completed and been discharged from his compulsory service as a Nahal brigade paramedic, serving, as paramedics typically do, in an instructional capacity at the brigade’s training base, the Bach. He was in his second month integrating back into civilian life when the Hamas attacks took place. 

“So in the first days (of reserve duty), they sent us to the North,” Tomer recalls. 

“There were a few incidents with terrorists there, a few situations where we had to give medical treatment, but everything was okay. And then we began preparing to go into Gaza,” he says, describing the days in between his call-up, when he was assigned to the 932nd Battalion, and the day he went into Gaza – where he had his first real combat medicine experience.

The IDF's Nahal brigade: Four combat battalions and their medics

The Nahal brigade is made up of four main combat battalions – the 932nd, the 50th, the 931st, and the 934th. Each of these has a number of companies within it, and each company is assigned its own medical squad – including a doctor or paramedic and two medics who work underneath them. During combat activity, the medical squad is usually somewhere in the area, with a mission to provide as close to real-time emergency medical care as possible when injuries occur in the field. While the IDF spokesperson passed on the conservative estimate of one hour and six minutes as the average time for a wounded soldier to be evacuated from the field and arrive at a hospital, in a recent The Jerusalem Post article, IAF Lt.-Col. N. of the command squad responsible for evacuation of wounded soldiers said it can be even faster: around 27 minutes from the moment a soldier is wounded until he or she is already on a helicopter ready to be flown to a hospital; plus 40 minutes on average for the soldier to make it into surgery. These times can be life-saving when a critically wounded soldier is awaiting evacuation. 

LT.-DR. SHAMA, 27, grew up in a Druze community of western Galilee. He’s the doctor of the 931st Battalion and a graduate of The Hebrew University of Jerusalem (HU) Faculty of Medicine. Shama says that as a high school student, he already had his mind set on becoming a military doctor, and after finishing his university degree and emergency medicine training, he started his service in Sayeret Nahal, before moving over to the 931.     

“Prior to this [October 7], there were all sorts of operations in Judea and Samaria in which the platoon was tasked with preventing terrorism and ensuring the security of the area, so we had activity, but nothing out of the ordinary,” Shama says. As part of their routine, the medical squad was on the scene of day-to-day medical emergencies such as car accidents, treating soldiers and civilians, as events occurred. “The war was essentially my first event from an operational aspect,” Shama adds.

And although both Tomer and Shama, as paramedic and doctor respectively, got their baptisms of fire by being thrown into things in real-time, each had already undergone a long journey before being sent into combat. 

Paramedics in the IDF begin with five months on a pre-military training course prior to two months of basic training for combat soldiers; a month in a hospital; five months as a paramedic with MDA (the initial instructional body for IDF paramedic training), and a further two months learning the basics of being a paramedic specifically in the IDF. Only then are they assigned their units. 

Doctors who have chosen the military route, on the other hand, begin by studying for their medical degree, spend time between academic years in basic training, and then complete the officer’s course. 

After another year spent interning in a hospital setting, they go through three months of IDF training focused specifically on military medicine, before going through a rotation where they experience different units, and finally, are assigned battalions. Once in a battalion, the young doctors serve under the brigade doctor, who is their guide for any medical and organizational issues encountered.         AS WITH Tomer and Shama, paramedic Sgt. First Class Inbar, 21, of Haifa, also found himself in his first live combat situation in Gaza, following October 7. 

“I went from 0 to 100 completely,” he says. Like Tomer, he had been serving at the brigade’s training base. “As soon as the war began, I insisted on joining maneuvering forces.” Inbar was assigned to Battalion 50.  

A few days after entering the strip, the squad that Inbar was with encountered terrorists, “apparently snipers, who waited for us in one of the buildings,” he says. He remembers screams of “‘medic, medic, medic’ ... like in a movie from World War II, that’s how it felt.” 

A soldier had been hit, his commander was holding his hand and screaming for medical, as the soldier bled out from his carotid artery. “My medic and the commander dragged the injured soldier to me, and I see he is spraying blood from his neck, he is bleeding a lot... blood that does not stop at all. We try to stop his bleeding by applying pressure, with dressings, with special catheters. Nothing works... At the same time, we open his vein to give him plasma.” All of this takes place while under fire and awaiting the extraction of the wounded soldier. 

Ultimately, the soldier survived, and later, thanked Inbar for saving his life, when they ran into each other at a gathering held for the Nahal brigade’s injured soldiers. Inbar was attending the meet-up because not long after the situation with the soldier, he was himself hit by shrapnel when a rocket fell next to where he was standing. The incident injured 11 people in total.

“We took cover in a building, we tried to understand who was hurt... I began to treat one of the injured that was next to me, started bandaging... And then a doctor arrived, and she says to me, ‘Inbar, you’re bleeding.’ We have a conversation that is not very deep and she is like, ‘Stop.’ And I am like, ‘No, I don’t want to.’” Inbar is evacuated to the hospital where he finds out that in addition to shrapnel injuries, he has two ruptured ear drums. 

In war, mettle is tested, in the moment, and in the larger picture, as Shama learned on October 9, when his uncle, the deputy commander of the 300 Brigade, was killed in a skirmish on the border of Lebanon. 

“That was more or less the worst tragedy that I could imagine,” Shama says. “But I saw that we were in an event that was much larger... As the doctor of the battalion, I could not let myself fall apart. I also knew that my uncle would expect me to continue with all my strength, and not to abandon the place where I was. This what is strengthened me at the start of the war – to prepare the brigade, to train the teams.”

“IT WAS do or die,” Tomer says with a slight laugh. This is what went through his head after being shot. “I had three booms, really hard in my chest,” he remembers. 

He and his commander had gone around to the other side of an alley, while the rest of their squad was around the front, trying to flush out a sniper who was shooting at them. 

What they hadn’t realized was that there were more terrorists around the back. 

Tomer’s commander was hit first, then Tomer. “I saw my right hand was full of blood, and then I realized that my commander was yelling, ‘I’m injured! I’m injured!’” Tomer applied a tourniquet to himself, asked someone to drag his commander to him, and then got to work on his friend, giving instructions to the medics with him, while he helped them with his healthy hand. “I decided to put on the hat of the paramedic... I just started doing what I was trained to do. And it just flowed. Only afterwards did the thoughts arrive.”

According to Inbar, being there for the soldiers is “an honor – to give them the confidence [that we are there for them] is definitely the most significant thing that I did in the army. It has given a different meaning to my military service and, beyond that, to me.” He says it has provided him with a “more mature view of life... of what can I give to others, to help other people and be there in their worst moments.”

Shama shares similar sentiments, “We need to give of ourselves so that we can continue to exist in security in this place. This is my tiny part, continuing in a chain of generations of people who have given of themselves.” 

He adds, “The medical corps are in a very good place. We bring medicine to the edge with the most advanced technologies... increasing the chances of bringing people’s loved ones home.” ■