My Magen David Adom Experience

By Jonah Kawarsky

This book is the journal of a Canadian University student volunteering for the Magen David Adom Overseas Volunteers Program stationed in Tel Aviv, Israel in the summer of 2022. The book was written with the intention of providing the reader with a firsthand account of what it's like to volunteer in an ambulance and remains mostly unedited. Inside you will find descriptions of patient interactions, medical case information, random observations, and personal thoughts. All the described experiences are true.

• Language: English
• Publisher: Lulu.com
• Release date: Feb 7, 2023
• ISBN: 9781329969728

Book preview

Copyright

Copyright © 2022 by Jonah Kawarsky

All rights reserved. This book or any portion thereof may not be reproduced or used in any manner whatsoever without the express written permission of the publisher except for the use of brief quotations in a book review or scholarly journal.

First Printing: 2022

ISBN: 978-1-329-96972-8

Prologue

All these experiences are true. They take place in Tel Aviv, Israel between June 25, 2022 and July 27, 2022.

This book was written in point form while I was on the ambulance between patients and remains mostly unedited. Through this writing, I hope to relay my personal thoughts on the MDA experience as I actively lived it. You can expect patient interactions, medical case information, random observations and more. While writing these notes, I never reviewed them, edited them, or had any plan on structure. A natural flow began developing as the days went on but was not planned.

Through this writing, I aimed to capture the fun-filled and fast paced environment. Eight-hour shifts had me forgetting what happened in hour 1 as early as hour 4.

I am thankful for the time I was able to spend with Magen David Adom and would highly recommend volunteering with them to everyone.

Names have been changed to ensure confidentiality of staff and patients.

All photos were taken by me or for me.  Cover illustration generated by Dall-E.

Chapter 1

Saturday, June 25, 2022

11:00pm-7:00am

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Meet driver. Almost at first call but then dragged to other one. Mentally off man that won’t get into ambulance and then won’t leave. Driver smoking right by O2 tanks¹. One nice driver who speaks English and one that speaks broken English that is much more Israeli in attitude. Sitting in hospital now. Waiting room. Maybe time is a construct? Typing this but not looking at the phone. Sitting watching ambulances bring in patients. Called to next place. Near beach. Should have been violence but no one was here. Medic trying to pick up chicks including the police officer.

Me: Are there a lot of accidents on scooters?

Driver: Yes, many. Good for business

Went quickly down beach to next call in Jaffa. Driver (Adam) grabs stretcher and I grab the Ambu bag², Defibrillator and oxygen tank. Walking through crowded bar area to get to patient who is a woman appearing in her 20s on the floor in the recovery position. Staff members of the restaurant are moving away tables to allow the stretcher to get in. She is brought onto the stretcher and I am now carrying all the stuff. Help keep ambulance doors open. On ambulance I take the blood pressure (BP). Can’t hear heart very well so best guess that BP is 120/80. Will need to put stethoscope closer to inner arm in future. Get pulse reading from carotid after trying wrist. 100! Driving now to hospital. Patient is responding to pain when squeezing trapezius hard. She is given vomit bag. Trying to now take her glucose?! Don’t know where garbage is yet so put stuff in front of me. Take glucose wrong by putting reader in backwards. Driver shows me correct way. At hospital. Walk into emergency room with patient. Waiting with the boyfriend who came along for the call. Get some water. Get taught how to replace sheet on the stretcher.

Need to buy stopwatch for cases. Don’t want to have Apple Watch dirty.

Main driver rolls and smokes literally every second he can.

Kicked cockroach out of ambulance when removing patient on stretcher. Going back to station to switch ambulances now to one that hopefully doesn’t have cockroaches.

Keep getting gloves stuck in zipper. Had to wipe away glucose test blood with glove because I didn’t know where the gauze was (now know) and I also had an open thumb hole.

Switched ambulances and English speaking driver left. Now just me and main driver, Adam. Had a quick coffee at station. Checked stuff on new ambulance. Chilling in car listening to radio.

Small nap while watching soccer game in break room. Driver and I understand each other through his general voice intention while speaking Hebrew and his broken English. It works. Driving 15 minutes out of city for mental health patient. Feeling a bit sleepy.

The case of Beit cholim. Woman in her late teens is undergoing some kind of mental anguish. Enter the home. Small apartment, large tile floors. Sit down on TV desk while family is on couch and driver is on window sill. She is scared and they say beit cholim probably 100 times in the conversation³. Nothing is resolved from my understanding but driver gives me the go ahead and the keys to grab the tablet⁴ and return the Ambu bag. Sitting outside with driver now on back of ambulance listening to family argue in their first story apartment. Overweight mom sitting on her own couch and concerned/tired dad sitting beside daughter. I tried to connect with their emotions but I didn’t feel much of anything towards the situation. Not sure if tiredness or language barrier block. Went back to apartment to have teen sign off that she does not want to be taken to hospital. Driver says that instead she will check into a clinic tomorrow.

Drove 20 minutes back into Tel Aviv. Patient had fallen downstairs but sent ambulances away. Found big puddle on stairs. Maybe that’s why they fell. Hopefully it’s water - Adam

Falling asleep over and over in car. Heart beat down to 50.

Stop for much needed rest and recovery period back at station. Protein bar, bathroom and water. Light coming out is a weird site after starting a shift at 11 pm. Birds are awake too.

Pick up guy from side of highway. No idea why he was there but we picked him up and dropped him off at the next highway stop.

Arrive at scene. Old man with husky dog. Told victim has fallen down. Patient has many open wounds (not bleeding) on his legs and arms. Mostly around the elbow and knee. Obviously has fallen from dirt marks on side of body but they do not match injuries present on body. Husky is not well groomed and barking when we try to approach owner. Many flies are landing on patient’s wounds. Over the 15 minutes we waited for the dog to calm down, his elbow wound got completely covered in flies. Most disgusting thing I have ever seen. I eventually help patient up and the dog is more calm. Dog has erection? Limp red wet thing where penis would be located. Get patient up the stairs of his apartment to second floor place. I unlock his house and he lets the dog in. Refuses to allow us to treat him or take him to hospital. Thanks us both. Driver tells me he is drunk. We get back to car and disinfect the hands we had in gloves. Driver thinks wounds are from drugs but has no idea. Its 6 am. Pretty much in Bat Yam. A rougher area for sure. Clear signs of homelessness and drug use. Extremely obese man waddled towards us from his bench. Sandals look like they are now part of his feet. He smells terrible. Asks for a new mask and leaves. Waiting for patient. He might come down. Said he was going to think on whether he would come with us to the hospital.

Lots of mental health calls today. Are they trained for these?

Spent the last hour waiting to see if he would come out. He did not. Then got to experience Israeli morning traffic. Back at station now.

Chapter 2

Monday, June 27, 2022

9:00am-5:00pm

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I slept until 8:43 am! My shift starts at 9 am! I threw all my stuff into my bag and got on the lime⁵ at 8:48 am. Luckily I had packed a separate backup clothes bag for myself when I went to my shift yesterday, otherwise I would have had no long pants and would have had to cancel my shift. I WHIPPED through the streets of Tel Aviv (even got lost a bit because I don’t know the exact way just yet) and got to my station at 8:59 am. Had to leave scooter on and run into building. Threw my shirt on and met my driver. With him now heading to a case to assist with removing a 79-year-old cancer patient from his place along with another MDA team.

Driver is Asher. Been with MDA 3 years. Driver for 1.5 year. Chef before this but long ago was medic in army. Wanted to always join MDA but didn’t have enough courage until COVID-19.

95% of cases are community care based - Asher

Helped the 79 year old cancer patient down 1 flight of stairs. I thought it would have been many more stairs. The first team just wanted to make sure the transition was as safe, smooth and comfortable as possible for the patient. Patient had some growths on their body and a left foot second toe that was pointed at a 90 degree angle. Had a care worker with him and the family was making breakfast in the home.

Heading back into city now. Sirens on. 20 year old female army soldier fell and injured her leg. We enter the main Israel army base located in the centre of Tel Aviv. Driver tells me that it goes at least 20-25 stories deep with a massive bunker that the army could use for months. Patient is already seated by army medic area. Big welt on ankle. No bruising or obvious pain but instead of hobbling her to ambulance, the driver gets the stretcher. I await putting her into the stretcher and then observe as he performs triage. Get to hospital. It’s more crowded during the day. Say hi to other MDA volunteers from my program. Patient starts telling me what’s going on in English (we are transferring her from our stretcher to a hospital wheelchair…. Later I’ll learn that we can’t leave her if she is still in our stretcher until they put her in a bed. That could take hours. If she can move on her own, there is a separate entry point for her that saves everyone time). I move the patient to the front desk by pushing her along in a wheelchair. After checking in we split up. Driver and I get coffee and some refreshments in the MDA food room. Swipe a plastic spoon to then eat my protein yogurt outside. First meal and pee of the day and it’s 11 am. Patient told me she was scootering and a 2-year-old child went into her way. She braked and swerved to avoid them and in the process hurt her ankle. I’m feeling more awake and alert after our stop.

Nice to speak English with driver. Creates a different dynamic during the drives. Heading now to 7-year-old girl who suffers from epilepsy and has had a seizure. Traffic is near gridlock during the day with all the construction and cars. Bus or taxi would never had gotten me to station in time this morning. Learned how to properly put all the stuff onto stretcher and moved it to second floor of doctor’s office. Picked up patient and father. Driver was very kind and fatherly with patient. Felt bad for little girl in sweet moment when she hugged her dad. Carried stuff out downstairs while patient took elevator. Put stuff back into correct places in ambulance. Assisted patient onto ambulance by kicking closed stretcher locking device. Travelling to children’s hospital (separate entire hospital within larger hospital). Dropped off patient with doctor. Fish tank in waiting area. Lots of bright colours and children themed things to make it more inviting. Lots of plants on the drive in. Bought small nut bar snack. Tucked in shirt, feels more professional.

Heading now to 84-year-old patient undergoing an anaphylactic attack. We are 15 minutes away. Yellow ambulance already at the scene taking care of patient (they have a doctor on board the yellow ambulances). Located in old Jaffa, all the houses are vintage and very pretty. Climb to second floor where home is and team was performing FAST test (stroke test). Drove past beach on way out.

Heading now to someone that was shouting from their apartment. We are being called along with the police. We are very close to the location. Driver says it’s a domestic affair. Later learned that driver noticed from the way the police were driving that they knew of the family already and had been called before a few times. I load up the stretcher (with my newly learned skills) and push it to the apartment. We wait at the bottom with a motorcycle MDA guy from the last call, nice breeze on our backs. We are not needed after all. I put everything back in its correct spot on the ambulance and even put the