The first responders who put themselves second on the high holidays

For most people, Yom Kippur is an energy sapping experience on a spiritual and physical level.

For Hatzolah Medical Rescue workers who save lives while fasting, the Day of Atonement adds an extra dimension to an already draining day.

“On this day, there’s nothing more meaningful than saving a life,” said Hatzolah Operations Manager Uriel Rosen.

It’s also demanding on Community Security Organisation (CSO) volunteers. Many spend hours in the hot sun ensuring that the community is safe while praying to be inscribed in the Book of Life.

Rosen and a team of highly skilled doctors and advanced life-support (ALS) paramedics perform the ultimate mitzvah of pikuach nefesh (saving a life) on the holiest day of the year.

Hatzolah medical manager and ALS paramedic, Yudi Singer, sits by the door of his shul in case he’s called to a medical emergency and has to rush off.

On a recent Yom Kippur morning, his cell phone alerted him to a life-threatening emergency requiring him to stop davening immediately. His Hatzolah partner, Avigdor Hack, received the same alert at his shul.

“People understand when our two-way radios or cell phones go off in shul. It’s not like we’re running to a braai,” said Singer, “and we can’t exactly keep it on silent in case we miss the emergency.”

An elderly male patient was at home with his family experiencing a severe heart arrythmia and was semi-conscious. It was touch and go as the patient was deteriorating rapidly, said Singer. The two experienced paramedics provided oxygen, checked his vital signs, put up a drip, administered medication, attached him to an electrocardiography machine, and connected the patient to an external pacemaker.

The patient was then taken by ambulance to hospital where he underwent surgery to put a pacemaker in his chest. He survived.

“I remember we were sweating. It was boiling hot in the middle of the morning, but we felt proud that we had done something good, the call went smoothly, and it worked out well,” said Singer.

It doesn’t always happen like that.

A few years ago on Yom Kippur, just after the Kol Nidre service, Rosen was called out to a life-threatening emergency to assist a man experiencing cardiac arrest.

He and his partner worked on the patient for what seemed like hours, performing cardio-pulmonary resuscitation, literally giving the breath of life. In spite of all efforts to save the patient, he passed away in front of his distraught family.

“I was sweating and dehydrated – it was traumatic. I remember thinking I could do with a glass of water, knowing that there were still 24 hours left of fasting. We pushed through. It’s part of the deal. It’s what we do,” he said.

According to Rosen, during Yom Kippur, only the most senior and experienced paramedics and doctors are on shift, preventing the need to call for extra back up. The most qualified people arrive on the scene to make the most vital lifesaving calls and clinical decisions.

“We try to limit the need to go to hospital, but sometimes it isn’t possible. If hospitalisation is needed, it’s treated with the same intensity and enthusiasm as a normal day,” said Singer.

Often, emergency calls occur shortly before yom tov, making it difficult for paramedics on duty to eat a meal before the fast starts. Likewise, emergencies can happen shortly before the fast ends, often requiring paramedics to continue working before breaking their fast.

Rosen said Hatzolah had now prepared for this eventuality, and a food hamper was placed in the ambulance should it happen.

On one occasion, Singer handed a patient over to hospital staff with five minutes to spare before the fast came in. “We were dirty with bloodied clothes, and had no time to shower and prepare ourselves for the fast. We put on clean hospital aprons and gloves and turned the stretcher into a table so that we could gobble something light provided by Hatzolah. It wasn’t exactly a gourmet meal, but it did the trick,” said Singer.

“There’s a brotherhood when it comes to this,” said Rosen, “Hatzolah always makes sure paramedics have something to eat to start their fasts in time, even if it means going to find them outside a hospital.”

The volume of calls on Shabbat and yom tov is the same, “just like any ordinary day”, said Rosen. “Our radios are going like it’s a Tuesday. Nothing changes, the only difference is that we’re in shul and fasting between calls,” he said.

There may be more dehydration and fainting spells, but usually these are successfully dealt with by doctors who happen to be in shul, he said.

“We never break our fast. When we finish an emergency call, we go back to shul. There are drivers who meet us at the end of a call to shuttle us back to the operational area,” said Rosen.

The organisation has arranged a Hatzolah minyan since the COVID-19 pandemic for despatchers, responders, and their families. It acts as a pop-up shul for those on call who find it easier to daven from the operational base.

During Rosh Hashanah, it’s not unusual for them to miss the blowing of the shofar, but “there’s always someone on standby who’ll blow it for us”, Rosen said. “We’ll make a plan because it’s important.”

If you call Hatzolah for help on Shabbat or a yom tov, it should be for only a life-threatening medical emergency, he said. “Of course, if you’re in doubt, call.”

The CSO also has hundreds of dedicated volunteers prepared to step up to protect the community and go the extra mile during this four-week high-holiday period, said Jevon Greenblatt, the CSO’s operations director.

“One year, an elderly man didn’t arrive to break the fast. We activated a team of people who were still fasting to go search for him. It took two hours to finally locate him, flag him down, and escort him safely to his family,” he said.

He had apparently got lost and confused. The CSO team didn’t make it home in time to break the fast with family.

“There are some extraordinary individuals who go above and beyond at this time,” said Greenblatt. They miss out on family and shul time, and remain vigilant throughout, in rain or shine. They arrive before shul starts, and leave when the last person has left. They do it willingly with a smile because they recognise the need for added security at this time.”