"We've already lost her," Dr. Adriana Katz says sadly, watching a woman walk slowly out of the Sderot shock treatment center.
Hosen, a branch of Ashkelon's Barzilai hospital, aims to treat shock victims and keep them from developing post-traumatic stress disorder. Katz, its director, explains that after a Qassam rocket hits the city, the shock victims come first to Hosen.
In the past week the number of victims has increased substantially, and every rocket strike sends about 30 city residents to the center.
Treatment doesn't end at the center, but continues at the city's mental health clinic, which is treating about 1,000 shock victims who have already visited Hosen. Sderot has 24,000 residents, and Katz believes many more are suffering from shock but not seeking treatment.
In the Hosen reception area, a young woman hides her face in her hands and refuses to lower them. Not far away, another woman sits shaking, repeatedly saying she hears a ringing. She is afraid to leave home. Nearby, staffers are taking a few patients' blood pressure.
"The symptoms of shock include a dry mouth, an accelerated heart rate, limbs 'falling asleep,' a sense of fainting, or seeming paralyzed or emotionally detached," says Barzilai chief of psychiatry Gabi Schreiber. Katz describes a sense of losing touch with reality, tremors, crying and screaming.
Initial medical treatment is administered at Hosen. It involves group talks or one-on-one therapy and a sedative if needed. The aim is to return people to their regular functioning, and get them out of the experience and back into a routine. One doctor is heard sending a woman home to keep straightening it up. But it doesn't always work. One of the women at the clinic says she still hears the ringing, even after treatment. She is in a disassociative state. In her mind, she is still stuck in the traumatic moment. Cases like hers are sent to the shock treatment center at Barzilai.
Katz directs both Hosen and the city mental health clinic. Some nights, she is also on call at Hosen.
Treating shock patients doesn't end when they leave Hosen. For most, that is just the beginning.
"We register all the injuries," Katz recounts. "A day or two later, we call them and invite them for further treatment at the mental health clinic."
Katz explains that shock impacts the patient's functioning for months after the event. She says many suffer from poor functioning and depression. Treatment helps them keep functioning. Thousands come to Hosen, and about 1,000 are currently in treatment at the mental health clinic.
Some refuse the invitation to the mental health clinic, others show up once and disappear, and others are treated and recover. "When the rocket strikes and alarms increase," Katz says, "we see many patients who had disappeared come back."
Katz believes many town residents are suffering from shock but are not getting treatment. Some of those cases, and Katz declines to guess how many, deteriorate into PTSD. Schreiber says 10 percent of shock victims may develop PTSD, a chronic disorder characterized by serious damage to routine functioning, harm to family relationships and constant thoughts of the traumatic event. The scared, insecure woman Katz described sadly as "lost" survived a Qassam strike on her home three years ago. Shock turned into PTSD, and now she finds it difficult to leave her home.
Last week, 21 shock victims were admitted to Barzilai. One patient asked Schreiber if she should go back to living in Sderot.
Treatment is supposed to give patients a sense of security, but this is problematic if they must return to the same situation. Schreiber and Katz concur that this problem has no solution.
"It is very hard for us," Katz says. "If things were to begin and end, it would be far simpler. But that isn't the case, and it hurts us too, as people and as medical staff. We also have fears. We are also really afraid."
Want to enjoy 'Zen' reading - with no ads and just the article? Subscribe todaySubscribe now