For Her, the Nightmares Come Back Every Day

A horrific fear of stepping on human flesh haunts Tamar Sharvit. And she is not alone. Tamar Rotem looks at indirect victims of terror.

The road is long washed clean; the dead have been buried; and routine has returned to the street. But the memories keep rising and washing over her. Looking out toward the bustling Sharon mall junction and the people casually crossing the street, Tamar Sharvit stares through them, seeing more layers of life reflected in their own. Every once in a while, it appears to her that the bleeding lumps of flesh are still lying on the road and that the gathering crowd is still staring at them, mesmerized.

Sharvit, a 28-year-old student at the Netanya College, was not supposed to be working that Friday, May 18, 2001, when the terror attack at the Sharon mall took place. She works as a security guard in the court near the mall and was there to check out her shift arrangement for the coming week. At the entrance to the court, she suddenly heard a huge explosion and watched a large mushroom cloud rising above the junction. She and another guard started running toward the mall to help the injured.

Four pedestrian crossings lie between the court and the mall's entrance at which the suicide bomber detonated his explosives. The distance can be covered in mere minutes, but took much longer. "The closer we got, the more and more difficult it became to get through," she recalls. "I was wearing sandals with heels. My foot was almost completely exposed. The entire way to the mall was filled with filth and a mess."

The blast was so powerful that it caused pieces of flesh to be dispersed far and wide. But at first, Sharvit did not register the terrible significance of the scene. Reaching the main road in front of the mall, where police officers from the nearby station were trying to restore order, she identified herself and offered her assistance. Although she wasn't in uniform, she was entrusted with blocking off the road to traffic and keeping the crowd at bay.

She remembers people screaming things at her from afar; but engrossed in her duties, she paid no heed to them. From nowhere, a victim identification volunteer appeared, frantically waving his hands and shouting: "Lady, don't step there." But it was too late. She stepped on a piece of human flesh. Weeks later, the so-concrete sensation still made her sick to her stomach.

In the staccato-like speech of a military commander, her eyes hidden by sunglasses, Sharvit speaks of the destruction:

"At the corner, right here around the corner, I saw spilled guts, and further along, someone's arm. I felt I was going to be sick to my stomach or pass out, but I was on duty. And anyway, there were people there in a lot worse state than I was, so I went on."

A stunned woman was sitting in a closed car. Sharvit helped her out and then drove the car herself away from the junction. And again she was gripped by the fear that she would "run over some flesh with the wheels of the car."

But shocking her no less than the stained tarmac and the scattered body parts was the amount of people she was forced to keep at bay - rubbernecks who turned up on the scene. "They put down material and packets on the pieces and kept shouting, `There's another piece here' or `Don't step here.' It was like a perverted circus."

Her senses dulled, Sharvit went about her task for more than two hours, until a policewoman collapsed in front of her. "She couldn't stop crying. It was difficult for me because I tried all the time to keep a hold of myself. When everyone started calling and asking how I was, I broke down."

Sharvit recovered only after two long months. She collapsed from exhaustion in the shower at home after the attack. She felt her legs go weak, as if she was afraid to step on human flesh - that same paralyzing fear. "I dreamed and had visions of attacks at the court, at the college, everywhere. I was scared I'd be blown to pieces in a bus and all the residents of Netanya would see bits of me scattered around."

The nightmares come back to haunt her to this very day.

Persistent tears

Encouraged by her boyfriend and mother, Sharvit reported for her next shift after the attack. But behind her sunglasses, the tears wouldn't stop rising. And it was the same on the following shifts, too. Her superiors didn't ask a thing. "They weren't aware of my problem at all," she says.

For more than six months, Sharvit wouldn't leave work and walk toward the junction, and has only been into the mall once since. "There could always be a piece that was left behind," she says.

Firecrackers became the in thing among the children in the neighborhood, and Sharvit's heart dropped each time she heard a bang. Even the sound of a low-flying plane overhead startled her. She alienated herself from her immediate surroundings, even people who were important to her, and sank into a depression. "I couldn't stand being in the presence of anyone," she recalls. Until one day, her grandmother, a Holocaust survivor, said to her: "Look what you look like. Don't forget, you are made of much stronger stuff."

Sharvit realized she needed help. "I felt weak, miserable. How dare I feel like I felt," she says. "At first, I thought I would cope with it alone, but I felt I was going insane, as if someone was putting a video tape into my brain and playing the attack over and over again."

Sharvit turned to the Israel Trauma Center for the Victims of Terror and War (known by its Hebrew acronym, "Natal") and was referred to an art therapist. Today, Sharvit is functioning, but without any joie de vivre. "Like everyone else, I used to think, `it won't happen to me,'" she says. "After what happened, I am sure it will; it's just a question of what and where."

The nightmares still haunt her; the sound of a distant ambulance siren is enough to arouse a sense of disaster in her. She travels on buses, but on a number of occasions, based on an inkling of fear, she has stopped an entire bus, requested ID cards from passengers and checked people who appeared to her as suspicious - the contents of bags, too.

Sharvit is not recognized as a casualty by the National Insurance Institute, which is responsible for implementing the Compensation Law for Victims of Hostilities. Her claim is being held up due to bureaucratic details: Because she wasn't evacuated to hospital, she has no document to prove that she was indeed at the scene. "I didn't go register at the police immediately after the incident; I didn't think I was some psycho who needed help," she says. "I have no intentions of bankrupting the state. There are disabled who certainly need the money more than I do. But I think I do at least deserve help with funding the psychological care. I went to offer my assistance; I helped. I think that gives me some kind of right."

In the professional jargon, they are known as "the secondary circle of trauma." Those who help during mass disasters - the police, Magen David Adom workers, fire-fighters - often see worse sights than are seen by those who are involved in the incidents themselves. The injured are evacuated from the scene quickly, while the rescue teams remain in the area and are exposed to the sights for many hours. Like them, the doctors, nurses and psychologists who treat the victims are also exposed to the harsh scenes and the experiences of the victims. Some 20 percent of them, according to researchers, are likely to suffer from symptoms such as those characteristic of post-traumatic stress disorder. The professional term coined by researchers to describe the phenomena is "compassion fatigue."

Those who clean up the sites of terror attacks, the individuals who fix the traffic lights, the metalworkers and municipal officials who arrive to restore order and routine are all exposed to the trauma. In cities in which numerous terror attacks have occured, the nature of the city officials' work has changed completely. They are no longer concerned with issuing citations or sleepily keeping watch; they are now on constant alert in locations that are exposed to terror attacks, such as markets, and busy themselves with restoring order in their wake. The professional literature also mentions media crews and workers from human rights organizations as being vulnerable to the trauma.

Just a decade ago in the United States, the experts began discussing the phenomenon of compassion fatigue among members of rescue teams, even those who functioned with distinction during the incident itself. The syndrome can manifest itself not only in psychological difficulties, but also produces physiological symptoms. The rescuers, as they are known in the professional literature, have developed worrying signs - depression, anxiety, unrest, a certain dullness of the senses and alienation, and a feeling of uselessness ("What am I worth?"). The symptoms also include loss of appetite, weight loss and disturbed sleep.

"The belief that the more exposed you are, the stronger you get, is unfounded," says Dr. Ze'ev Wiener from the Mental Health Clinic in Ramat Chen. "The uniforms help, but only in the short term. When they get home, they are liable to break down."

Haifa Municipality officials have a hard time hiding their laughter when Dr. Roni Berger, a clinical psychologist at Natal, asks them to close their eyes, connect to themselves and imagine their feelings. It appears as if they have never been asked to do something like that - and they still don't know that later in the day, they will even be asked to draw. This is a "Rescue the Rescuers" seminar, one of dozens of Natal seminars designed to help teams that have worked at the sites of terror attacks to combat fatigue and a sense of being drained. Most of the time during the seminars is dedicated to "airing emotions."

Berger: "People have to speak about it, but the objective is also to examine how they are coping, to reassure them that it's okay to feel what they are feeling, and to try together to find the emotional resources that can help them cope in the future."

Over the past year, Berger has been visiting various organizations twice a week, arranging the teams in a circle - hospital nurses, health maintenance organization workers, municipal officials - and listening to their stories. At the Hadera Municipality, one official, a Russian immigrant, tells him that since the terror attacks, in an effort to immunize himself, he has been constantly watching war films from Chechnya in which acts of abuse and mutilation are depicted. Even the ultra-Orthodox Disaster Victim Identification organization has come to realize that the issue is a vital one, and Berger will soon begin working with this organization, too.

Following the terror attacks in Haifa, all municipal employees, at all levels, participated in the seminar. The talk with the tough-looking officials who patrol the streets revealed that they are living at a high level of anxiety and that they don't all share their experiences at home. Most spoke of their concern for their children. Two related that in the evenings, they go out together to keep watch from afar over their daughters who go out to have fun in the city. "So if something happens to them, we will be nearby," one says. The girls, of course, know nothing about it.

Farji Elias, a Christian Arab, was at the Matza restaurant when it was attacked. He has stopped eating meat since then. "I saw terrible things. Since then, I am always under stress." Elias's son, who serves in the army, was injured some six weeks ago, and Elias went out of his mind with worry. Today, the boy is fine, but the father insists on driving him to and from his base in the south of Haifa.

Aside from the street officials, the circle also included electricians, welders and metalworkers, who appeared constantly with looks of surprise on their faces. Embarrassed, most didn't know what to do with their gnarled hands; they weren't told the reason for the gathering and kept quiet for most of the time. One of them, a metalworker by the name of Yossi, says that after the attack at Halisa, he was called in to clean the flesh off the windows. "I fought in the wars; brothers of mine died, but here it is different," he says. "The war ends eventually. Here, you don't know where it's coming from and when it will end."

Despite participating in the seminar, a number of the officials doubted its effectiveness.

Dr. Ze'ev Wiener believes, however, that it is possible to strengthen the resolve of the teams both before and after an attack. Managers must make sure that the duration of the shifts is reasonable, and that the teams eat and sleep properly. "[They] must be acquainted with the team," he says. "If someone suffered a trauma recently, such as the death of a parent or abandonment, he must not be allowed to work on the front line of a disaster.

"Most people want to survive. They were at an incident. All they want to do is to go home in peace and not speak about it." Doctors, he adds, constitute the most unwilling group when it comes to organizing seminars to combat compassion fatigue - the police too.