Two female Israel Defense Forces soldiers are sprawled out in the corner, snacking on potato chips, sending messages from their mobile phones, looking bored. In front of them, lying in the hospital bed, eyes closed, her dark curly hair matted, a small unopened prayer book propped up on her chest, is a woman just about their age.
She is not, however, a friend. Rather, Amal Jamal Takatka is someone accused of stabbing an Israeli hitchhiker in the neck with a small steak knife on December 1 at the Gush Etzion junction – a 22-year-old suspected terrorist whom these 19-year-old soldiers have been sent to guard.
A few elevator stops below, in the ground-floor intensive care unit at Jerusalems Hadassah University Hospital, Ein Karem, Canadian-born Chaim Rothman is also lying in a bed. His eye is bandaged, his skin is pale, and he is shaking. He is not expected to be released anytime soon.
The 54-year-old father of 11 has been in a medically induced coma ever since he was brought in on November 18, gravely wounded by terrorists who hit him on the head with a meat cleaver while attacking his synagogue in Jerusalem's Har Nof neighborhood. Four other people praying alongside Rothman were killed that morning, as was a Druze policeman who came to their aid.
Rothmans wife, Risa, 48, sits outside his room, as she has done every day, all day long, since that morning. She knows a suspected terrorist in another case is being treated in a room not too far away, just as she knows other terrorists have come and gone through these halls, and will come and go again. But, she says, she disconnects.
Why go there? she asks, fiddling with her hands. I hear the chatter. All the talk about, this shows how humane we are, but I dont engage. I am not going to put energy into anything I cant change.
Commitment to care
The commitment of Israeli hospitals to treating perpetrators of terror, says Charles Sprung, director of the general intensive care unit at Hadassah in Ein Karem, and head of the hospitals Institute of Medicine, Ethics and Law – is indeed one of those things that cannot be changed. Nor, he stresses, should it be.
Charles Sprung, director of the general intensive care unit at Hadassah in Ein Karem. Photo by Emil Salman
He references the Hippocratic Oath, under which he, like all physicians, is bound to act for the benefit of the sick according to ability and judgment, and to keep patients from harm and injustice. Sprung, a religious man, also cites the Oath of Maimonides, the famed 12th-century Jewish physician, which obligates doctors to never see in the patient anything but a fellow creature in pain. Sprung shrugs. That is all there is to it, really.
A counter argument could be made, and sometimes is, that the Geneva Conventions ־ which provide guidelines for the medical treatment of enemies and prisoners of war – do not extend to terrorists, as these are defined as unlawful combatants or unprivileged belligerents who themselves, so goes the logic, do not follow the laws of war.
Is it incumbent upon individuals in a nation whose very existence is constantly being threatened to act compassionately toward those who set out to destroy them? asks Avi Rivkind, head of Hadassahs Division of Emergency Medicine and Trauma, in an oft-quoted 2009 paper co-authored with colleagues from the IDF and Haifa's Rambam Medical Center in the American Journal of Bioethics (Medical Care for Terrorists – To Treat or Not to Treat by Gesundheit, Ash, Blazer and Rivkind). Should hospitals expend limited public health care resources on a terrorist, thereby perhaps depriving other patients of medical care? the authors wonder.
The answer, they conclude, is clearly yes.
Its not that we applaud what such terrorists do, explains Rivkind, who has spent 30 years at Hadassah, a hospital which, due to its location and the fact that it runs a sophisticated trauma unit, says it has over the years treated more terror victims – and terrorists – than any other medical institution in the country.
Quite the opposite. They take human lives whereas we try to save them. There is a big discrepancy between us and no bridge" between terrorists and physicians, he says. But we have our obligations under the Hippocratic Oath. So, at the end of the day, there is really no question.
Even national security or political concerns – such as the possibility of future exchanges of prisoners which could allow a cured patient to resume terrorist activities – should not in any way be seen as relevant to the medical treatment rendered, stresses Rivkind.
In equal measure, adds Sprung, benefits that might be gained by treating a terrorist – such as the possibility that, once saved, he or she might provide valuable information under interrogation – also do not guide the care that is given.
We just focus on our jobs, they both agree.
And so injured terrorists are wheeled into Israeli hospitals, sometimes right alongside the victims, and are cared for, year after year. The resulting interactions – even at a hospital like Hadassah that is used to the daily mixing of doctors, staff and patients of all kinds, from Orthodox Jews to right-wing settlers to pious Muslims and Christians – can be surreal.
Treating terrorists at Hadassah University Hospital. Photo by Emil Salman
There was the time the father of a suicide bomber, who suffered heart failure the day after his son perpetrated an attack, was treated on the same ward at Hadassah as one of his sons victims. There was the Palestinian doctor who found himself caring for his next-door neighbor – who, it turned out, had just committed a terror attack. And the settler-nurse asked to care for a terrorist who had killed her neighbor (she was granted permission to pass her duties onto a fellow nurse).
Finally, Rivkind recalls, there is the famous tale of the mother of one terrorist – Samer Kawasbeh – who knitted tablecloths as farewell gifts to her sons Jewish doctors when he was discharged and headed off to prison. It was, Rivkind notes, a beautiful tablecloth.
The IDF and the Israel Police typically pick up the tab for the medical care of suspected terrorists. In some cases, the hospital itself does. For example, in the case of Kawasbeh, a Hamas member who stormed the Church of the Nativity in Bethlehem in 2002, taking monks hostage – his months of treatment, for septic shock brought on by an untreated gunshot wound, cost $350,000.
I have got to believe that the terrorists appreciate what we do for them. And I do think they are often surprised by our humanity, says Rivkind. I would not be surprised if many changed their stripes and decided not to partake in terror anymore. Even if they dont, he half jokes, their mothers might stand in their way next time.
Sprung is not so sure. We took care of a terrorist here many years ago who was later freed in a prisoner exchange. He gave an interview in which he was asked how he was treated in the Israeli hospital and he said he greatly appreciated it, and imagined he could not have received better treatment anywhere the Arab world, the doctor relates. Asked afterward if he intended to leave his terror ways behind, he said: No. One thing has nothing to do with the other.
I actually thing we sometimes overcompensate, and go above and beyond when it comes to treating terrorists, Alon Pikarsky, acting head of surgery at Hadassah, says thoughtfully. We have this desire to show ourselves, and show the world, that we are a light unto the nations.
A nurse in Pikarskys department, Hadas Sapir, recounts how Maher Hamdi Hashalamun – the terrorist who stabbed and killed 26-year-old Dalia Lemkus as she waited for a lift home on November 10 near the settlement of Alon Shvut southwest of Jerusalem – was brought to Hadassah after being shot by a security guard. He soon began complaining about the service and never thanked any of the staff, she says.
One of the nurses who was taking care of him sat down outside his room at one point and just cried, Sapir says. We are human beings, of course, and Israeli citizens.
When asked if he believed that doctors in, say, the Gaza Strip would act similarly when faced with an Israeli soldier brought into their hospital, Pikarsky answers immediately: Without a doubt, he says. I am sure they would also honor their professional obligations.
One of the nurses nearby shakes her head. She is not convinced.
Nurse Aline Ben David at Hadassah University Hospital. Photo by Emil Salman
Thirteen years ago, Dvir, a settler from Beit Hagai near Hebron, was wounded in a terror attack and hospitalized in Hadassah. He spent months here, and then years coming back for more and more operations – he stopped counting at 30, he says – to try and fix his shattered limbs.
Today, hobbling on a cane at 26, Dvir, who asked that his last name not be used, still comes in once a week for physiotherapy, and sticks around to volunteer in the hospitals heritage center, devoted to the history of the Hadassah Women's Zionist Organization of America.
Its just the way it is, says Dvir, echoing Risa Rothmans comment, when asked both about Israeli hospitals' treatment of perpetrators of terror, as well as of relatives of avowed enemies of the state – for example, the granddaughter of Hamas leader Ismail Haniyeh, and the sister of Hamas spokesman Moussa Abu Marzouk.
When I was a child, I would rage and ask why we were treating these people, Dvir admits. I hated the sight of them. But, over time, that anger has subsided, and he has come to accept how things work at this home-away-from-home.
I grew up, he says, And I realized that rules are different in here. A hospital is not a battleground.
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