On Oct. 7, 2023, United Hatzalah, a volunteer emergency medical services (EMS) organization, managed to mobilize about 1,700 volunteers out of its network of more than 7,000 across the country, along with over 30 ambulances, more than 100 emergency vehicles, two helicopters, SUVs, and other necessities. The thousands of other volunteers were also busy, albeit not in the South; they were tending, as usual, to other emergencies in the country, such as heart attacks and allergic reactions, and a good number of them were immediately drafted into the reserves.
A year later, volunteer EMTs Drs. Adam Ballin and Shlomo Gensler recalled that horrific day in separate conversations with the Magazine.
BALLIN, A 39-year-old family physician at Maccabi Health Services, made aliyah in 2013 from Sydney, Australia. A resident of Jerusalem, he began volunteering with United Hatzalah within a year of moving to Israel, but not for the first time. He had met Eli Beer, United Hatzalah’s founder and president, and Dovie Maisel, vice president of operations, in 2003 while studying at Midrash Shmuel, a haredi yeshiva in Jerusalem. After returning to Sydney, where he studied medicine at the University of New South Wales, he volunteered with United Hatzalah on numerous trips to the Jewish state.
A married father of five, Ballin rose early on that fateful Simchat Torah, looking forward to celebrating one of his favorite holidays. Already, sirens had wailed in the city. “In Jerusalem, when it’s quiet, you can hear the reverberations of explosions, and I heard some. On the way to shul [synagogue], I got a call from the dispatcher – a conference call – at about 8 o’clock. We were told about a major situation in the South – lots of rockets, terrorists rampaging. A responder was in the field on his own, treating a patient who was shot in the chest. The equipment was all used up; the patient wasn’t responding, and there was no treatment. He asked us what to do,” the volunteer EMT said.
“In the background, we could hear that there was no sign of life from the patient – he had been shot by a terrorist – as well as the explosions and the shooting. He [the medic] was exposed, out in the open; he was out of equipment. There were no ambulances or forces coming to help him; he was totally alone. At this point, we told him to get to a safe place and barricade himself until we could get people there.
“That was a very jarring way to start the day. Right after we hung up, we heard the tzeva adom [red alert siren], and then had a conference call with the director of operations.”
THE DOCTOR then described the dilemma they faced in the first hours of the attack.
“The problem was that we had this massive situation in the Gaza border region, and we didn’t know if the attack was a coordinated effort or if terrorists would start coming in from the North or from Yosh [Judea and Samaria]. So, should we take all our forces down there or hold on in case rockets start flying all over the country? It was a very difficult decision to make, but as we got more information it became clear that the main issue was the South, and we had to start getting heavy forces down there,” he said.
“The call center was flooded, giving advice to people in Be’eri, Kfar Aza, and all the communities where people were locked in their safe rooms, among them many wounded.”
When the decision to go south was finalized, Ballin said a quick goodbye to his wife and asked Rabbi Binyamin Moskowitz, the rosh yeshiva [dean] of Midrash Shmuel, for a blessing. “This is your mission. You’re needed there. This is your life’s work, and you must go,” the rabbi told him.
“I didn’t know if I’d be back, and I didn’t know what I was going to, but my wife was very supportive, despite hearing all the risks involved while sitting in the safe room and hearing the back and forth. It was very emotional. My rebbe’s blessing gave me strength,” Ballin said.
“At the beginning,” he continued, “we thought there might be some people killed, then we thought there might be dozens of people killed, and then there were reports about hundreds being killed. We had reports of people counting bodies – 30 bodies here, 60 bodies there – and at first, we wondered if they were exaggerating or maybe just overwhelmed.”
WORKING NON-STOP amid the carnage, the gravity of it all “didn’t sink in right away,” he said. “We just kept moving in robot mode. We understood what our mission was: to stay as safe as possible but also to save as many people as we could. We realized very early on that things had gone badly wrong and that we just needed to do the best we could.”
When asked if he suffers trauma, he replied, “This wasn’t my first rodeo, but it certainly was my worst rodeo. In the days after, I was eating less. I took a few days off work to rest and recover. On the first day of the war, I worked for about 24 hours straight, so by Sunday morning I was wiped and stayed in bed for 12 hours. I was also lucky in many ways. My role wasn’t as traumatic as some of the others.
“However, it was a big loss of innocence,” Ballin said. “Without getting political, we had gotten used to living with a certain sense of quiet, with little flare-ups here and there. So, it was a surprise – similar, I think, to what people felt when the Yom Kippur War broke out. Initial shock and disbelief, asking how it went so wrong and how we could have been caught by such surprise.”
MANY WONDER: Will this be a generation of “survivors”?
“I grew up in Sydney, which has one of the largest populations of Holocaust survivors in the world, and most of my friends’ grandparents were Holocaust survivors,” Ballin said. He remembered when the University of Southern California (USC) Shoah Foundation was started. Founded by Steven Spielberg, it sent film crews to his school. “My friends’ grandparents would come and give testimony,” he recounted.
“So it was very jarring to me when, a few weeks after Oct. 7, I got a call from the Shoah Foundation to come and give testimony. ‘Hang on,’ I thought; ‘that’s something that my friends’ grandparents who are Holocaust survivors do. It’s something that we watch on TV,’” Ballin said.
“That was a real paradigm shift moment for me. It felt like they took a day from 1943 and transplanted it to 2023.”
Still, “it wasn’t all doom and gloom,” the doctor said. “Even in the midst of all the horror, there were some amazing miracles that happened – and despite the horror, I did feel God’s providence on that day.”
Ballin recounted some incidents in which people survived and recovered against all odds, often due to the arrival of help and resources that were totally unexpected. He also talked about a father who came to the triage after pushing on the door handle of his safe room for 12 hours straight while terrorists were shooting and trying to open it. “He just held on for dear life and saved himself and his daughter. I’m just in awe of the bravery,” the EMT said.
SHLOMO GENSLER told the Magazine that “like everyone else in Jerusalem, we woke up to the sirens in the morning. It was a bit of a shock.”
An oleh (immigrant to Israel) from the New York area, he and his wife studied medicine at the Technion in Haifa in 2014. While in medical school, he began volunteering with United Hatzalah.
In the US, Gensler first earned a degree in business. He began volunteering on the side in ambulances for 911 emergencies, “and that pulled me to study medicine.”
An anesthesiologist, he works in the Intensive Care Unit at Hadassah Hospital. “Emergencies are very much my specialty,” he said.
A father of four young children, he’s often on call throughout the week but more so on weekends.
On the morning of Oct. 7, he had his radio on and heard that “something was going on down south, but no details. While I was getting ready for shul, there was another siren, and then I got a call asking if I’d be willing to speak with people trapped in the Gaza border region.”
At that point, “we heard there was some kind of mini-invasion going on and that some terrorists had crossed into Israel, but it was still very spotty information. So I started speaking to people, giving medical advice.
“The first person I spoke to was in Kfar Aza in a safe room. Her father had been wounded by a rocket and lost a significant amount of blood; he was going in and out of consciousness. She asked if there was any way to get evacuated. I called the army hotline, and the representative said, ‘I’m sorry, but we’re just not in control down there. We aren’t able to help them.’
“That was the biggest shock,” he said, regarding the army’s inability to help citizens under attack.
“The person in the military said that maybe they should make a break for it. I called them back to tell them that, but then I heard rapid gunfire in the background, and I was able to hear explosions. They couldn’t go outside.
“Then it sank in: the gravity of the situation. They started asking for help, and they specifically called me to come down.”
GENSLER ASKED his wife how she felt about his going, “and she immediately responded, ‘This is our country. We’re under attack. If you need to go, that’s the right thing to do.’”
He took another EMT, Moshe Paskesz, along in his intensive care jeep and headed south, to Heletz Junction. “It was a staging area. We encountered our first fatality there,” he said.
“We had bulletproof vests and helmets from United Hatzalah, but when we started to hear the news and learn more about what was happening, we understood there was a massive invasion, RPGs, and things that were much graver than firearms. We understood that we were going into a war zone. You could see the rockets in the air and the Iron Dome responding to it... There were many wounded people with no one to treat them,” Gensler recounted.
“We went to Sderot, and then started driving toward Ofakim – there was active fighting in the area – to try helping and saving people. We started to see abandoned cars,” he said.
“There was a body lying face down. There was no pulse. We flipped it over and saw bullet wounds all over the back. His eyes were blown out. It was very grotesque. Being naïve at that point [regarding the number of casualties], we started moving the body out of respect, not to leave it in the middle of the street. It looked like he was a middle-aged security guard on his way back from work, and we put his body on a stretcher in the jeep,” Gensler said.
“Afterwards, the number of bodies we saw on the ground...” he said, pausing. “We understood the enormity of the situation and kept moving further in. We took the bodies back to the Heletz Junction area. Not only were we taking wounded people; we also emptied one of the logistics trucks to store the bodies in a respectful way. Then we went toward Netivot, and on the way we began witnessing the carnage – cars everywhere, strewn bodies of people who were gunned down while trying to run.”
Echoing Ballin’s dilemma about whether to concentrate the entire effort on the South, he continued: “They kept saying there’s a terrorist invasion, but no one knew from which direction they were coming. There were police and soldiers around, but they were also very uncertain. Just down the road, there was a police car that had been hijacked by terrorists in a firefight just shortly before we arrived, and a terrorist was dead inside the police car. The terrorists had been hijacking police cars and ambulances and driving them... It was a very tense situation. We could hear the gunfights as they happened.”
AMONG THE patients Gensler treated was a soldier who was shot in the head; the fighting was just down the road. “I’ve responded to many terror attacks and routine calls in Jerusalem, but what I saw there in one day was what we’d normally see in months,” the doctor said.
Two blocks away, a missile fell. “We were running back and forth to the bomb shelter while treating patients as they kept coming. We stayed there for a few hours, and then advanced with the fighting to Shuva Junction, near Kibbutz Be’eri, and set up a larger triage area with some military personnel there. We had started running out of equipment very quickly, so I had the logistics team bring a truckload of medical equipment and stretchers that we set up on the side of the road,” Gensler said.
“A lot of us who were there have kept in very close touch since then – not only from United Hatzalah. It was a very defining moment.”
Many foreign workers were wounded, and many families were being evacuated, the EMT said. “An older woman was shot in the chest, but the bullet missed her vital organs. There were many wounded soldiers. You could see a lot of the pain and anguish in those soldiers’ eyes. They were feeling completely overwhelmed and unprepared. Someone told me his best friend had just died in his arms...
“United Hatzalah was the only emergency service that allowed its volunteers to give medical assistance in that region,” Gensler said. “ZAKA was also there, but they don’t give medical care. They have the gory job of collecting body parts.” He said that the army and United Hatzalah were working together.
After Shuva, they advanced to Be’eri and Nahal Oz. The United Hatzalah ambulances were going into the kibbutzim. “It was a bit terrifying driving in the dark in a terror-infested area... We drove over shrapnel and could hear it crunching under the wheels. We saw bodies and blown-up cars and army trucks. Fields and houses were on fire, like those villages on fire that you see in pictures from the Holocaust,” he recalled.
“I was speaking to different soldiers, and it was very chaotic until the evening, when the full military response started to kick in.” Up until then, when he would ask soldiers where their units were, they had no idea.
“At the same time, I saw a tremendous amount of bravery and people caring for one another. There had been that big divide in Israel [over the planned judicial reforms], and it just dissipated. There was one soldier looking at another – both were wounded pretty badly – and he said, ‘Take him first – he looks worse than me.’ There was a lot of that.”
GENSLER THEN described the moment that hit him the hardest: A woman came and told them that her grandchildren were trapped in a safe room – as he recalled, likely in Kfar Aza – so the doctors put her in touch with the army.
“Within 40 minutes, they rescued those kids,” who looked to be about nine or 10 years old. “They said they witnessed their parents being killed in front of their eyes. They were tired and hungry; they hadn’t eaten all day. That was the first time I broke down crying. I had to walk away,” he said.
“When you’re down there working, you’re in this adrenaline mode. Basically, experiencing that raw pain of seeing new orphans, seeing these innocent children – it was very intense. But then I had to shrug it off and go back to treating people.”
He worked non-stop from 12:30 p.m. on Saturday through to 7:30 the next morning.
“I was collapsing,” he said. “I was slurring my words out of exhaustion, but when someone would ask me a medical question, I’d just perk up and get back to it. At that point, it started to slow down a little bit. We drove back to Jerusalem, and when I got home my kids jumped on me. The contrast of being in an intense war zone and coming home to your family that you love was a very emotional experience and definitely very challenging. I slept for five hours, and then went back down to help again.
“It was very difficult to witness, but I’m not living in trauma,” Gensler said. “I see very difficult things as a doctor, especially in a large trauma center – terrorist attacks in Jerusalem, incidents in the ghetto areas in the US.” But on Oct. 7, “it was just the severity and the brutality of it.” He credits his “amazing, supportive wife, who’s also a doctor, and we’re able to talk it through, which is very therapeutic.”
“ONE STRENGTH about United Hatzalah is that we have volunteers spread all over Israel – Jews, Arabs, Christians, Circassians, Bedouin, Druze,” Ballin said. “That’s the beauty of it and how we can manage a 90-second response time. We embed people in every community across Israel.
“It doesn’t matter if a patient is male or female, in Mea She’arim, Rahat, the beach in Tel Aviv, or anywhere else – we will rush there in 90 seconds to help.”
“United Hatzalah is Israel, and Israel is United Hatzalah,” said Gensler. “They have every walk of life and volunteers from every spectrum of society.”