On a stone wall at the Genocide Memorial in Kigali, Rwanda, there is a quote that inhabits the periphery of my mind: “If you knew me, and you really knew yourself, you would not have killed me.”

I was in Rwanda to teach a trauma surgery course, but I have never felt closer to home than I did at that moment. As I walk the halls of my hospital south of Tel Aviv, the last few years have been, to put it in medical terms, completely heartbreaking.

The hemodynamic collapse of our region is visible everywhere. I see them in the photos from a Palestinian resident’s wedding that I missed because of the war. I see them in the continued clinic visits of a 23-year-old woman, shot five times on October 7th, whose father looks at me with eyes that mirror my own, also as a father of a teenager – protective, weary, and simmering with rage. Outside the endless ‘booms’, the clinks of falling shrapnel in front of my feet, the infinite footage of mass destruction and suffering.

As this regional war expands, we have moved the majority of our hospital underground, bracing for a “mega-mass casualty” event. I know the situation is complex. I know the intelligence agencies are neck-deep in a web of global interests, alliances, and agendas. I realize only a fraction of reality is broadcast by news agencies and social media experts. Yet, while leaders talk about the expansion of borders and billion-dollar munitions deals, I am anchored by a different reality: the one we are persistently and stubbornly building beneath the surface, amidst the heartbreak and the smoke.

For five years, through a program called Operating Together, we have brought (and continue to bring) over 400 Palestinian and Israeli physicians and nurses together for trauma care training. Even during the most brutal days of the Hamas conflict and now the Iran war, we continue. In a quiet room, 10 Palestinians and 10 Israelis are training to save lives together.

Our courses are a microcosm of the realities of our communities. There was Dr. X, who had just returned from reserve duty in the ruins of Khan Younis to teach. There was Dr. Y, whose family members were killed in Jabalia. There was Dr. Z, who lost his childhood best friend in a kibbutz on October 7th. Just last week, the Israelis and Palestinians had to pause the course to go down together into the basement of the hospital as the sirens blared to stay safe from the incoming missiles.  In the eyes of the world, they are enemies. In reality, they are together, sharing a common obsession and devotion in the trauma bay: to work together and keep the patient alive.

What is more human than saving a life together? When there is blood on our Blundstones and the trauma team is moving with the rapid precision of Chopin’s Winter Wind, the patient is neither left-wing nor right-wing. There is no religion, no “good” or “bad” person. There is only a human, and an urgent need to stop the bleeding and return them to their families, their pets, their lives.

This is the core of our training. It is part of why I love what I do with a grateful, humble, and relentless passion. From this human-first-focused tenet, I believe there are principles of “health diplomacy” that our leaders must adopt in order to survive (at least our souls) this current era.

The first is “Relentless Commitment to Life.” In medicine, we advocate for the patient regardless of who they are when they arrive on our hospital bed. Our leaders must become equally obsessed with the survival of civilians, blind to which side of the border they inhabit. This cannot be a secondary concern; it must be the primary mandate. To lead is not just to hold territory or monetary profit, but to ensure that populations can thrive, flourish, and reach their individual dreams.

The second is the “Anatomy of the Mistake.” Surgeons are shaped by their complications. We review our errors in Morbidity and Mortality conferences to learn from our mistakes and be even better than before. Our political leaders, conflicting sides, must come together and acknowledge their mistakes – historical and recent – in order to move forward and be better. 

Finally, we must return to the foundational oath: “Do No Harm.” We must move away from the norm of an explosive kinematic force and the belief that destruction is a viable path to security. Peace, after all, is the most effective injury prevention program ever devised.

Six months into the war with Hamas, I was having coffee with a friend, a lifelong “hippy” who preached love when she was not dancing at music festivals. She looked at me and said, “I don’t care what happens to them anymore.” Her limitless hope and love were destroyed, dissipated, and fossilized in some deep, deep place.

As a trauma surgeon, as the person I am, I refuse to lose, or even fossilize, hope. I have seen too many young humans speaking their last words with bullet holes sprinkled over their torsos – scared and vulnerable. I have told too many parents/partners/children that the human they had breakfast with is gone. And on these same days, I have seen my Palestinian colleagues navigate three-hour roadblocks just to treat Jewish patients (among others). I have seen Jewish maintenance staff helping elderly Arab men into their gowns with the tenderness they would show their own fathers. At these moments, all of these people are the same religion, sex, race, politics – the same exact human biochemistry. Life is precious and fragile; we don’t have to destroy it if we focus on trying not to. This is the truth, and if we choose humanity, peace will prevail. 

Most say that war is inevitable, it is human nature, the “Lord of Armies” is whom we pray to. But in the trauma unit, we have already broken that cycle. If we can operate together in the basement of a hospital while missiles fall above us, our leaders can find a way to sit in a room and work it out.

We have the skills to stop the bleeding. Now, we just need the political will to put down the knife.

© The Times of Israel (Blogs)