“The Angel of Death” Paramedic Reflects on Meron One Year Later

By Avi Marcus

I felt like the angel of death last year in Meron. I was supposed to leave the mountain and the festival at 12:00 a.m. as that is when my shift ended. I am the Deputy Head of United Hatzalah’s Medical Department and a paramedic. I was in charge of the medical treatments given on the mountain during the Lag Ba’Omer festival. We have a member of the medical department present at all times to oversee the two medical clinics that the organization operates as well as the 8-15 teams of volunteers active at any given time during the celebration. My job was to make sure the proper treatments are being given to those who need them and to orchestrate with our dispatch center as well as other medical organizations in the area any and all medical needs, everything from making sure all of the medical supplies were in order and that we had enough of everything to treatment to transporting patients off the mountain.

Psychotrauma and Crisis Response Unit volunteer comforting a distraught EMT after the tragedy in Meron

I didn’t leave at midnight. Instead, I stayed to talk with some of my fellow responders for a while and check in with them to see how they were holding up on one of the most active nights of the year. Just before 1:00 a.m., the tragedy began to unfold and I was right in the middle of it.  

At the beginning, the call went out that a balcony had collapsed. We didn’t quite know what was happening, but we ran to the location indicated. I found a man lying on the floor, and together with other first responders, I began performing CPR on him. Someone came up to me and asked me why I was performing CPR as this was a mass casualty incident (MCI) and as one of the highest-ranking medical personnel at the scene, I had to manage the scene itself. I looked a few meters further down the path and that is when I saw multiple teams performing CPR on multiple casualties. That is when I understood the magnitude of what was taking place. It wasn’t a collapsed balcony, but a crush, and it was a major MCI. 

I couldn’t perform CPR on each and every one of them, that wasn’t my job at that moment. I switched to MCI protocol and I began going back and forth between those who were receiving CPR and I began declaring people dead. As it was loud and as per MCI protocols I checked pulses for 20 seconds each, not the usual 10. I checked the pupils of each individual multiple times to make sure that there was no response. These signs are some of the tools used to make sure that the person was actually deceased and had no pulse, and not simply miss their life signs due to the noise or chaos at the scene. 

That is how I passed through the crowd. Declaring people dead right and left. Sometimes I even declared a person dead multiple times because when one team stopped performing CPR and left the body to go help someone else, another team came and began performing CPR once again, not knowing that the person had already been declared dead. 

I remember the vast number of volunteers that had gathered and the incredible amount of medical supplies that were used and then simply strewn on the ground with no time to clean them up as teams went from person to person trying to save them. There were CPRs taking place in multiple locations a few meters away from where the tragedy took place, was taking place. Some of them were inside the clinic of United Hatzalah which was just a few meters away from where the crush took place. Some were further away on pathways that had been cleared for the purpose. Everywhere I went I declared people dead. Over the course of a short period of time, I declared more than 30 people dead.

At some point, we collected all of the bodies of the deceased at the lower parking lot. At that point, I helped bring a few more bodies from our clinic down to the parking lot. Then a doctor came from one of the ambulance teams and again pronounced the death of those who I had already declared deceased. 

Once the incident was over, and those injured were transported and those deceased had been properly taken care of, as much as we could at the scene, I went to work in my other job, as the Director of the Psychotrauma and Crisis Response Unit. Throughout the evening members of our unit who were at the mountain for the pilgrimage were providing psychological care and emotional stabilization for the eye-witnesses and survivors, those who made it but were traumatized by witnessing the horror of the evening. 

After everyone else was cleared off the mountain, we held a debriefing circle for the responders themselves. I went out into the forest and the area around the mountain and collected all of the volunteers who had gone off to cry by themselves. I brought them back so that we could cry together and through this, begin the process of healing. For some of us, this would be a process that would take a lot of time. Some of the volunteers took months to fully recuperate from the experience. Some of them still haven’t. Our unit tried to help them all. Through a group meeting that night at the mountain, phone calls throughout the next day before Shabbat, and then 15 group meetings in different locations around the country on Saturday night. Wherever the volunteers were located, that is where we had highly trained personnel from the unit performing debriefing circles and group therapy, not just for United Hatzalah volunteers, but all first responders were invited and many came from other organizations. 

In one instance, I brought a responder to the mountain 8 months after the incident to heal. She hadn’t been sleeping for the entirety of the time since the tragedy. I went with her to visit the mountain and told her, here you tried to save lives. 

Shortly after the incident, I felt a lot of anger, even rage. I didn’t sign up to be the angel of death, to pronounce the death of more than 30 people who went to celebrate a holiday. I had my own personal crisis. I changed my job and lessened my responsibilities from being the head of the medical department in United Hatzalah and became the deputy so that I could go out to the field less. I wrote protocols to assist the organization in handling MCIs better and respond faster. No we train all of the volunteers in MCI protocols and have spent the last year doing so. 

Now, a year later, I’ve managed to make my peace with what happened. I still feel like I was the angel of death that night, but I know in retrospect that I acted according to protocol and the work I did perhaps saved some others who may have met a different fate had I acted differently. Perhaps even the angel of death has a purpose, perhaps even the angel of death can save lives.

 

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