"Every day there is resuscitation, souls, deaths. It is difficult to remain optimistic" • While the vaccine euphoria is taking over the country, hospitals are once again fighting for the lives of hundreds of critically ill patients • A day in the corona ward at Shaare Zedek, the busiest in Israel • Report from the battlefield
"A lot of times the families are not there in the last moments, and it breaks the heart."
The Corona Department at the Gates of Justice, this week
Photography:
Efrat Eshel
Tuesday this week,
8 p.m.
A black container finishes the night shift an hour later than usual.
The eyes are tired, the legs are sore, but the adrenaline is still flowing in the body.
Also the desire to be there for those who need it so much.
For more than three hours she has been in the corona ward, the "crown ward" is called here.
Wrapped in white overalls, mask, galoshes and gloves.
The medical staff are asked not to stay in the ward for more than two and a half hours in a row, because of the cumbersome and hot protective clothing.
But the work is hard, and time flies between the fingers.
"Now I notice that I did not even have time to drink even water," she says as she leaves the ward, after she sheds the white overalls that separate the world inside from the outside.
Tough shift, physically and mentally.
Six new patients were admitted within two hours.
Another patient experienced a deterioration in respiratory condition.
Another patient in critical condition, and one whose attempts to save her life failed.
"The problem with the corona is that by the time you get used to a certain routine, it immediately changes," says Michal.
"But make no mistake, everyone here, asked to be here."
She is 23 years old from the religious kibbutz in Alvim near Modi'in.
Three years ago, she joined Shaare Zedek Hospital.
First as a student, and after graduating from nursing - as a nurse.
At the same time, she studied for a master's degree in emergency and disaster management at Tel Aviv University.
She landed in the Corona Department right when it opened.
"I asked to come in here because it sounds like a challenge to me, something huge is happening in the world and we have a chance to be a part of it. It challenged me professionally. And we really went through so many new things in therapy, in patients. We learned together with patients how to deal with this disease."
In this ward lay the first Israeli to die of corona, the late Aryeh Even, 88. Michal remembers how for two weeks he was clear, and suddenly his condition deteriorated. Then, in the first wave, the families were not even allowed to approach the ward. "We were their family. , Their friends, their caregivers.
We held their hand in the last moments, we offered them prayers for the exit of the soul.
Even if today allows families to come in to be near their loved one, it is not for long.
Many times they are not there in the last moments, and we are the ones who are with them.
And it's heartbreaking. "
I ask her when was her last calm shift." It was June, "she smiles," the first wave faded, and there were four hospitalized here.
Since then, I have not even had time to go to the bathroom during a shift.
You're supposed to be inside for two or three hours, but in practice, you stay much longer, because you just do not have time.
He ran all the time from patient to patient.
There is no free moment.
"We are the first to see a result of a closure. When there is a closure, there is a significant decrease in the number of patients in the ward."
Each shift lasts eight hours, alternately, near the patients in the isolated part, or in the corona, where they are monitored through computer screens. Eight hours of high voltage, of uncertainty, of mission.
At 7:00 the
morning shift
staff arrives
.
Michal passes the night events to the nurses, bed after bed.
Long overlap.
There are 50 beds in the Crown A ward, and another ten in the Corona intensive care unit, which is a direct continuation.
All 60 beds are staffed.
Five floors above - Crown B Class.
40 beds, behind insulated curtains.
Occupancy is almost full.
As of this week, Shaare Zedek Hospital is the busiest in the country for Corona patients.
On Tuesday, 89 patients were hospitalized here.
Michal will spend the long journey home thinking.
45 minutes separating the pressure cooker of the stormy ward from life outside.
At this time, the morning team will again have to deal with resuscitation.
One of the patients suddenly deteriorated, and after almost three weeks of hospitalization, his heart stopped beating.
An hour later his bed would already be occupied by a new patient.
We spent long hours there.
We met the difficult patients, with whom our conversations were interrupted repeatedly due to their heavy breathing.
We heard the incessant phone calls of the family members, the noise of the activation of the oxygen balloons, the beeping of the respirators, which disturbed the silence in the intensive care unit.
We saw the crew members clinging to their nails so as not to crash, after nine difficult months.
We have seen them perform CPR, help a sick patient, fill the place of family members.
We saw a slight smile on their faces as one patient managed to stand on his feet, after a long time lying helpless.
The faculty members are still collecting the fragments from the Saturday night shift two weeks ago, so they had to perform two resuscitations at the same time, each about 40 minutes.
The patients did not survive.
Even the shift of the day, which we stumbled upon by chance, they will not soon forget.
The crown department is divided into three areas.
A diamond, in which lie the hard and very hard patients;
Shoham and Barkat, where the patients are in a moderate-to-severe condition.
Next to each patient is a phone and a video screen, which allow continuous communication with him.
The intensive care unit is adjacent to the ward.
In the absence of the ability to set up rooms, curtains divide the patients.
Each department has its own Knesset, a small window and a microphone, through which you can communicate with the staff inside the isolated area. Whenever you need something, from finished wipes to an X-ray, the staff inside turns to the Knesset microphone.
Sometimes you have to repeat things over and over again, because some can already be heard through a space suit.
"I need auxiliary power to move some devices here, is that possible?"
One of the nurses asks, and the paramedics tell her that if it is not urgent, she will have to wait for the next time the auxiliary force enters. The need to defend before each entry causes the crews to consider how many times to leave, and when to enter again. In
one shift eight brothers and sisters, five doctors , Mainly boarders, national service girls, and other auxiliary workers such as paramedics or transport workers. The two secretaries today are Jewish and Tehila, and they also fail to move from the chair. In the wrong week. This is how it is when there is no difference between night and day, the days are confusing.
Before entering the ward there is a dressing position. White overalls that close on the whole body in three sizes, white masks, additional transparent partitions for protection. Protected in two to three minutes. If it is a quick entry for resuscitation or help, they do it in less than a minute. Even for heavy breathing inside, get used to it: if they used to take three steps and gasp, today they can perform CPR even after hours.
In bed number 4
lies Sarah Tayeb (68).
On her face is an oxygen tube, which helps her where the body has failed.
She was already due to be vaccinated on Monday this week, in the line set at the start of the vaccination campaign.
But last week a fever started, and after three days, on Saturday, she was evacuated by ambulance to the hospital, where she was diagnosed with coronary heart disease.
"Save me the shot," she laughs until her breathing is heavy again. Her body is weak, and the cough makes it even harder. "My daughters, aged 40 and 46, talk to her on the phone from their pavilion. Every visit must be arranged in advance so that the ward is not filled with all the families at once.
" I live alone, and I would meet with friends under the house, "she reveals to us aloud. Quiet. "I was probably infected by a friend who felt bad, and today she is also hospitalized.
They wanted to move me to the center at first because there was no room.
But I'm occasionally treated here on the 10th floor because of heart problems, so I asked to only come here.
The staff are charming, sensitive and helpful.
"It's important for people to hear that it's a serious thing. Do not make fun, go get vaccinated. And do not underestimate. It's a big thing. I feel every minute of this disease. I do not wish it on my haters."
In bed number 42, in Corona Intensive Care, lies Lillian Shukron (70), anesthetized and breathing.
She arrived here on Saturday, after a few days of feeling unwell. Next to her sits her granddaughter, Zehavit Afra (26), who works in the department as a soul technician. Now she is torn between work pressure and the desire to be with her grandmother, who fights for every breath. She is the only one here who can Accompany family members within the ward.
"It all happened so fast," she caresses her grandmother's face softly. "On Sunday she still talked to me, said she wanted to be at my wedding.
Yesterday I still held her oxygen mask, and she fought to take it off.
Today she is already asleep and breathing.
It's a nightmare.
"Suddenly I understand what it's like to be on the other side," her eyes gleamed with tears.
"It's not that we do not identify with patients, it's hard to see people dealing with the soul. But you do not really feel it in your stomach. Until suddenly it happens in your family.
" My luck is that I work here, and I could be with her.
I do not know how people go through it alone, because families can not always enter.
With us, the whole family of my grandmother, except me and my uncle, who did not meet her, went into isolation.
It's a great privilege I can be with her.
I feel like I can not leave her, that I have to fight for her life.
With the help of the name, she will still be at my wedding. "
Dr. Abram Abramovitch walks among the patients. In a moment he will meet with the family of one of them, to update a situation.
"Even before Hanukkah I realized that there will soon be another wave here," he says. "In the second wave there was a heavy load, and it was clear it would return.
The second wave also started like the first.
There was a group of patients from the gymnasium (dozens of high school students who had a mass party and became infected in Corona; BA), followed by a significant increase in the number of patients. And everything was busy and not over. "
He is 38 years old, married and the father of two sons, aged 10 and 3 and a half.
He has been at Shaare Zedek for ten years, since he left the USSR in 2010. He started working at 8 in the morning, and hopes to finish at 6 in the evening. "This month I also worked on Fridays, until the afternoon.
How can it be otherwise when there are so many patients? "
10:00.
A patient who had been hospitalized for three weeks had difficulty breathing.
The nurses run to him and begin resuscitation attempts.
After more than half an hour, he passed away.
One of the nurses outside the isolated section is looking for handcuffs, to close and insert a "deceased kit".
Wrapping bags, including special marking of corona dies.
"Do not forget that he is considered recovering," Tamar Keinan, director of the Nursing Department in the Department of Internal Medicine, storms in. "This is important, because in Corona patients the wrap is different, you can't see the deceased's face to say goodbye, everything is different.
That way they will have a regular funeral, a regular burial, the family will be honored to say goodbye. "
She holds in her hands admission documents for the hospital, prepares for the arrival of the next patient to the ward." We did not have time to digest the second wave, and a third has already arrived.
And this wave started in very despairing trouble.
We are constantly seeing a significant increase in numbers.
Once there is an increase in the number of patients in the community, there is an increase in hospital referrals.
"We are constantly under pressure. None of us know when it will be infected, from whom it will be infected. Jerusalem is a country in itself. In the last week, for example, each of the hospitals in Jerusalem has more patients than the three major hospitals in the center combined. It's because there are fewer patients. We have it everyday, and it's floating everywhere. Do you know what 90 patients are? How many staff do you need to treat such a large number of people? Not to mention isolated patients in wards who have come in contact with Corona patients, or did not know That they are sick. "
She has been working here at Shaare Zedek for two years, after 18 years at Hadassah.
She was part of the team setting up and planning the crown wards, and today runs among the nurses and patients.
44 years old from Jerusalem, married, mother of three.
The eldest is 12, the youngest is 9. "They have grown up a lot during this time, realizing that there is not much choice, that mom and dad work all week, and they have to fend for themselves. When there is a free weekend, we take advantage of family time to travel, and get back to work."
Between the first and second wave, the hospital managed to take existing employees on refresher vacations.
"But very quickly the disease went up again," says Tamar.
"In September, dozens of new nurses were admitted to the hospital. Once a week, the team has group zoom conversations with psychologists, for emotional support. There, all difficulties are resolved and forces are given for further treatment. Many are helped by these conversations. We all need support."
The vaccines give them hope.
"Thanks to them, you can see the end," says Tamar.
"Although the immunization rate in Jerusalem is not high, I believe it will reduce stress. The staff will be vaccinated or recovering, and when the staff is vaccinated and understands that he will not get sick, he will also work differently. I hope in about a month we will see a decrease in patients, or milder patients. To be another chronic ward that exists with a low number of patients. "
Aaron Nissim (76) is
lying behind curtain number 9. His breathing is heavy and slow, and he is connected to oxygen.
He is married and a father of three, a grandfather of six, from Wolf Peak.
He used to be a taxi driver.
"This is a segment, I missed the vaccine in two weeks," he says.
"I do not know who I contracted, it came suddenly. Two weeks ago I came home on Friday as usual, bought eggs, and had no strength to lift the bag home. I felt unwell. I went home, lay down to rest, but could not fall asleep. I felt terrible weakness. , I was evacuated to the emergency room because of muscle aches, and I've been here ever since.
"I'm a normal person, usually everything peaks.
In my dreams I did not believe that such a thing would happen to me.
And I was very careful.
I bought masks, changed masks every time.
Everyone belittles, thinking there is no Corona, but lo and behold, there is.
I did not think it was such a serious illness.
I would now give a billion shekels to get out of here.
You can get out of it, right? "He turns to the nurse. She reassures him with a smile.
Nehama Nachmani enters the ward and moves between the patients. Since they brought a jumpsuit that fits her slim size, she has been dealing with it more easily. She is an ultra-Orthodox, 38, married and mother of three. In her fourth and final year of nursing studies.
She used to have a children's clothing store in Jerusalem, but her love of the profession sent her to study, and she left the store. "I am supposed to work two shifts a week, but actually work five or six shifts, because of need.
And the load is huge.
"When you see what happens every time a patient deteriorates, you realize that control is really not in our hands, there is a world creator who decides everything. What hurts me most is that when we are inside, we are the patients' family. We approach, dial the outside family, persuade them to eat. "It has already happened to me that I came to talk to a family whose relative has died, and they comforted me, instead of me comforting them."
Last week she came out crying from a shift.
"It can happen a lot, but not because of the difficulty, or lack of strength. I cry when I do not have time to do everything I wanted to do in the shift, because of the rush. A patient in bed 1 asks for something, even a cup of tea, and you so want to give him, that you even Asks how much sugar he loves her daughter.But on the way to the kitchenette you are stopped in another bed, and another bed, and suddenly another patient experiences breathing problems that you must treat urgently, and really wanted to make the first patient tea, but you do not even get it, because there is so much work "With so many patients, and very quickly two or three hours passed and you went out to breathe some air, and in the end you did not have time to make him the tea he asked for. It is frustrating. If it was a regular ward, it would be less problem to go in and out."
In the intensive care unit,
on the other side of the crown department, there are several computers.
On the computer monitors the patients are divided into small cubes, according to the numbers of the beds, lying motionless.
A quiet, sad class, where you can mostly hear the beeping of machines.
The Knesset was once the workers' dining room. To this day it is called that in cameras, the dining room.
"The first wave was bad, and kept going on and on and on," says Prof. Philip Levin, director of the General Intensive Care Unit and Corona. Abrasive.
Mainly because one has to deal with manpower shortage.
People on the team go into isolation, people get sick on their own.
Any such change creates very large fluctuations in manpower.
The system is stretched and stretched, the departments are full.
We are waiting to see how the vaccines will affect, but it will also take some time.
And we are eroding. "
He is religious, married and a father of four.
Been here almost 12 hours every day, and last Saturday was the third time he was called to help in the ward.
"It is impossible not to appreciate my wife for this effort as well. She works as a lawyer, and when I am called in the middle of the night, she also wakes up. And she deals with all the children's and her work zooms, and well done to her for that. Not simple at all."
Even before he has had enough of going through the protection post to get into the ward, Levin is called to the general intensive care unit, on the 8th floor.
"We are already worn out," continues Michal Sheetrit, the veteran director of the respiratory system at Shaare Zedek.
She is married and a mother of three, and lives in Pisgat Ze'ev.
"Many of the crew members are experiencing fatigue and collapse. Some of us were in isolation, some were sick, and it was not over. In the first wave we got a hug and a public echo, then it disappeared."
Throughout the period she remarked to people on the street who did not wear a mask and did not keep their distance.
"So I wake someone up, and even explain to him that I'm a soul technician at a hospital and I see exactly what this disease does, and he answers me that we invent this disease, and there is no such thing. Older people tell me, 'Nonsense, everything's fine.' They decided the disease. It does not exist, so go convince them otherwise. "
Shlomit Baron
leaves the Crown Department with shining eyes.
The protective mask left thin lines on her forehead, marks connecting the outside world to the inside.
She repeatedly rubs her hands with the cleansing soap attached to the exit door, far beyond the usual rinse, as if trying to take the difficulty of the last shift off herself.
"I need a moment to recover, then I have another full-time job," she straightens her head covering.
She had been inside for several hours.
As a responsible nurse, Shlomit (41) usually goes in for a limited time in the morning, greets the patients, checks everyone's progress, and goes to work at the Knesset. Recently, as mentioned, the shifts are especially busy, and every pair of hands must be used.
She is married and mother of eight. The 20-year-old, the youngest is 3 and a half years old. At first she thought of a different kind of mission, she studied teaching, but at the age of 28 she switched to nursing. She has been a nurse in the hospital's boarding school for seven years, which in early March became the first crown ward. She ran the department for a short time. At the end of the first wave, when they decided to institutionalize the Corona Department and the Crown Department A was born, they asked her to run it.
"I said, come on, little one, I will help them," she smiles. "In a week or two it will close. .
What innocence.
Within a week of starting, the number of patients had quadrupled.
And kept going up, and went on, and went on.
September was a terrible month of dozens.
"We were in a temporary tent outside the emergency room, we recruited nurses from all sorts of wards and places, and since then we're here. The pace here is insane. When the second wave started, we realized it would be harder than the first. Day by day it was worse here, with more difficult and complex patients. That's what you do.
"In the third wave, which started very recently, the numbers are rising.
At the beginning of December we had several patients, then we went up to 50 patients, each in critical condition.
And now it's almost 90. We have reached shifts where we breathe in patients at a pace, one after the other. "
When she is at work, her mother keeps the children." She always says it is her contribution to the war in Corona.
Sitting with them in zooms, helping them, taking care of them.
On Sukkot she fell ill, and the whole family went into isolation.
I did not see her at all, because I was at work so much, and thanks to that I also did not have to go into isolation.
My family stayed home, and I stayed to sleep in the hospital. "
How do you take care of yourself?
" I'm kind of an ascetic.
Almost completely avoids going to joys.
"I managed to fly to London in February, before the first eruption, and I have not been on leave since."
She finishes her work day at 6:30 in the evening, three and a half hours after the due date.
"You can never know what is expected of you on duty. I very much hope that the vaccine will bring us back to sanity. Seeing the adults, who are hospitalized without the family by their side, is one of the most horrible things there is."
The ward's physiotherapist, Tom Bouquet of Honor (30), approaches a patient in one of the beds, trying to help him stand.
He is seriously ill, has been lying here for almost a week, and now his muscles are weak.
She is single, has been working at the hospital for two and a half years.
In the second wave, which began about four months ago, she became the department's regular physiotherapist.
Practicing breathing with patients who have already passed the peak of the disease, teaching them to breathe again from the diaphragm, hold the air inside and inhale in a slow and controlled manner.
"Stick your lips together, like you're doing poo on soup," she tries to explain to one of the patients, who desperately wants to hear her but has a hard time, because of the protection.
"Yes, it's hard when you do not see the face, and barely hear, but it's part of it, and in the end you succeed."
She looks out of the Knesset window at their patients for help until a moment ago. "Suddenly you see how this thing collapses completely healthy people.
People degenerate into a situation where it is difficult for them to lift arms and legs, and courses.
It's wierd.
"We had a patient who could not get out of bed. Her family asked us to hang pictures of her children and grandchildren on the wall. We put her in front of that wall and told her, 'Look what awaits you outside.' It encouraged her to try to walk. In the end she got out of the ward and really went back. .
"I'm coming after visiting doctors, enters two or three hours, go out for a break to take a break, and come back in two hours.
When you're inside, you'll be at work.
It is not pleasant to say, but every day there are resuscitations, souls, and also deaths.
It is difficult to maintain optimism like this.
As far as I'm concerned, everyone who leaves here comes out miraculously, and that's not obvious. "
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