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Purity of Arms

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Field Hospital at Ruchama  E-mail

The pre-fab hospital at Kibbutz Ruchama had already acquired a history.

Early in September, the Egyptians had strafed it while Ivan Barnett and Ossie Treisman were operating on a casualty. That decided them. They had to go underground. An underground shelter, covered by two meters of soil, was converted into a new hospital with twenty bunks. One room was used as an operating theatre and a small ante-room was used for the preparation of instruments.

Now the two doctors found themselves doing, medically speaking, "impossible things." Looking back twenty-six years later, Dr. Treisman attributed some of the "miracles" to "incredible good fortune... God seemed to be working with us."

Several South Africans were there: a medical student, Elliot Bader, today practicing in the Transvaal; another medical student, Harry Miller, who had some air force experience, today practicing in Durban; and, at different times, nurses Margaret Carruthers, Merle Gillis and Sylvia Sher.

Harry Miller had a special role. The shelter had not been built according to the specifications of stretchers in use in Israel, and he was the only person who could move them in and out without difficulty with their patients on them,  by a trick of tilting the stretchers, of which he was the only master.

The two young doctors were ready for the casualties. The essential equipment was there except oxygen, the essential gas for administering anaesthesia. Treisman administered open-ether anaesthetics on a mask. Then he ran short of ether and was reduced to the use of sodium pentothal, an induction agent, not an agent for prolonged anaesthesia. It was horrifying.

Barnett was outstanding in rendering initial surgical services. The doctors could not rely on a regular evacuation service from the kibbutz. Night planes might or might not arrive. Sometimes a few ambulances were available, sometimes not. In the latter situation, Miller would manipulate the patients on stretchers out of the underground shelter to a jeep, which would take the casualties one by one to the airfield and lay them on the ground. Then they would wait for the promised airlift from Tel Aviv. When and if the airlift did come, it was possible to evacuate some of the casualties. It fell upon the two young doctors to care for the severely wounded for anything up to five days. The kibbutzniks of Ruchama were the blood donors. Fortunately, there were ample supplies of plasma, the gift of American Jews.

Margaret Carruthers worked with a colleague, an Israeli theatre sister, Micky, from Germany who, like Miss Carruthers, gave her soul to the work. When Micky left, a Romanian immigrant sister took her place. When the two doctors were hard-pressed, they called on the services of an Italian doctor, Askerelli, attached to one of the infantry units stationed nearby. He was a physician and, at that time inexperienced in surgery, but he was able to help, though not in the theatre.

It must be true that the gods smile on those who, without complaining and with willing hearts, get on with the labors that are assigned to them. In two ways, they did so at Kibbutz Ruchama: first, with the lighting of the hospital and second, by discovering a portable X-ray machine at the kibbutz

At first, lighting was provided by paraffin lamps, quite inadequate for operating. The doctors could not get power from the kibbutz. In a hut on the kibbutz, a crate containing a generator was uncovered. Dr. Treisman: "The knowledge we had of electricity was minimal, but we got some men from the airfield to help us. We dug a hole next to the shelter, dropped the generator into it and wired it up. The electrician was Harry Miller. First kick, the engine turned over and we had lights. We had electricity till the end of our period at Ruchama. In fact, the plant failed during the last operation, while we were operating on a man's leg. We pushed him to the edge of the theatre where it met the steps and worked by the light of dawn, which had just broken. There was enough light to complete the operation. The engine had packed up a few times, but we had always managed to repair it. This time we could not. It lasted exactly the right length of time."

The X-ray machine was also found in a hut. The plausible explanation is that the doctors' American predecessor, Dr. Marcus, had ordered both machines and, on leaving, had forgotten to leave word about them. The X-ray machine was accompanied by a book of instructions in German and with the help of German Jews on the kibbutz, the doctors managed to assemble it and to set up a dark room above the ground. The usefulness of the machine was limited ("no fancy X-rays") but the doctors could take pictures of fractures. The routine was moving the patients out of the shelter to the dark room, and then returning them to the shelter. It was unwieldy but there was no alternative.

The drive into the Negev brought casualties in streams, some of the soldiers in pitiable shape. The fighting on the way to Beersheba and in the area around Kibbutz Dorot, accounted for some of them, but the largest number were from vehicles going over mines, not only Egyptian but also unmapped Israeli mines, a persisting defect of the times.

Two cases remain unforgettable to the doctors. The first was that of a man from the settlement of Bet Eshel on the outskirts of Beersheba. This settlement, under attack for many months, held off numerous Bedouin and other Arab attacks, the members spending many of their days underground. The capture of Beersheba ended their ordeal. In the excitement and celebration of the occasion, this man and others careened around in a jeep that struck a mine. He was carried into the hospital at Ruchama with both legs blown off and severe arm and chest injuries He was dying and knew it, but begged the doctors to keep him alive until his parents arrived. They were displaced persons and he had had word that they were on a ship sailing to the Land. He died a day before they arrived.

The story of another casualty had a happier ending. He was a young man who received a bullet which entered his face just near his lower jaw, traveled down his neck and injured his larynx. He had extreme difficulty in breathing, indeed, he could only breathe while lying on his abdomen. He could not swallow and was salivating. As a first-aid measure, Treisman administered a pentothal anaesthetic, and then flipped him over on his back for Barnett to perform a tracheotomy, which enabled the patient to breathe. The doctors then improved his condition with plasma and blood. There was no evacuation of casualties that or the following night, and Barnett decided to operate. The young man's larynx, he noted, was severely injured. Missing was the bullet which the primitive X-ray had shown lying in or very near the larynx. It was a perplexed Barnett who stitched the larynx.

When this casualty was evacuated three days later, the two doctors had little hope he would survive. If he did, he would certainly not be able to speak. To their utter astonishment, he was back at the kibbutz six weeks later to thank them. His speech was normal. What interested the doctors medically was that the Tel Aviv doctors had also not found the bullet. The explanation was that it lay first in his gullet, in his esophagus behind the larynx, and had passed down his alimentary tract and finally out of his body. A little further surgery healed him completely.

A more than an anecdotal story; the narrator Dr. Trelsman: "A soldier had died. I asked where he would be buried and was told, at a little cemetery near the kibbutz. We asked who would conduct the service. The kibbutzniks did not understand the question. There would be no service, they said. The man would be buried and that was that. His grave would be marked. The kibbutz had moved away from Jewish tradition. Ivan Barnett, who was O.C. Medical Services in our small unit, an irreligious fellow himself, but brought up in the traditions of the Diaspora, was highly indignant and said, "Well, if they won't conduct a burial service, we will." We assembled a number of men from our own group and from the airfield and Ivan Barnett, with a little help all round, conducted the service."

 

Reproduced from “South Africa’s 800” by Henry Katzew