Author tackles issue of deal with ongoing threats


Because Israel has had to endure so many suicide bombings, shootings, rocket attacks and other acts of terrorism, the country has had to develop a sophisticated new field of “terror medicine,” and Israel’s experience in coping with terrorism can be of great value to the United States in the post-9/11 world, according to Leonard A. Cole, an expert on bioterrorism and terror medicine and author of several books. Cole was the guest speaker of the Jewish Community Relations Council at a meeting of JCRC members which was held last week at the Center of Clayton.

Cole has just published his eighth book, Terror: How Israel Has Coped and What America Can Learn (Indiana University Press), and previously had published The Anthrax Letters: A Medical Detective Story. He told the JCRC gathering, “No country has experienced more acts of terrorism over a prolonged period than Israel. The frequency of attacks has propelled Israel toward innovative methods to address the threat. Indeed, treating so many victims of physical and psychological trauma has given rise to the new field of terror medicine.”

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Cole pointed out that traditional emergency medicine has not been adequate to handle the immediate aftermath of a terrorist attack in which large numbers of people are killed and seriously or gravely wounded. “Neither traditional emergency medicine nor even disaster medicine and drills can adequately prepare first responders, hospitals and other emergency workers for the specific problems that occur in the aftermath of a terrorist attack,” Cole said.

The author noted, “the subject of my latest book, terrorism, while a serious subject is not morbid or ‘down.’ I hope it can be a book of hope and inspiration if we follow Israel’s example and develop similar responses to terrorism. It is important that the United States also do the right thing to protect our citizens.”

Cole added, “I have been asked, why did I even write this latest book? I have written a lot on bioterrorism, including a book on the anthrax scare. One of the reasons is that I live in Ridgewood, N.J. and can see the Manhattan skyline from my home. I saw the actual collapse of the World Trade Center on TV, like most Americans. It has now been almost seven years since those horrible events of 9/11, and just like when you are driving in a car, the farther you travel the more distant things seem to be in your rear view mirror. While we have fortunately not had any comparable terrorist attacks in the United States even while Israel continues to deal with it, there have been several thwarted attacks, including one planned against the Los Angeles Airport, the Lincoln Tunnel, JFK Airport and Fort Dix, N.J. These bad-guy actions that were prevented should remind us of the continued importance of being better prepared to deal with such attacks, not only to prevent them, but how to respond if they do occur despite our best prevention efforts.”

Cole expressed concern that despite the many pledges for action in the immediate aftermath of 9/11, many of the findings and recommendations of the 9/11 Commission Report and other studies have not been implemented, including coordination of communications systems among first responders, such as police, fire and paramedic groups. “By contrast,” Cole pointed out, “Israel has made sure that all of its emergency responders are able to communicate quickly and directly with one another. Here in the U.S., turf wars between fire and police departments have prevented cities from linking such systems together. The lack of coordination and such linkages on 9/11 was a major cause of the deaths of so many police and fire people on that date. We must follow Israel’s example and get this accomplished.”

Cole indicated that his book not only covers several aspects of Israel’s coping with terror attacks, including, “The hands-on things Israel has developed in the past few years; how do you explain Israel’s resilience in the wake of constant terrorist attacks? How, at the height of the Intifada, when attacks were occurring once or twice every day, could parents send their kids off to school, go to work or even board a bus? How was it possible for people in Israel to live normally under such circumstances?”

Among the “hands-on” steps Israel has taken cited by Cole are:

* Communication. We learned on 9/ll that the New York Police Department and New York Fire Department radios operated on different frequencies, one of the major factors which resulted in the deaths of hundreds of police and fire people. Many police were killed going up to top floors because they could not be warned on fire department radios. Sadly, while Israel has dealt with this problem effectively, to this day in New York and in St. Louis, the problem exists.”

Cole said that he had met earlier in the day with St. Louis Police Chief Joe Mokwa and learned that the St. Louis Police Department has not yet resolved the lack of compatible equipment between police and fire departments in the City of St. Louis. “Nationwide, the Department of Homeland Security hopes to have this problem resolved by 2023. By contrast, in Israel, all hospitals can talk to each other, along with all police, fire, ambulances and other emergeny agencies.”

* Terror medicine. “Emergency medicine has been a separate discipline for about 35 years,” Cole said. “About 15 years ago, disaster medicine developed as still another subset of response, and more recently terror medicine has emerged in Israel as a separate discipline.

“Traditional emergency medicine or even disaster medicine is not equipped or prepared to deal with problems that occur in a terrorist attack,” Cole said. “For example, suicide bombers often use such weapons as bombs packed with nails, which can cause hundreds of puncture wounds, injuries not commonly seen by phyicians in emergency rooms. There can also be crush-induced injuries as when a terrorist rocket throws a person against a wall or other solid structure causing burst ear drums, punctured lungs and other serious traumas.”

* Rapid clearing of terrorist attack scenes. “Israel has developed a system for the rapid removal of terrorist victims from the streets where attacks often occur. Instead of taking all the wounded to the nearest hospital and overwhelming its staff, the most seriously wounded are taken to the closer hospitals and others to hospitals farther away, assuring that all the wounded can get appropriate care. Israel is able to get patients to the hospital within an hour, while in the terrorist attack on the London subway trains in 2003, it took nearly four hours to get some wounded to the hospital.”

Cole added, “In London, there was poor preparedness resulting in traffic jams and delays in getting wounded to the hospital. In Israel there is a triage commander on the scene immediately who can help the ‘scoop and run’ policy of getting the wounded out at once unless there is serious bleeding that would make moving them dangerous. The triage officer’s job is to deploy the wounded to the nearest hospital if the wounds are serious, or to outlying hospitals if they are less serious wounds.”

Discussing the resilience of the Israel population despite constant terror attacks, Cole said, “back in 2001 there was a horrible attack on a former dolphinarium that had been converted into a dance hall popular among Russian Jewish teens. A Palestinian terrorist came in wearing a wind breaker in which a bomb was hidden. When it was set off, 21 of the young people were killed and more than 100 were wounded. In contrast to the usual practice of quickly repairing and then re-opening restaurants and other facilities after an attack, this location was left unrepaired as a symbol in Tel Aviv. Next to the site was a life-sized silouette of an Israeli boy and girl holding hands with the caption, ‘This is our home,’ in Russian, and ‘We will not stop dancing’ in Hebrew. This to me symbolizes the resilience of the Israeli people which is a major factor in their ability to move on with their lives despite terrorism.

“Israel has certainly provided the United States with a number of concrete and specific steps which we can and should emulate to help us better prevent terrorism and to deal with it if it happens in our country,” Cole concluded.