‘Could I have done more?’ MDA paramedics are haunted by October 7

HEALTH AFFAIRS: Many paramedics and first responders from Magen David Adom, who treated the wounded on October 7, 2023, remain haunted by the memories.

As the two-year anniversary of October 7 passes, Israel is still reeling in shock, and the fatal wounds of that day remain painfully raw. Families of victims, hostages, and fallen soldiers continue to navigate the long and difficult healing process.

Alongside them, many paramedics and first responders who treated the wounded remain haunted by the memories. Among these, Magen David Adom paramedics were instrumental in saving countless lives. Now, two years later, their reflections offer a powerful glimpse into the tragedy and its lasting impact.

Zvi Tibber: ‘I didn’t think twice’

Zvi Tibber, a senior MDA volunteer paramedic, hi-tech professional, and married father of three, recalled the harrowing events of that day.

Like most Israelis, he was awakened by sirens at 6:30 a.m. When MDA called and asked if he was prepared to go to the South, he responded “of course” and jumped into his ambulance without hesitating.

“I didn’t think twice,” he told The Jerusalem Post.

Together with another ambulance driver from his yishuv (community), Alfei Menashe, Tibber set off for Ofakim in an armored ambulance, listening to news reports in an attempt to understand the unfolding crisis. But the true extent of the horror was unimaginable.

Within minutes of arriving, they began treating the wounded. Their first patient was a police officer with a severe bullet wound to the hand. Tibber managed to stop the bleeding.

Another officer was suffering a massive panic attack, after fighting terrorists for hours. Inside the ambulance, he was finally able to release all the stress he’d been holding on to. “I was sure I wouldn’t survive this day,” he told Tibber. “I have been fighting since 7 a.m.” It was 11 a.m. at this point.

Tibber managed to calm the man but couldn’t transport him to a hospital, as intensive care was reserved only for the most severely wounded.

Another patient was a reservist who was traveling with a friend when terrorists opened fire on his car. They managed to flee the car and reach Ofakim while the terrorists continued shooting at them. The reservist had a serious back wound and was bleeding heavily. Tibber transported him to Soroka Medical Center, Beersheba, and called the man’s wife, telling her to meet them there.

Throughout the day, Tibber and his colleague made repeated trips between Ofakim and Soroka. By evening, they moved toward Gaza, evacuating the wounded from nearby yishuvim and transferring them to helicopters. Tibber also had to identify many bodies, many of which had been mutilated in ways he still can’t fathom.

“There was a shooting. How could a body look like this?” he said. “I just couldn’t imagine how someone could do this to someone who had already died or while they were dying.”

Two years later: ‘Could I have done more?’

When asked how he feels now, two years later, or how October 7 has changed him, Tibber said that it was a complex question. “We have all moved on with our lives, but we are still living in the shadow of the war, which has been going on for two years already, along with all the challenges, like the Iran war.”

He stressed that the ordeal isn’t over, as 48 hostages are still being held captive. “We really want to reach closure, but it’s impossible while the hostages are still there.”

On that fateful day, Tibber knew there were terrorists, and that their ambulance could be hit by Hamas RPGs. But he could never have anticipated the full scale of the horror. The ongoing war has forced him to reflect and face tough questions, such as could he have done more?

When asked how October 7 changed how MDA operates, Tibber said that it has elevated the organization’s level of preparedness. It now has better resources, improved equipment, and knows how to identify personnel for emergency situations.

Living in an isolated community himself, he said that neither MDA nor the yishuvim were adequately prepared. His ambulance wasn’t equipped for treating more than one or two patients, forcing multiple trips to Soroka to replenish his supplies. Soroka itself was running low on resources. “We had to manage as much as we could.”

Today, he said, MDA is ready for dangers far beyond what anyone could have imagined before October 7.

Although he doesn’t personally attend therapy or support groups, Tibber shared that speaking about his experience helps him. Since the attack, he has shared his story several times on behalf of MDA.

Dr. Shafir Botner

Dr. Shafir Botner, director of MDA’s Paramedic School and a senior member of the elite Medevac Helicopter and ECMO Unit, helps certify about 650 paramedics annually. The medevac unit operates two emergency helicopters from hubs in northern and southern Israel, while the ECMO Unit makes MDA one of the few emergency organizations worldwide to use this advanced technology.

On October 7, Botner was at home when the sirens went off. “Like everybody else, I woke up from the sirens. It took just a few minutes to realize this was no false alarm.”

After seeing the reports, he put on his uniform – “as I always do,” he said – and headed south, as directed by a colleague.

At the Sde Teiman junction, Botner faced a choice, which, in hindsight, may have ultimately saved his life: turn right to Ofakim or left to Beersheba. Choosing Beersheba, thinking he could be more efficient there, he headed left. Looking back, he said, “We most probably would not be speaking right now,” had he chosen to head to Ofakim.

Botner spent several hours assisting the dispatch center in Beersheba before he was called to Sde Teiman and asked to prepare a third helicopter for evacuations – a rare request, as MDA usually operates only two. Within minutes, Botner and his colleague were treating three severely wounded soldiers. Over the next 72 hours, from Shabbat morning until Monday evening, he and his colleague evacuated and treated casualties throughout the Negev and some in central Israel, too.

A near-death experience

On Monday evening, Botner was transporting three patients from the helipad at Barzilai Medical Center in Ashkelon to the Center when he suddenly heard a massive explosion that shook the entire helicopter violently.

“It felt like being inside a spinning washing machine. It lasted 30-40 seconds but felt like forever,” he said. Believing they’d been hit by a missile, he thought, It’s over for us.

Later he learned that a missile had been intercepted just above them and that a piece of shrapnel had hit the aircraft and broken a blade off, nearly tearing the helicopter apart.

Somehow, while this was happening, Botner managed to call for help. “I asked for ambulances to come, because in a few seconds I was going to be the one who needed an ambulance.”

News spread quickly on social media. His daughter, an MDA medic, saw reports that an MDA helicopter had been hit. Knowing that her father was on a helicopter, she called him repeatedly in a panic. Eventually, he managed to answer and reassure her that he was alright.

That was when he knew he had to go home to see his family, said Botner. After 72 hours in the field, Botner returned home, only to return to the helipad the following day. “We knew that if we didn’t continue flying then, we may never fly again.”

A new perspective

Two years later, Botner is still piecing together what happened, and has a whole new understanding of the significance and meaning behind this famous Jewish saying “Whoever saves one soul, it’s as if he saved a whole world.”

He shared several poignant stories illustrating this newfound perspective. One night, his brother-in-law, a policeman, visited a colleague who had been severely wounded on October 7. All the man remembered was being evacuated by helicopter. Botner recognized him instantly from a photo; it turns out that he had treated this man. “He was in such a bad condition,” Botner recalled. “He begged me, ‘Keep me alive. I have a new baby.’”

Botner related another story in which he found out that the three Counterterrorism Unit soldiers he had treated on October 7 later took part in the daring rescue of hostages Luis Har and Fernando Marman from Gaza. A colleague of theirs, now a student in Botner’s paramedic school, sought him out to personally thank him for saving his friends.

In another incident, this time during the Iran war, Botner responded to a missile strike in Beersheba. Inside the damaged building, he saw a policeman rescuing someone. The policeman turned out to be a man he had treated on October 7. Here he was, a year and a half later, alive and saving others.

“These encounters reaffirm how important my job really is, educating and preparing paramedics,” Botner said. “Who knows who they will save in the future?”

When asked how October 7 has changed him or how he works, Botner said that it has made him view emergency situations entirely differently. In his 20 years as a paramedic, he rarely paused to think about the risks or of what he was leaving behind every time he responded to a call. Now, he’s more aware of the dangers and of the importance of family.

MDA has long been regarded as among the world’s most advanced emergency services. But nothing could have prepared it for the horrors of October 7. According to Botner, the unprecedented events of that fateful day have pushed MDA to an entirely new level. Now, the organization is better equipped, better trained, and has improved its procedures. “We are at a completely different level now than we were on October 7. Absolutely. Unfortunately.”

The trauma of that day also sparked a rise in mental health challenges across Israel. In light of this, Botner highlighted that MDA has expanded its services to provide active support to frontline responders as well as dispatchers and others deeply affected.

“We are not leaving this subject on the side. It’s very important. It’s a long process, and we’re not even in the middle of it,” he said.

For Botner, sharing his experiences has become a form of therapy, especially as he grasps just how meaningful his work is.

He also emphasized the vital role of paramedics in Israel and noted a surprising trend: since October 7, many more people – military and civilian – have enrolled in paramedic training. Despite the trauma of what so many endured, the desire to help others has only grown stronger.

As the nation continues to heal from the wounds of October 7, the stories of paramedics like Zvi Tibber and Dr. Shafir Botner stand as powerful testaments to courage, resilience, and the enduring commitment to save lives against all odds.