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Foreign Exchange Want the mentality in metric form? The Israeli national ambulance service, Magen David Adom, has nearly 1,600 paid employees— supplemented by more than 11,000 active volunteers, half of them teenagers. The Israeli National Police force has around 28,000 offi cers—bolstered by another 50,000 volun- teers. Imagine what a U.S. service could do with that proportion of unpaid help. “The Israelis’ dedication and commitment to public service is really amazing,” says Pittsburgh EMS Chief Robert McCaughan, who was part of the American EMS delegation that visited the country in April. “It starts at the early ages in the schools, then carries forward into the military service and afterward. They really look out for one another.” But Americans are a bit different. By nature or at least values, we are fractious and individu- alistic. What the Holocaust is to Israeli DNA, “don’t tread on me” is to ours. We don’t feel mortally threatened, and we don’t like to be told what to do. That will make some aspects of the Israeli approach very diffi cult to replicate here. We can borrow ideas for trauma care and surge response, but not the specter of annihilation to motivate people. “We saw in their eyes how seriously they approach things—there’s no goofi ng around,” says delegation member Bernard Heilicser, DO, FACEP, medical director for the South Cook County EMS system in Illinois. “There’s an incredible intensity, and things are done the right way, with minimal egos. They’re in it together because that’s part of survival, not just so the mayor can look good at the next election.” It’s worth noting that we had a small taste of the existential threat here in America on 9/11/01. In response, we smashed up al Qaeda and constructed an entire homeland security industry in a few short years. That was a remarkable achievement, even if momentum ultimately waned, and should prompt one to wonder what America might accomplish under an interminable barrage of attacks like Israel faces. And if it can be achieved any other way. The Delegation: Furthering the Forgotten Profession The delegation of American EMS leaders and decision-makers who went to Israel numbered a dozen. It was arranged by former Illinois EMS director Leslee Stein- Spencer, RN, MS, who now oversees medical administration and regulatory compliance for the Chicago Fire Department, working with Israel’s consulate to the midwestern U.S. “The folks at the consulate and the Delegation members meet with Israeli officials at the Ministry of Health’s Emergency and Disaster Management Division on their first morning in Tel Aviv. Ministry of Health agreed that EMS was an important area for exchanging ideas,” Stein-Spencer says. “For the trip they wanted people who were in policy- making positions within our region, who also had national exposure. I wanted a well-rounded group—not just EMS, but from across the healthcare disciplines. Everyone who went was someone I of the Emergency Nurses Association; Robert McCaughan, Pittsburgh EMS chief and chair of the International Association of EMS Chiefs’ Metro Chiefs Section; Gary Wingrove, program manager with the North Central EMS Institute and director of government relations for Minnesota’s Mayo Clinic Medical Transport; John Hick, MD, medical director for bioterrorism and disaster preparedness and assistant medical director for EMS at Hennepin County Medical Center in Minneapolis; Bernard Heilicser, DO, FACEP, medical director for the South Cook County EMS system in Illinois and also deputy commander and deputy medical director for the Illinois Medical Emergency Response Team; and a reporter from EMS World Magazine. Those are some titles you’d think The U.S. delegation poses with Dr. Adriana Katz outside her clinic in Sderot, a town that’s been under continual bombardment. knew personally, and knew their level of participation and commitment.” The delegation included Stein- Spencer, who also serves as a program manager for the National Association of State EMS Officials (NASEMSO); her husband, Mike Spencer, retired assistant deputy chief paramedic for the Chicago Fire Department; CFD First Deputy Fire Commissioner Charles Stewart and his wife, Zandra, a school psychologist; Montana EMS Supervisor Jim DeTienne, NASEMSO’s president- elect; Pennsylvania EMS Director Joe Schmider, chair of NASEMSO’s Domestic Preparedness Committee; NASEMSO Program Manager Kathy Robinson, RN, EMT-P, a past president 6 JULY 2011 EMS WORLD could influence change. What they can bring back and apply, given the differing backdrop and contexts and interests of American EMS, will ultimately define the success of their mission. “What we learned was significant. I’ve been to Israel several times, but I truly learned the most this time, looking at their preparedness and response activities,” says Stein-Spencer. “It’s so important for us in the United States to open up these types of relationships and be able to share experiences in emergency medical services. Many times it’s a forgotten profession, and I think by going there and opening the door, there’s so much we can learn from each other. I hope it doesn’t end with our trip, and that more EMS people will be able to go over and learn from the Israelis and share what we can bring to the table as well.”