Medicine: Memo to New Drivers
By targeting teens before they get their driver’s license, Hadassah’s new program is attempting to reduce the number of car accidents in Israel.
The 12th graders gathered in a room in the Hadassah–Hebrew University Medical Center at Ein Kerem are young, healthy and strong.
The girls wear tight jeans, their long hair tangled in their flowing scarves. The boys joke around, gently punching one another. They have their own ID cards now, many have opened their own bank accounts and most have begun driving lessons. In another six months, they will venture out into the world of Israel Defense Forces service, foreign travel, careers—and driving on Israel’s brutal roads.
“I was once like you,” Ronen Argalazi, 39, tells the teenagers from the wheelchair he has needed since a car crash turned him into a quadriplegic at age 17. “I rode a bike, drove a car, hung out at the beach like everyone else. Then, in the blink of an irresponsible move, I broke my neck and my life changed forever.”
Argalazi, a graphic artist who holds a brush in his mouth to paint, is one of the more than 3,000 people severely injured on Israel’s roads each year. For the past three years, he has come regularly from his Tel Aviv home to Ein Kerem, as part of a program designed to tell groups of high school seniors about the importance of driving safely.
The pilot program was launched in the 2004-2005 academic year. Its emphases are those of most road- safety programs—personal responsibility, seat belts, limiting mobile phone use and safe driving. Four hundred students from three Jerusalem schools attended during that pilot year, and the program received a safety award from the city. In its second year, 30 schools took part, each sending over 100 students. Another huge leap in participation is expected by the end of this year.
If it seems odd to be conducting a safe-driving campaign from a hospital—a place more closely linked with the results of Israel’s road carnage than its causes—that’s exactly the point.
“Hadassah treats some 20,000 road casualties a year,” says Dr. Shlomo Mor-Yosef, director general of the Hadassah Medical Organization. “The number of 18-to-24-year-old victims brought to Hadassah is two and a half times greater than all the others, in line with national statistics. I felt that we must extend our help beyond medical care.”
“Because of our leading trauma unit, Hadassah takes in many of the more severely injured, and many of them are in this age group,” says trauma unit head Dr. Avi Rivkind. “Seeing this day after day, it was clear we had to expand our role.”
With many groups in Israel already working to combat road accidents, “we searched for an area where we could make a contribution,” says Rachel Dvorkin, who works in patient administration at Hadassah. “I headed a committee of physicians, nurses, social workers and administrators to search out our own niche.”
With hindsight, that niche was obvious. “What we have to share is the take of a hospital on road accidents and rehabilitation,” says committee member Amitai Rotem, HMO marketing director.
“With our patients, we can show in the most vivid way possible that severity of outcome relates directly to speed,” explains Shlomit Wasserzug, R.N., head of in-service nursing education at Hadassah, who also sat on the committee. “We can show that while seat belts and bags reduce mortality, they increase the number of very severe injuries. We can show what the so-called ‘light’ injuries are, and how even they can translate into no IDF service and no coming-of-age trip abroad.”
Dvorkin was made responsible for developing and running the initiative, which, she says, explains to 12th graders: “Here in our hospital, we see so many people who are hurt so badly on the roads. We don’t want to go on seeing this, and you don’t want to be hurt, so we’re in this together….”
“The trauma unit was fascinating,” says Anna Zesavski, 17, part of a group from the Masorati High School Jerusalem that took part in the program in November 2006. “I’d never seen anything like that outside the movies. The head nurse explained everything, the overhead booms, the lights, the sterile units, the X-rays. She told us how the unit works, and that it’s unfortunately very busy. She said that the day before we wouldn’t have been able to see it, as they had four really badly hurt road-accident victims there. It was really interesting—but my strongest feeling as I left was that I never ever want to come back.”
Surprise was the first impression of the Masorati group shown Hadassah’s rehabilitation unit at its Mount Scopus hospital. “I’d expected many or even most of the people there to be terror victims,” says 18-year-old Anat Cohen. “But almost 90 percent were injured on the roads. There were people there without hands or feet, arms or legs. It was really scary to think that that’s how a car accident can leave you.”
“It’s not like you don’t know you can be really badly hurt in a car crash,” says Daniel Gordon, 17. “But there’s something different about actually seeing it. Will it make me drive more carefully when I get my license? I think so. I hope so. We’re certainly at the right age to see all this. And it’s not something that any of us are going to forget in a hurry.”
Hadassah developed its program with a number of partners: Jerusalem’s Education Board, the Or Yarok (Green Light) Association for Safer Driving, the National Council for the Prevention of Traffic Accidents, the City of Jerusalem and the Ministries of Transportation and Education. Or Yarok gave professional guidance to the Hadassah staffers, all of whom volunteer in the program.
“School principals, even some from outside Jerusalem, are begging to have their schools included even though there aren’t, as yet, any statistics with which to measure its effectiveness,” says Rotem. “However, according to its participants, to the city, the education board and the piles of letters we have been getting from schools, it’s a runaway success!”
The program comprises three sessions, one at school, one at Hadassah and one led by Or Yarok. While the program’s still being fine-tuned, the main features of the Hadassah component are established.
“A group of about 100 youngsters arrives at one of our Hadassah hospitals first thing in the morning,” Dvorkin explains. “They’re welcomed by a senior staffer—often by Dr. Mor-Yosef himself. Along with the spoken welcome, this tells them that they and the subject of their visit are very important to us.”
The half-day visit that follows is intensive. It includes the sobering encounter with Argalazi, meetings with a senior trauma surgeon (Dr. Rivkind, when he can) as well as a senior orthopedic surgeon, visits to hospital units (trauma or rehabilitation), short road- safety films and discussions.
A social worker explores with the teens the emotional toll wrought by road accidents, explaining that many victims spend months dealing with fear, guilt or depression or put their lives on hold for years. And accidents don’t impact only on the drivers: The social worker emphasizes that serious accidents affect the whole family unit. “The kids often react very emotionally to this part,” says Dvorkin.
“Being in a hospital creates a certain atmosphere,” relates Wasserzug. “The welcome from the hospital head. The surgeons coming straight from the OR or the trauma unit relating what they’ve seen. All this makes a powerful impression.”
This year a new component has been included to combat driving under the influence. Three different strengths of goggles mimic the way alcohol alters vision. With the first, you see as you would after drinking a beer and a half, which puts 0.06 percent of alcohol in your blood, just over the legal limit of 0.05 percent. The second reproduces vision with 1-percent blood-alcohol and the third, with 2 percent.
“We tried shaking hands, catching a ball, walking a straight line and hopping, wearing the different glasses,” says Odem Aroush, 17, from the Masorati school. “Lots of us stumbled and all of us dropped the ball. We weren’t drunk, of course, and knew we were seeing double. But it’s terrifying to think of driving a car when you aren’t even aware that your vision is off.”
By the end of the visit, the Masorati high schoolers had grown rowdy. “It’s often like this,” says Dvorkin. “The content of the program is very disturbing, very alarming. But for most of the time the kids are with us, you can hear a pin drop.”
By 2008, Hadassah hopes hospitals throughout the country will be running similar initiatives. “As far as we know, our program is both unique and effective,” says Dvorkin. “We see it becoming part of a national outreach, and we are sharing the teaching materials we have developed with other hospitals…. Our message is: Accidents can be prevented. If we save even one or two lives, we have still done something important.”