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Sky’s the Limit

What if Hatzolah had a fleet of airplanes that could be on the tarmac at a moment’s notice?

Photos: Naftoli Goldgrab, Personal archives

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very time I contacted Eli Rowe to set up a meeting, I’d get texts like these:

“We got a request to help a frum family from New York, they had a baby born at only one pound. He’s in the NICU in Texas. They’ll have to stay there many months if we can’t fly them back.”

“We flew a boy to Miami a month ago for 24 hours, now we flew with him with a medical team to Israel on Sunday. He was niftar 24 hours after landing… so sad.”

“We have a pickup in Arkansas, the patient is very sick. Will let you know.”

When Captain Rowe finally managed to schedule a time to meet in Brooklyn, I sat for half an hour waiting, assuming he’d hit traffic coming from Queens. Wrong. Upon reaching Flatbush, he received word of a car that had plowed into a building when the driver suffered a stroke. He stopped to help the critically injured bystanders.

Eli Rowe, a man in perpetual motion, walks into the coffee shop in his Hatzolah jacket, a Bluetooth in his ear, and a pack slung over his shoulder. He got off a plane from Israel at four thirty this morning, and he hasn’t missed a beat since. “I’m up and moving 20 hours out of 24,” he says, and it’s no exaggeration. He’s the founder and CEO of Womba, a company that aggregates health data for the insurance industry, is a pivotal member of Queens Hatzolah and founded its Paramedic Division in the early ’90s, and is a licensed commercial pilot, flying people in need for over 20 years.

There are aviation brokers and commercial air ambulance companies and lots of first responders, but that rescue work is generally on an ad-hoc, individual basis. “It’s reactive, not proactive,” he says. And that’s what Eli and his colleagues decided to change. Given our community’s phenomenal growth and commensurate needs, it became clear that a more formal, organized emergency air service was needed — and that’s how Eli, along with his friends and Hatzolah colleagues Gilles (Yaakov) Gade and Dr. Avishai Neuman, became the founders of Hatzolah Air, an ambitious new initiative to provide free urgent and emergent air transport for people in their most challenging moments.

“You happen to have caught me after a really difficult week of flights around the country, from early morning to night, some of them really sad and difficult, yet all extremely rewarding. We’re thrilled to have been able to make a difference in ways that simply do not exist anywhere else,” Eli Rowe tells me. “Today we had three Hatzolah Air flights, the most we’ve ever flown in one day. It’s been a really rough but amazing week.”

“Treating children in distress is the hardest for me personally,” he continues. “But transporting them to a place for treatment they wouldn’t have had access to is an incredible zechus.”

Avishai Neuman, an MD who met Eli through Queens Hatzolah about 24 years ago, took an interest in medicine back when he was a talmid at MTA and Yeshivas Ohr Hachaim, working as a service unit during his teenage years for Hatzolah, stocking ambulances and generally helping out where he could. (His mother is a pharmacist.) While learning at Yeshivat Hakotel in Eretz Yisrael, he spent summers volunteering with Magen David Adom and later attended medical school in Tel Aviv at the Sackler School of Medicine.

Avishai did his residency in anesthesiology at SUNY Downstate, and today serves as the medical director of Centurion Anesthesia. He never broke the connection with Hatzolah though; since 2007, as a physician, he holds a “REMAC” position — a doctor who takes medical control of the situation and assigns field orders to paramedics.

“Anesthesiology is a part of critical care,” he explains. “But ER doctors don’t do what we do. If an airway is blocked, or a line needs to be changed, they call the anesthesiologist. When extremely challenged patients need to be transported, in an ICU-type situation, you need such a doctor along to manage the care.”

In the past, Hatzolah would sometimes assist critically ill patients traveling back and forth to Israel on commercial flights, but it was cumbersome and costly; to fit in the patients, medics, and apparatuses often required buying five or more seats. “Commercial flights are also a problem for immune-compromised patients,” Avishai says. Yet as hospitals become more specialized (Johns Hopkins, for example, specializes in pancreatic cancers), he says it’s becoming more common to transport patients to specialized hospitals.

The third partner in the Hatzolah Air initiative, Gilles (Yaakov) Gade, became an EMT just a few years ago, but he’s recently been bitten by the medical flights bug: He’s already accompanied Eli on many medical missions, such as flying patients to and from various states around the US and Eretz Yisrael, as well as having coordinated the aerial search mission for Rabbi Reuven Bauman a”h. In 2014, he and Eli flew to Israel during the Operation Protective Edge-Gaza war in order to help replace the scarcity of medics in Jerusalem.

Originally from Marseilles, Gilles came to New York when he took a job at Bear Sterns in 1991. Today he’s the CEO of Cross River Bank, and although his Hatzolah involvement often takes him away from his family — usually not for more than a day at a time — he says his wife is understanding and his children are proud. His involvement in Hatzolah is more recent than that of his airborne colleagues. “I always wanted to join Hatzolah, but I knew it would be a big-time commitment, and I never felt I had the time,” he admits. Today, though, he sees it differently.  Referring to himself and his partners, all of whom are highly successful, he comments, “I believe that in our businesses, we do well because we do good.”

In addition, he says, the Hatzolah Air people are an inspiration, providing critical assistance that simply doesn’t exist anywhere else. “Look at our chief pilot, Freddy Sivan, who’s a former Israel Air Force pilot. He flew thousands of missions for Israel, and now he’s devoting himself to helping people with medical needs.”

Eli imbibed Hatzolah work with his mother’s chicken soup. His father, Dov Rowe, founded Hatzolah of Queens in 1977, and Eli became its first paramedic in 1991. He was there over the years that Hatzolah evolved from a loose group of volunteers into a highly professional operation. “Before Hatzolah, if there was an emergency, a doctor would pick up his bag and run. Then Hershel Weber started Hatzolah in 1969 with an oxygen tank in his car, and for a while it grew in a pretty random fashion. But over the years it’s become extremely professional and organized, and today its thousands of soldiers worldwide operate like clockwork.”

Today, everyone knows that having a well-oiled emergency-response system in place is crucial, and, says Eli, the same goes for medical flights. “Who will cover an emergency flight if a scheduled airline, charter flight, or volunteer pilot is not available?”

Until now, Hatzolah members would occasionally escort patients to destinations when necessary, but they didn’t have a service you could count on. While Hatzolah volunteers include many doctors, paramedics, and pilots, including members like Eli who fly their own planes, it was often difficult to find the combination of doctor, paramedic, and plane all together in the time frame needed. “We’d get two out of three pretty often,” Avishai says, “but lining up all three was often challenging.”

The three directors put together a detailed five-year global plan to get Hatzolah Air literally off the ground. As with any good business plan, every angle was carefully and explicitly spelled out: medical protocols, management experience, fiscal accounting, organizational leadership, legal considerations, project plan, likelihood of success. To their surprise and gratification, the Central Board of Chevra Hatzolah voted unanimously in favor of their plan, and Hatzolah Air was set up with its own separate 501c(3) status to allow for funding and donations. The partners made it a priority to cover the halachic angle as well, since when it comes to medical emergencies, halachic issues are inevitable. Rav Asher Weiss from Israel and Rav Herschel Schacter from New York are currently on board as Hatzolah Air’s poskim.

The long-range plan includes ample allowance for growth. “Our vision is to have seven regional airplanes, and one long-range, multi-mission airplane that can fly nonstop to Eretz Yisrael from New York,” Eli says. Those seven regions will be serviced from planes based in New York, Miami, Chicago, Los Angeles, London, Israel, and South America. All planes will have dedicated pilots and mechanics and will be staffed with local medical crews. The partners would eventually like to add rotorcraft, which are useful for transporting patients between hospitals, as well as for search-and-rescue operations, such as drownings or searching for hikers lost in forests. Helicopters land easily on hospital helipads, and can be equipped with infra-red heat-seeking equipment for search and rescue.

Every visionary is allowed one big dream. Eli’s is to eventually add a large plane that will operate like a hospital in the sky, with separate areas for triage, life support, radiology, and surgeries.

One of my own grandsons, at age six months, needed a very delicate, complicated heart surgery by a specific surgeon at Stanford University Medical Center. The baby was too fragile at that point to withstand a commercial flight from the New York area, so he was flown in a private, medically equipped plane with barely enough room for him, his parents, and the paramedics (thanks to the operation, b’chasdei Hashem, this child is much better today). My son and his wife were deeply impressed by the experience, describing in detail the way the plane was outfitted with all manner of life-support devices and medical equipment.

That experience left us with some sense of the complexities of transporting medically fragile patients by air. The Hatzolah planes will be able, after some mechanical adjustments, to convert from full intensive care stretcher air ambulances, equipped with oxygen, suction, ventilator, IV pumps, and full cardiac monitoring equipment to a transport aircraft with maximum seats. Hatzolah Air will use special machines to monitor carbon dioxide output and vital signs, perform EKGs, and serve as external pacemakers for patients whose hearts aren’t functioning adequately. All this data will be shared with the hospitals through advanced real-time airborne telemetry.

Hatzolah Air wants to make its planes available for any disaster that requires assistance beyond ground transportation. That could be an inter-facility flight to a specialized medical center, like my grandson’s flight from New Jersey to Palo Alto. It could mean flying a patient, or an organ, to a transplant center when time is of essence. It could mean flying in a person who became sick or injured far from home. It could be several family members languishing in critical condition after being hit by an oncoming truck while on vacation in a far-off country or island. “My friend’s father was in the Bahamas and fell near the ocean,” Eli relates. “He had a brain bleed, and the local hospital determined that he needed a craniotomy, but they weren’t equipped to do it. So we flew him in the middle of the night for advanced care.”

This sort of air travel often becomes necessary when medical or humanitarian issues arise in remote places where good medical care isn’t available. Eli anticipates that Hatzolah Air will work closely with Chabad Houses, which are often the only Jewish centers in remote places. Two years ago, for example, Eli, Avishai, and a team of volunteers flew 6,000 pounds of food and supplies directly to the Chabad House in Puerto Rico to distribute across the island after a devastating hurricane. When a massive earthquake hit Haiti in January of 2010, Eli and Shlomo Zakheim a”h (who Eli refers to as his mentor, older brother, and closest friend), flew down to help with disaster relief. “We were the only non-military jet that landed,” he says. Two years ago, he went back with Avishai and a team of specialists to help with hurricane relief, setting up a 12-person field hospital that treated over 600 people.

The planes will also be available for search and rescue missions, like when Eli and Gilles took to the skies to join the search for Rabbi Reuven Bauman this past summer. Hatzolah Air later flew the niftar from Virginia to New Jersey for kevurah, a mitzvah they’ve done numerous times. For example, when a Darchei Torah rebbi suddenly passed away, Eli flew the rebbi’s teenage daughter from upstate New York back to Far Rockaway for her father’s levayah. When she asked how she could thank him, he told her, “Invite me to your wedding.” Five years later, the invitation arrived. Similarly, when a Chabad shaliach lost his 27-year-old wife, Eli and Chaim Gewirtzman, a dedicated askan and medical liaison for the New England area now living in Waterbury, flew her from Duke University Hospital in North Carolina so she could be buried that same day before shkiah.

Then there are the non-emergency, but still pressing, flights for a different kind of chesed: flying children who have been sent home on hospice on a dream trip so that, as Eli says, “They can leave This World with a smile on their faces…. For the children and their families, it’s a priceless experience.” This summer he and Avishai flew two girls with cancer to Disneyworld and Miami. One was in remission; the other, he says, still needs rachmei Shamayim. Pilot Brian recently flew an Israeli boy, ill with cancer, to Miami, in order to spend time with his family there. “Then I flew him back. He passed away just a week ago,” he says.

One imagines that Hatzolah Air could quickly become barraged with requests for free flights. “I believe our toughest challenge — even more than fundraising or medical challenges or aircraft operation — will be deciding who we fly and who we don’t,” says Gilles Gade. “We’ll have to follow a strict system of triage, deciding which cases are most urgent.”

Many people don’t realize the expense, details, and effort that go into each flight,” says Roniel Levy, a pilot, attorney, and Hatzolah Air director, who volunteers dozens of hours each week. “At times callers who could have gone by ground or flown commercially ask for flights, and sometimes people ask for flights that wouldn’t be safe or practical.”

Hatzolah Air is also hoping to create a global network of people and organizations that can volunteer their aircraft for non-emergency flights and for people to share airline miles to help with air travel when commercial flights are indicated. A few such options already exist, such as Kanfei Chaim, Miles for Life, that the group works with. “In this way, we can still help people with air travel even if a Hatzolah plane is not doing the flying,” Gilles says.

Because every case is so individual and specialized, each mission leaves its own particular mark. Avishai tells about an Israeli girl who had become extremely ill with encephalitis while in Canada for a summer program. After many months in the hospital, the doctors felt they could do no more for her, and her parents, who spoke little English and who had been living in the local bikur cholim house, wanted to bring her back to Eretz Yisrael. “She was one of our most critical cases — she was sedated, she was on a vent, and her situation was touch-and-go,” Avishai says. “So she needed an experienced team to get her through the ten-hour transport. But she survived the flight. Her parents wept tears of gratitude when she arrived, and the last I heard, she was getting better.”

“For a parent who’s suffering with a sick child, or a person with a sick spouse — imagine a wife who hears her husband will die if he doesn’t immediately get to the Mayo Clinic, and there are no available flights — they’re in such a state of helplessness and worry it’s like the world’s gone gray,” says Eli. “Then someone tells them, ‘Hey, you can call Hatzolah Air.’ ”

This past summer, a van transporting 14 bochurim in North Carolina rolled over. Thirteen of them suffered broken bones and other non-life-threatening injuries, but one was so badly injured he had to be intubated, and his parents were told his chances of making it through the night were only 50-50. The boy was so critically ill he spent two weeks on an ECMO machine during his 40 days in a critical care unit. His mother came down and never left his side.

When he was finally able to return home to a rehab facility, the boy’s mother reached out to Hatzolah Air. “They saw us like a neis from Shamayim,” Eli says. “They were there with no friends and no family and so far from home, and we brought them food, care, and then — our plane. They couldn’t believe their eyes. They couldn’t believe Hatzolah actually had its own plane.”

Eli, Avishai, and Gilles concur that their most dramatic and highly publicized flight was transporting Rabbi Yitzi Hurwitz, the former ebullient Chabad shaliach who created a kehillah in Temecula, California, before being diagnosed with ALS in 2011. Today Rabbi Hurwitz (whose family relocated with him to L.A.) is unable to move any of his limbs and is in need of a trach to breathe, which requires constant suctioning. Despite being a prisoner in his own body, he continues to write inspirational pieces using eye movements and computer-tracking technology, and communicates incredible positivity and wellsprings of emunah to his many visitors and followers of his blog. A song he wrote many years ago, “Shine a Little Light,” became a hit when a panoply of Jewish music stars banded together to produce it as a video in his honor after he became ill.

Malkiel Gradon, the director of Misaskim in Los Angeles as well as Hatzolah Air’s representative on the West Coast, had called Eli with a special request: Yitzi’s youngest son’s bar mitzvah was coming up, and Gradon realized that the Hatzolah Air plane would make it possible to fly him to New York to celebrate with his son at 770 Eastern Parkway. (Chabad chassidim have a minhag to put tefillin on a bar mitzvah boy and give him an aliyah at 770 when possible.) Rabbi Hurwitz had missed other sons’ bar mitzvah celebrations because there had been no way to transport him.

It wasn’t the first time Hatzolah flew an ALS patient. Mendy Rosenberg, a former Hatzolah member himself, has ALS and can’t travel under normal circumstances. The flight team — comprised of his Hatzolah brothers — transported him to Florida in the winter, where the milder climate is easier on him.

On September 4th, Eli was able to transport Rabbi Hurwitz in the new Hatzolah Air plane, with Avishai Neuman on board as the doctor in charge. The oldest Hurwitz son accompanied his father on the flight there, while the bar mitzvah boy came on the flight back, during which he helped put tefillin on his father. “Yitzi hears everything, and his mind is completely intact,” Avishai says. “When someone mentioned we were flying at 600 miles an hour, he communicated ‘520 KTS’ — he’d calculated that 600 miles equals 520 knots per hour. When we were flying over the Grand Canyon, he spelled out ‘Colorado River’ as we passed over it.”

It was during that flight that the crew realized they hadn’t thought to keep a pair of tefillin, a tallis, or even a siddur on the plane. After that, pilot Brian Killian stepped forward to donate them.

The family wrote grate fully, “From entirely funding the costs and aircraft for the flight, to all the emergency transport details necessary for moving someone in such a situation — you have delivered with such love, care, and compassion and made it all happen with such skill, ease, and competence… You have given Yitzi a gift of freedom that will make an indelible impact on his life and his son’s life, forever.”

But after meeting a person so challenged, yet so inspirational, the crew members felt that they were the ones who’d been given a gift. “When we returned to Los Angeles on our return trip, and Reb Yitzi left the airport,” Avishai says, “there wasn’t a dry eye among us.”

As a physician, Avishai knows intimately that death and grief are part and parcel of providing medical care, but on the other hand, he says, the tragic stories are offset by the triumphs. “For every ten terrible stories you hear about, there’s always a special story, like Reb Yitzi’s flight. And those stories can keep you going. You never say, ‘Oh, I can’t do CPR for someone, I’m too tired.’ You have a purpose, and the adrenaline kicks in. You don’t even know your own strength.”

So, how do they find the strength to keep going, when so often the calls come when they’d rather be collapsing into bed? “It’s like being a soldier in the field,” Gilles Gade says. “You push forward, because you have no choice. Or imagine that you’re at work, and you get a call that a family member is in a critical condition. You wouldn’t hesitate, you’d leave right away — and we see every Yid as family.”

If this was a job, Eli says, he probably would have quit a long time ago. But it isn’t a job; it’s a mission that has possessed all of them. “It’s not a hobby,” he says, “and it’s not even like responding on regular Hatzolah calls or taking an overnight shift. We’re always on call — because for us, this is our life.” —

 

New Heights for Healing

Hatzolah Air has recently put into service its very first plane, a 2000 Bombardier Lear 60 twin turbine jet. The plane itself was gifted by an “extremely special” benefactor. “I would love to shout his name from the rooftops, but he prefers to remain anonymous,” says Hatzolah Air founder Eli Rowe. Other generous donors came forward to help with expenses like electronics upgrades, paint, and medical equipment. Acquiring planes, of course, is only the first stage of expenses; Hatzolah Air must also pay for their upkeep (managed by professional maintenance crews) and hourly flying costs.

With its navy and chartreuse paint job, and the words “HATZOLAH Emergency Air Response Team” displayed boldly along its side, the plane is a thing of beauty, standing sleek and handsome on the tarmac of its home base at the Farmingdale, NY, airfield. Inside, there’s space for a patient on a stretcher, and comfortable seating for family members and the medical team.

The Farmingdale airfield was chosen as Hatzolah Air’s base for a variety of reasons. It has a 24-hour hangar with a quick call-out and maintenance facility. It’s close to New York, but is much less busy than an airport like JFK, where planes often have to wait over an hour, behind 20 or so other planes, before being cleared for takeoff. Farmingdale’s smaller size means the plane can get to the runway and take off in minutes.

“Lear planes are extremely popular in the air ambulance world due to their fast speed and generous door size,” Eli says. “The Lear 60 also has increased range over smaller Lear jets, allowing it to fly over 2,000 nautical miles without stopping for fuel.” The plane will always be flown by a professional crew consisting of two pilots, the PIC (pilot in command) and SIC (second in command).

A basic pilot’s license isn’t sufficient for flying a Lear 60; there are many different grades of pilot. Eli himself has qualified for a multi-engine jet rating on multiple types of aircraft, which involves attending school full-time for many weeks. Hatzolah Air made the decision to use only FAA-certified commercial pilots on their flights, and even those pilots need to undergo specialized simulator training in this particular model. (The training is only offered in a handful of facilities worldwide.)

The Hatzolah Air pilots are not all Jewish (one is a former Coast Guard), but some of them are. Chief Pilot Commander (Ret) Freddy Sivan, who retired from El Al, was an F-15 fighter pilot in the Israeli Air Force and brings 28,000 hours of flying experience to the table.

Brian Killian, a former Navy pilot who became a baal teshuvah nine years ago, cut back his accounting career in Fort Lauderdale in order to pilot for Hatzolah Air. Brian spends most of his time in the cockpit, but he’ll often help patients and their teams get on board, making sure the stretchers roll smoothly and no one bumps a head.

“I hesitated at first, since it was a new organization,” he says. “But I spoke to my rabbi, took a leap of faith, and ever since I’ve been on fire.”

(Originally featured in Mishpacha, Issue 786)

 

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