The topic was terrorism. "How underprepared are we in the U.S.?"
That exchange, between an emergency care physician at Cedars-Sinai Medical Center and Dr. Jonathan Halevy, director of Shaare Zedek Medical Center in Jerusalem, was part of an ongoing effort in Los Angeles to change the answer.
Almost immediately after Sept. 11, El Al's legendary security became a model for improving procedures at American airports. Now the scope has broadened, and Los Angeles hopes to learn from Israel's hard-won knowledge of terrorism, prevention and response. Local officials for law enforcement, private security and medical care are reaching out to their Israeli counterparts for answers: What do we do if, or when, it happens here?
"[Suicide bombing] is likely to start happening here," says Los Angeles County Deputy Sheriff Mark Seibel. For 10 days in late April, Seibel traveled throughout Israel with deputies and LAPD bomb-squad members, visiting sites of previous attacks and going through the paces of prevention and response with Israeli national police.
"There's things they do there that we can do here," Seibel says. Though he could not share details of law enforcement tactics or plans, Seibel did offer one area where local agencies are taking cues from Israel. "Patrolmen get briefings from the bomb squad twice a year on the procedures of the bad guy," in order to know what to look out for, and civilian versions of those briefings are presented to high school students. Seibel believes the average Israeli high school student has a level of awareness of danger signs equal to any patrol officer in America. "They share information fantastically, distribute every piece of information immediately," said Seibel.
Since returning from Israel, the deputy sheriff has worked with the L.A. County Terrorism Early Warning Group, a six-year-old task force, presenting what he learned in Israel to police and fire departments and representatives of all agencies responsible for safety throughout the county. "The bad guys are a network team," he says, "In order to respond well, we need to respond in kind."
That sentiment is echoed by Amotz Brandes of Chameleon Consulting, Israeli American security experts based in Canoga Park who co-sponsored a security forum in March, with the Israel Economic Mission, called, "Collaboration of Knowledge in the Age of the Terrorist Threat." That conference attracted 170 attendees from law enforcement, public institutions and corporate security groups. Brandes calls the techniques and technology of security "the most important product Israel has to offer."
In addition to more effectively sharing information with other agencies, Brandes recommended that local security officials overhaul the way they look at security. "The basic thing police and the public sector have to learn is to look at security in a more targeted fashion," he said. "American law enforcement has a lot of procedures, but no goal. In Israel, there is a goal, but few procedures."
Even the Israelis, of course, cannot prevent every attack. Los Angeles has much to learn from Israel's similarly hard-won expertise in responding once the deed is done. That is where Halevy hopes to be of service. He took to the road in June, visiting hospitals across the United States with a lecture on "The Impact of Urban Terror on Hospitals: The Jerusalem Experience." In his presentation, the doctor walked his L.A. colleagues through every step, from the first call to the post-cleanup arrival of the politicians, that his hospital has developed and repeatedly put into action after a "mass casualty event (MCE)." An MCE may be natural, unintentional or intentional; intentional may be conventional or unconventional. Hospitals must prepare for every scenario, and Halevy added this chilling addendum: "We have an official alert that hospitals are targets."
At Cedars-Sinai, 100 doctors listened carefully and took notes. Halevy described a cabinet in his emergency room, holding an extensive, color-coded list of toxicological agents with protocols for treatment in the event of a mass exposure. In the audience, above the sound of quick, careful note-taking, a doctor's voice could be heard, whispering to a colleague: "That's a good idea."