IMAJ | volume 24
Journal 9, September 2022
1Surgeon General's Headquarters, Israel Defense Forces, Ramat Gan, Israel
2 Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
3 Department of Internal Medicine E, Sheba Medical Center, Tel Hashomer, Israel
4 Department of Military Medicine, Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Israel
5Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
War is as old as history. Some may say it is older. The first Biblical war, dated 1880–1875 BCE, is depicted in the book of Genesis between nine kings in the vicinity of the Jordan river near Jericho. By the end of the war, Abraham (Abram) gets involved in saving his nephew Lot.
In addition to war, military medicine also has its roots in historical times. Hippocrates (460–377 BCE), the father of medicine, derived his medical knowledge from the battlefield, and Sushruta , the father of plastic surgery, mentioned the physician's preventive role in noting environmental hazards: "A common practice of the enemy is to poison the wells on the roadside, the articles of food, the shades of trees, and the fuel and forage for cattle; hence, it is incumbent on a physician marching with the troops to inspect, examine, and purify these before using any of them, in case they are poisoned."
The Greeks stated new ideas of military health, pointing to fitness promotion, gymnastics, and healthy diets to prevent illness. Over the centuries, from Alexander the Great to Napoleon’s army and wars in the 20th century, military conflicts have led to the death of hundreds of millions of people from trauma and war-related disease. Amazingly analyses of the 18th and 19th centuries have shown that 80% of the soldiers died from disease, and historians and military personnel agree that during armed conflicts in known history, only a minority of soldiers perished by the sword.
In Israel, the Israel Defense Forces-Medical Corps (IDF-MC) holds a unique position embedded in military and civilian national medicine. All medical personnel (e.g., physicians, nurses, technicians, veterinarians) who work in the IDF-MC receive their diplomas from civilian universities, train in civilian hospitals, and continue to practice in the national health system. The majority of these professionals continue to work in different civilian medical platforms in Israel after finishing their mandatory service. The IDF-MC's primary mission is to provide optimal medical care to IDF soldiers at all times (including wartime), to prevent disease and promote health, advance military medicine, and aid the civilian sector as ordered by the Government of Israel.
In this special issue of Israel Medical Association Journal (IMAJ) is to expose readers to the continuous efforts of the IDF-MC to fulfill its mission by promoting research in multiple medical fields, including trauma, ambulatory care, health administration. In addition, in this issue of IMAJ, authors discuss the unique collaboration with the civilian system during the coronavirus disease 2019 (COVID-19) pandemic.
Trauma and trauma-related injuries are the main focus of military medical research. Ben-Avi and colleagues  described outcomes of emergent exploratory thoracotomies on military casualties and addresses parameters that may impact the survival of these casualties. Minervini  further discussed the issue. Bez et al.  researched the impact of isolated versus non-isolated traumatic brain injuries on injury identification and decision-making by care providers in austere scenarios. Tsur and co-authors  described the characteristics of a unique type of terror attack: vehicle ramming.
Additional examples of treatments provided in the military prehospital arena were analyzed by Nakar and colleagues  who discussed how to assess pain medications administered to trauma casualties in the past two decades by IDF-MC care providers. Rittblat et al.  further described the use of freeze-dried plasma, a blood component used in the prehospital arena and administered via intraosseous vascular access.
The IDF-MC is a continuously changing organization emphasizing the adoption of advanced technologies and devices. Chen et al.  presented a blinded study on the use of point-of-care ultrasound and remote telementored ultrasound by inexperienced operators, and Sorkin et al.  described the BladeShield 101: a novel device for the battlefield designed to continuously measure vital signs and medical treatment provided and to transfer data through roles of care.
In this special issue of IMAJ, authors also discusse gender-related aspects at the core of medical treatment. Segal et al.  examined whether missed injuries were related to the medical provider's gender, while Gelikas et al.  assessed whether treatment with analgesia was associated with casualty gender in the military prehospital trauma setting
Over the past two and a half years, the COVID-19 pandemic has been a significant part of our lives. During these years, medical systems and teams throughout Israel and around the world struggled to adapt to this new disease and save lives fighting the pandemic. Geva et al.  and Shental et al.  discussed the impact of COVID-19 on the IDF medical system, lessons learned during the outbreak, and effects of different diseases during these times on medical treatment provided by the IDF to soldiers.