NAHARIYA, Israel — It is a cliché to say that a hospital is a place you never want to be in, but this tidy, gleaming establishment, the Western Galilee Hospital, is a place you really never want to be.
In much the same way as a good thriller, it unfolds to portend horror.
Start at the emergency entrance, which at first glance appears to be a standard if spacious squared-off white tunnel about 60 feet long. In Nahariya, a beachside resort, the sun shines through, lending a cheery, sun-shade feeling to the spot.
But strange round metallic spouts sprout from the ceiling, just outside the glass doors.
And through the glass, before the reception area, the wall is a foot thick and framed in metal. A cement door so massive it looks unmovable hangs menacingly from it. Hagai Einav, the hospital's genial spokesman, points out the next reinforced barricade, on the other side of the small intake room.
This is a hospital that can be sealed off in stages.
In fact, this may be the world's most elaborately equipped medical center prepared to withstand bombs and chemical and biological contamination. That's what the outdoor fixtures are for. Not to mention the reinforced partitions. And the 29 especially equipped "non-conventional beds."
In 2006, during the Second Lebanon War, this hospital, the northernmost in Israel, sustained a direct missile hit that destroyed part of the fourth floor ophthalmology ward. No one was hurt due to a prescient evacuation of all exposed rooms; all patients were underground.
Since then, it has prepared for much worse. It has built a shadow hospital beneath its buildings, all the wards connected by tunnels.
The Western Galilee Hospital is almost within shouting distance from the tense Lebanese border and Syria, which is unraveling. With one hour's notice it can double its normal capacity of 440 beds, release its elective patients to their homes and transfer all its departments, including ICU, shock room, surgical theaters, dialysis and birthing rooms, to an underground warren that to the untrained eye resembles nothing so much as a heart-stopping scene in one of the better Bond flicks.
Why dialysis? Because in wartime, Einav explained, anyone who can afford to flees. Those who stay behind are "the poor, the sick, the feeble. Dialysis patients don't leave for Tel Aviv, because they can't."
When not in use, it's a spectral sight: the underground emergency entrance snakes down into what initially appears to be a parking lot that rapidly reveals itself to be another complete hospital, hidden from sight. The rooms and halls are dusky and cool; beds and stretchers are parked haphazardly along the walls, piled with dusty mattresses that just wait. The entire subterranean edifice can be sealed off from the atmosphere in an airlock.
Truth be told, when not in use, the liveliest place in the buried hospital is its bright yellow air support room, a hall filled with warmly humming filters and tubes pulsing with air.
In the event of contamination from chemical or biological weapons, the hospital can be transformed into its own sealed-off, self-sustaining island, with no admissions and no discharges.
Medical administrators and trauma doctors have made the pilgrimage to Nahariya in droves since 2001 to study the system, which includes open-space color-coded emergency protocols marked in huge letters: SWINE FLU. EARTHQUAKE. MASS CASUALTY. CHEMICAL. Louisianan doctors came after Katrina.
Like other institutions that prepare for the most ominous eventuality, Western Galilee is staffed by a cheerful, efficient team of highly-trained professionals.
"Our vision is of the individual at the center," said Dr. Masad Barhoum, the hospital's director. "We are not primarily a research facility. Our aim is to care for people in a humane manner in tune with technology — not to become technocrats. We focus on the person in front of us."
Recently, some of the people in front of Dr. Barhoum have been wounded Syrians — civilians or rebels, it is not clear, but they've arrived wearing jeans, not uniforms. In late March, a critically injured Syrian reported by Arab media to be a rebel leader died in Nahariya after sustaining an in-and-out head wound.
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Barhoum hasn't chatted with any of them, beyond medical updates. "The IDF brings them in ambulances, and when they can be released they take them away.”
The two Israeli hospitals in which Syrian citizens are now under treatment are Western Galilee and Rambam Hospital in Haifa. Dr. Rafi Beyar, Rambam's director, said, "We don't ask questions. We do our work. They are grateful for the treatment."
Dr. Hany Bahouth, director of acute care surgery at Rambam, said the only question any of the Syrians have asked him is, "when they will be released."
Both hospitals have a wealth of experience. People wounded on the Turkish Mavi Marmara flotilla three years ago were airlifted to Rambam.
The relatively small, provincial Western Galilee Hospital treated more than 300 airlifted soldiers and 800 civilians during the month-long 2006 conflict with Hezbollah in Lebanon.
About a week ago, Dr. Michael Weiss, head of trauma care in Nahariya, softly announced the news that a Syrian in his late 20s who had arrived into his care with life-threatening complex stomach injuries, head wounds and no pulse had just emerged from the depths. "He's communicated. He's recovering," he said. The young man's estimated time in neurosurgical emergency care was a month.
Meanwhile, the rest of the hospital was gearing up for its next joint drill with the army, on April 25, in which emergencies much more dire than mere shrapnel or bullet wounds would once again be practiced. Just in case.