During Operation Roaring Lion, hundreds of people received medical treatment from Magen David Adom (MDA) teams, including many treated by male and female paramedics in mobile intensive care units (MICUs). These units have operated in Israel since the 1980s thanks to the vision, experience, and knowledge of one woman: Prof. Nancy Caroline. Moreover, they exist because of her dedication to saving lives in Israel. For International Women’s Day, we present the story of MDA’s first medical director, whose work continues to shape lifesaving medicine in Israel today.
Few people can truly be said to have sparked a revolution, and even fewer of them are women. This is the story of a woman who changed the face of emergency medicine in Israel. Prof. Nancy Caroline, a Jewish physician, was born in Newton, Massachusetts, in 1944 and began her professional career as an emergency medicine resident in Pittsburgh, Pennsylvania. Fifty years ago, this young doctor arrived from the US and transformed the landscape of emergency medicine in Israel through determination, perseverance, and a distinctive personality.
As early as the 1960s, Caroline was already leading groundbreaking work in the United States. As medical director of Freedom House, an ambulance service that trained residents from disadvantaged neighborhoods to serve as paramedics in their own communities, she helped create the first national model of its kind.
In this role, she helped shape the modern concept of the paramedic: a highly trained medical professional who is not a physician but is authorized, through specialized training, to perform advanced lifesaving procedures in the field. Caroline was also among the pioneers who developed advanced theories of pre-hospital resuscitation and helped introduce routine EKG monitoring to rapidly identify heart attacks and other life-threatening cardiac conditions.
MDA leadership recognized the potential to advance emergency medicine in Israel and approached Caroline to serve as the organization’s first medical director. The goal was to introduce the paramedic profession to Israel and further the mission of saving lives, which has been central to MDA since its inception. In 1976, Caroline immigrated to Israel, bringing extensive experience and expertise. The move soon bore fruit.
Israel became the third country to operate paramedics in mobile intensive care units
A woman of vision and action, Caroline led the establishment of the paramedic profession in Israel. In 1979, she initiated and taught the first paramedic training course at Magen David Adom, a milestone that made Israel the third country in the world to operate paramedics in mobile intensive care units. Today, MDA trains hundreds of paramedics every year, including in collaboration with the IDF Medical Corps.
Nathan Kudinsky, a participant in that historic first course and former head of MDA’s training department, recalls that Caroline was a remarkable teacher. He says she knew how to convey both theoretical and practical material so effectively that all the students, many of whom were themselves instructors in the IDF and MDA, were extremely impressed.
He adds that she had an extraordinary ability to teach and that there was no chance a student would sit in her class and leave without gaining the knowledge she intended them to acquire. Beyond that, she was professional, punctual, and serious; her classes always began on the dot. At the same time, she was a warm person, and no one ever heard her raise her voice because there was simply no need. She was always there for the students and created a pleasant and supportive atmosphere around her.
The influence of Caroline’s work was felt across the entire country. She was not satisfied with training only the first generation of paramedics; she sought to create a shared professional language for all those working in emergency medicine.
The textbook she wrote in 1979, Emergency Care in the Streets, became one of the foundational texts in paramedic training worldwide and was translated into many languages. For many years, the book served as a professional cornerstone for MDA field teams. In its opening pages, the book emphasizes that being a paramedic represents a continuous journey of growth and excellence, challenging students to become more compassionate, conscientious, and clinically skilled medical professionals.
Alongside her work in Israel, Caroline also held medical and humanitarian roles in Africa and in international medical frameworks. Even after completing her official role at MDA, she maintained close ties with the organization’s leadership and personnel for the rest of her life.
In the later years of her career, Caroline focused on oncology and palliative medicine. She founded the Upper Galilee Hospice, a pioneering framework providing supportive care for cancer patients and their families. Until her passing in 2002, she continued to work as a physician, lecturer, and consultant, while also contributing her experience to MDA, Sheba Medical Center, and other medical institutions in Israel.
Prof. Nancy Caroline’s legacy reflects a rare combination of medical professionalism, human sensitivity, and the determination to bring about meaningful change through perseverance and dedication.
Nathan Kudinsky concludes that Caroline was a remarkable woman who deserves to be remembered for generations. Fifty years after her arrival in Israel, and as International Women’s Day approaches, her life’s work is reflected daily in the efforts of thousands of paramedics, EMTs, and volunteers of Magen David Adom who continue to carry forward the medical and ethical vision she helped build.