Since the soaring violence returned to the streets in October, dozens of Israelis have been killed in random acts of violence while more than 170 Palestinians have died – most while in the act of inflicting grave harm and even death on people they don’t know. It’s all about the blood.Periods like this have been upon us before. We even number them: first intifada, second intifada. Then we debate: are 200 acts of violence enough to give it a number – the third intifada? Yet, the one constant that remains in each set of violent acts, whether suicide-bombings or this macabre stabbing fetish that demonizes young people and takes its toll in youthful deaths – is the courage of first responders.To my brave colleagues who arrive at the scene to pandemonium and confusion, that we are stepping in line to become the terrorists’ most promising target is by necessity pushed from our minds. Abstract arguments and debates aside, the first responders treat anyone with wounds, victims and terrorists alike. However, don’t think for a moment it’s an easy choice, or that we don’t agonize over the innocent and aren’t repulsed by destroyers of life.Like other first responders, my parents brought me up to respect and celebrate life; to embrace the hearts of others – not stab them. The recent reality of responding to the scene of a call only to find a teenager lying dead and learning that he – or she – was the assailant – is a horror surpassed only by the thought of young children witnessing the brutal murder of a parent, an image that will never be erased.In the past decade, I’ve responded to thousands of emergency calls including terrorist attacks. Each time I arrive on the scene my heart pounds with adrenaline and anticipation. We are prepared to do the utmost to save the life of anyone who can still be saved – even if it means risking your own life – this is more than a given: it’s a part of the job and it’s expected.But what is not expected and rarely understood beyond the circle of first responders and emergency medical personnel is what we feel when the last ambulance has departed the scene and reality replaces the rush.Somehow peeling off the bloodstained gloves fails to remove the true stain that remains on our hearts. The incessant emotional highs and lows take an unfair toll on those who respond day after day. I recall how the surreal nature of what we do was driven home on October 3, arguably the start of the “knife intifada,” when on Saturday afternoon two men were stabbed in Jerusalem’s Old City and I participated in efforts to resuscitate them. Tragically, both died. A mere few hours later I was escaping to the amazing sounds of the great Bon Jovi, singing in Tel Aviv. It was not only a macabre juxtaposition, but for me it represented the melding of horror and heartbreak with the need to carry on; perhaps too confusing for anyone but a first responder to comprehend.Being involved in international operations for United Hatzalah (and America’s United Rescue), I’m often asked about Israel’s seemingly endless innovation and leadership in life saving.I answer that while it’s no great honor to achieve such a distinction out of necessity, it is nevertheless an endless source of pride that our first responders can be called into service all too frequently to arrive at scenes all too horrific to comprehend without losing their sense of perspective and dedication to saving lives. Any lives.As a medic I constantly pray that the most recent victim is the last: but deep down I know that me and my fellow first responders will likely fail to finish our next meal. It’s a horrible feeling to wish that next call is a person in distress and not a terrorist attack, but we are nevertheless ready to respond. We can never allow the fear of not responding to enter our minds because once that happens, the enemy has won. The next call will inevitably come and when it does, we’ll reach for the keys and rush out the door – without thinking twice.Not responding is not an option.Giving up on humanity is for the terrorists, not for the first responder.The writer, deputy director of International Operations for United Rescue (Israel’s United Hatzalah), has been responding to emergency calls for 12 years. He holds a masters of public health in emergency and disaster management from Tel Aviv University.