Carl Leibowitz: welcome to another episode of A Conversation with Carl. Please remember to like, follow, and subscribe for the latest content. Today I'm very excited to have the opportunity to speak with Dr. Anna Goldenberg. Dr. Goldenberg is an associate professor of surgery at Cooper Medical School and Director of Trauma Research at Cooper University Healthcare. She's the subject of the documentary The Asset, which highlights her humanitarian effort to bring advanced battlefield surgical training to conflict zones. Welcome, Dr. Anna Goldenberg to the conversation.
Dr. Anna Goldenberg: Thank you, Carl. Thanks for having me.
Carl Leibowitz: So why did you do this documentary?
Dr. Anna Goldenberg: So the documentary actually started out as just a simple conversation with Adam Tietenbaum who I met through a friend who supported the asset mission. and the conversation was just simply about how I pivoted, you know, as a Jewish individual after October seventh, you know, where I channeled my frustration, my energy, into good rather than negative. So it started out as a conversation and I never thought anything would come. of it because I thought it was just gonna be a small little podcast episode. until Adam called me back and he said, Hey, listen, we really need to make this into a movie, you know, a little documentary, just showing all the good that happened from this this initiative.
Carl Leibowitz: it's a great documentary. one of the things I found fascinating nobody on the pit wants to leave the hospital. And I was fascinated by the same comment that you made. during the documentary,
Dr. Anna Goldenberg: Yeah, so you know, th that applies so much to when I was a resident. Obviously, as you go through time, you want to leave the hospital a little bit. But you know, I think it comes from the the idea that we are really in in the realm of trauma and even, you know, when they show in the pit, we are really in the most humbling situations, right? We are seeing patients in their worst of the worst moments, and it's just so humbling that you don't want to leave the hospital. You want to give it a hundred percent and then another thousand percent because humble experiences for people, they never stop, you know, in our trauma bay. So I found myself just addicted to helping people in their worst moments. And that's kind of what I've built my career on over the last ten years at Cooper, as a trauma surgeon.
Carl Leibowitz: So when you're when you're in the room, how do you remain so calm? Because I imagine you have to be really calm and you're making decisions at a really fast pace that you don't really have time to think, Am I doing the right thing? Do you know what I'm saying?
Dr. Anna Goldenberg: Yeah, so yeah, totally. So so unlike the pen on like Graze Anatomy, where people, you know, they thrive on seeing the chaos, that's not really the case, right? Chaos doesn't get your results. Chaos gets you chaos for the patient. It does not get you improved outcomes. So, you know, in trauma we learn that calmness and repetition, algorithmical thinking is what really saves lives, right? Time every second counts, and every second you are in chaos. Is every second spent out of making critical decisions, both for yourself and your, you know, the the staff that's around you. So, you know, we have a team, right? Everybody is on a team, everybody has the same goal. When you go into trauma activation on a severely injured patient, or maybe even not a severely injured patient, everything's the same, right? We go through the alphabet. It's just as simple as learning the A B C's, and that's what we call it A, B, C, D, E. Right. And every one of those letters stands for something. And until you get through that letter, you cannot go on to the next letter. So that's what's trained and sort of inherent in us as humans. I think trauma's not for everybody. You do have to be pretty calm, but at the same time, you have to carry yourself as the person that everybody looks to for decisions. and I think I think it's it's learned, it's acquired, and but it's it's certainly not for everybody.
Carl Leibowitz: And then can you talk about the documentary The Asset?
Dr. Anna Goldenberg: the asset, I think in the documentary it's a little bit of a play on words. I hope that people understand it after seeing it. So the asset actually is an advanced exposure and trauma surgical course that came out of the American College of Surgeons. That was born out of the Afghanistan-Iraq conflict after nine eleven, where surgeons were deploying Taking care of severely injured soldiers. And because the United States had not been involved in a conflict in a really long time, they were missing certain injuries. They were just not up to speed. And most of the surgeons that were deploying were surgeons that were doing everyday general surgery. So doing appendixes and gallbladders. And trauma is a very, very different animal. you know, trauma, you're talking about ballistic missiles, rifles, things like that. So severely, severely injured patients. And what that conflict taught the United States military is that we can prevent deaths, right? And the way to prevent deaths on the battlefield is to train our surgeons at rapid exposure and trauma, surgical exposure, and hemorrhage control. So if it's bleeding, you gotta stop the bleeding really, really quickly and get that patient out of there to get them to, you know, a definitive place of treatment. so the course was built out of that. In the movie. the the way that asset came about was that after October seventh, Israel had, you know, a massive influx of casualties that day, right? That's just known and to all the different hospitals. Because of that, a lot of the surgeons that were taking care of those patients were not necessarily trauma surgeons. They were maybe, you know, surgeons that were taking care of other types of patients. And that course that we teach all around the world was not offered in Israel. And at that time one of my fellows, my former fellows who trained who I trained at Cooper, Shahar Shamanovich, Dr. Shahar Shamanovich, he was dying of metastatic colon cancer. And I texted him after October seventh. I texted him maybe a couple of days later and I said, Hey, I said now's our time to bring this course. You know, we've been talking about it for a while. And now's our opportunity. in you know, your last couple of months of life really, we we spoke that candidly about it, to try to push this forward and get the surgeons and the residents, people really taking care of patients on the ground, this course to empower them to to to learn, to to collaborate, to connect during such a hard time, right? Both for Jewish people in America and you know, the people in Israel. so we worked really hard and we brought this course there and we've been taking it back and back and back and expanding it. So Dr. Shachar Shamanovich died before we came there the first time. But he knew that it was gonna happen and hopefully this is a legacy sort of that he left for his, you know, trauma community for his country and his colleagues. So that's where I came about.
Carl Leibowitz: So how do you do they let the bodies come in or do you have to bring the bodies from do people donate the bodies? 'Cause I found that fascinating and I was so where do you get the bodies?
Dr. Anna Goldenberg: No. No. So interestingly enough, the the asset course is taught with fresh frozen cadavers. They're much different than what you would normally see in, like, let's say, a medical school. Cadaver anatomy, those are formaldehyde. Fresh frozen cadavers are essentially people that have just died, and they are pre procured in a very special way to keep the body and the tissues and the blood vessels, everything intact, as if. The person's looking like they are alive. So everything, once that cadaver is defrosted, it looks very real. the way that this happens is that there are multiple companies. The the biggest one is in the United States that supplies bodies all over the world. They get donations from people donating their bodies to science, they procure them, and then they ship them all over the world. the interesting
Carl Leibowitz: How long do you have after the body is like first?
Dr. Anna Goldenberg: You I mean you have you can use them up for a certain amount of time. I think they stay frozen, years maybe. I don't know, honestly. You know, in the doc No, no, it's it's funny because in the in the documentary I have this discussion with Gil, who's, you know, my partner in crime over in Israel helping me plan these courses. I tell him it's like people are taking their last field trip, right, to Israel. So right, so they've died and now they're taking their last field trip and making, you know, this contribution to people.
Carl Leibowitz: Okay. Okay. Okay. Got it. Okay. It's not like you have like six days and then we gotta go. Okay. Yeah. Yes.
Dr. Anna Goldenberg: And then that's that's the end of their body, right? They're not they've never been buried, they haven't been cremated. so they ship them from the United States, various locations. So Las Vegas is one of them. There's a couple of other ones. They ship them to Israel. during that time, during the war, it was very difficult to get the bodies there. And also, there needs to be a permission from the Ministry of Health to ship these bodies because this is not something that they do in Israel and in other, you know. Middle Eastern countries because you're supposed to bury the body, you're supposed to respect the body. And although you can do organ donation in Israel, you're not supposed to really procure your body, you know, in the Jewish religion. So, so yeah, we we do ship them from the United States. So when we defrost the bodies, it's literally like a fresh person has just died. So all of the dissection is very, very real. you know, you're able to isolate vessels, you're you're able to simulate injuries to blood vessels and to organs. and this the course is taught very, very systematically. It's an amazing course. It was created by Dr. Mark Boyer. and the course is just amazing the at the amount of knowledge and time that we take to really talk about severely injured patients and how to, you know, how to help them. and then the bodies get cremated, and interestingly enough, this is another issue that we we encountered, believe it or not. There's only like one or two crematoriums in Israel. And yeah, no.
Carl Leibowitz: Yeah, I w I would imagine that there weren't that many.
Dr. Anna Goldenberg: No, and and part of the controversy is then how some of these crematories are not even disclosed because they're heavily they they are heavily protested by, you know, Orthodox religious people, which for for their own reasons. So it was very difficult to find a crematorium that would dispo you know, like properly
Carl Leibowitz: I would also imagine just because of the Holocaust that's adds another layer layer to the story of like why you can't find the crematoriums in Israel. Yeah. Yeah.
Dr. Anna Goldenberg: Я? Я. Absolutely. Absolutely, absolutely, 'cause most people are not crem cremated in Israel, so it's it's controversial.
Carl Leibowitz: Yeah. Yeah. he comes to you, wants to do this documentary, and what's your first reaction?
Dr. Anna Goldenberg: let's do it. And I again I didn't think that we were, you know, we when he kind of said that, I was like, all right, like and then I just left it alone. And then, you know, he reached out to me and he said, you know, he found Raveet, who's an award-winning Israeli filmmaker, documentary maker, and we kind of planned out all of the steps and we we weren't sure yet what the vision was for the film, but you know, she really created a beautiful, beautiful piece of art. that tells the story, but not only the story of, you know, the asset course of what we do as trauma surgeons, really just about like she calls it, a platonic love story, which is so hard to find nowadays, you know, about friendship and legacy, and giving back and connection and humanity. And that's sort of like what the Jewish faith is all about, right? So it was very fitting.
Carl Leibowitz: And it's also your story too about going to Israel. and you go there now, how you you said I think you've gone there four or five times after
Dr. Anna Goldenberg: Yeah. Yeah, yeah. Yeah, we've gone f four or five times. We've expanded the course to teach medics and paramedics. We're using the body for other to teach other subspecialties. So we're really, you know, fortunate to have support from the South Southern Federation of New Jersey, my local community here, and they believed in the mission, and they've been very supportive on sending us back to continue the work that we're doing there.
Carl Leibowitz: Have you gone with your family? Or just not yet. Yeah, okay.
Dr. Anna Goldenberg: No, no, not yet. No. I've called my kids from multiple Mamads, you know, during sirens and during the Iran attack in October. but no, they have not gone with me yet.
Carl Leibowitz: Yeah. Yeah, bomb shelters, yeah. and then, you know, when you were in Israel, well talk about being in the bomb shelter While you're teaching the class, I see that there's one shot where you guys all running down to the bomb shelter. Yeah.
Dr. Anna Goldenberg: Yeah. Yeah. So for the first mission that we went, it was at the height of the war, the height of the you know, the the Gaza Is Israel conflict, and pretty much all day there was rockets being sent into Israel and to Tel Aviv, and every hour or so we would have to stop, you know, the cadaver course and we would have to run to the bomb shelter. and then everybody would have to take a cigarette break. So it, you know, initially It took a really long time to get through the first two days, the first course that we made. And as the as the the as we came back every couple of months, it got a little bit better. until the Iran attack. I I believe it was October first that it happened. we were there teaching and that was a first attack and we were in in a bomb shelter at night trying to leave Tel Aviv to go back to JFK, which you'll also see in the movie. that was another scary moment. You'll see a terrorist attack that happened the same day after we finished training our surgeons at Ed Edith Wolfson Medical Center, and Ichilov and they took care of patients at both hospitals. you'll also see that in the movie, and that happened right close to us at a restaurant we were eating at. So again
Carl Leibowitz: Well, everybody leaves to go the doctors that you're all eating with, they all leave to go to the hospital. Did you go to the hospital or did you not know Yeah.
Dr. Anna Goldenberg: Yeah, they they leave. Yep, they leave. So no, no, no. That was our our you know, we were in shelter, we were taking but yeah, it was it was a scary moment for for me and my two partners that were both there. both of them are highly decorated, you know, military trauma surgeons now, not in active duty, but very active. both of them have both been in, you know, high conflict combat zones. so they kept me, you know, they kept me calm, they kept me, you know, sort of sane. So I was thankful for them being there.
Carl Leibowitz: How do you take care of yourself emotionally and mentally to make sure that you're okay?
Dr. Anna Goldenberg: Yeah, so, you know, again, ten years, you know, I've been doing this since fellowship for ten years and I think the best way to describe this to people is that yeah, we have really bad days. We lose multiple peop people a day to severely, you know, traumatic injuries, accidents that, you know, somebody was just driving to work and they got plowed by a tractor trailer. Somebody was just outside and their kid was hit by a car. and we lose not only adults, but we lose children. And again, I have three you know, three you know, young children. So the best way I describe how I deal with the sadness and the emotions of losing patients is that I take myself out of the victimhood, right? And that's kind of just been my life perspective in general, even after October 7th, even through anti-Semitism, I remove myself from being a victim, right? I'm not the victim. So although I was I'm upset, I'm I'm raw and emotional about losing an adult or a child or even an elderly patient. I'm not the one who died and I'm not their family member. So I always come out of every trauma with a sense of gratitude for my my life. you know, that I'm able to continue to wake up every day and and to have loved ones around me. So that's how I I always come back to that, that I'm not the victim. And that has saved me time and time again when people, you know, talk about burnout and they talk about, yeah, it's very emotionally draining, but I always pull myself out of that. to say, Hey, you're still alive, right? That wasn't your kid. you know, that wasn't your mom. and that keeps me keeps me in perspective. That makes sense.
Carl Leibowitz: I mean it must be tough, 'cause it's it's you know, it's tough. It must be i incredibly gratifying when you save someone's life, and it must be in terribly sad on other days.
Dr. Anna Goldenberg: Yeah, it's sad, but you know, we can't you know, the thing with trauma is that when you're sad in the moment, in the next five minutes there could be somebody next coming. So you really can't like sort of feel sorry for yourself and wallow in the sadness because you need to be a hundred percent there. You need to show up, you know, what I teach my residents is, you know, every patient need show up a hundred and ten percent for them because that could be your mom, that could be your kid, that could be you. And you want somebody's head to be in the right space to do the best work that they possibly can. So we snap out of it really quickly at you know, we do we do reflect, you know, we do talk, we debrief, we, you know, we we in our group we talk about things that that keep us going, which is, you know, the love and the passion for the job. And the wins really give you a really, really big high. So, you know, we balance it. You know, when you have a lot of loss, you balance it by that really, really big win of saving somebody. It carries you.
Carl Leibowitz: Is there a specific moment or breakthrough with the student, I imagine Shakar was one of them, that during these courses that will stay with you forever? In Israel just during the ASAF of the la the from the last ten years teaching this class?
Dr. Anna Goldenberg: It is real. Yeah, so so again, with my trainees, you know, my biggest my biggest thing for them is that when people actually do things with their hands procedurally on real patients and they feel competent about doing them. It it's my most favorite thing to see and what I've, you know, shared with Shahar for the year that he was with us and again is so not visible in the documentary, but just through a couple of pictures of us is that we shared so many incredible moments from across the table during a trauma. And you know, to look eye to eye and and really feel like, whoa, like we did this, like we saved this person. You know, we we're sweating there, we're standing there covered in blood socks, covered in blood, and we look across the table and we know, you know, man, you know, we're we we got this. So I think those are always the moments that I really appreciate. I think also when you know, I really appreciate with my students and and teaching this throughout the the the years is that how How humbling it is and how we're still learning, right? We're all still constantly learning. Like I'm not an expert, right? I'm constantly looking for ways to get better. I'm constantly looking to l learn from my partners or people in, you know, other trauma centers or even from my Israeli colleagues around the world. We talk about cases, we talk about outcomes, we're constantly really, really trying to get better. And I think the whole goal is is to to save people because if we're not evolving, if we're not questioning what we're doing. then we we're not doing the best for our patients. So those are the moments and I always tell them, I was like, listen, I said, this is literally the most humbling profession. I can't I can't describe it in any other way to see people, like I said, at their worst in their last moments, to look them in the eyes. It it humbles you to it brings you to your knees sometimes, to be in that position.
Carl Leibowitz: What has reaction to the film been like from people who've seen it?
Dr. Anna Goldenberg: I I think, you know, we haven't shown it to a lot of people yet. We premiered at Dance Us with Films in Los Angeles. The feedback was amazing. They said it was so powerful. but that's a set group of audience. I I'm st I'm curious to see as we take the film across the country and the globe how people will react to the concept of having Israel in it. There has been a couple of negatives. Because again, it's it's frightening for me even as a physician, currently in the environment of anti-Semitism, to say that this film has an Israeli surgeon in it to talk about my Jewish identity. Because anything that is Israel currently is not great, as we know. So so I'm I'm scared but excited to I'm excited to see the positive, but nervous to see the negative.
Carl Leibowitz: Yes, yes.
Dr. Anna Goldenberg: Although the film is not political at all, because again it's just between two people that know each other, right? And I happen to be Jewish, it is easily a politicized topic, even in medicine, where politics has no place, in my opinion.
Carl Leibowitz: Well i tha that's right. Politics doesn't have a place and the film isn't political. The film is it takes you it's I I think it's a love story. It's it shows your love of what you do. it shows why you're in the profession, it shows what Shakar wanted. I I think that's what a lot of this was. 'Cause I was thinking the same thing that you just brought up, like how does and w how are people gonna react when to me it was very powerful.
Dr. Anna Goldenberg: Yeah, I think I think we know we highlight the fact that, you know, the Israel is such a diverse medical community, right? Like there's, you know, one of the characters, you know, he's Muslim. He's, you know, there's so many other people that I connected while I was there that were Christian or that were Muslim or that were Druze. And we taught side by side, and I still keep connections with these people. So I hope that people see through the fact that it's just Israel. I hope they see through the fact that again, like We all share a common goal, is specifically in this profession, and that this profession really has the opportunity to to to bring people together, that no matter what religion you are or what you believe in, that if your if your core value is to save lives, you don't have to speak the same language and you don't have to even have the same common goals all the time. but that this should transcend that. So I hope people take that away from the movie rather than the fact that it's very like, you know, it's focused in Israel. 'Cause that's not the message here. The message is that, you know, we we just work all together. it doesn't matter if
Carl Leibowitz: Well i it tells you it it shows you how hard it was to get the bodies, the cadavers to Israel. Shows you how hard it was and that you wanted to bring it there. And then there's the terrorist attack at the end where you see like here's some of the what you guys went there to do.
Dr. Anna Goldenberg: Yeah, absolutely. Yeah. And hopefully we continue to do that, right? We continue to empower just people across the world to to get better, right? To push yourself. That you may think you know everything, but maybe you don't. And that's okay too. And that's why, you know, collaboration is so wonderful, you know, across all borders. you know, not just Israel, everywhere around the world.
Carl Leibowitz: I think we know very little about medicine. as we move forward you learn new things and maybe in ten years we'll be like, Well, this wasn't done right or that wasn't done right. This is an easier way to do. So
Dr. Anna Goldenberg: A hundred percent. I hundred percent agree.
Carl Leibowitz: I know AI doesn't play a role in the film, but how does AI play a role in medicine and how do you see a changing medicine?
Dr. Anna Goldenberg: mean, it's huge. There are so many facets of AI and people are either nervous about it or they're not or they embrace it. I'm f I fully support embracing good technology. I think there's no substitute for clinical thinking, clinical rationale. I i in terms of surgical care, actually like the tactiles of it, I don't think it's gonna replace surgeons, but I think it's making Data collection, data sharing, innovation, it's it's it's gonna take medicine really far. I think it's gonna enhance what we do every day. I think it's gonna help us be more efficient as physicians in general. So I'm I fully embrace it. I, you know, there's a lot of talk about how AI is gonna affect research, how it's gonna affect, you know, patient outcomes. And, you know, that's to be determined. But if we use it the right way, I think it could be a really good friend to us.
Carl Leibowitz: Yeah, and as we wrap up, is there anything I should have asked you that I didn't ask you?
Dr. Anna Goldenberg: No, I think this was great. I think hopefully when people listen, they wanna see the documentary. They want to have more conversations about you know, not not only the documentary, but just about, you know, medicine and and cross collaboration and and identity, you know, using negative, you know, I think this I think there is still a lot of anti-Semitism. What I tell all of my students that are Jewish or my friends, I said, listen, I said, we gotta like p you know, you have to pivot. You have to pivot somewhere. Like not everybody's gonna like you all the time, and that's okay. But rather than complaining about it and posting on social media, why don't we try to do something? Right? Why don't we show show through action, you know, how, you know, we could be stronger or not channel our energy into the the victimhood, channel it into something else.
Carl Leibowitz: Yeah, no, I mean it's a great documentary. Dr. Anna Goldberg, thank you so much for joining me today. The documentary is the asset. I will put the link in the comments below so you can figure out how to see that. thank you out there for listening. And as always, be safe until next time, everyone.
Dr. Anna Goldenberg: Thank you so much.
Dr. Anna Goldenberg: Thank you, Carl. Thanks for having me.
Carl Leibowitz: So why did you do this documentary?
Dr. Anna Goldenberg: So the documentary actually started out as just a simple conversation with Adam Tietenbaum who I met through a friend who supported the asset mission. and the conversation was just simply about how I pivoted, you know, as a Jewish individual after October seventh, you know, where I channeled my frustration, my energy, into good rather than negative. So it started out as a conversation and I never thought anything would come. of it because I thought it was just gonna be a small little podcast episode. until Adam called me back and he said, Hey, listen, we really need to make this into a movie, you know, a little documentary, just showing all the good that happened from this this initiative.
Carl Leibowitz: it's a great documentary. one of the things I found fascinating nobody on the pit wants to leave the hospital. And I was fascinated by the same comment that you made. during the documentary,
Dr. Anna Goldenberg: Yeah, so you know, th that applies so much to when I was a resident. Obviously, as you go through time, you want to leave the hospital a little bit. But you know, I think it comes from the the idea that we are really in in the realm of trauma and even, you know, when they show in the pit, we are really in the most humbling situations, right? We are seeing patients in their worst of the worst moments, and it's just so humbling that you don't want to leave the hospital. You want to give it a hundred percent and then another thousand percent because humble experiences for people, they never stop, you know, in our trauma bay. So I found myself just addicted to helping people in their worst moments. And that's kind of what I've built my career on over the last ten years at Cooper, as a trauma surgeon.
Carl Leibowitz: So when you're when you're in the room, how do you remain so calm? Because I imagine you have to be really calm and you're making decisions at a really fast pace that you don't really have time to think, Am I doing the right thing? Do you know what I'm saying?
Dr. Anna Goldenberg: Yeah, so yeah, totally. So so unlike the pen on like Graze Anatomy, where people, you know, they thrive on seeing the chaos, that's not really the case, right? Chaos doesn't get your results. Chaos gets you chaos for the patient. It does not get you improved outcomes. So, you know, in trauma we learn that calmness and repetition, algorithmical thinking is what really saves lives, right? Time every second counts, and every second you are in chaos. Is every second spent out of making critical decisions, both for yourself and your, you know, the the staff that's around you. So, you know, we have a team, right? Everybody is on a team, everybody has the same goal. When you go into trauma activation on a severely injured patient, or maybe even not a severely injured patient, everything's the same, right? We go through the alphabet. It's just as simple as learning the A B C's, and that's what we call it A, B, C, D, E. Right. And every one of those letters stands for something. And until you get through that letter, you cannot go on to the next letter. So that's what's trained and sort of inherent in us as humans. I think trauma's not for everybody. You do have to be pretty calm, but at the same time, you have to carry yourself as the person that everybody looks to for decisions. and I think I think it's it's learned, it's acquired, and but it's it's certainly not for everybody.
Carl Leibowitz: And then can you talk about the documentary The Asset?
Dr. Anna Goldenberg: the asset, I think in the documentary it's a little bit of a play on words. I hope that people understand it after seeing it. So the asset actually is an advanced exposure and trauma surgical course that came out of the American College of Surgeons. That was born out of the Afghanistan-Iraq conflict after nine eleven, where surgeons were deploying Taking care of severely injured soldiers. And because the United States had not been involved in a conflict in a really long time, they were missing certain injuries. They were just not up to speed. And most of the surgeons that were deploying were surgeons that were doing everyday general surgery. So doing appendixes and gallbladders. And trauma is a very, very different animal. you know, trauma, you're talking about ballistic missiles, rifles, things like that. So severely, severely injured patients. And what that conflict taught the United States military is that we can prevent deaths, right? And the way to prevent deaths on the battlefield is to train our surgeons at rapid exposure and trauma, surgical exposure, and hemorrhage control. So if it's bleeding, you gotta stop the bleeding really, really quickly and get that patient out of there to get them to, you know, a definitive place of treatment. so the course was built out of that. In the movie. the the way that asset came about was that after October seventh, Israel had, you know, a massive influx of casualties that day, right? That's just known and to all the different hospitals. Because of that, a lot of the surgeons that were taking care of those patients were not necessarily trauma surgeons. They were maybe, you know, surgeons that were taking care of other types of patients. And that course that we teach all around the world was not offered in Israel. And at that time one of my fellows, my former fellows who trained who I trained at Cooper, Shahar Shamanovich, Dr. Shahar Shamanovich, he was dying of metastatic colon cancer. And I texted him after October seventh. I texted him maybe a couple of days later and I said, Hey, I said now's our time to bring this course. You know, we've been talking about it for a while. And now's our opportunity. in you know, your last couple of months of life really, we we spoke that candidly about it, to try to push this forward and get the surgeons and the residents, people really taking care of patients on the ground, this course to empower them to to to learn, to to collaborate, to connect during such a hard time, right? Both for Jewish people in America and you know, the people in Israel. so we worked really hard and we brought this course there and we've been taking it back and back and back and expanding it. So Dr. Shachar Shamanovich died before we came there the first time. But he knew that it was gonna happen and hopefully this is a legacy sort of that he left for his, you know, trauma community for his country and his colleagues. So that's where I came about.
Carl Leibowitz: So how do you do they let the bodies come in or do you have to bring the bodies from do people donate the bodies? 'Cause I found that fascinating and I was so where do you get the bodies?
Dr. Anna Goldenberg: No. No. So interestingly enough, the the asset course is taught with fresh frozen cadavers. They're much different than what you would normally see in, like, let's say, a medical school. Cadaver anatomy, those are formaldehyde. Fresh frozen cadavers are essentially people that have just died, and they are pre procured in a very special way to keep the body and the tissues and the blood vessels, everything intact, as if. The person's looking like they are alive. So everything, once that cadaver is defrosted, it looks very real. the way that this happens is that there are multiple companies. The the biggest one is in the United States that supplies bodies all over the world. They get donations from people donating their bodies to science, they procure them, and then they ship them all over the world. the interesting
Carl Leibowitz: How long do you have after the body is like first?
Dr. Anna Goldenberg: You I mean you have you can use them up for a certain amount of time. I think they stay frozen, years maybe. I don't know, honestly. You know, in the doc No, no, it's it's funny because in the in the documentary I have this discussion with Gil, who's, you know, my partner in crime over in Israel helping me plan these courses. I tell him it's like people are taking their last field trip, right, to Israel. So right, so they've died and now they're taking their last field trip and making, you know, this contribution to people.
Carl Leibowitz: Okay. Okay. Okay. Got it. Okay. It's not like you have like six days and then we gotta go. Okay. Yeah. Yes.
Dr. Anna Goldenberg: And then that's that's the end of their body, right? They're not they've never been buried, they haven't been cremated. so they ship them from the United States, various locations. So Las Vegas is one of them. There's a couple of other ones. They ship them to Israel. during that time, during the war, it was very difficult to get the bodies there. And also, there needs to be a permission from the Ministry of Health to ship these bodies because this is not something that they do in Israel and in other, you know. Middle Eastern countries because you're supposed to bury the body, you're supposed to respect the body. And although you can do organ donation in Israel, you're not supposed to really procure your body, you know, in the Jewish religion. So, so yeah, we we do ship them from the United States. So when we defrost the bodies, it's literally like a fresh person has just died. So all of the dissection is very, very real. you know, you're able to isolate vessels, you're you're able to simulate injuries to blood vessels and to organs. and this the course is taught very, very systematically. It's an amazing course. It was created by Dr. Mark Boyer. and the course is just amazing the at the amount of knowledge and time that we take to really talk about severely injured patients and how to, you know, how to help them. and then the bodies get cremated, and interestingly enough, this is another issue that we we encountered, believe it or not. There's only like one or two crematoriums in Israel. And yeah, no.
Carl Leibowitz: Yeah, I w I would imagine that there weren't that many.
Dr. Anna Goldenberg: No, and and part of the controversy is then how some of these crematories are not even disclosed because they're heavily they they are heavily protested by, you know, Orthodox religious people, which for for their own reasons. So it was very difficult to find a crematorium that would dispo you know, like properly
Carl Leibowitz: I would also imagine just because of the Holocaust that's adds another layer layer to the story of like why you can't find the crematoriums in Israel. Yeah. Yeah.
Dr. Anna Goldenberg: Я? Я. Absolutely. Absolutely, absolutely, 'cause most people are not crem cremated in Israel, so it's it's controversial.
Carl Leibowitz: Yeah. Yeah. he comes to you, wants to do this documentary, and what's your first reaction?
Dr. Anna Goldenberg: let's do it. And I again I didn't think that we were, you know, we when he kind of said that, I was like, all right, like and then I just left it alone. And then, you know, he reached out to me and he said, you know, he found Raveet, who's an award-winning Israeli filmmaker, documentary maker, and we kind of planned out all of the steps and we we weren't sure yet what the vision was for the film, but you know, she really created a beautiful, beautiful piece of art. that tells the story, but not only the story of, you know, the asset course of what we do as trauma surgeons, really just about like she calls it, a platonic love story, which is so hard to find nowadays, you know, about friendship and legacy, and giving back and connection and humanity. And that's sort of like what the Jewish faith is all about, right? So it was very fitting.
Carl Leibowitz: And it's also your story too about going to Israel. and you go there now, how you you said I think you've gone there four or five times after
Dr. Anna Goldenberg: Yeah. Yeah, yeah. Yeah, we've gone f four or five times. We've expanded the course to teach medics and paramedics. We're using the body for other to teach other subspecialties. So we're really, you know, fortunate to have support from the South Southern Federation of New Jersey, my local community here, and they believed in the mission, and they've been very supportive on sending us back to continue the work that we're doing there.
Carl Leibowitz: Have you gone with your family? Or just not yet. Yeah, okay.
Dr. Anna Goldenberg: No, no, not yet. No. I've called my kids from multiple Mamads, you know, during sirens and during the Iran attack in October. but no, they have not gone with me yet.
Carl Leibowitz: Yeah. Yeah, bomb shelters, yeah. and then, you know, when you were in Israel, well talk about being in the bomb shelter While you're teaching the class, I see that there's one shot where you guys all running down to the bomb shelter. Yeah.
Dr. Anna Goldenberg: Yeah. Yeah. So for the first mission that we went, it was at the height of the war, the height of the you know, the the Gaza Is Israel conflict, and pretty much all day there was rockets being sent into Israel and to Tel Aviv, and every hour or so we would have to stop, you know, the cadaver course and we would have to run to the bomb shelter. and then everybody would have to take a cigarette break. So it, you know, initially It took a really long time to get through the first two days, the first course that we made. And as the as the the as we came back every couple of months, it got a little bit better. until the Iran attack. I I believe it was October first that it happened. we were there teaching and that was a first attack and we were in in a bomb shelter at night trying to leave Tel Aviv to go back to JFK, which you'll also see in the movie. that was another scary moment. You'll see a terrorist attack that happened the same day after we finished training our surgeons at Ed Edith Wolfson Medical Center, and Ichilov and they took care of patients at both hospitals. you'll also see that in the movie, and that happened right close to us at a restaurant we were eating at. So again
Carl Leibowitz: Well, everybody leaves to go the doctors that you're all eating with, they all leave to go to the hospital. Did you go to the hospital or did you not know Yeah.
Dr. Anna Goldenberg: Yeah, they they leave. Yep, they leave. So no, no, no. That was our our you know, we were in shelter, we were taking but yeah, it was it was a scary moment for for me and my two partners that were both there. both of them are highly decorated, you know, military trauma surgeons now, not in active duty, but very active. both of them have both been in, you know, high conflict combat zones. so they kept me, you know, they kept me calm, they kept me, you know, sort of sane. So I was thankful for them being there.
Carl Leibowitz: How do you take care of yourself emotionally and mentally to make sure that you're okay?
Dr. Anna Goldenberg: Yeah, so, you know, again, ten years, you know, I've been doing this since fellowship for ten years and I think the best way to describe this to people is that yeah, we have really bad days. We lose multiple peop people a day to severely, you know, traumatic injuries, accidents that, you know, somebody was just driving to work and they got plowed by a tractor trailer. Somebody was just outside and their kid was hit by a car. and we lose not only adults, but we lose children. And again, I have three you know, three you know, young children. So the best way I describe how I deal with the sadness and the emotions of losing patients is that I take myself out of the victimhood, right? And that's kind of just been my life perspective in general, even after October 7th, even through anti-Semitism, I remove myself from being a victim, right? I'm not the victim. So although I was I'm upset, I'm I'm raw and emotional about losing an adult or a child or even an elderly patient. I'm not the one who died and I'm not their family member. So I always come out of every trauma with a sense of gratitude for my my life. you know, that I'm able to continue to wake up every day and and to have loved ones around me. So that's how I I always come back to that, that I'm not the victim. And that has saved me time and time again when people, you know, talk about burnout and they talk about, yeah, it's very emotionally draining, but I always pull myself out of that. to say, Hey, you're still alive, right? That wasn't your kid. you know, that wasn't your mom. and that keeps me keeps me in perspective. That makes sense.
Carl Leibowitz: I mean it must be tough, 'cause it's it's you know, it's tough. It must be i incredibly gratifying when you save someone's life, and it must be in terribly sad on other days.
Dr. Anna Goldenberg: Yeah, it's sad, but you know, we can't you know, the thing with trauma is that when you're sad in the moment, in the next five minutes there could be somebody next coming. So you really can't like sort of feel sorry for yourself and wallow in the sadness because you need to be a hundred percent there. You need to show up, you know, what I teach my residents is, you know, every patient need show up a hundred and ten percent for them because that could be your mom, that could be your kid, that could be you. And you want somebody's head to be in the right space to do the best work that they possibly can. So we snap out of it really quickly at you know, we do we do reflect, you know, we do talk, we debrief, we, you know, we we in our group we talk about things that that keep us going, which is, you know, the love and the passion for the job. And the wins really give you a really, really big high. So, you know, we balance it. You know, when you have a lot of loss, you balance it by that really, really big win of saving somebody. It carries you.
Carl Leibowitz: Is there a specific moment or breakthrough with the student, I imagine Shakar was one of them, that during these courses that will stay with you forever? In Israel just during the ASAF of the la the from the last ten years teaching this class?
Dr. Anna Goldenberg: It is real. Yeah, so so again, with my trainees, you know, my biggest my biggest thing for them is that when people actually do things with their hands procedurally on real patients and they feel competent about doing them. It it's my most favorite thing to see and what I've, you know, shared with Shahar for the year that he was with us and again is so not visible in the documentary, but just through a couple of pictures of us is that we shared so many incredible moments from across the table during a trauma. And you know, to look eye to eye and and really feel like, whoa, like we did this, like we saved this person. You know, we we're sweating there, we're standing there covered in blood socks, covered in blood, and we look across the table and we know, you know, man, you know, we're we we got this. So I think those are always the moments that I really appreciate. I think also when you know, I really appreciate with my students and and teaching this throughout the the the years is that how How humbling it is and how we're still learning, right? We're all still constantly learning. Like I'm not an expert, right? I'm constantly looking for ways to get better. I'm constantly looking to l learn from my partners or people in, you know, other trauma centers or even from my Israeli colleagues around the world. We talk about cases, we talk about outcomes, we're constantly really, really trying to get better. And I think the whole goal is is to to save people because if we're not evolving, if we're not questioning what we're doing. then we we're not doing the best for our patients. So those are the moments and I always tell them, I was like, listen, I said, this is literally the most humbling profession. I can't I can't describe it in any other way to see people, like I said, at their worst in their last moments, to look them in the eyes. It it humbles you to it brings you to your knees sometimes, to be in that position.
Carl Leibowitz: What has reaction to the film been like from people who've seen it?
Dr. Anna Goldenberg: I I think, you know, we haven't shown it to a lot of people yet. We premiered at Dance Us with Films in Los Angeles. The feedback was amazing. They said it was so powerful. but that's a set group of audience. I I'm st I'm curious to see as we take the film across the country and the globe how people will react to the concept of having Israel in it. There has been a couple of negatives. Because again, it's it's frightening for me even as a physician, currently in the environment of anti-Semitism, to say that this film has an Israeli surgeon in it to talk about my Jewish identity. Because anything that is Israel currently is not great, as we know. So so I'm I'm scared but excited to I'm excited to see the positive, but nervous to see the negative.
Carl Leibowitz: Yes, yes.
Dr. Anna Goldenberg: Although the film is not political at all, because again it's just between two people that know each other, right? And I happen to be Jewish, it is easily a politicized topic, even in medicine, where politics has no place, in my opinion.
Carl Leibowitz: Well i tha that's right. Politics doesn't have a place and the film isn't political. The film is it takes you it's I I think it's a love story. It's it shows your love of what you do. it shows why you're in the profession, it shows what Shakar wanted. I I think that's what a lot of this was. 'Cause I was thinking the same thing that you just brought up, like how does and w how are people gonna react when to me it was very powerful.
Dr. Anna Goldenberg: Yeah, I think I think we know we highlight the fact that, you know, the Israel is such a diverse medical community, right? Like there's, you know, one of the characters, you know, he's Muslim. He's, you know, there's so many other people that I connected while I was there that were Christian or that were Muslim or that were Druze. And we taught side by side, and I still keep connections with these people. So I hope that people see through the fact that it's just Israel. I hope they see through the fact that again, like We all share a common goal, is specifically in this profession, and that this profession really has the opportunity to to to bring people together, that no matter what religion you are or what you believe in, that if your if your core value is to save lives, you don't have to speak the same language and you don't have to even have the same common goals all the time. but that this should transcend that. So I hope people take that away from the movie rather than the fact that it's very like, you know, it's focused in Israel. 'Cause that's not the message here. The message is that, you know, we we just work all together. it doesn't matter if
Carl Leibowitz: Well i it tells you it it shows you how hard it was to get the bodies, the cadavers to Israel. Shows you how hard it was and that you wanted to bring it there. And then there's the terrorist attack at the end where you see like here's some of the what you guys went there to do.
Dr. Anna Goldenberg: Yeah, absolutely. Yeah. And hopefully we continue to do that, right? We continue to empower just people across the world to to get better, right? To push yourself. That you may think you know everything, but maybe you don't. And that's okay too. And that's why, you know, collaboration is so wonderful, you know, across all borders. you know, not just Israel, everywhere around the world.
Carl Leibowitz: I think we know very little about medicine. as we move forward you learn new things and maybe in ten years we'll be like, Well, this wasn't done right or that wasn't done right. This is an easier way to do. So
Dr. Anna Goldenberg: A hundred percent. I hundred percent agree.
Carl Leibowitz: I know AI doesn't play a role in the film, but how does AI play a role in medicine and how do you see a changing medicine?
Dr. Anna Goldenberg: mean, it's huge. There are so many facets of AI and people are either nervous about it or they're not or they embrace it. I'm f I fully support embracing good technology. I think there's no substitute for clinical thinking, clinical rationale. I i in terms of surgical care, actually like the tactiles of it, I don't think it's gonna replace surgeons, but I think it's making Data collection, data sharing, innovation, it's it's it's gonna take medicine really far. I think it's gonna enhance what we do every day. I think it's gonna help us be more efficient as physicians in general. So I'm I fully embrace it. I, you know, there's a lot of talk about how AI is gonna affect research, how it's gonna affect, you know, patient outcomes. And, you know, that's to be determined. But if we use it the right way, I think it could be a really good friend to us.
Carl Leibowitz: Yeah, and as we wrap up, is there anything I should have asked you that I didn't ask you?
Dr. Anna Goldenberg: No, I think this was great. I think hopefully when people listen, they wanna see the documentary. They want to have more conversations about you know, not not only the documentary, but just about, you know, medicine and and cross collaboration and and identity, you know, using negative, you know, I think this I think there is still a lot of anti-Semitism. What I tell all of my students that are Jewish or my friends, I said, listen, I said, we gotta like p you know, you have to pivot. You have to pivot somewhere. Like not everybody's gonna like you all the time, and that's okay. But rather than complaining about it and posting on social media, why don't we try to do something? Right? Why don't we show show through action, you know, how, you know, we could be stronger or not channel our energy into the the victimhood, channel it into something else.
Carl Leibowitz: Yeah, no, I mean it's a great documentary. Dr. Anna Goldberg, thank you so much for joining me today. The documentary is the asset. I will put the link in the comments below so you can figure out how to see that. thank you out there for listening. And as always, be safe until next time, everyone.
Dr. Anna Goldenberg: Thank you so much.
