A Canadian-Israeli dual citizen is in a medically-induced coma after being injured Tuesday in a bloody attack at a synagogue in Jerusalem, according to friends and family.

Howard Rotman, 53, suffered multiple stab wounds to his head, eyes and arms in Tuesday’s attack, which saw two Palestinians armed with meat cleavers, knives and a handgun enter a Jerusalem synagogue during morning prayers.

"He was trying to fight off the attackers; he's in a coma -- he's in critical condition," said Toby Trompeter, a family friend who has known the Toronto-raised man for 40 years.

Five people were killed in the attack, which was Jerusalem's bloodiest in years, including three Americans and one Briton, all with dual-Israeli citizenship. Reports say a fifth victim, a police officer, died in hospital Tuesday.

Shelley Rotman-Benhaim described her brother as a very kind person.

“He’s one of the sweetest nicest people you could ever hope to meet,” she said. “Always has a smile on his face.”

She said Rotman moved to Israel 30 years ago and now has 10 children and one month-old grandchild. She said he works for the government there, having originally travelled to the country to study the Torah.

“It was a dream come true to him to move to Israel.”

Rotman-Benhaim said her brother contributed to the building of the synagogue in which he was attacked. “Because that’s how people live in Israel.”

Toronto emergency room doctor Joyce Morel was one of the first responders on the scene. She tended to the injured as police stormed the synagogue.

“I saw an injured person sitting on the sidewalk right outside the synagogue and went over to check on him,” she told CTV Toronto.

Five other people were wounded by the attackers before officers killed them in a shootout, according to authorities.

Police have identified the assailants as Palestinian cousins Ghassan and Oday Abu Jamal. The Popular Front for the Liberation of Palestine (PFLP) organization said the cousins were among its members.

Michael Mostyn, CEO of B'nai Brith Canada, was outraged by the incident.

"It's barbaric, it's savage, it's attacking Jews just for being Jews," Mostyn told CTV News Toronto.

Mostyn believes that there is a credible threat of violence against Canadian Jews.

"That hatred is already in Canada," Mostyn said. "The terror attack that just happened on Parliament Hill -- Canadians that leave overseas to join ISIS -- none of this happens in isolation."

Trompeter, who learned about the attack from a mutual friend in Jerusalem, was still shaken by the news of attack.

"I just thought, no, no, no; I was just aghast."