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29 SEPTEMBER 2016

Hope for us, hope for Israel, hope for the world
Supplement

THE HERO
HEALER
An injured soldier who
saves children is just
one of Shaare Zedeks
superheroes. Noga
Tarnopolsky met him

f Asael Lubotzky were a doctor in the UK, heads


would turn when he entered a hospital. Handsome,
confident and with a ready smile, he is the sort of
man who attracts attention, but it is the specially
modified crutches on which he leans that would
set him apart. Sadly this is not the case in Israel,
where the sight of a young man with battle scars is
all too commonplace and where Lubotzky, the senior
resident in pediatric medicine at Jerusalems iconic
Shaare Zedek hospital, inhabits two worlds, as that
of healer and of the walking wounded.
If people stare at Lubotsky in the hospital, it is not
because they are fascinated by his crutches with torches
on the handles and suction pads on the base, but because
they recognise him as the young doctor who has become
something of a celebrity since publishing a memoir that
turned into a local bestseller.
His book, From the Wilderness and Lebanon, is about
his experience of battling the Shiite militia Hezbollah in
Lebanon where, in 2006 at the age of 23, he was a lieutenant in the Golani brigade commanding a platoon of
30 soldiers.
Lubotzky was almost killed when a missile registered
a direct hit on the spot on which he was standing in the
tank. He survived with extensive wounds and with one leg
so badly mangled his doctors were close to amputating it.
Lubotzkys circumstances are extraordinary by any
standard, but at Shaare Zedek, which in English means
Gates of Justice, they have been treating the war wounded
for almost 115 years and the hospital permeates with
stories like his that beggar belief.

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Jewish News 29 September 2016

Shaare Zedek / Safe in Their Hands

THE FACT THAT


A DOCTOR COMES
INTO THE ROOM ON
CRUTCHES OR IN
A WHEELCHAIR
ALLOWS FOR MORE
INTERACTION AND
BETTER CHEMISTRY

As the Second Lebanon War raged, Lubotzky,


one of six children from the Gush Etzion town
of Efrat, decided he would sign up for one more
year in the army. After that, he planned to
return to the yeshiva and pursue an academic
career in physics or chemistry.
It was a foreseeable path for a Lubotzky, who
was born and bred into the academy with his
grandfather, Murray Roston, a native Londoner,
a professor of English at Bar-Ilan University
and his father, Alex, a professor of mathematics
at the Hebrew University. But that one more
year as a soldier changed all that.
Ill never forget the pain, he says reflecting
on the moment of the strike. There was no time
to react. Ill never forget the feeling of the
explosion burning me from top to bottom.
I saw smoke, ash, and my right leg twisted inside
out with the shoe facing up. And I was holding
myself up with my elbows.
Critically wounded, Asael was rushed to a
local hospital, where he became conscious just
in time to overhear doctors discussing whether
to amputate his legs.
In the end, limb salvage was chosen. It is
a decision he will grapple with for the rest of
his life.
The heavy neurological damage caused by
the blast produces severe, constant neuropathic pain in both legs, at every hour, at any
moment, he says. He undergoes daily sessions
of physiotherapy. His back and right arm are

Asael Lubotzky and his brother-in-law Maru Gete, an otolarynologist at Shaare Zedek

damaged as medics took muscle from his right


shoulder to rescue the leg. He walks with the aid
of an ankle foot orthotic, and sometimes resorts
to a wheelchair.
At the time of the blast, he says, as a healthy
person, Id had very limited exposure to
medicine.
My situation exposed me to a completely
new world and to the dynamic of a medical team
that includes everyone from physicians and
orderlies to nurses and therapists who keep
a patient on track, he explains.
More than a year later, with 15 operations
under his belt, he had become something of an
expert and was inspired.
I got to see how medicine is not an exact
science but involves a lot of humanity, he says.
When youre there for so long, the hospital

becomes a second home; you discover for good


and for bad how a persons attitude, a glance,
even just a word can influence you dramatically.
Part of my interest in the world of medicine
began then.
As he contemplated an unforeseen future,
Lubotzky applied to the Hebrew Universitys
department of physics, as planned, and to the
school of medicine.
I hesitated because it was an area I knew
less well, so I spoke with the doctors. Id show
up in a wheelchair with iron pins poking out of
my arms and my legs, scars all over my body and
told them I was thinking of becoming a doctor.
Some of the doctors said I was crazy but some
said: If your head is ok and you really want it,
nothing will stop you.
These days, his visible disability serves as an

opening to conversation when he meets new


patients and their parents at Shaare Zedek.
They see me and realise were all in the same
boat, he says, acknowledging that the sight of a
doctor who is also a patient can be disorienting.
The cognitive dissonance is useful, he says.
It removes you from the stereotypesthe fact
that a doctor comes into the room either on
crutches or in a wheelchair, it allows for more
interaction and better chemistry with the kids
or the parents because they know that whatever
it is, were in it together.
The children are not frightened by his
extraneous accoutrements, which include an
exoskeleton bracing his right leg. They play
with the crutches, he says. My kids put stickers
on crutches, so theres no need for me to bring in
any toys. I have a built-in icebreaker.
Lubotzky is a prime example of how Shaare
Zedek doctors treat the patient not the illness
and he is able to build strong and meaningful
relationships with the children he sees.
Shaare Zedek is something of a family home
for Lubotzky. He, his wife Avital and their three
children were born there. His father-in-law,
professor Michael Schimmel, directs the hospitals neonatal intensive care unit and Maru Gete,
an Ethiopian-born officer who served alongside
Lubotzky in the Second Lebanon War, now
works alongside him as an otolaryngologist and
is also his brother-in-law.
Im the shadchan! Lubotzky declares with
unabashed delight at the fact he introduced
Maru to his younger sister, Shakked, who is
finishing her doctorate in public health. They
have also given him five nieces and nephews.
Professor Schimmel will celebrate his 40th
anniversary at Shaare Zedek this month. He
grumbles cheerfully about now being more
famous as Asaels father-in-law than for my
own achievements.
Lubotzky smiles, but for all the glory, there
are days when his pain is so acute he leaves the
crutches at home and goes about his work in a
wheelchair.
If he were a doctor in the UK this might
cause a stir. In Israel they merely step aside for
a healing hero.

WORKING ALONSIDE ASAEL LUBOTZKY AT SHAARE ZEDEK HOSPITAL ARE OTHER MEN AND
WOMEN WHO DEVOTE THEIR LIVES TO HELPING PATIENTS. THESE ARE JUST A FEW OF THEM

NO ONE WANTS to deliver bad news but,


when its necessary, Amran Jaber is somewhat of an expert. Coping with the pain and
panic of those who have been involved in
terror attacks and major accidents is a key
part of his job as the chief trauma nurse at
Shaare Zedek Medical Center, and no one is
better equipped to allay fears or, in the case
of a fatality, inform the families.
Amran Jaber, 47, is so adept at handling this
responsibility that last month he was invited
to deliver a lecture on this very subject at the
second Global Conference on Emergency
Nursing and Trauma Care in Spain. Notably,
Jaber was Israels only representative, but
the fact he is an Israeli-Arab defied the global
perception of Arab-Israeli relations.
He lives the countrys dichotomies daily and
recalls being questioned about his allegiances
by Arabs and Jews alike at university.

I am very bothered when people try to put


me into one of their categories, he says. In
East Jerusalem, you can hear people saying
Israeli Arabs are traitors, but I have never
been to Palestine, and I just say Leave me
alone. I am Israel Arab, dont come to me with
preconceptions.
At Shaare Zedek, where the conflict remains
outside the hospital walls, Jaber is just a muchvalued member of staff who has taught the
hospitals students since 1995. But on those
rare occasions when a patient objects to being
treated by an Arab nurse, he rises above it.
If they object, that is the patients right,
Ive no problem with it, he says. Just as
one may not want to be treated by a man or
another by a woman. It is perfectly acceptable.
I have learnt not to be insulted.
But those who have had the misfortune
of being involved in a major trauma quickly

Photos by Nir Keidar, words by Noga Tarnopolsky, Brigit Grant

THE HEAD NURSE

Amran Jaber is the chief trauma nurse whose inspiration is Florence Nightingale

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Safe in Their Hands / Shaare Zedek


discover that being cared for by Jaber is their
good fortune, for this tall, robust man with the
kindest face cites none other than Florence
Nightingale as his inspiration and he follows her
lead managing the care of his patients.
I see in my profession a way of life, he says,
a second skin.
It was his childhood dream to become a
doctor, but when he failed to get into medical
school, Jaber embarked on a career in nursing.
I love nursing, he says. You have to relate to
the person in a holistic way, taking into account
his pathology, but also his family, his culture,
his religion.
Jaber was at his post on 18 April 2006, when
victims of a bus bombing started pouring into
the emergency room. We received six people,

all of them the colour of coal. A nurse asked me:


What is this, where are these people from?
They were all carbonised. In the middle of work,
someone pointed at one of the stretchers and
said: I think hes the terrorist and near him we
had three of the victims. The bomber had placed
the explosive in a bag between his legs. So in the
same room, I was in charge of the care of three
victims and the terrorist. In those moments,
it is your responsibility to decide on resource
management. We tried stabilising him for three
hours before he died.
Jaber has many degrees in varied subjects,
but the most surprising qualification is his
Israeli tour guides licence, as one would
struggle to imagine when he finds the time for
sightseeing. But he does, and in a very specific

area, as Jaber has a keen interest in Jewish


Studies, specifically in the Shoah and is the only
Arabic-language tour guide licensed to conduct
Holocaust tours.
I got interested in the subject when
I worked as a chef in a sanatorium in a Judean
Hills kibbutz that catered for Holocaust
survivors whose treatment was paid for by the
German government. I heard so many stories
from them and wanted to learn more, he says,
adding that his first tour was bilingual,
in Hebrew and Arabic, for friends from work.
An inveterate student, he chose tourism as
a secondary field for those moments in which
I cant stand bodies and the Arab-Israeli
conflict and I need to just take a day away
and show people the country I love. This is

something I do for my soul, so that I am not only


exposed to death and trauma.
In the early 2000s, during the Second Intifada, an old friend from Abu Gosh,whose sister
had attended high school with Jaber, was killed
in a bombing at Jerusalems Machane Yehuda
market. At these moments you feel whoa,
whoa, its coming, its here.
But it as he heads off to deal with more
pressing issues, he offers a bittersweet anecdote.
A few years ago, around independence day, a
very sweet girl gave me an Israeli flag. I took it to
put on my car, like everybody does. But as
I was walking out, I heard another girl ask her:
Why did you give him the flag? I am an Israeli
through and through, he says, and I know
what I am.

THE TRAUMA CHIEF


DR OFER MERIN is a marathoner. In life
and in his work, he takes the long view.
Although he planned, as a youth, to study
architecture, his army experience as a
doctor and his fathers medical career
drew him to medicine. But my daughter
is now studying architecture in London,
he says with satisfaction.
From the vantage point of the average
Israeli, Merins lean runners face is the face
of Shaare Zedek, and as a result, the face of
national authority.
Its not simple to be exposed to the media
because of terror says Merin, 55, Shaare
Zedeks deputy director and chief of trauma
medicine.
There is no doubt communications is a
greater part of trauma than any other field of
medicine and that as a result, we are more wellknown than other doctors.
Immediately following attacks in the
year-long spate of violence that has besieged
Jerusalem, Israeli eyes and ears are attuned
to Merins even voice as he transmits the
condition of victims and sometimes perpetrators of stabbings, shootings and car
rammings from the hospitals ambulance bay.
Trauma is simple medicine, he says. You
dont need to be an atomic scientist. It mostly
hinges on instincts, cool nerves and the will-

Dr Ofer Merin is chief of trauma medicine

ingness to work crazy hours.


His wife, he says, doesnt even hear the
telephone. There is no other way to be married
to a trauma surgeon.
You really dont have to be a great genius,
he emphasises. That may be, but in the popular
imagination, trauma specialists are the
gauchos of medicine, working in isolation and
at great risk.
By definition, its in the character of medicine that nothing is planned zero and that
everything is urgent and unforeseen. Within
that spectrum of the unforeseeable, some
patients arrive in decent condition and others
are already dead. In trauma, the decisions made
in the first minutes can be fateful and ones
influence as a doctor is significant, he says.
Some people are attracted to trauma
because of the adrenaline, he continues.
When an incident occurs the only thing you
know is that the wounds will never be typical.
Like so many of the superheroes who strive
to perform the impossible at Shaare Zedek,
Merin has a backstory worthy of the big screen,
but he doesnt parade it. Instead, it falls to
others to tell of the woman on a train headed
for Auschwitz who realised the fate awaiting
her and her children at the end of the journey.
Kissing them goodbye, she threw her eightyear-old son and six-year-old daughter out on
to the track and together they found their way
to a small Polish village, where a young Christian woman hid them until the war was over.
They went to Israel soon after independence,
where the boy eventually became a doctor,
married and had three children. Merin is his
second son.
Merin believes his story embodies the
well-known saying: To save one persons life is
to save the whole world and he does just that
every day.
In addition to his three positions at the
hospital and his daily long runs, he is a reserve
colonel in the Israel Defense Forces, and
commander of the IDF field hospital unit,
which is a self-sufficient team equipped for any
situation in any country that needs their help.
There are few places Merin has not gone and
often with only hours of notice. His last mission
was to Nepal in 2015 following the catastrophic
earthquake, where his team treated 1,600
patients, performed 90 life-saving operations
and delivered eight babies including six by
C-section.
It was on that trip, the unexpected
happened when Merin found himself short of
a manager for the field hospital he was putting
together.

Hospital director Professor Jonathan Halevy with his deputy, Dr Ofer Merin in Nepal

They were unusual circumstances,


Merins boss, hospital director Jonathan
Halevy recalls. Merin came to me at the last
minute, with a couple of hours notice, and
told me they needed someone to run the field
operation.
I managed to put together a backpack. We got
kit from the Home Front Command and at age
67, I went back into the army, with my deputy
as my commander.
In civilian life, I am his boss, Halevy
laughs, while Merin says: I got to be the boss of
my boss!
Although they make light of the mission,
for two weeks, the two top men at Shaare Zedek
hospital slept on army cots while caring for
hundreds of Filipinos who went for help
to the only medical aid facility on the island
of Ceba.
Such is the level of expertise, training,
equipment and supplies of the field hospital
that Merins most recent destination was to a
meeting with senior World Health Organization officials, who are discussing the adoption
of Israeli standards for dealing with trauma
situations. This is a tribute to the teams ability
and
is worthy of wider recognition, but thats not
why Merin does the job.
I dont think there is any professional more
filled with superstition, Merin says, about
trauma medicine in general. There are people
who always step into the operating theatre
using the same foot or who wear the same socks

when they come in, but not me. Then he says:


But I never drink coffee on days when I know
Ill be operating. I dont want to have to go to
the bathroom after five hours; these are not
operations that you can just walk out of.
He adds: I need the surgery to be quiet.
There are surgeons who play music during
operations, but I dont allow it. Major surgery
is not a disco. You dont want the music to lull
you into a nonchalant mood.
In extreme situations, for example in a
resuscitation, there isnt much to think about.
Its the clearest situation. Who can be holistic
if someone is bleeding to death? You just need
to staunch the blood, and quickly.
But in every other respect, at Shaare Zedek
and in the field, Merin focuses on the totality
of a patients circumstances. He mentions a
planned surgery he will be starting in some 10
minutes, a woman in her eighties undergoing
open-heart surgery.
Im very fascinated by the way the family
circle or circumstances just before surgery
a conversation with the doctor, is one thing
can affect the outcome of convalescence. It can
provide a real mental boost before surgery and,
whether we understand it or not, it is part of the
care we offer patients.
Ever the marathoner, Merin moves too
quickly to be affected by much of his own star
power, but when he crosses the finish line,
he just keeps running to wherever he is
needed. His grandmother would have been
very proud.

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Jewish News 29 September 2016

Shaare Zedek / Safe in Their Hands

24 HOURS AT
SHAARE ZEDEK
A closer look at the trauma, trials and life-changing moments
that take place on a single day in this Israeli hospital

here is no such thing as a typical


day at Shaare Zedek. Doctors
and nurses will always be in
attendance and the sound of
sirens never far away, but that is as
typical as it gets, for not even veteran
staff can predict how 24 hours will pan
out at this hospital, where everyone
is welcomed. But sometimes a patient
grabs everyones attention. On the last
day of August, it was a 10-year-old girl
with a pink flower band in her hair.
Two days earlier, the unnamed little girl
had been stabbed in the heart with scissors,
in front of her younger sister, by her father.
Initial news flashes said only Stabbing in
North Jerusalem, so the public assumed
another terror attack had taken place.
The team at Shaare Zedek deals in facts,
not assumptions, and witness the tragic
results of brutal acts every day. The mother
of the injured girl had fainted when she saw
her child and doctors knew they were dealing
with an act of domestic violence. Repairing
the girls heart was the job of trauma surgeon
Danny Fink who, having done his very best to
save her, watched as she was wheeled to the
pediatric intensive care ward.
Near the little girl on the same ward, a
four-month-old baby from East Jerusalem
was recovering from abdominal surgery,
while in a bed opposite, a 12-year-old Arab
boy suffering from cerebral palsy was unable
to breath after repeated cardiac surgery.
Silence on a childrens ward is unnerving,
but not for the nurses who move from bed
to bed, constantly checking the little ones
in their care. Down a hallway in the childrens emergency room, Dr Giora Weiser was
handling the cases that had come in during
the day. The list is daunting.
An 18-month-old boy with pneumonia.
A 17-year-old with anxiety attacks and a
two-year-old with extreme facial swelling
who was suffering from nephrotic syndrome
and required emergency care. They are all
priority cases, with anxious parents standing
by waiting for news. Weiser is at the front
line faced with the challenge of making
sure the boy with epilepsy is seen as quickly

Naama
Bagrish,
head nurse
of the
emergency
department

Professor
Jonathan
Halevy,
hospital
director

as the teenage paraplegic who was back at


the hospital with another of his unending
complications. And more children were
coming in.
In the outpatient pavilion, a healthylooking Shachar Cohen, 13, from the
northern Israeli town of Kiryat Motzkin sat
in an easy chair with his arm attached to a
drip. His father, Yossi, stood next to him, his
face a mixture of fortitude and worry.
A genetic test had recently found that
Shachar has Fabry disease, and he was undergoing the first of what is predicted to be a
lifetime of enzymatic replacement therapies
that is, if the therapy works. For now, its in
experimental stages.
But for all the sorrow, there is always joy
and this day was no exception, for outside
the childrens ward, an elated woman in her
mid-70s was asking to be directed to maternity, where her great-granddaughter had just

PROTOCOLS SAY NEWBORN RESUSCITATION


SHOULD BE HALTED AFTER 10 MINUTES, BUT
THESE DOCTORS DIDNT WANT TO LET HER GO.
THE BABY BREATHED AFTER 13 MINUTES

given birth. She was beaming. Everyone in


the vicinity shouted mazeltov!
Upstairs in a conference, teachers and
educational staff of the school at Shaare
Zedek, 15 in total, gathered to plan for the
new school year, while in the therapeutic pet
room Sophie, a 12-year-old whose mother is
an intensive care nurse and Diana, a 17-yearold suffering from acute Crohns disease,
dressed in pink pyjamas, contemplatively
stroked the spines of Nachum, a mustardyellow Eastern Bearded Dragon. Parrots,
rabbits, guinea pigs and chinchillas formed
part of the surrounding menagerie.
Downstairs, Naomi Amsalem, 33, the
deputy chief nurse of the emergency ward,
reigned over her realm with preternatural
calm. She had, she said, some good, or
sort-of good, news: an 85-year-old man,
a widower who devoted his existence to a
memorial to his only son, who fell in battle,
had finally accepted he had pancreatic cancer
and agreed to be admitted to hospice. The
problem Amsalem confronted was that the
hospice required specific tests before admission, and no one could perform them before
morning. Hed have to stay overnight. What if
he changed his mind? Amsalem sighed.
Behind her counter, an elderly woman
in the apparent throes of a stroke was being
wheeled in, with her son, a betweeded

man in his 60s, carrying her paperwork and


her grandson lucidly outlining her medical
conditions to the speed-walking doctor.
Amsalem mentioned that the life of a
38-year-old woman had serendipitously been
saved that day. Shed been accompanying her
mother to a scheduled oncology treatment
when tram inspectors accused the two women
of not having properly purchased their tickets.
An argument ensued, and someone called the
police. The older woman fainted, at which
point an ambulance was summoned. In the
emergency ward, while her mother was recov-

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Safe in Their Hands / Shaare Zedek


ering, the younger woman suddenly said: I
cant feel my arm.
The doctors examined her. She had a
huge blood clot in her neck. It was a matter
of minutes, but she was saved.
Meanwhile, Amsalem juggled a young
man who came in racked with pain and
guilt, confessing to having had a single
drink the night before. He had appendicitis. A 21-year-old motorcyclist with
a shattered heel lay in one bed, while in
another, a 75-year-old patient suffering
from pulmonary disease looked on.
Her family keeps asking us why
shes not getting better. She cant quit
cigarettes. We treat her and she keeps on
smoking, Amsalem said, bemoaning
the ravages of addiction. So she doesnt
get better.
Naama Bagrish, head nurse of the
emergency department is another Shaare
Zedek employees who does over and above
what is expected of them every day. And
within those days are moments when she
has cared for victims of terror attacks and
she is visibly moved as she reflects on this.
It shakes you up emotionally and you think
about your own family. But when a seriously
injured patient recovers and they leave here
on their own two feet, that is the beauty of
this profession. And a nurse who doesnt cry
or break down shouldnt be here any more.
In his office, professor Michael
Schimmel, the head of neonatal intensive
care, was preparing a paper about the
resuscitation of a baby girl who was
born with no detectable pulse and no
heartbeat.
A team of three senior physicians got
to the maternity ward within seconds of
the emergency alarm being raised.
For 10 minutes, they massaged her
heart. Monitors showed her blood circu-

lating but still, no pulse.


International protocols require that
resuscitation for newborns be halted after
10 minutes, but these doctors didnt want
to let her go. At the 13th minute, the baby
started breathing. Days later, she left the
hospital in good health.
Its a real ethical dilemma thats
being addressed all over the world,
said Professor Schimmel The 10-minute
protocol is being re-evaluated, and were
part of that process.
The professor paused. Did you hear
about the girl who got stabbed by her
father? he asked quizzically.
It was the story that had captured the
hearts and minds of all the hospital medics
on this typically untypical day and they all
wanted to know about the girls condition.
It was Dr Sarit Shahrur, the head of the
department who announced that the child
was awake and reported her first words.
She asked if her father was home and then
said she has a heart-ache.
The doctor shook her head and shuddered at her young patients inadvertent
wisdom .
Later it fell to Dr Ofer Merin, the hospitals deputy director and chief of trauma
medicine, to announce that the breathing
tube had been removed.
Now its convalescence and the
attending issues: this girl had her faith
in the most sacred thing shattered, her
trust in the people who should take care
of her. So now well bring in psychologists, social workers this is all part of the
support we give.
In the weeks to come, the last day of
August will not stand out in the memory
for the staff at Shaare Zedek. For them, it
was just another day.

SZ6

Jewish News 29 September 2016

www.jewishnews.co.uk

Shaare Zedek / Safe in Their Hands

THE

SCIENCE OF
DEDUCTION
Noga Tarnopolsky meets the geneticist changing the world

anked among the top 50 of the


worlds most influential Jews,
Professor Ephrat Levy-Lahad is
the ultimate can-do woman.
With prevention rather than cure as her
mantra, the director of the Medical Genetics
Institute at Shaare Zedek is an expert of
global renown in the genetics of breast and
ovarian cancer and the identification of genes
underlying rare diseases.
As a young science-oriented soldier
pondering her future, Levy-Lahad wanted
to do something that brought people and
research together.
Her mothers experience as a talented
chemist who gave up her career to raise a
family was at the forefront of her mind as she
settled on medical school because, she says,
one advantage of the medical profession is
that if, in the end, you cant do science, at least
youve acquired an important and interesting
career.
She enrolled in medical school knowing
she wanted to deal with something scientific.
I didnt want to go into paediatrics because
it is either heartbreaking or they have a
cold, she says, before acknowledging that no
medical speciality can inure you to anguish.
Levy-Lahads work first made headlines
while she was on a post-doctoral fellowship at
the University of Washington, in Seattle, and
discovered a gene for Alzheimer's disease.
In the 1990s when I began my career as
an internist with a primary interest in adult
diseases such as Alzheimer's, geneticists were
mostly pediatricians, explains the professor.
The idea that an adult disease could also be
related to genetics was new.
So new that a man who had read some of
the media coverage on Levy-Lahads findings
called her to say that his mother had just been
diagnosed with Alzheimers and hoped the
young scientist could provide medication that
would reverse the diseases course.
It broke my heart, she says, and even
now, until today, there is no treatment.
But the absence of cures only makes LevyLahad more driven and meeting Mary-Claire
King, PhD, the discoverer of BRCA1 while
studying in Washington, this pioneering
Israeli scientist returned to her own country
to set up one of the worlds first cancer
genetics clinics.
It is in that clinic that she has done
ground-breaking research in to the BRCA1
and BRCA2 cancer genes, which has had such
an enormous impact on Jewish women.
The BRCA1 and BRCA2 are cancer genes
that we are all born with and they normally
help protect cells from cancerous changes.
However in some people a gene muta-

contrary, if you are a carrier, you can prevent


disease.
This is not what we do when we test for
blood sugar, she says pointedly, where only a
person at high risk is informed about possible
consequences of disease.
She is right now in the midst of a
randomised control trial, in which one set
of women receive todays standard protocol
while another receive only a short written
explanation and are called, as is standard in
other blood tests, only if she is found to have
the mutation or has a family history.
Shaare Zedeks Pre-implantation Genetic
Diagnosis (PGD) department is the most
active in Israel. PGD utilises an advanced
technological process to identify genetic flaws
in an embryo before it is implanted in the
uterus. This enables couples who are known
to be carriers of specific genetic diseases
to know with a high level of certainty that
their child will not be born with that disease.
Shaare Zedek is a national leader in this
all-important partnership between medical
genetics and reproductive medicine.
Professor Ephrat Levy-Lahad is the director of the Medical Genetics Institute at Shaare Zedek
Alongside cancer research, Professor LevyLahad is looking extensively in to paediatric
tion occurs and cancer develops. BRCA1
we mustnt.
hereditary diseases such as microcephaly,
and BRCA2 gene mutations account for 11
The Hollywood star Angelina
Gauchers, Tay-Sachs, Duchenne
percent of breast cancer and 40 percent of
Jolie, who is not Jewish, has
and other muscular dystrophy.
ovarian cancer in Ashkenazi women, but until
become the symbol of preWith all of the research,
recently women had not been screened for
emptive care chosen by
Levy-Lahads topmost
breast or ovarian cancer unless there was a
women who are carriers
goal is prevention and
family history of the disease.
of the gene. Using
she would impress this
My main focus is using what is known
her as an example,
upon anyone who
about breast cancer genetics to improve
Levy-Lahad says
wants to help fund
prevention strategies, states Levy-Lahad.
that once a woman
the work being done
I was one of the first who said you have to
has completed
at Shaare Zedek.
test. It is common sense to check. There
her family, ovary
In terms of
is a dichotomy when it comes to precision
removal is a very
prevention, genetics
medicine. In those areas in which we really do simply procedure,
holds huge promise
know what we are doing, we get cold feet, and
but ovarian cancer
and certainly in
is devastating. There
the curing of breast
should be no question
cancer, she says.
about genetic testing.
I can envision a not
In fact, she affirms:
too distant future where
Every Ashkenazi woman
we can understand most of
should be tested for the common
the genetic predispositions to
mutations in these genes even if
Angelina Jolie
cancer. Even though I am a genetithere is no history of breast cancer in
cist, I know that not everything is
the family and they dont show signs
genetic. So there will be other risk
of the illness.
factors, but understanding what's genetic will
What this demands is a change of
allow us to weed out what is genetic and what
mentality about the significance of the test,
is not.
according to Levy-Lahad. Until now, when a
Even now, when you look at treatment
women comes in to be tested, she is solemnly
of breast cancer, there has been tremendous
informed of the possible consequences.
progress. I think finding a cure will happen
The test itself becomes a heavy thing,
at a much faster pace because we'll undershe laments, when in reality, a minority
stand more of the biology. I think it's a
of women are carriers, and being a carrier
combination of prevention, early detection,
BRCA gene mutations cause cancer
does not mean you have the disease. On the
and treatment.

29 September 2016 Jewish News

www.jewishnews.co.uk

SZ7

Safe in Their Hands / Shaare Zedek

THE SECRET OF

OUR SUCCESS
Realising the dreams for a world-class hospital only
happens with the right support

IN THE SUMMER OF 2015, Shaare Zedek


Medical Centre celebrated the opening of
its cutting edge new childrens facilities.
British support was crucial to the project,
with over more than 3 million raised
for what the hospitals director general,
professor Jonathan Halevy, calls one of
the most ambitious development projects
in the hospitals 113-year history.
In a city in which 34 percent of the population is 14 or younger, more than 60 percent of
Jerusalems children live below the poverty
line. Poverty in childhood has profound effects
on childrens health throughout their lifetime.
Shaare Zedek was one of the first hospitals
in Israel to recognise the need for specialist
paediatric medical facilities. With this demand
for paediatric and maternity services growing
each year, Shaare Zedek launched one of the
most ambitious development projects in its
113 year history: the Next Generation building.
The first of its kind in Jerusalem, the eightstorey building houses all paediatric, maternity and neonatal services and provides the
most comprehensive medical care available to
women and children under one roof.
The new building incorporates Shaare

Professor Halevy with donors from the Juliet Keldan Institute

Zedeks approach to personalised holistic care


with a design that best limits the emotional
trauma associated with hospitalisation and
ensures that patients can be closely supported
by family members. Every detail has been
designed with the needs of the children in
mind. The building is colourful, playfully
decorated and full of play areas and family
space. The medical services are complemented
by comprehensive educational facilities and
holistic treatments including art, music and pet
therapy and support from medical clowns.
Shaare Zedek UK has raised funds for the
Next Generation building project since 2007.
Many of the hospitals prestigious departments
and centres of excellence bear the names of
British donors:
The Lincoln David Abraham Paediatric
Educational Institute is home to all the
childrens educational activities, including the
school and complementary art, music and pet
therapy programmes.
The Vivienne Wohl Department of
Paediatric Surgery is truly unique, with dedicated paediatric facilities designed around the
specific needs of children during surgery. Each
operating theatre is connected to an elaborately
engineered computer network that maximises
the surgeons control over the procedures and
also allows the operations to be observed by
physicians outside the theatre via the internet.
The Leon and Lesley Berman
Pediatric Dialysis Unit treats from as far
away as Dimona and the Negev. Most suffer
from chronic renal failure and are waiting for
transplants. They require dialysis between
three and six times each week, making the
department their second home. Since more
than 50 percent of the patients are from the
Arab sector, many friendships formed cut
across religious and ethnic divides, making
the department a flagship for coexistence and

understanding. The department made headlines in 2002 when the kidneys of Glaswegian
terror victim Yoni Jesner were transplanted to
seven-year-old Yasmin Abu Ramila, a Palestinian Shaare Zedek paediatric dialysis patient.
The Juliet Keidan Institute of Paediatric Gastroenterology and Nutrition has
become an international leader in its field. The
prevalence of serious digestive disorders within
the Jewish and Arab communities has led to
rapid expansion of paediatric gastroenterological services, research and groundbreaking
new procedures. The department houses The
Anne and Joe Turner Pediatric IBD Center,
which hosts regular workshops to support
children coping with Crohns and ulcerative
colitis. Practical sessions teach the children
and their families cooking led by Israels top
chefs while social and emotional needs are
addressed in confidence building and team
building exercises.
One of the first departments to open in the
new building was Neonatal Intensive Care
Unit (NICU). It is the largest in Israel and
among the largest in the world, caring for up
to 70 babies at any time. UK supporters have
provided the NICU with a six crib area, a four
crib area, a nurses station, a family room, and
eight state-of-the-art giraffe incubators to treat
babies who need the most intensive care.
Shaare Zedek UK executive director Simi
Ben Hur said: British donors have supported
the hospital for nearly 80 years, raising more
than 29m in the past 10 years alone, and have
created the ideal environment for scientific
innovation. We are immensely proud of
the strong British contribution to the most
advanced women and childrens health facility
in Jerusalem. This has been a truly communal
project to ensure the health of the next generation is safe. Thank you to everyone who has
helped make our vision a reality.

As the man who paves the way and


leads the team at Shaare Zedek,
director-general professor Jonathan
Halevy is well placed to know what
makes the hospital special.
We are proud of our international
reputation for excellence. The great
diversity of population, which you see
both in intake and among our staff, is
what makes this place great, he says.
We are a control group of multiculturalism and multi-ethnicity among our
staff and patients, because that reflects
what Jerusalem is. Here we have secular
Jews, traditional, Orthodox and 35
percent of our population is Arab.
The most riveting thing, and what
has compelled me to refuse all offers
from hospitals that at the time were
much bigger than us, is the uniqueness of
this institution and my fascination with
the varied staff and the results of the
work here. Its a very special challenge. I
think a hospital like ours spearheads any
movement towards peace. This is where
you see and live our shared destiny.
Professor Halevy also appreciates
that the hospital is able to function as
well as it does because of the generosity
of those who support it.

EVERY BRICK AND EVERY


PIECE OF EQUIPMENT IS A
PERPETUAL TESTIMONY TO
THE ENORMOUS GENEROSITY
OF DONORS PAST AND
PRESENT, HE SAYS. ALL
THESE DEVELOPMENTS
ARE ONLY MADE POSSIBLE
THROUGH THE GENEROSITY
OF FRIENDS AROUND THE
WORLD. SO THANK YOU
FOR YOUR KINDNESS AND
SUPPORT.

SZ8

www.jewishnews.co.uk

Jewish News 29 September 2016

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