Issue 1 PDF

Hadassah
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Hadassah Health is published by:
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Welcome
Hadassah UK
26 Enford Street
London
W1H 1DW
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Editorial P8
News bites
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Hadassah’s Chagall windows
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Israel’s team in Haiti P14
Molecularly linked: The Jewish people P18
New research into dystonomia P20
Stem cells- Hadassah helps you see
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Defeating cancer
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Hadassah’s Paediatric intensive care unit
Sub Editors: Tamar Mendelsohn, Sofie Blaugrund
Design: Josh Saunders
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A Revolution in Medical Care
by James Artbuthnot MP Articles thanks to: Wendy Elliman, Judy Segal-Itzkavich, Ralph Dobrin,
Caroyln Weiniger, James Arbuthnot M.P., Tamar Mendelsohn.
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Care not creed Photos: Debbie Cooper, Avi Hayun, Yasmin Keats
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An anaesthetist’s view at Hadassah
With special thanks to:
Marylou Grimberg
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We’re Building the futureSarah Wetsman Davidson Tower T : 020 7723 1144
F : 020 7723 1222
E : uk.office@hadassah.org
www.hadassahuk.org
Registered Charity No 1040848
Editor in Chief: Prof Michael Baum
Editorial Board: Prof Michael Baum, Lord Leslie Turnberg, Prof David Katz,
Sir Ian Gainsford, Prof Victor Hoffbrand, Prof Stuart Stanton
And to our Anonymous Sponsor
Supporting the Hadassah Medical Organisation, Jerusalem
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t gives me great pleasure to welcome you to the first issue
of Hadassah UK’s magazine, Hadassah Health. As editor, I need to make clear the nature of my vision, shared
by our trustees who are well represented on our editorial
board. Firstly, Hadassah is not raising funds to support the
equivalent of an Israeli NHS. If that was all we had in mind
I might recommend you gave your charitable donations to
Holby City NHS hospital trust. No, Hadassah is different,
very special and close to my heart.
We hope this magazine will help bond the Anglo-Jewish
community and its many non-Jewish well wishers with the
Hadassah Medical Organisation in Jerusalem. Hadassah
Health will capture the imagination of both lay and medical
readers by reporting on the medical achievements, scientific discoveries and general atmosphere that make Hadassah so special, and of such importance to the Middle East
and the world at large. In addition, as a British publication,
we focus on the achievements brought about by the money
raised specifically by Hadassah UK and promote fund raising activities within the UK. We also aim to showcase Israeli
medicine in Britain in order to support Anglo-Jewish doctors in their fight against an academic boycott of Israel.
Welcome
My most enduring memory of my last visit to Hadassah, Ein
Kerem, is of my tour of the paediatric oncology unit that is
housed in the amazing tower dedicated to children’s health.
Professor Shlomo Mor-Yosef, HMO’s director general, was
showing me around, when he introduced me to the chief
nurse looking after the kids with leukaemia. Whilst standing
in the glass atrium at the end of wing, with one of the best
views over the seven hills of Jerusalem, she mentioned in
passing that as all the children in her care were bald from
the effects of chemotherapy, one could not distinguish their
race, religion or ethnicity. Everyone in the mosaic of minority groups in Israel is at equal risk of developing childhood
leukaemia and each has equal right to the best care available in the Middle East. Incidentally the chief nurse was an
Israeli Arab; and I almost forgot to mention that the Paediatric Oncology Department is totally funded by the generous donations from the UK from the Dyna & Fala Weinstock
Charitable Trust. I think that one vignette summarises our vision and the ethos of Hadassah UK and Hadassah Health.
In this first edition of Hadassah Health you will find many
similar stories both to warm your heart and stimulate your
imagination.
Hadassah UK exists to support the Hadassah Medical Organisation in Jerusalem with its work in healing, teaching,
research and outreach.
We raise funds, put on events and bring speakers from Hadassah to the UK such as Dr Shir Dar from the IDF Haiti
rescue mission and other Hadassah doctors to speak about
its breakthroughs in medical research, treatments and procedures. Hadassah UK publicises the hospital’s work to
medical professionals, journalists, MPs and Peers and to
the general public. Our Young Hadassah group and special
interest committees have programmes of events to support
their chosen projects within Hadassah.
Please contact Mark Addleman at Hadassah UK if you are interested in helping us,
visiting Hadassah or finding any other information on
020 7723 1144 or email uk.office@hadassah.org
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Editorial
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his is not my first outing as an editor as I was, until recently editor-in-chief of the International Journal
of Surgery. In that role I made the final decision on
which papers were published and which were returned to
sender with my insincere regrets. However the best part
was not this prerogative, but the opportunity it provided for
the occasional self -indulgence as expressed in my editorial columns and my on-line blog. I think it is obvious by
now if you’ve read my welcome, where my prejudices lie.
Apart from that I have a dark secret, and that is my passion
for fine art. It was therefore obvious to me right from the
start that the lead feature had to be related to those iconic
stained glass windows by Chagall that fenestrate the synagogue of Hadassah at Ein Kerem. In many ways I prefer
Chagall’s work with glass to those works on canvas or on
paper. Even though his best oils create an impression of
transmitted light I prefer being literally bathed in the colours
of his windows. In what better way can you enjoy the early
summer light in Jerusalem, than by its refraction through the
cobalt blue and vermillion tones of Chagall’s masterpiece?
The next feature, on the activity of the IDF and the Israeli
medical teams in Haiti, was an obvious choice being both
highly topical as well as being one of the best examples of
showcasing Israeli doctors at work outside the boundaries
of their hospitals and of Israel herself.
My chest swelled with pride when Sky television showed
the new baby boy named ‘Israel’ as a token of gratitude to
the medical corps of the IDF. Incidentally he was delivered
in Haiti by Hadassah Paediatrician, Dr Shir Dar.
The next feature is another example of my self- indulgence
in describing the molecular genealogy of the Jewish people
as judged by the inheritance of the genetic malfunction that
pre-disposes to breast and ovarian cancer. Many of our
readers will come from families blighted by these diseases
as is mine and it might yet be in our enlightened self-interest
to donate to HMO to support their research in this area.
We then present a series of delightful essays with human-interest stories that feature the staff and patients of the HMO.
Finally to capture the interest of our medical readers there
are accounts of some of the scientific research and new
clinical services at Hadassah. Although much of this is
rather esoteric, we have edited the text so that it should
be of some interest to and understood by the intelligent lay
reader. As that applies to all who have read so far, sit back
and enjoy. When you reach the end papers you will learn
just how easy it is to donate to Hadassah in Jerusalem via
Hadassah UK.
Professor Michael Baum
WHO KNOWS, YOU OR YOUR LOVED ONES MAY YET
HAVE NEED OF THEIR SERVICES SHOULD YOU FALL
IN A WADI IN THE NEGEV AND NEED AIR LIFTING
TO THE NEAREST A&E DEPARTMENT THAT JUST
HAPPENS TO BE ON A HILL OVERLOOKING THE
VILLAGE OF EIN KEREM.
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‘Hadassah’s Golden Eagle’
Revolutionary technique
saves father of ten
Hadassah’s stroke unit is using a revolutionary new technique to save the lives
of stroke victims. A corkscrew device
called a MERCI clot retriever is being
used to prevent the permanent loss of
brain function among stroke victims.
The device is introduced through the
femoral artery to reverse blood clots,
re-establishing blood flow to the brain
and preventing neurological damage.
Moshe, a 64-year-old father of ten recently underwent the procedure following a massive stroke.
A two-hour operation by the director of
Hadassah’s Endovascular Neurosurgery
and Invasive Neuroradiology Unit, Professor José Cohen, and his stroke team
successfully removed the 4cm clot, allowing Moshe to regain full neurological
function.
Improving health in
Abu Gosh
Twenty-five volunteers graduating from
Hadassah’s health promotion trainer’s
course. The Head of the Abu Gosh Council attended the graduation ceremony
and warmly congratulated the women
on their involvement and achievements.
At the graduation ceremony, youngsters
from Abu Gosh performed the Arabic
Debka dance.
A second group of volunteers from the
Arab village of Abu Gosh has completed
Hadassah’s 80-hour training course to
become health promoters in their home
village.
The Project for the Promotion of Women’s
Health is an outgrowth of Hadassah’s vision to create partnerships with different
communities. The initiative, with funding
from the L’Oreal Foundation, operates
under the auspices of our Patricia and
Russell Fleischman Women’s Health
Centre. At their graduation ceremony,
volunteers said that the programme had
helped change their lives, empowering,
educating them and helping them to
bring about improvements in their communities.
Immuron and Hadasit:
working together
Hadasit, Hadassah’s technology transfer arm, is the largest clinical research
centre in Israel, and has a global reputation for excellent medical and scientific
research. With a 20% stake it is now the
largest shareholder in Immuron, a biopharmaceutical company.
Professor Yaron Ilan of Hadassah will
serve as Immuron’s medical director. Dr
Einat Zisman, CEO of Hadasit, believes
the “combined efforts of Hadassah’s IP
and Immuron capabilities can yield a
new approach to address serious diseases and metabolic syndromes.”
Making matches
Before Hadassah launched its bone
marrow campaign in October 2008,
200 people from the Arab community
had enrolled in the 60,000-person database. To emphasise the importance of
its bone marrow registry, Hadassah then
set about distributing an Arab-language
brochure, organising workshops, lectures and drives to recruit people in three
hospitals in Nazareth, at the Hebrew
University-Hadassah Medical School,
in Arab towns around Israel and in the
Palestinian Authority. Dr Amal Bishara,
head of the project, says there are now
2,920 Arab donors in the registry, and
some have already been good matches
for patients.
with a history of marrying among themselves to have a particular type of retinal disease.
Identifying the causative genes is a “significant step forward”,
according to Dr Eyal Banin, head of Hadassah’s Centre for
Retinal and Macular Degeneration. “These patients and families now have a home and an address to which to turn. That
address is Hadassah.”
Israel’s first medical tissue bank
One of Hadassah’s senior pathologists, Karen Meir, has helped
to establish Israel’s first medical tissue bank. The goal, Dr Meir
explains, “is to preserve and store tissue from malignant tumours so we can study them and come up with predictive tests
and markers.” This, in turn, will help in the development of specific, tailor-made therapies.
Now in its start-up phase, the bank is targeting patients with
malignancies of the breast, lung, pancreas, and colon. Dr Meir
says that Israel’s unique demographics are of invaluable use in
this field. “In a small geographical space we have an amazing
mix of genetic populations, in both the Jewish and the Arab
communities. For the purpose of molecular comparisons, this
is a treasure trove.”
Hadassah eyes it up
Hadassah really treats everyone
Hadassah has identified the genetic
cause of a retinal disease which has
plagued Israeli and Palestinian families
for generations. The findings, published
in the journal Archives of Ophthalmology, describe specific mutations in a
gene which creates a wide range of retinal phenotypes. Using specific genetic
methodology, the Hadassah team was
able to identify a single mutation that
caused six families from the same village
Hadassah’s Ophthalmology Department has successfully
treated a golden eagle. The bird had already lost one eye due
to an injury, and had been diagnosed with cataract in the other.
Having been approached by the managers of the Jerusalem
Biblical Zoo, Hadassah agreed to help. Dr Michael Halpert
(first on the left) performed the operation and saved the
eagle’s sight.
From Esti Katz who looks after patients and
their relatives at Hadassah
Working in Hadassah hospital, has provided me with many
powerful and emotional experiences, but after some years, I
thought I had become “immune”. Years of Intifada and other
heart-tearing experiences had convinced me that I had seen
everything. Well, I had not, not until today.
Earlier today I was asked to speak with a young man. His
name, Eliad Sharoni, didn’t mean anything to me. He told me
that he was visiting his 43-year-old sister, Yifat, in the oncology
department. “My sister has only a few days left – maybe even
hours – before she dies,” he said, trying not to cry. “I have
come especially from Italy to be with her, and spent last night
massaging her for hours to try to ease her pain. This morning I
went to have a cup of coffee and I saw a piano in the main lobby of the hospital. I am a pianist and my sister has never heard
me play. I’d like to bring her in a wheelchair and play for her.”
I said yes, of course, and he started crying, telling me that this
was his last chance to compensate for not spending time with
her before.
For the next 30 minutes I was a witness to one of the most
powerful and moving concerts I have ever heard. Eliad, who
turned out to be a great pianist, was crying as he played, while
his sister, who was too weak to speak or move, was sitting in a
wheelchair in front of him, listening. Only her shiny black eyes
could tell what was happening inside her. Their mother stood
behind her, holding her hand throughout the entire concert.
As the music played, people gathered around looking at the
surreal scene. It was very difficult to comprehend what we
were watching. It was as if everything stood still.
And then it ended. Eliad hugged his sister, told her how much
he loved her, took her back to the department, the maintenance people locked the piano and life went on again.
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Hadassah is home not only to medical
excellence, but artistic excellence too.
Twelve stained glass windows by Marc
Chagall adorn the Hadassah Hospital
Synagogue in Jerusalem.
“This is my modest gift to the Jewish people who have always dreamt
of biblical love, friendship and of
peace among all peoples. This is my
gift to that people which lived here
thousands of years ago among the
other Semitic people.”
Marc Chagall February 6th 1962
The eldest of nine children, Chagall
the roof” recurs frequently, often hovering within another scene. Strong colours portray the world with a dreamlike
simplicity, and the fusion of fantasy and
religion gives his work a joyous quality.
While Chagall’s work was influenced
by contemporary French painting, his
style remains independent of any one
school of art. During the first world war,
Chagall lived in Russia, and in 1917,
endorsing the revolution, he was appointed Commissar for Fine Arts in
Vitebsk and then director of the newly
established Free Academy of Art. But
the Bolshevik authorities frowned upon
Chagall’s style of art as too modern,
“All the time I was working,” he said,
“I felt my father and my mother were
looking over my shoulder, and behind them were Jews, millions of
other vanished Jews of yesterday
and a thousand years ago.”
The Bible was Chagall’s main inspiration, particularly Genesis 49, where
Jacob blesses his 12 sons, and Deuteronomy 33, where Moses blesses
the Twelve Tribes. The dominant colours used in each window are inspired
by those blessings as well as by the
description of the breastplate of the
High Priest in Exodus 28:15, which
were described as gold, blue, purple
THE TWELVE WINDOWS OF
HADASSAH
was born in 1887 in Vitebsk, Byelorussia (Belarus today), to a poor Hassidic family. At the age of 20, despite
his father’s disapproval, Chagall pursued his interest in art and went to St
Petersburg to study with the Russian
painter Leon Bakst. Influenced by contemporary Russian painting, Chagall’s
distinctive, child-like style, often centring on images from his childhood,
began to emerge. Chagall then spent
four years living in Paris, absorbing the
works of the leading cubist, surrealist,
and fauvist painters. It was during this
period that Chagall painted some of
his most famous paintings of the Jewish shtetl (village), and developed the
features that became recognizable
trademarks of his art; the “fiddler on
and in 1922 he left Russia. Chagall
settled in France the following year. He
lived there permanently except for the
years 1941 to 1948 when he fled to the
United States. Chagall’s horror over
the Nazi rise to power is expressed in
works depicting Jewish martyrs
and refugees.
The 12 Hadassah Windows
To fully understand the significance
of the Windows, they must be viewed
against Chagall’s deep sense of identification with the whole of Jewish history, its tragedies and victories, as well
as his own personal background in the
shtetl of Vitebsk, where he was born
and raised.
and scarlet, and contained 12 distinct
gems. Each gem was dedicated to a
tribe with the tribe’s name engraved
on it.
According to the Bible, each of the
tribes had its own flag and emblem,
as cited in Numbers: 2, 2: “The sons
of Israel shall encamp, each by his
flag, with the emblems of their fathers’ house.” The background of the
flag was said to be based on the colour of the corresponding gem on the
breastplate. The tribal emblems were
based mainly on the texts of Jacob’s
blessings of his sons (Genesis 49) and
Moses’ blessings of the tribes
(Deuteronomy 33).
Example: The Window of Judah
Jacob’s blessing, Genesis 49
“You, O Judah,
Your brother shall praise;
Your hand shall be on the nape of your foes;
Your father’s sons shall bow low to you.
Judah is a young lion;
On prey, my son, have you grown.
He crouches, lies down like a lion,
Like the King of Beasts – who dare rouse him?
The sceptre shall not depart from Judah,
Nor the ruler’s staff from between his feet;
So that tribute shall come to him
And the homage of peoples be his.
He tethers his donkey to a vine,
his ass-foal to a choicest vine;
He washes his garments in wine,
His robe in the blood of grapes.
His eyes are darker than wine
And his teeth are whiter than milk.
Moses’s blessing, Deuteronomy 33
And this He said of Judah:
Hear O LORD, the voice of Judah,
And restore him to his people.
Though his own hands strive for him,
Help him against his foes.
Midrash Rabbah Bamidbar 2
His gem was red garnet (NOFEKH),
his flag was sky-blue,
with a lion on it.
The red background of the window
refers undoubtedly to the wine image in Jacob’s blessing. But it also
may be connected to the royal purple garment. The significance of
the crown in the top is obvious. So
is the lion at the bottom. The hands
remind us of the verse “Though
his own hands strive for him”, and
“Your hand shall be on the nape
of your foes”. Simultaneously, the
two hands are raised in the manner
of the priestly blessing.
Behind the lion there is the city of
Jerusalem. Chagall signed this
Window in Hebrew.
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ISRAEL’s team
in HAITI
N
ews of the devastating earthquake
that hit the Haitian capital of Port-auPrince in January traveled quickly right
across the globe. Within two days more than
20 countries had sent military personnel to
help. Within a fortnight the world’s nations
had pledged some $1 billion in emergency aid.
In just under eight hours Israel had assembled a medical team to build a field hospital
amid the destruction and chaos. Armed with
supplies and equipment, the Israel Defence
Forces (IDF) delegation, which included 220
army and medical personnel, set up the largest field hospital in Haiti to provide immediate disaster relief. The hospital was the most
advanced medical facility in the area, with
intensive care units and operating rooms, as
well as over 40 doctors, specialists and volunteers.
In the media
The BBC and Sky News were quick
to highlight Israel’s rescue operations in Haiti. CNN praised Israel’s
doctors and nurses for mounting a
swift and sophisticated response
to the earthquake. ABC News described the Israeli hospital’s emergency unit as “legendary”, reporting
that it was cause for the Americans
to “rethink their entire emergency
response”.
Israeli rescuers worked tirelessly to locate
survivors trapped in the ruins of buildings.
They investigated reports of voices heard
from inside the wreckage, with one of the
Israeli search and rescue teams freeing
69-year-old France Gilles. “We told him we
were from Israel and he asked if we were
mocking him,” one member of the delegation
recalled. At another site Israelis spoke with
a man trapped under rubble, apparently the
only survivor after a building had collapsed.
After several hours of excavation rescuers
provided him with fluids intravenously, and
freed him within a few hours.
“We’ve had to drill through a concrete girder,
as he is trapped between pipes and planking,” said Liron Shapira, deputy commander
of the Israeli delegation. “We removed most
of the piping and managed to attach intravenous drips to his torso.” Zaka teams (Disaster Victim Identification units), representing
Israel, also worked tirelessly, saving the lives
of eight people as well as recovering the
bodies of several victims. During the searches, teams from Nicaragua, Russia, and
Venezuela located two girls who had been
trapped in a collapsed building for more than
five days. The girls were evacuated to the Israeli hospital, where they were treated. The
first girl to be rescued had serious injuries,
and CNN Reporter Chris Lawrence brought
her in his truck to the hospital where she received life-saving treatment. The second girl
was in much better condition, with only minor
injuries.
By the end of January the confirmed death
toll from the earthquake had exceeded
150,000 in the Port-au-Prince area alone.
The Israeli field hospital had treated some
970 patients, performed 300 surgeries and
delivered 16 babies.
Hadassah’s Dr Shir Dar delivered the first healthy baby
in the Israeli field hospital delivery ward. Naming the
child “Israel” to show gratitude to the doctor and his team,
the mother was extremely quiet. “It wasn’t even clear initially
that she was in labour,” Dr Dar explained. Childbirth in impoverished Haiti doesn’t normally take place in hospitals.
“It is very exciting,” Dar added. “It offers some small balance to the things that are happening. Life is stronger,
after all, and a woman will give birth even if the ground
is shaking. This is what maintains the human race. This
country has a very high infant mortality rate, and we
delivered this healthy baby.”
The following is from Hadassah’s Dr Taras Shirov, an anaesthesiologist and orthopedic surgeon,
who has been working in Haiti, running back and forth between the anaesthesia machines and
the operating table.
“We arrived and built the field hospital from scratch in a
football stadium. There was no local infrastructure such
as running water or washrooms. We worked for 36 hours
non-stop, operating on more than 70 people (not counting
endless small treatments and procedures for which there
are no records). People can now have showers under running water, instead of using three large bottles of water per
person.
“The numbers of injured and sick people are overwhelming
and it seems as if no change is around the corner. Ameri-
can physicians and nurses help in the Israeli hospital, and
an American nurse who has been living in Haiti for years
serves as a translator because language differences is a
major problem. Imagine a situation where a physician or a
nurse tries to take vital signs from patients and cannot communicate with them.
Most of the ER work is done at night; operations are carried
out during the day. The weather has been favorable so far
although it’s very hot and humid. The only air conditioner
is in the operating room, and they use regular ventilators.”
Hadassah nails it
When the hospital ran out
of screws for external reinforcement structures for
limb fractures, Hadassah’s
Reuven Gelfond, a nurse
from Mt Scopus, stepped
in. He found a local factory
where he had them create
the necessary screws out
of regular nails.
Israel mounts rescue effort
following Haiti’s devastating
earthquake
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Molecularly THE
JEWISH
PEOPLE
by Professor Michael Baum
M
y son-in-law is a “Cohen” and
I am proud that my daughter
has married into this princely
and scholarly lineage. My son-inlaw’s father is Rabbi Dr Jeffrey Cohen
and through the oral tradition they
can trace their lineage back to the
Cohenim of the Temple in Jerusalem.
We now know that this oral tradition
has been scientifically confirmed by
studying the Y chromosome of Cohenim. The Y chromosome is associated
with the male sex and handed down
through the generations from father to
son. The Y chromosome of the Cohenim has certain characteristics that
are common to all the Cohenim in the
world, confirming the veracity of the
oral tradition (figure 1). Perhaps more
remarkable is the tradition that our
ethnicity is handed down through the
maternal line. Every cell in the human
body has two sources of DNA. The
major source is within the nucleus and
this can be described as the blue print
that codifies our personhood: the way
we look, our height, the colour of our
eyes and to a large extent our attitudes
and intelligence.
Hidden in the cytoplasm between the
nucleus and the cell membrane, and
only clearly seen on electron microscopy, are the mitochondria (figure 2).
These tiny structures are vitally impor-
tant in burning food to provide energy
for cellular activity. The mitochondria
are peculiar. Back in evolution they
were once bacteria, living symbiotically in primitive cells. They still retain
some of their own original DNA that
codes for a few proteins that are essential for the organization of these
“organelles”. (An organelle is a specialized subunit within a cell that has
a specific function.) This mitochondrial
DNA is now known to be entirely maternal in origin, handed down through
the generations via the female line. So
the mitochondrial DNA in the fertilized
egg is all maternal. As is the case
for the Y chromosome, mitochondrial
Figure 1
Figure 2
DNA also differs in subtle detail, between individuals and through this it
is possible to trace the origins and migration of peoples of different ethnicity from the first hominids who evolved
from the apes in central Africa in the
dark distant past. Once again genetic
anthropology confirms that the majority of people who consider themselves
Jewish are indeed Jewish as judged
by their mitochondrial DNA. Subtle
differences in this coding also allows
us to trace the migration of the Jewish
people over time and even suggests
that our origins might indeed have
arisen from four different matriarchal
tribes.
Sadly along the way the Jewish people have collected a number of deleterious mutations within their cellular
DNA of the germ line that has also
been passed on through the generations. These include the mutations
that are associated with breast cancer, and those linked to Tay Sachs
disease, which causes deterioration of
mental and physical abilities. The origin of these mutations in time can be
traced by considering the migration
and dispersion of the Jewish people in
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ancient history. The story starts about
3000 years ago (figure 3).
In 586BCE, after the Babylonian conquest and the fall of the First Temple,
the major Jewish dispersion was to
Mesopotamia; “by the rivers of Babylon, there we set down yea we wept
when we remembered Zion” (Psalm
137). Some Jews migrated to Egypt
and others north into Syria. Later many
Jews drifted back to the land of Israel, but after the revolt against Persia,
359-338BCE, many migrated towards
the Caspian Sea with gradual migrations through trading further north into
Europe. The Jews who migrated to
Mesopotamia enjoyed a long history,
emerging ultimately as Iraqi Jews,
most of whom were forced to leave after the Second World War.
The next cataclysmic event in Jewish
history was the sacking of the Second Temple by the Romans in 70CE.
This event was celebrated by the Roman legions in the bas -relief seen on
the arch of Titus in Rome, where the
Temple menorah is seen carried on
the shoulders of the triumphal Roman
legionnaires. This is also celebrated
by the coin that was struck embossed
with the words Judea Capta (figure 4).
At this point 80,000 Jewish slaves were
shipped across to the Roman province
of Hispania and settled in the region
just south of Cordova. This colony ultimately gave rise to the Sephardic
population. Some Jews remained behind in cities such as Jerusalem, Hebron and S’fad with descendents to
this very day, whereas others continued their migration through Asia Minor
into Eastern Europe (figure 5).
Until the expulsion of the Jews from
Portugal and Spain at the end of the
15th century, there was very little inter-marriage between the Sephardim
and the Jews in Mesopotamia, Asia
Minor and Europe. With these historical facts in mind it is then all the more
interesting to look at the distribution
of the BRCA 1 and BRCA 2 mutations
amongst women from the different
Jewish communities. These mutations
occur in the genes that have an important role in DNA repair. This means
that carriers of these mutant genes ac-
cumulate sufficient DNA damage that
can initiate malignant transformation
of normal cells
Amongst Jewish women within Israel and the diaspora, 1 in 40 women
(2.5%) are affected. When you look
at the individual mutations you see
how the history of the Jewish people
has been reflected, once again at the
molecular level. First of all Sephardi
women do not carry any of these mutations. Therefore the mutations that
have been identified must have occurred after the fall of the Second
Temple or amongst those families who
remained in Mesopotamia or migrated
north after the fall of the First Temple.
There are three “Jewish” mutations.
These can be roughly dated by analysis of mitochondrial DNA. The oldest
mutation (185del AG) on the BRCA 1
gene occurs in 1% of both Ashkenazi
and Iraqi Jews and is estimated to be
between 2500 and 3000 years old.
This therefore must have occurred by
a founder germ line mutation in Mesopotamia shortly after the fall of the First
Temple and also have been carried
Figure 3
Figure 4
Figure 5
north amongst those Jews who ultimately contributed to the foundation of
the Ashkenazi tribes.
The second mutation (617del IT) is on
the BRCA 2 gene. It is found in 1.4% of
Ashkenazi Jews only, and is estimated
to be about 700 years old. Long after
the fall of the Second Temple, almost
certainly the founder germ line mutation must have arisen from the Jews
that had settled in Eastern Europe.
The third mutation (5382ins C) is on the
BRCA 1 gene. It occurs in 0.1% of the
Jewish population and is said to reflect
another tragic event in Jewish history.
This mutation is also seen amongst
high-risk non-Jewish women of Eastern European origin and is sometimes
described as a “pogrom” mutation. In
other words it is the consequence of
pregnancies following rape.
Both the Israeli and the British experience confirm that women carrying one
of the BRCA 1 mutations have a nearly
80% chance of developing breast cancer by the time they are 80 years old.
For those carrying the BRCA 2 mutations the risk is about 35%. These
mutations are also associated with an
increased risk of ovarian cancer and,
curiously, prostate cancer amongst
the male members of the family. Rarely, these mutations can be carried
and express themselves as breast
cancer in the male relatives of such at
risk groups.
Hadassah is undertaking cutting-edge research into understanding
and managing these “Ashkenazi” breast cancers, which will benefit
women all over the world. I hope this essay will remind potential donors that not only do we have emotional and cultural links to Jerusalem but our very molecular structure can trace its roots to the time
of the Second Temple 2,000 years ago.
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H
NEW RESEARCH ENDS A
LIFE OF SUFFERING
Treating dystonia with surgery developed for
Parkinson’s disease
adassah Hospital has a new
treatment for dystonia sufferers
that helps reverse their painful
and debilitating disease
By the time Talia Zusman had finished
high school, the tremors in her legs that
had begun when she was 12 years old
had put her in a wheelchair.
“My friends were going off to the army,
and I was worrying about how to get
upstairs,” she says. “I had an incurable disease. This was my reality. I accepted it.”
says Dr. Israel. “Inherited or primary
dystonia is, unfortunately, an Ashkenazic disease.”
A year later, a healthy and active Zusman addressed the Hadassah convention in Los Angeles. She couldn’t
attend in person as she was doing
national service with children at risk,
and they needed her. Instead Zusman
appeared via video to express her intense gratitude to the neurosurgeon
and the medical centre that rid her of
the symptoms of dystonia.
“Zusman is one of 22 dystonia patients
on whom we have performed deepbrain stimulation in the past six years,”
says neurosurgeon Zvi Israel of the
Hadassah Medical Organisation, who
introduced the technique to Israel and
has helped develop it. “Her affected
elder brother waited to see the results
of Talia’s surgery. Fourteen months
later, he was in our operating room as
well. Zusman and her brother Roi were
completely cured.
Deep-brain stimulation, the surgery
that has turned life around for dystonia
patients, was, in fact, developed for
people with Parkinson’s disease. In the
early 1990s, Israeli physiologist Hagai
Bergman of the Hebrew University–
Hadassah Medical School discovered
a tiny area, deep in the brain, which
is overactive in Parkinson’s sufferers.
When he altered the electrical activity
in this tissue, all overactivity was improved.
Dystonia is a neurological disorder, a
problem with the way the brain controls movement. Its victims suffer continuous muscle contractions, which
cause uncontrolled twisting and repetitive movements, often with cramping
and pain. In some patients, only a single muscle is affected. In others, the
disease attacks groups of muscles in
the arms, legs or neck, or it can affect
the whole body.
There are two main types: one results
from birth-related or other physical
trauma, infection, lack of oxygen or
drug reaction. The other, which the
Zusmans have, is genetic. “The fact
that most of our dystonia patients have
the genetic form is no coincidence,”
The mutated gene implicated in dystonia is carried by 3 to 5 percent of
Ashkenazic Jews, compared with less
than 1 percent of the general population. The faulty gene, known as DYT1
and first mapped in 1989, probably
results from a single mutation event in
the Ashkenazic Jewish population in
Lithuania about 350 years ago.
Dr Israel learned the technique at the
Oregon Health and Sciences University in Portland, USA. He brought the
technique to Israel, where he built a
deep-brain stimulation surgery program at Hadassah. As expertise in
deep-brain stimulation for Parkinson’s
grew worldwide, surgeons began
wondering if the technique had broader applications.
Zusman remembers lying on the operating-room table, listening to an iPod,
with a stereotactic frame fitted around
her head. Once her brain was scanned
and the image combined with an earlier MRI to pinpoint the malfunctioning
area, Dr. Israel got to work. He drilled a
small hole through Zusman’s skull just
above her hairline. He then inserted
three inches of wire the thickness of
a paper clip, four tiny electrodes at its
end, and advanced it to the target.
With one end of the silicon wire in
place, he took the other, emerging
from Zusman’s skull, placed it under
her skin and trained it down the side
of the head, neck and chest to her upper abdomen. There, he connected it
to an electrical generator, a lightweight
device the size of a small computer
mouse, also implanted under the skin.
“The electrodes immediately stun the
overactive cells, and the patient is often dramatically better,” says Dr. Israel. “Within a week or two, however, the
cells begin recovering, and it is time
to program the generator. We place
a hand-held electrical device on the
patient’s skin over the generator and
fine-tune the electrical pulses it delivers to the brain. Initially, we give only
a small amount of stimulation, which
must sometimes be increased.” The
stimulation usually results in a complete reversal of symptoms.
The technique is not able to cure patients suffering from Parkinson’s, but
Hadassah is working to improve it.
One way is by developing tools that
ensure the electrodes are inserted in
precisely the right area. The second
important refinement is the degree of
stimulation delivered to the malfunctioning brain area. Brain activity drops
when a patient sleeps and rises when
he or she goes running. If activity in
the brain’s cortex can be recorded,
it can be used to indicate how much
stimulation should be given at different
times and provide exactly the correct
amount.
People are looking to stem cell therapy
as the next major advance in treating
Parkinson’s. But until biologists can
say: ‘Here are the stem cells!’ Dr Zvi
believes deep-brain stimulation has a
long way to go and much help to give
patients with a range of difficult neurological disorders.
Dr Zvi Israel’s work has been supported by our Hadassah UK’s Parkinson’s
At The Hadassah (PATH) Committee.
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Hadassah researchers help you see
R
epresenting a significant step towards treating
and preventing age-related macular degeneration, researchers from the Hadassah Medical Organisation in Jerusalem have produced findings that
have since been published in the journal Cell Stem Cell.
NEW HADASSAH
RESEARCH USING
HUMAN EMBRYONIC
STEM CELLS
Age-related macular degeneration causes major vision
damage. It is the leading cause of blindness in adults
over 50 in the western hemisphere, with 30 million afflicted around the world. A disease which causes millions
of people worldwide to lose their sight, it damages the
central area of the retina, the macula, which is responsible for the sharpness of vision and activities such as
reading, driving or watching television.
Researchers from the Hadassah Medical Organisation
have transplanted pigment-containing visual cells derived from human embryonic stem cells, successfully
preserving the structure and function of the specialised
light-sensitive lining of the eye in an animal with macular
degeneration.
Professor Benjamin Reubinoff, Director of the Hadassah
Human Embryonic Stem Cell Research Centre, and Dr
Eyal Banin, Director of the Hadassah Centre for Retinal
and Macular Degeneration, led the research team, creating unique laboratory conditions for deriving pigmental cells of the retina from human embryonic stem cells.
They found that nicotinamide (vitamin B3, NIC) and Activin A, a stem cell maturation agent protein, turned human embryonic stem cells into pigmental retinal cells.
When transplanted into the eye of a rat with macular degeneration caused by malfunctioning pigmental cells,
they were able to delay deterioration of retinal structure
and function.
“Our findings are an important step towards the potential future use of human embryonic stem cells to replenish RPE in diseases that result in blindness,” Dr. Banin
stated. Experimental transplantation of pigment cells in
human patients is expected in two years.
Professor Benjamin Reubinoff was featured on Fox
News explaining how Hadassah’s manipulation of cells
to model different diseases could help us understand
how diseases evolve and how to correct the diseased
state. Some Israeli scientists predict there may well be
treatment for formerly untreatable diseases in as little as
three years’ time.
Human embryonic stem cells slow down MS
Multiple sclerosis is the most common cause of neurological disabilities in young adults. It is an autoimmune
inflammatory disease of the central nervous system in
which the immune system attacks the insulation of neurons (myelin). As a result, the nervous system is damaged at a number of levels, leading to functional deficiencies in a number of neurological systems: sensory,
motor, balance, sphincteral and vision.
Following a long-term collaboration between Professor
Tamir Ben Hur, Director of the Neurological Department
and Professor Benjamin Reubinoff, new research has
paved the way to further developments towards clinical
application in MS patients.
This research, as published in the scientific journal PL0S
ONE, involves the transplantation of human embryonic
stem cells into the brains of a mouse with MS, which
slowed down significantly the clinical symptoms and
pathological manifestations of the disease.
They anticipate in the future, using embryonic stem
cells, the inflammatory effects of MS may be reduced
through repairing the damaged myelin in the brain.
Cell Cure Neurosciences, a Hadasit Biotech Company
which focuses on the development of human embryonic
stem cells for transplantation therapy in neurological
disorders, will further translate the results of the study to
allow future clinical application in MS patients.
This research also demonstrated that human embryonic
stem cells can improve the functioning of a rat with Parkinson’s disease. The stem cell therapy offers the first
real possibility of curing Parkinson patients by replenishing their dying dopaminergic neurons.
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Malignant germ cell tumours
This tumour arises when germ cells
abnormally migrate during the embryonic
period, travelling from the testes to the chest.
They remain dormant for years, but eventually
develop into a tumour.
A
two-and-a-half-year-old girl from Russia with an eye
tumour, known as retinoblastoma, and a fourteenyear-old boy from Cyprus, have defeated the cancers that were threatening their lives thanks to Hadassah’s
Dyna & Fala Weinstock Paediatric Haematology-Oncology
Department.
The department, which was kindly donated by a UK donor,
is renowned for providing comprehensive and sophisticated medical treatment to children and adolescents with cancer and severe non-malignant haematological diseases.
Referrals come from well beyond the borders of Israel and
it is designed to serve the needs of paediatric and adolescent oncology patients as well as their families. This department together with “Linda’s Activity Centre” is located in the
Mother and Child Centre at Hadassah Ein Kerem and this
whole second floor was built as a result of donations raised
from UK donors.
The only comprehensive Paediatric Cancer Centre
Jerusalem, it serves a large and heterogeneous population
from diverse ethnic and psychosocial backgrounds who are
treated by a multidisciplinary staff, using the most up-todate diagnostic and therapeutic tools. Further, it is actively
involved in the teaching of medical students, paediatric
residents and paediatric Haematology-Oncology fellows.
The parents of the toddler with the eye tumour could not
accept that their child would have to have both of her eyes
surgically removed after physicians in Russia had informed
them of this likelihood. After finding Professor Jacob Pe’er,
director of Hadassah’s Department of Ophthalmology, and
Dr Michael Weintraub, director of the Department of Paediatric Haematology-Oncology on the internet, the parents of
the toddler contacted them.
The parents and child flew to Hadassah, where tests and
consultations began. Giving the parents a ray of hope, the
Hadassah team explained that with chemotherapy, one of
the child’s eyes could definitely be saved and possibly the
vision in her second eye.
“In cases of retinoblastoma,” Dr Weintraub explains, “we
obviously do everything possible to control the tumour,
which is our main concern. However, beyond the immediate medical need, we also try to avoid having to remove the
eye, for obvious cosmetic reasons.”
The fourteen-year-old boy from Cyprus was brought to Hadassah with an unusually large tumour on his chest. Unable to treat it successfully, physicians in his home country
had all but given up hope. Offering another ray of hope,
Hadassah’s Dr Weintraub and Thoracic Surgeon Dr El-Ami
diagnosed the lesion as a malignant germ cell tumour. With
surgery and chemotherapy, however, the boy recovered
completely and returned to his normal life.
DEFEAT CANCER
An everyday
story from
Hadassah’s
Paediatric
Intensive Care
Unit
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by Wendy Elliman
Eli (not his real name) is scarcely aware of what went on. It’s
his parents who carry the memories, and the thankfulness
that they still have their four-and-a-half-year-old son.
PICU medical staff, nonetheless, continued ventilating Eli
as aggressively as they could without causing further damage, to protect his organs and brain.
It began when Eli’s mother noticed swellings in the child’s
neck and armpits. A visit to the doctor led to a specialist,
a biopsy and the difficult news that the child had cancer of
the lymphatic system, Burkitt’s lymphoma. But, they were
reassured treatment results were generally very good, with
90 to 95 percent of children cured.
Eli’s parents scarcely left him as the child hovered between
life and death. But Eli himself knew nothing of what was
going on. He was sedated and immobilized throughout the
two weeks of intensive treatment he received in the PICU.
As the days went on, the news began to improve. Eli was
holding his own. The doctors were gradually able to reduce
the ventilation pressure and the air bubbles and swellings
beneath the child’s skin were absorbed. Eli began to look
like himself again.
They had just accustomed themselves to the routine of Hadassah’s Dyna & Fala Weinstock Paediatric HaematologyOncology Department, where Eli was given his chemotherapy, and to watching out for signs of infection or fever in
Eli, when the child went suddenly and unexpectedly into
multi-organ failure. This intense septic shock led to acute
respiratory distress syndrome, a severe infection of the entire lungs.
The child was rushed to Hadassah’s Paediatric Intensive
Care Unit (PICU), where each complication lead to another.
His respiratory distress syndrome required high-pressure
ventilation at high oxygen concentrations to avoid damage
to his brain and organs — but this, in turn, resulted in airleaks from the little boy’s trachea into the skin of his neck
and head. Everywhere that air leaked, his skin ballooned
outward, disfiguring his appearance in an alarming manner.
Next came the process of weaning the young patient off sedation and, once he became conscious, assessing whether
his brain had been damaged in the crisis. The whole unit rejoiced when he woke without any sign of neurological complications. In some ways, he was in better shape than his
parents: the boy remembered nothing of the fraught period
he had spent in the PICU, while his mother and father had
to deal with disturbing memories.
Finally well enough to be released from the PICU, Eli returned to the Dyna & Fala Weinstock Paediatric-Haematology Oncology Department; and then — two weeks later —
he went home. Today, Eli’s lymphoma is in remission, his
crisis in the PICU forgotten and everyone’s hopes are high
that the disease has been defeated.
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A REVOLUTION
IN MEDICAL
CARE
F
ollowing his visit to the Hadassah Medical Centre in Jerusalem last year, the Rt Hon James Arbuthnot MP wrote
a congratulatory article in the Conservative Friends of Israel magazine, highlighting in particular Hadassah’s humanitarian care, educational outreach, and trauma unit:
Israel has long believed that medical care is a universal
right that transcends ideology and borders. As a result, Israel has one of the best healthcare systems in the world. In
Jerusalem, Hadassah Hospital, with its world class medical
and research centre, is colour and creed blind with regard
to caring for its patients. Today the hospital accommodates
1,100 patients and contains 130 departments and clinics in
22 buildings.
During World War II, the staff of Hadassah Hospital played a
significant role in helping Allied military forces throughout the
Middle East. They offered weekly lectures and meetings to
British medical personnel that acquainted them with regional
medical issues including blood diseases, jaundice, dysentery and anaemia. Hadassah truly brought modern medicine
to the Middle East, being the first to perform a successful
heart transplant, establish a cancer care centre, and open a
bone marrow transplantation unit.
Rt Hon James Arbuthnot MP
Parliamentary Chairman of
Conservative Friends of Israel
The hospital today is still a world
leader with recovery success rates
that exceed the United Kingdom.
During my visit to Hadassah Hospital, statistics were supplied which
compared recovery rates between
UK and Israeli hospitals for those
seriously injured. UK hospitals had
an (alleged) 57% recovery rate compared with a more favourable 91.7%
recovery rate for Hadassah itself.
The dedicated trauma units that have
been set up in Hadassah hospital go
some way to explaining recovery success rates. The statistics provided to
me compare the success of trauma
units with that of accident and emergency departments. These trauma
units, with expert teams, are geared
to treating serious injuries and are
proven to save more lives than normal accident and emergency rooms.
The great thing about Hadassah hos-
pital is that, fundamentally, it does not
let politics into the premises. Medical
staff at the hospital have saved the
lives of Palestinian suicide bombers
and terrorists who were injured during the recent Intifada, as well tending to the medical needs of patients
form the Mediterranean Basin, Europe, South America and the United
States. Professor Shlomo Mor-Yosef,
director general of Hadassah Medical Organisation stated “We consider
it is our mission to serve as a bridge
to peace by forging links between
peoples of all nationalities, races and
religions who come to our doors for
healing.” Hadassah Hospital stands
as a reminder to us all that, whatever the challenges, we must always
strive to help those in need.
Since 1994, when the Palestinian
Authority assumed responsibility for
the lives of Palestinians in the territo-
ries, Israel has continued to pledge
healthcare for those Palestinians who
need it. In 2007, when Hamas seized
control of the Gaza Strip through a
violent coup, Israel increased permits to receive healthcare by 50%
with more than 7,000 permits for Palestinian patients, and almost 8,000
permits for their escorts, to come into
Israel to receive medical attention.
The success of Hadassah Hospital
exemplifies how Israel, despite the
difficulties it faces, is determined to
use its innovative medical technology to provide world class healthcare
to Palestinians and Israelis alike. The
openness of Israeli society and its
ability to reach beyond the conflict in
this way is truly something Israel can
be proud of.
“CARE
NOT
CREED”
“CARE
NOT
CREED”
“CARE
NOT
CREED”
“CARE NOT CREED”
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A
young Arab woman wearing a hijab dashed to catch the
elevator. She was too late – the doors closed. But an elderly, bearded charedi man in the elevator, quickly pressed
the button to re-open the doors. She nodded her thanks with a
modest smile. Under normal circumstances in Israel this would
have been a rare occurrence. But this was Jerusalem’s Hadassah Hospital.
I was recovering from an operation when I witnessed the elevator
scene. I was the donor in a kidney transplant for my daughter,
whose renal system had collapsed. Throughout my eight-day
stay at Hadassah, I kept seeing such scenes of spontaneous,
cordial interaction between the different groups of people who
make up the patient population.
Race, religion and social status have far less significance in the
corridors and wards of a hospital. Patients, no matter who they
are, have a common denominator, which is anxiety, pain, discomfort and the need for patience. Patients wear ill-fitting hospital
gowns. They share ward space and the attentions of the staff.
They hear each other’s groans. It is all a great leveler. Jews and
Arabs become fellow-patients; Jewish and Arab doctors and
nurses become professional colleagues; racial differences, usually so loaded in this part of the world, are almost completely
erased.
As a Jew in a Jewish hospital, I found myself being treated by
many Arab nurses and doctors, in addition to the Jewish staff.
The surgeon in charge of the transplant was Professor Ahmed
Eid (pictured). His Jewish colleagues cooperated fully under his
expert and amiable direction. A similar situation exists in many
other Israeli hospitals.
Almost half of the patients in the ward seemed to be Arabs, coming from East Jerusalem as well as other Arab areas. In a neighbouring bed was an elderly Jew who on entering the ward informed me quietly that he did not like the fact that there were so
many Arabs – staff and patients. “Surely they have their own hospitals,” he grumbled. He later told me that his daughter had been
seriously wounded in a suicide bombing a few years before.
A few minutes after he settled down in his bed, yet another patient
was wheeled in – a groaning, middle-aged Arab, followed by a
retinue of sons and a wife. The elderly Jew leaned towards me
and pulled a face conspiratorially. The ward becomes a crowded
place during visiting hours. I found that some of the Arab’s sons
were sitting quite close to me. I began to chat with them, enjoying
the opportunity to practise my shaky Arabic and soon we were
chatting like old friends.
After a while I quietly tried to introduce the Arab patient to the
elderly guy in the bed next to mine. The Arab man nodded politely, but the old man promptly shut his eyes. Later a young nurse
came in to measure his blood pressure and take his temperature.
From her accent it was clear that she was an Arab. Grumpily,
he allowed her to put a thermometer in his mouth. She was an
incredibly sweet-looking person. Diminutive, chirpy, with a hint of
naughtiness in her smile, she softly hummed an Arab song, while
tending to the patients. “I hope you are feeling a little better,” she
beamed at the old guy. He just stared at her.
Next morning, nurses came into the ward to measure blood pres-
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sure and temperature and hand out medicine. Doctors came in
with syringes to take blood samples. Patients got up to go to the
bathroom. The old man and the Arab happened to get out of
their beds at the same time and almost bumped into each other.
“Good morning,” the Arab said in Hebrew with a deferential nod,
“Boker Tov”.
The old Jew looked at him coldly for a moment and then nodded
and moved his hand to the Arab’s shoulder, almost touching it.
Slowly, as though he was trying to remember the words, he said:
“Sabbah el Ghir,” (‘Good morning’ in Arabic.) The two men would
get onto more comradely terms during the next few days.
Later, a portly, elderly man entered the ward, came to my bed
and asked how I was feeling. He examined me, asked a few more
questions, said he was pleased with my progress, gave some
instructions to a nurse, quipped an amusing observation and
walked out of the ward.
After he left, I asked my Arab friend if he knew who the man was.
He shook his head. I said, “That’s the doctor who did my transplant. That’s Professor Eid.” I added: “Professor Ahmed Eid.”
The Arab got out of his bed and walked quickly to the exit of
the ward to observe Professor Eid’s departing figure. Then he returned and stood by my bed. His face glowed with pride. He put
his hands on my shoulders. “May you be healthy,” he repeated in
Arabic a few times. “Thank you, Rafi. Thank you.” He was actually
trembling with excitement.
I realised that the mere presence of Professor Eid in a Jewish
hospital had raised the Arab’s spirits and made him feel less of
an outsider. I had become his friend – his Jewish friend in this
Jewish hospital where he would get the best treatment possible,
and he wanted to give thanks for everything. And so did I.
While the central figures in contact with patients are doctors and
nurses – a hospital can’t exist without a huge army of other specialists, such as radiologists, lab workers, physical therapists,
pharmacists, dieticians, social workers, as well as kitchen, maintenance, laundry and cleaning staff. Those doing the menial jobs,
as indeed in most Israeli hospitals, are mainly Arabs, or Russian
or Ethiopian immigrants.
One of the women who made the beds was a roly-poly Jewish,
Moroccan-born, amazon-type nursing assistant with a ready
smile. She would often share a joke with our daughter and her
room-mate, who would frequently be an Arab woman. There was
no difference in the genial amazon’s attitude.
It is natural that the generations-old conflict between Jews and
Arabs in the Middle East generates deep suspicion and hostility throughout the land. Tragically, so many events keep stoking
these sentiments but in Israeli hospitals it’s as though there is an
unwritten sign at the entrance: “Prejudice has no place in this
hospital – here it’s a defunct disease!”
by Ralph Dobrin
Ralph Dobrin, writer, editor and publisher, originally from South Africa,
has lived in Israel for over 50 years.
Reproduced from Jewish Renaissance
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“S
o why did you make aliyah?”
It was the 15th time I had been asked this question since I started work one hour previously in
the operating rooms in Hadassah Ein Kerem. Masked surgeons whom I had never met asked me seemingly unusual questions when introduced to their new British trainee
anaesthetist: “Are you religious?” “Are you married?” A far
cultural cry from the British surgeon’s: “Are you coming to
the pub at the end of the operating list?” I used to say that
it was because of the weather. And of course it would be
untrue to deny the pleasure of a long hot summer.
Clearly I chose Hadassaheveryone I worked with in
London knew the Hadassah
Medical Organisation. Professor Cotev, the wonderful
emeritus Head of Anaesthesia had promised me a
job when I arrived. Slowly I
learned my way around the
building, the people and the
questions. Then one day 10
years ago I found myself in
the Labour ward, and have
never left.
A microcosm of Israeli life all
in one ward; every day unexpected but thrilling as we witness new life born. How do you chat to someone in extreme
agony who speaks only Arabic, Russian or Yiddish? But
their pain speaks the same language and it is my job, my
pleasure to make their labour a memory to be treasured not
feared.
The Hadassah hospitals combined witness 9,500 deliveries
per year in the two sites. Women come from every walk of
life and all over the country to bring their child into the world
in Hadassah. As tertiary specialist care centre with a multidisciplinary team of obstetricians, anaesthetists, neonatolo-
gists and nursing teams specialising in high risk deliveries,
the task at hand is always challenging and rarely dull.
my children’s school’s Remembrance Day ceremony for the
fallen soldiers and terror victims.
Last week the head chef of the Hadassah kitchens brought
his lovely wife in to have their sixth “and final” baby! She
spoke only Arabic, and he translated so that I could safely
provide her with an epidural for labour. Before I came to
work in Hadassah I knew many Muslims at university in
Manchester, some were very close friends, but I never imagined I would have relations with Muslims in Israel. After
all the news portrays them as far away, distant, different,
separated.
Where would we ever meet?
Yet in Hadassah our paths
cross daily as we live a special reality were all we want
is the safe delivery of healthy
children.
Picture a school yard with hundreds of small gorgeous children hearing stories about soldiers who gave their lives for
the State of Israel, remembering men and women who died.
They light candles of remembrance and sing songs and recite poems written by the dead and those who loved them.
As the siren sounds I lower my head and faces flash before
my eyes.
I get up every day, dress my
four children as my husband
makes their packed lunch.
After kisses and hugs I drive
from the centre of Israel
where we made our home in
a new modern city built on
the ruins of a great old Hasmonean city. This beautiful
daily journey on the winding
main road that rises from the plains up towards Jerusalem
never fails to impress. From Latrun to the Kastel, sites of
fierce battles for the very heart of the new State of Israel, the
way is lined with tank wreckage, as modern cars filled with
young Israelis make a daily journey to work. How lucky I am
to drive this special road up to the City of Zion every day, as
opposed to the North Circular battle-ground I used to have
to traverse in the UK.
So 14 years after our aliyah which we made as a young idealistic couple, I reflect back on this question when I attend
The boy from the bomb outside Bet Shmuel in Jerusalem
who we treated in the Intensive Care Unit for over 60 days,
following multiple surgeries who eventually succumbed to
his injuries. The small boy I treated after a bus bomb, when
we had no idea if his parents were alive to claim him, and
the young Russian immigrant woman who we operated on
all night, pumping blood from donors into her veins, but she
could not be saved. I wipe tears from my eyes, and fleetingly wonder if I am doing the right thing that my children
should be at this ceremony at being exposed so young to
death. But this my home, I feel safe here even though it
is frequently not a relaxing place to live, and my children
share in every experience for better and for worse.
So on a daily basis I share pleasures of new lives with a
multitude of families from every walk of life. I experience
people and cultures I would never otherwise meet and I am
lucky enough to realise that the Middle East peace talked
about all over the world is a daily reality for me as we get on
with the business of healing. I hope that our whole country
will be blessed some day with the same peace that today
I see in the special cocoon in Hadassah. These are my
hopes and joys as we raise a family in Israel.
Carolyn Weiniger is Consultant Anaesthetist in the Department of Anaesthesia and Intensive Care Therapy,
Hadassah University Medical Organisation.
Reproduced from Jewish Renaissance
VIEW FROM AN
ANAESTHETIST
CAROLYN WEINIGER
haddasah health 35
haddasah health 34
The Sarah Wetsman Davidson Tower
Since 2000 Hadassah has been working to improve its inpatient facilities. Occupancy rates currently exceed bed
capacities and more space is needed to meet the new paradigm in patient care, including more privacy, adaptable
function rooms, increased family involvement and patient
comfort.
To maintain Hadassah’s standards of excellence, a new
physical plant was needed, both to support the established
superior performance at every level and to continue to attract the best medical practitioners to work within a teaching oriented environment. Hadassah also had to ensure that
the working environment continued to support and maintain
its integrated research, which entails the involvement of
everyone, from nurses to surgeons, and is fundamental to
its “lab to bedside” research philosophy.
For this reason the units on the site were moved to allow
for the construction of a new integrated surgical tower unit.
Consisting of 14 stories and 500 beds, 20 operating theatres and a 48-bed intensive care unit, the new high-tech
tower is now being constructed on the Hadassah campus
in Ein Kerem, Jerusalem, providing hope for both the patients and their families. Due to be completed in 2012, exactly 100 years since the founding of Hadassah, the stateof-the-art Sarah Wetsman Davidson Tower will be one of the
most advanced medical centres in the world.
A symbol of the future
This complex will help Hadassah maintain its reputation as
one of the best hospitals in the world. Patients will be offered therapy and nursing care in an all-encompassing environment. Magnificent healing gardens will be constructed
to create an environment beneficial to patient recovery.
The new tower complex will facilitate dedicated medical
treatment; and encourage pioneering scientific research in
everything from stem-cells to computer-generated surgery,
which will be of global importance.
Making the impossible possible
The Sarah Wetsman Davidson Tower has developed well
so far. This is thanks to our loyal supporters and their appreciation of the significance of this building for Hadassah,
the Municipality of Jerusalem and for Israel. But we now
need new donations to complete the project.
This is what has always happened with Hadassah projects
in the past, which start with the initiation of a revolutionary
new idea, then are followed by repeated support in various
ways. Hadassah has always been able to fulfil its ambitious
forward-looking projects to bring the newest in medicine to
all, thus creating possibilities where impossibilities previously lay.
What can I do?
With your help our vision of the future can be fulfilled. Would
you like to link your name to Hadassah? You can do this:
for £21,500 you can sponsor a treatment room, a standby
duty room for doctors or a nurse’s room bearing your name;
£3,000 will buy a Mezuzah for the new tower.
Please help us to secure the future of medicine in the
Hadassah Medical Organisation in Jerusalem.
Hadassah UK would like to sponsor, with the help of your
donations, a “UK Floor” in the Sarah Wetsman Davidson
Tower. We are justifiably proud at Hadassah UK to have
helped in almost every one of the 130 departments of Hadassah and to have the whole second floor of the Mother &
Child Centre paid for solely by kind UK donors.
One floor costs £6.25 million. We would like to pledge this
sum towards the 2012 completion of the new Tower in Hadassah Medical Centre in Jerusalem. Please help! Every
small donation brings us nearer to our goal.
“From little acorns…..”
To watch the progress of the construction LIVE on the
Hadassah Medical Organisation webcam, go to:
www.hadassah.org/TowerLivefeed.