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Hadassah Health is published by:
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Welcome
Hadassah UK 26 Enord Street London W1H 1DW
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Editorial
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News bites
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Hadassah’s Chagall windows
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Israel’s team in Haiti
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Molecularly linked: The Jewish people
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New research into dystonomia
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Stem cells- Hadassah helps you see
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Deeating cancer
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Hadassah’s Paediatric intensive care unit
Sub Editors : Tamar Mendelsohn, Soe 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 utureSarah Wetsman Davidson Tower
T : 020 7723 1144 F : 020 7723 1222 E : uk.oce@hadassah. uk.o
[email protected] org www.hadassahuk.org
Registered Charity No 1040848
Editor in Chie : Pro Michael Baum
Turnberg, Pro David Katz, Editorial Board : Pro Michael Baum, Lord Leslie Turnberg, Sir Ian Gainsord, Pro Victor Hobrand, Pro Stuart Stanton
And to our Anonymous Sponsor Supporting the Hadassah Medical Organisation, Jerusalem
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I
t gives me great pleasure to welcome you to the rst i ssue o Hadassah UK’s magazine, Hadassah Health. As editor, I need to make clear the nature o my vision, shared by our trustees who are well represented on our editorial board. Firstly, Firstly, Hadassah is not raising unds to support the equivalent o an Israeli NHS. I that was all we had in mind I might recommend you gave your charitable donations to Holby City NHS hospital trust. No, Hadassah is dierent, 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 Organisation in Jerusalem. Hadassah Health will capture the imagination o both lay and medical readers by reporting on the medical achievements, scientic discoveries and general atmosphere that make Hadassah so special, and o such importance to the Middle East and the world at large. In addition, as a British publication, we ocus on the achievements brought about by the money raised specically by Hadassah UK and promote und raising activities within the UK. We also aim to showcase Israeli medicine in Britain in order to support Anglo-Jewish doctors in their ght against an academic boycott o Israel.
Welcome
My most enduring memory o my last visit to Hadassah, Ein Kerem, is o my tour o the paediatric oncology unit that is housed in the amazing tower dedicated to children’s health. Proessor Shlomo Mor-Yose, HMO’s director general, was showing me around, when he introduced me to the chie nurse looking ater the kids with leukaemia. Whilst standing in the glass atrium at the end o wing, with one o the best views over the seven hills o Jerusalem, she mentioned in passing that as all the children in her care were bald rom the eects o chemotherapy, one could not distinguish their race, religion or ethnicity. Everyone in the mosaic o minority groups in Israel is at equal risk o developing childhood leukaemia and each has equal right to the best care available in the Middle East. Incidentally the chie nurse was an Israeli Arab; and I almost orgot to mention that the Paediatric Oncology Department is totally unded by the generous donations rom the UK rom the Dyna & Fala Weinstock Charitable Trust. I think that one vignette summarises our vision and the ethos o Hadassah UK and Hadassah Health. In this rst edition o Hadassah Health you will nd 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 unds, put on events and bring speakers rom Hadassah to the UK such as Dr Shir Dar rom 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 proessionals, journalists, MPs and Peers and to the general public. Our Young Hadassah group and special interest committees have programmes o events to support
Please contact Mark Addleman at Hadassah UK i you are interested in helping us, visiting Hadassah or nding any other inormation on 020 7723 1144 or email uk.o
[email protected]
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Editorial T
his is not my rst outing as an editor as I was, until recently editor-in-chie o the International Journal of Surgery. In that role I made the nal 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 or the occasional sel -indulgence as expressed in my editorial columns and my on-line blog. I think it is obvious by now i you’ve read my welcome, where my prejudices lie. Apart rom that I have a dark secret, and that is my passion or ne art. It was thereore obvious to me right rom the start that the lead eature had to be related to those iconic stained glass windows by Chagall that enestrate the synagogue o Hadassah at Ein Kerem. In many ways I preer Chagall’s work with glass to those works on canvas or on paper. Even though his best oils create an impression o transmitted transmitte d light I preer being literally bathed in the colours o his windows. In what better way can you enjoy the early summer light in Jerusalem, than by its reraction through the cobalt blue and vermillion tones o Chagall’s masterpiece? The next eature, on the activity o the IDF and the Israeli medical teams in Haiti, was an obvious choice being both highly topical as well as being one o the best examples o showcasing Israeli doctors at work outside the boundaries o their hospitals and o Israel hersel. My chest swelled with pride when Sky television showed the new baby boy named ‘Israel’ as a token o gratitude to the medical corps o the IDF. Incidentally he was delivered in Haiti by Hadassah Paediatrician, Dr Shir Dar. The next eature is another example o my sel- indulgence in describing the molecular genealogy o the Jewish people as judged by the inheritance o the genetic malunction that pre-disposes to breast and ovarian cancer. Many o our readers will come rom amilies blighted by these diseases as is mine and it might yet be in our enlightened sel-interest to donate to HMO to support their research in this area. We then present a series o delightul essays with human-interest stories that eature the sta and patients o the HMO. Finally to capture the interest o our medical readers there are accounts o some o the scientic research and new clinical services at Hadassah. Although much o this is rather esoteric, we have edited the text so that it should be o some interest to and understood by the intelligent lay reader. As that applies to all who have read so ar, 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.
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 ather o ten Hadassah’s stroke unit is using a revolutionary new technique to save the lives o stroke victims. A corkscrew device called a MERCI clot retriever is being used to prevent the permanent loss o brain unction among stroke victims. The device is introduced through the emoral artery to reverse blood clots, re-establishing blood fow to the brain and preventing neurological damage. Moshe, a 64-year-old ather o ten recently underwent the procedure ollowing a massive stroke. A two-hour operation by the director o Hadassah’s Endovascular Neurosurgery and Invasive Neuroradiology Unit, Proessor José Cohen, and his stroke team successully removed the 4cm clot, allowing Moshe to regain ull neurological unction.
Improving health in Abu Gosh Twenty-ve volunteers graduating rom Hadassah’s health promotion trainer’s course. The Head o the Abu Gosh Council attended the graduation ceremony and warmly congratulated the women on their involvement and achievements.
rom Abu Gosh perormed the Arabic Debka dance. A second group o volunteers rom the Arab village o Abu Gosh has completed Hadassah’s 80-hour training course to become health promoters in their home village. The Project or the Promotion o Women’s Health is an outgrowth o Hadassah’s vision to create partnerships with dierent communities. The initiative, with unding rom the L’Oreal Foundation, operates under the auspices o 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 transer arm, is the largest clinical research centre in Israel, and has a global reputation or excellent medical and scientic research. With a 20% stake it is now the largest shareholder in Immuron, a biopharmaceutical company company.. Proessor Yaron Ilan o Hadassah will serve as Immuron’s medical director. Dr Einat Zisman, CEO o Hadasit, believes
and Immuron capabilities can yield a new approach to address serious diseases and metabolic syndromes.”
Making matches Beore Hadassah launched its bone marrow campaign in October 2008, 200 people rom the Arab community had enrolled in the 60,000-person database. To emphasise the importance o 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 o the project, says there are now 2,920 Arab donors in the registry, and some have already been good matches or patients.
with a history o marrying among themselves to have a particular type o retinal disease. Identiying the causative genes is a “signicant step orward”, according to Dr Eyal Banin, head o Hadassah’s Centre or Retinal and Macular Degeneration. “These patients and amilies now have a home and an address to which to turn. That address is Hadassah.”
Israel’s rst medical tissue bank One o Hadassah’s senior pathologists, Karen Meir, has helped to establish Israel’s rst medical tissue bank. The goal, Dr Meir explains, “is to preserve and store tissue rom malignant tumours so we can study them and come up with predictive tests and markers.” This, in turn, will help in the development o specic, tailor-made therapies. Now in its start-up phase, the bank is targeting patients with malignancies o the breast, lung, pancreas, and colon. Dr Meir says that Israel’s unique demographics are o invaluable use in this eld. “In a small geographical space we have an amazing mix o genetic populations, in both the Jewish and the Arab communities. For the purpose o molecular comparisons, this is a treasure trove.”
Hadassah eyes it up
Hadassah really treats everyone
Hadassah has identied the genetic cause o a retinal disease which has plagued Israeli and Palestinian amilies or generations. The ndings, published in the journal Archives of Ophthalmol- ogy , describe specic mutations in a gene which creates a wide range o retinal phenotypes. Using specic genetic methodology, the Hadassah team was able to identiy a single mutation that
Hadassah’s Ophthalmology Department has successully 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 o the Jerusalem Biblical Zoo, Hadassah agreed to help. Dr Michael Halpert (rst on the let) perormed the operation and saved the eagle’s sight.
From Esti Katz who looks ater patients and their relatives at Hadassah Working in Hadassah hospital, has provided me with many powerul and emotional experiences, but ater some years, I thought I had become “immune”. Years o Intiada 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, sister, Yiat, in the oncology department. “My sister has only a ew days let – maybe even hours – beore she dies,” he said, trying not to cry. “I have come especially rom Italy to be with her, and spent last night massaging her or hours to try to ease her pain. This morning I went to have a cup o coee and I saw a piano in the main lobby o 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 or her.” I said yes, o course, and he started crying, telling me that this was his last chance to compensate or not spending time with her beore. For the next 30 minutes I was a witness to one o the most powerul 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 ront o 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 dicult to comprehend what we were watching. It was as i 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 mainte-
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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.
the roo” recurs requently, oten hovering within another scene. Strong colours portray the world with a dreamlike simplicity, and the usion o antasy and religion gives his work a joyous quality. While Chagall’s work was infuenced “This is my modest git to the Jew- by contemporary French painting, his ish people who have always dreamt style remains independent o any one o biblical love, riendship and o school o art. During the rst world war, peace among all peoples. This is my Chagall lived in Russia, and in 1917, git to that people which lived here endorsing the revolution, he was apthousands o years ago among the pointed Commissar or Fine Arts in other Semitic people.” Vitebsk and then director o the newly Marc Chagall February 6 th 1962 established Free Academy o Art. But the Bolshevik authorities rowned upon The eldest o nine children, Chagall Chagall’s style o art as too modern,
“All the time I was working,” he said, “I elt my ather and my mother were looking over my shoulder, and behind them were Jews, millions o other vanished Jews o 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 i nspired by those blessings as well as by the description o the breastplate o the High Priest in Exodus 28:15, which were described as gold, blue, purple
THE TWELVE WINDOWS OF HADASSAH was born in 1887 i n Vitebsk, Byelorussia (Belarus today), to a poor Hassidic amily. At the age o 20, despite his ather’s disapproval, Chagall pursued his interest in art and went to St Petersburg to study with the Russian painter Leon Bakst. Infuenced by contemporary Russian painting, Chagall’s distinctive, child-like style, oten centring on images rom his childhood, began to emerge. Chagall then spent our years living in Paris, absorbing the works o the leading cubist, surrealist, and auvist painters. It was during this period that Chagall painted some o his most amous paintings o the Jewish shtetl (village), and developed the eatures that became recognizable trademarks o his art; the “ddler on
and in 1922 he let Russia. Chagall settled in France the ollowing year. He lived there permanently except or the years 1941 to 1948 when he fed to the United States. Chagall’s horror over the Nazi rise to power is expressed in works depicting Jewish martyrs and reugees.
The 12 Hadassah Windows To ully understand the signicance o the Windows, they must be viewed against Chagall’s deep sense o identication with the whole o Jewish history, its tragedies and victories, as well as his own personal background in the shtetl o 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 o the tribes had its own fag and emblem, as cited in Numbers: 2, 2: “The sons o Israel shall encamp, each by his fag, with the emblems o their athers’ house.” The background o the fag was said to be based on the colour o the corresponding gem on the breastplate. The tribal emblems were based mainly on the texts o Jacob’s blessings o his sons (Genesis 49) and Moses’ blessings o the tribes (Deuteronomy 33).
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Example: The Window o Judah Jacob’s blessing, Genesis 49 “You, O Judah, Your brother shall praise; Your hand shall be on the nape o your oes; Your ather’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 o Beasts – who dare rouse him? The sceptre shall not depart rom Judah, Nor the ruler’s sta rom between his eet; So that tribute shall come to him And the homage o peoples be his. He tethers his donkey to a vine, his ass-oal to a choicest vine; He washes his garments in wine, His robe in the blood o grapes. His eyes are darker than wine And his teeth are whiter than milk. Moses’s blessing, Deuteronomy 33 And this He said o Judah: Hear O LORD, the voice o Judah, And restore him to his people. Though his own hands strive or him, Help him against his oes. Midrash Rabbah Bamidbar 2 His gem was red garnet (NOFEKH), his fag was sky-blue, with a lion on it.
The red background o the window reers undoubtedly to the wine image in Jacob’s blessing. But it also may be connected to the royal purple garment. The signicance o the crown in the top is obvious. So is the lion at the bottom. The hands remind us o the verse “Though his own hands strive or him”, and “Your hand shall be on the nape o your oes”. Simultaneously, the two hands are raised in the manner o the priestly blessing. Behind the lion there is the city o Jerusalem. Chagall signed this Window in Hebrew.
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ISRAEL’s team I N
ews o the devastating earthquake that hit the Haitian capital o 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 ortnight the world’s nations had pledged some $1 billion in emergency aid.
T I A H n i
In just under eight hours Israel had assembled a medical team to build a eld hospital amid the destruction and chaos. Armed with supplies and equipment, the Israel Deence Forces (IDF) delegation, which included 220 army and medical personnel, set up the largest eld hospital in Haiti to provide immediate disaster relie. The hospital was the most advanced medical acility 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 or mounting a swit and sophisticated response to the earthquake. ABC News described the Israeli hospital’s emergency unit as “legendary”, reporting that it was cause or the Americans to “rethink their entire emergency response” respo nse”. Israeli rescuers worked tirelessly to locate survivors trapped in the ruins o buildings. They investigated reports o voices heard rom inside the wreckage, with one o the Israeli search and rescue teams reeing 69-year-old France Gilles. “We told him we were rom Israel and he asked i we were mocking him,” one member o the delegation recalled. At another site Israelis spoke with a man trapped under rubble, apparently the only survivor ater a building had collapsed.
Ater several hours o excavation rescuers provided him with fuids intravenously, and reed him within a ew hours.
“We’ve had to drill through a concrete girder, as he is trapped between pipes and planking,” said Liron Shapira, deputy commander o the Israeli delegation. “We removed most o the piping and managed to attach intravenous drips to his torso.” Zaka teams (Disaster Victim Identication units), representing Israel, also worked tirelessly, saving the lives o eight people as well as recovering the bodies o several victims. During the searches, teams rom Nicaragua, Russia, and Venezuela located two girls who had been trapped in a collapsed building or more than ve days. The girls were evacuated to the Israeli hospital, where they were treated. The rst girl to be rescued had serious injuries, and CNN Reporter Chris Lawrence brought her in his truck to the hospital where she received lie-saving treatment. The second girl was in much better condition, with only minor injuries. By the end o January the conrmed death toll rom the earthquake had exceeded 150,000 in the Port-au-Prince area alone. The Israeli eld hospital had treated some 970 patients, perormed 300 surgeries and delivered 16 babies.
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Hadassah’s Dr Shir Dar delivered the rst healthy baby in the Israeli eld 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 labour,” ,” Dr Dar explained. Childbirth in impoverished Haiti doesn’t normally take place in hospitals.
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“It is very exciting,” Dar added. “It oers some small balance to the things that are happening. Lie is stronger, ater all, and a woman will give birth even i the ground is shaking. This is what maintains the human race. This country has a very high inant mortality rate, and we delivered this healthy baby.”
The ollowing is rom Hadas sah’s DrTaras Shirov, Shirov, an anaesthesiolo gist and orthopedi c surgeon, who has been working in Haiti, running back and orth between the anaesthesia machines and the operating table. “We arrived and built the eld hospital rom scratch in a ootball stadium. There was no local inrastructure such as running water or washrooms. We worked or 36 hours non-stop, operating on more than 70 people (not counting endless small treatments and procedures or which there are no records). People can now have showers under running water, instead o using three large bottles o water per person. “The numbers o injured and sick people are overwhelming and it seems as i 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 or years serves as a translator because language dierences is a major problem. Imagine a situation where a physician or a nurse tries to take vital signs rom patients and cannot communicate with them. Most o the ER work is done at night; operations are carried out during the day. The weather has been avorable so ar although it’s very hot and humid. The only air conditioner is in the operating room, and they use regular ventilators.” ventilators.”
Hadassah nails it When the hospital ran out o screws or external reinorcement structures or limb ractures, Hadassah’s Reuven Gelond, a nurse rom Mt Scopus, stepped in. He ound a local actory where he had them create the necessary screws out o regular nails.
Israel mounts rescue eort ollowing Haiti’s devastating earthquake
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Molecularly
THE JEWISH PEOPLE by Proessor Michael Baum
y son-in-law is a “Cohen” and I am proud that my daughter has married into this princely and scholarly scholarly lineage. My son-inson-inlaw’s ather is Rabbi Dr Jerey Cohen and through the oral tradition they can trace their lineage back to the Cohenim o the Temple in Jerusalem. We now know that this oral tradition has been scientically conrmed by studying the Y chromosome o Cohenim. The Y chromosome is associated with the male sex and handed down through the generations rom ather to son. The Y chromosome o the Cohenim has certain characteristics that are common to all the Cohenim in the
world, conrming the veracity o the oral tradition (gure 1). Perhaps more remarkable is the tradition that our ethnicity is handed down through the maternal line. Every cell in the human human body has two sources o DNA. The major source is within the nucleus and this can be described as the blue print that codies our personhood: the way we look, our height, the colour o 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 (gure 2). These tiny structures are vitally impor-
tant in burning ood to provide energy or cellular activity. The mitochondria are peculiar. Back in evolution they were once bacteria, living symbiotically in primitive cells. They still retain some o their own original DNA that codes or a ew proteins that are essential or the organization o these “organelles”. (An organelle is a specialized subunit within a cell that has a specic unction.) This mitochondrial DNA is now known to be entirely maternal in origin, handed down through the generations via the emale line. So the mitochondrial DNA in the ertilized egg is all maternal. As is the case or the Y chromosome, mitochondrial
Figure 1
Figure 2
DNA also diers in subtle detail, between individuals and through this it is possible to trace the origins and migration o peoples o dierent ethnicity rom the rst hominids who evolved rom the apes in central Arica in the dark distant past. Once again genetic anthropology conrms that the majority o people who consider themselves Jewish are indeed Jewish as judged
by their mitochondria mitochondriall DNA. Subtle dierences in this coding also allows us to trace the migration o the Jewish people over time and even suggests that our origins might indeed have arisen rom our dierent matriarchal tribes. Sadly along the way the Jewish people have collected a number o deleterious mutations within their cellular
DNA o the germ line that has also been passed on through the generations. These include include the mutations mutations that are associated with breast cancer, and those linked to Tay Sachs disease, which causes deterioration o mental and physical abilities. The origin o these mutations in time can be traced by considering the migration and dispersion o the Jewish people in
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ancient history. The story starts about 3000 years ago (gure 3). In 586BCE, ater the Babylonian conquest and the all o the First Temple, the major Jewish dispersion was to Mesopotamia; “by the rivers o 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 drited back to the land o Israel, but ater the revolt against Persia, 359-338BCE, many migrated towards the Caspian Sea with gradual migrations through trading urther north into Europe. The Jews who migrated to Mesopotamia enjoyed a long history, emerging ultimately as Iraqi Jews, most o whom were orced to leave ater the Second World War. The next cataclysmic event in Jewish history was the sacking o the Second Temple by the Romans in 70CE. This event was celebrated by the Roman legions in the bas -relie seen on the arch o Titus in Rome, where the Temple menorah is seen carried on the shoulders o the triumphal Roman
legionnaires. This is also celebrated celebrated by the coin that was struck embossed with the words Judea Capta (gure 4). At this point 80,000 Jewish slaves were shipped across to the Roman province o Hispania and settled in the region just south o Cordova. This colony ultimately gave rise to the Sephardic population. Some Jews remained remained behind in cities such as Jerusalem, Hebron and S’ad with descendents to this very day, whereas others continued their migration through Asia Minor into Eastern Europe (gure 5). Until the expulsion o the Jews rom Portugal and Spain at the end o the 15th century, there was very little inter-marriage between the Sephardim and the Jews in Mesopotamia, Asia Minor and Europe. Europe. With these historihistorical acts in mind it is then all the more interesting to look at the distribution o the BRCA 1 and BRCA 2 mutations amongst women rom the dierent Jewish communities. These mutations occur in the genes that have an important role in DNA repair. This means that carriers o these mutant genes ac-
cumulate sucient DNA damage that can initiate malignant transormation o normal cells Amongst Jewish women within Israel and the diaspora, 1 in 40 women (2.5%) are aected. When you look at the individual mutations you see how the history o the Jewish people has been refected, once again at the molecular level. First o all Sephardi Sephardi women do not carry any o these mutations. Thereore the mutations that have been identied must have occurred ater the all o the Second Temple or amongst those amilies who remained in Mesopotamia or migrated north ater the all o the First Temple. There are three “Jewish” mutations. These can be roughly dated by analysis o mitochondrial mitochondrial DNA. The oldest mutation (185del AG) on the BRCA 1 gene occurs in 1% o both Ashkenazi and Iraqi Jews and is estimated to be between 2500 and 3000 years old. This thereore must have occurred by a ounder germ line mutation in Mesopotamia shortly ater the all o the First Temple and also have been carried
Figure 3
Figure 4
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Figure 5
north amongst those Jews who ultimately contributed to the oundation o the Ashkenazi tribes. The second mutation (617del IT) is on the BRCA 2 gene. It is ound in 1.4% o Ashkenazi Jews only, and is estimated to be about 700 years years old. Long ater the all o the Second Temple, almost certainly the ounder germ line mutation must have arisen rom the Jews that had settled in Eastern Europe. The third mutation (5382ins C) is on the
BRCA 1 gene. It occurs in 0.1% o the Jewish population and is said to refect another tragic event in Jewish history. This mutation is also seen amongst high-risk non-Jewish women o Eastern European origin and is sometimes described as a “pogrom” mutation. In other words it is the consequence o pregnancies ollowing rape. Both the Israeli and the British experience conrm that women carrying one o the BRCA 1 mutations have a nearly
80% chance o 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 o ovarian cancer and, curiously, prostate cancer amongst the male members o the amily. Rarely, these mutations can be carried and express themselves as breast cancer in the male relatives o such at risk groups.
Hadassah is undertaking cutting-edge research into understanding and managing these “Ashkenazi” breast cancers, which will beneft 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 o the Second Temple 2,000 years ago.
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NEW RESEARCH ENDS A LIFE OF SUFFERING Treating dystonia with surgery developed or Parkinson’s disease
adassah Hospital has a new treatment or dystonia suerers that helps reverse their painul and debilitating disease By the time Talia Zusman had nished high school, the tremors in her legs that had begun when she was 12 years old had put her in a wheelchair wheelchair.. “My riends were going o 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, unortunately, 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 o the symptoms o dystonia. “Zusman is one o 22 dystonia patients on whom we have perormed deepbrain stimulation in the past six years,” says neurosurgeon Zvi Israel o the Hadassah Medical Organisation, who introduced the technique to Israel and has helped develop it. “Her aected elder brother waited to see the results o 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 lie around or dystonia patients, was, in act, developed or people with Parkinson’s disease. In the early 1990s, Israeli physiologist Hagai Bergman o the Hebrew University– Hadassah Medical School discovered a tiny area, deep in the brain, which is overactive in Parkinson’s suerers. 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 suer continuous muscle contractions, which cause uncontrolled twisting and repetitive movements, oten with cramping and pain. In some patients, only a single muscle is aected. In others, the disease attacks groups o muscles in the arms, legs or neck, or it can aect the whole body. There are two main types: one results rom birth-related or other physical trauma, inection, lack o oxygen or drug reaction. The other, which the Zusmans have, is genetic. “The act that most o our dystonia patients have
The mutated gene implicated in dystonia is carried by 3 to 5 percent o Ashkenazic Jews, compared with less than 1 percent o the general population. The aulty gene, known as DYT1 and rst mapped in 1989, probably results rom 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 or Parkinson’s grew worldwide, surgeons began wondering i the technique had broader applications. Zusman remembers lying on the operating-room table, listening to an iPod, with a stereotactic rame tted around her head. Once her brain was scanned and the image combined with an earlier MRI to pinpoint the malunctioning area, Dr. Israel got to work. He drilled a small hole through Zusman’s skull just above her hairline. He then inserted three inches o wire the thickness o a paper clip, our tiny electrodes at its end, and advanced it to the target. With one end o the silicon wire in place, he took the other, emerging rom Zusman’s skull, placed it under
o the head, neck and chest to her upper abdomen. There, he connected it to an electrical generator, generator, a lightweight device the size o a small computer mouse, also implanted under the skin. “The electrodes immediately stun the overactive cells, and the patient is oten 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 ne-tune the electrical pulses it delivers to the brain. Initially, we give only a small amount o stimulation, which must sometimes be increased.” The stimulation usually results in a complete reversal o symptoms. The technique is not able to cure patients suering rom 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 renement is the degree o stimulation delivered to the malunctioning brain area. Brain activity drops when a patient sleeps and rises when he or she goes running. I activity in the brain’s cortex can be recorded, it can be used to indicate how much stimulation should be given at dierent 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 o dicult 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
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epresenting a signicant step towards treating and preventing age-related macular degeneration, researchers rom the Hadassah Medical Organisation in Jerusalem have produced ndings 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 o blindness in adults over 50 in the western hemisphere, with 30 million aficted around the world. A disease which causes millions o people worldwide to lose their sight, it damages the central area o the retina, the macula, which is responsible or the sharpness o vision and activities such as reading, driving or watching television. Researchers Researcher s rom the Hadassah Medical Organisation have transplanted pigment-containing visual cells derived rom human embryonic stem cells, successully preserving the structure and unction o the specialised light-sensitive lining o the eye in an animal with macular degeneration. Proessor Benjamin Reubino, Director o the Hadassah Human Embryonic Stem Cell Research Centre, and Dr Eyal Banin, Director o the Hadassah Centre or Retinal and Macular Degeneration, led the research team, creating unique laboratory conditions or deriving pigmental cells o the retina rom human embryonic stem cells. They ound 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 o a rat with macular degeneration caused by malunctioning pigmental cells, they were able to delay deterioration o retinal structure and unction. “Our ndings are an important step towards the potential uture use o human embryonic stem cells to replenish RPE in diseases that result in blindness,” Dr. Banin stated. Experimental Experimental transplantation o pigment cells in human patients is expected in two years. Proessor Benjamin Reubino was eatured on Fox News explaining how Hadassah’s manipulation o cells to model dierent diseases could help us understand how diseases evolve and how to correct the diseased state. Some Israeli scientists predict there may well be treatment treatme nt or ormerly untreatable diseases in as little as three years’ time.
Human embryonic stem cells slow down MS Multiple sclerosis is the most common cause o neurological disabilities in young adults. It is an autoimmune infammatory disease o the central nervous system in which the immune system attacks the insulation o neurons (myelin). As a result, the nervous system is damaged at a number o levels, leading to unctional deciencies in a number o neurological systems: sensory, motor,, balance, sphincteral and vision. motor Following a long-term collaboration between Proessor Tamir Ben Hur, Director o the Neurological Department and Proessor Benjamin Reubino, new research has paved the way to urther developments towards clinical application in MS patients. This research, as published in the scientic journal PL0S ONE , involves the transplantation o human embryonic stem cells into the brains o a mouse with MS, which slowed down signicantly the clinical symptoms and pathological maniestations o the disease. They anticipate in the uture, using embryonic stem cells, the infammatory eects o MS may be reduced through repairing the damaged myelin in the brain. Cell Cure Neurosciences, a Hadasit Biotech Company which ocuses on the development o human embryonic stem cells or transplantation therapy in neurological disorders, will urther translate the results o the study to allow uture clinical application in MS patients. This research also demonstrated that human embryonic stem cells can improve the unctioning o a rat with Parkinson’s disease. The stem cell therapy oers the rst real possibility o 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 rom the testes to the chest. They remain dormant or years, but eventually develop into a tumour.
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two-and-a-hal-year-old two-and-a-hal-yearold girl rom Russia with an eye tumour, known as retinoblastoma, and a ourteenyear-old boy rom Cyprus, have deeated the cancers that were threatening their lives thanks to Hadassah’s Dyna & Fala Weinstock Paediatric Haematology-Oncology Department.
accept that their child would have to have both o her eyes surgically removed ater physicians in Russia had inormed them o this likelihood. Ater nding Proessor Jacob Pe’er, director o Hadassah’s Department o Ophthalmology, and Dr Michael Weintraub, director o the Department o Paediatric Haematology-Oncology Haematology-Oncology on the internet, the parents o the toddler contacted them.
The department, which was kindly donated by a UK donor, is renowned or providing comprehensive and sophisticated medical treatment to children and adolescents with cancer and severe non-malignant haematological diseases. Reerrals come rom well beyond the borders o Israel and it is designed to serve the needs o paediatric and adolescent oncology patients as well as their amilies. This department together with “Linda’s Activity Centre” is located in the Mother and Child Centre at Hadassah Ein Kerem and this whole second foor was built as a result o donations raised rom UK donors.
The parents and child few to Hadassah, where tests and consultations began. Giving the parents a ray o hope, the Hadassah team explained that with chemotherapy, one o the child’s eyes could denitely be saved and possibly the vision in her second eye. “In cases o 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, or obvious cosmetic reasons.”
The only comprehensive Paediatric Cancer Centre Jerusalem, it serves a large and heterogeneou heterogeneous s population rom diverse ethnic and psychosocial backgrounds who are treated by a multidisciplinary sta, using the most up-todate diagnostic and therapeutic tools. Further, it is actively involved in the teaching o medical students, paediatric residents and paediatric Haematology-O Haematology-Oncology ncology ellows. The parents o the toddler with the eye tumour could not
The ourteen-year-old boy rom Cyprus was brought to Hadassah with an unusually large tumour on his chest. Unable to treat it successully, physicians in his home country had all but given up hope. Oering another another ray o hope, Hadassah’s Dr Weintraub and Thoracic Surgeon Dr El-Ami diagnosed the lesion as a malignant germ cell tumour. tumour. With surgery and chemotherapy, however, the boy recovered completely and returned to his normal lie.
DEFEAT CANCER
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An everyday story rom Hadassah’s Paediatric Intensive Care Unit by Wendy Elliman Eli (not his real name) is scarcely aware o what went on. It’s his parents who carry the memories, and the thankulness that they still have their our-and-a-hal-year-old son.
PICU medical sta, nonetheless, continued ventilating Eli as aggressively as they could without causing urther 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 dicult news that the child had cancer o the lymphatic system, Burkitt’s lymphoma. But, they were reassured reassure d treatment results were generally very good, with 90 to 95 percent o children cured.
Eli’s parents scarcely let him as the child hovered between lie and death. But Eli himsel knew nothing o what was going on. He was sedated and immobilized throughout throughout the two weeks o 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 himsel again.
They had just accustomed themselves to the routine o Hadassah’s Dyna & Fala Weinstock Paediatric HaematologyOncology Department, where Eli was given his chemotherapy, and to watching out or signs o inection or ever in Eli, when the child went suddenly and unexpectedly into multi-organ ailure. This intense septic shock led to acute respiratory distress syndrome, a severe inection o 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 rom the little boy’s trachea into the skin o his neck and head. Everywhere that air leaked, his skin ballooned outward, disguring his appearance in an alarming manner. manner.
Next came the process o weaning the young patient o 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 o neurological complications. In some ways, he was in better shape than his parents: the boy remembered nothing o the raught period he had spent in the PICU, while his mother and ather had to deal with disturbing memories. Finally well enough to be released rom the PICU, Eli returned to the Dyna & Fala Weinstock Paediatric-HaematolPaediatric-Haematology Oncology Department; and then — two weeks later — he went home. Today, Eli’s lymphoma is in remission, his crisis in the PICU orgotten and everyone’s hopes are high that the disease has been deeated.
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A REVOLUTION F IN MEDICAL CARE
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 o 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 o the best healthcare systems 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 or its patients. Today the hospital accommodates 1,100 patients and contains 130 departments and clinics in 22 buildings. During World War II, the sta o Hadassah Hospital played a signicant role in helping Allied military orces throughout the Middle East. They oered 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 rst to perorm a successul heart transplant, establish a cancer care centre, and open a bone marrow transplantation unit.
Rt Hon James Arbuthnot MP Parliamentary Chairman o Conservative Friends o Israel
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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 or those seriously injured. UK hospitals had an (alleged) 57% recovery rate compared with a more avourable 91.7% recovery rate or Hadassah i tsel. 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 o trauma units with that o 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, undamentally, it does not let politics into the premises. Medical sta at the hospital have saved the lives o Palestinian suicide bombers and terrorists who were injured during the recent Intiada, as well tending to the medical needs o patients orm the Mediterranean Basin, Europe, South America and the United States. Proessor Shlomo Mor-Yose, director general o Hadassah Medical Organisation stated “We consider it is our mission to serve as a bridge to peace by orging links between peoples o all nationalities, races and religions who come to our doors or healing.” Hadassah Hospital stands 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 or the lives o Palestinians in the territo-
ries, Israel has continued to pledge healthcare or those Palestinians who need it. In 2007, when Hamas seized control o the Gaza Strip through a violent coup, Israel increased permits to receive healthcare by 50% with more than 7,000 permits or Palestinian patients, and almost 8,000 permits or their escorts, to come into Israel to receive medical attention. The success o Hadassah Hospital exemplies how Israel, despite the diculties it aces, is determined to use its innovative medical technology to provide world class healthcare to Palestinians and Israelis alike. The openness o Israeli society and its ability to reach beyond the confict in this way is truly something Israel can be proud o.
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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 rom an operation when I witnessed the elevator scene. I was the donor in a kidney transplant or my daughter, whose renal system had collapsed. Throughout my eight-day stay at Hadassah, I kept seeing such scenes o spontaneous, cordial interaction between the dierent groups o people who make up the patient population. Race, religion and social status have ar less signicance in the corridors and wards o a hospital. Patients, no matter who they are, have a common denominator, which is anxiety, pain, discomort and the need or patience. Patients wear ill-tting hospital gowns. They share ward space and the attentions o the sta. They hear each other’s groans. It is all a great leveler. Jews and Arabs become ellow-patients; Jewish and Arab doctors and nurses become proessional colleagues; racial dierences, usually so loaded in this part o the world, are almost completely erased. As a Jew in a Jewish hospital, I ound mysel being treated by many Arab nurses and doctors, in addition to the Jewish sta. The surgeon in charge o the transplant was Proessor Ahmed Eid (pictured). His Jewish colleagues cooperated ully under his expert and amiable direction. A similar situation exists in many other Israeli hospitals. Almost hal o the patients in the ward seemed to be Arabs, coming rom East Jerusalem as well as other Arab areas. In a neighbouring bed was an elderly Jew who on entering the ward inormed me quietly that he did not like the act that there were so many Arabs – sta 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 ew years beore. A ew minutes ater he settled down in his bed, yet another patient was wheeled in – a groaning, middle-aged Arab, ollowed by a retinue o sons and a wie. The elderly Jew leaned towards me and pulled a ace conspiratorially. conspiratorially. The ward becomes a crowded place during visiting hours. I ound that some o 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 riends. Ater 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, chirpy, with a hint o naughtiness in her smile, she sotly hummed an Arab song, while tending to the patients. “I hope you are eeling a little better,” she beamed at the old guy. He just stared at her.
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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 o their beds at the same time and almost bumped into each other. “Good morning,” the Arab said in Hebrew with a deerential nod, “Boker Tov”. The old Jew looked at him coldly or 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 ew days. Later, a portly, elderly man entered the ward, came to my bed and asked how I was eeling. He examined me, asked a ew more questions, said he was pleased with my progress, gave some instructions to a nurse, quipped an amusing observation and walked out o the ward. Ater he let, I asked my Arab riend i he knew who the man was. He shook his head. I said, “That’s the doctor who did my transplant. That’s Proessor Eid.” I added: “Proessor Ahmed Eid.” The Arab got out o his bed and walked quickly to the exit o the ward to observe Proessor Eid’s departing gure. Then he returned and stood by my bed. His ace glowed with pride. He put his hands on my shoulders. “May you be healthy,” he repeated in Arabic a ew times. “Thank you, Ra. Thank you.” He was actually trembling with excitement. I realised that the mere presence o Proessor Eid in a Jewish hospital had raised the Arab’s spirits and made him eel less o an outsider. I had become his riend – his Jewish riend in this Jewish hospital where he would get the best treatment possible, and he wanted to give thanks or everything. And so did I. While the central gures in contact with patients are doctors and nurses – a hospital can’t exist without a huge army o other specialists, such as radiologists, lab workers, physical therapists, pharmacists, dieticians, social workers, as well as kitchen, maintenance, laundry and cleaning sta. Those doing the menial jobs, as indeed in most Israeli hospitals, are mainly Arabs, or Russian or Ethiopian immigrants. One o the women who made the beds was a roly-poly Jewish, Moroccan-born, amazon-type nursing assistant with a ready smile. She would oten share a joke with our daughter and her room-mate, who would requently be an Arab woman. There was no dierence in the genial amazon’s attitude. It is natural that the generations-old confict 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 deunct disease!”
by Ralph Dobrin Ralph Dobrin, writer, editor and publisher, originally rom South Arica,
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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 ar anaesthetist cultural cry rom the British surgeon’s: “Are you coming to the pub at the end o the operating list?” I used to say that it was because o the weather. And o course it would be untrue to deny the pleasure o a long hot summer. Clearly I chose Hadassaheveryone I worked with in London knew the Hadassah Medical Organisation. Proessor Cotev, the wonderul emeritus Head o 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 ound mysel in the Labour ward, and have never let. A microcosm o Israeli lie all in one ward; every day unexpected but thrilling as we witness new lie 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 eared. The Hadassah hospitals combined witness 9,500 deliveries per year in the two sites. Women come rom every walk o lie and all over the country to bring their child into the world in Hadassah. As tertiary specialist care centre with a multidisciplinary team o obstetricians, anaesthetists, anaesthetists, neonatolo-
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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 or the allen soldiers and terror victims.
Last week the head che o the Hadassah kitchens brought his lovely wie in to have their sixth “and nal” baby! She spoke only Arabic, and he translated so that I could saely provide her with an epidural or labour. Beore I came to work in Hadassah I knew many Muslims at university in Manchester, some were very close riends, but I never imagined I would have relations with Muslims Muslims in Israel. Ater all the news portrays them as ar away, distant, dierent, 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 sae delivery o healthy children.
Picture a school yard with hundreds o small gorgeous children hearing stories about soldiers who gave their lives or the State o Israel, remembering men and women who died. They light candles o 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 aces fash beore my eyes.
I get up every day, dress my our children as my husband makes their packed lunch. Ater kisses and hugs I drive rom the centre o Israel where we made our home in a new modern city built on the ruins o a great old Hasmonean city. This beautiul daily journey on the winding main road that rises rom the plains up towards Jerusalem never ails to impress. From Latrun to the Kastel, sites o erce battles or the very heart o the new State o Israel, the way is lined with tank wreckage, as modern cars lled with young Israelis make a daily journey to work. How lucky I am to drive this special road up to the City o Zion every day, as opposed to the North Circular battle-ground I used to have to traverse in the UK. So 14 years ater our aliyah which we made as a young idealistic couple, I refect back on this question when I attend
The boy rom the bomb outside Bet Shmuel in Jerusalem who we treated in the Intensive Care Unit or over 60 days, ollowing multiple surgeries who eventually succumbed to his injuries. The small boy I treated ater a bus bomb, when we had no idea i his parents were alive to claim him, and the young Russian immigrant woman who we operated on all night, pumping blood rom donors into her veins, but she could not be saved. I wipe tears rom my eyes, and feetingly wonder i 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 eel sae here even though it is requently not a relaxing place to live, and my children share in every experience or better and or worse. So on a daily basis I share pleasures o new lives with a multitude o amilies rom every walk o lie. 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 or me as we get on with the business o 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 amily in Israel. Carolyn Weiniger is Consultant Anaesthetist in the Department o Anaesthesia and Intensive Care Therapy, Hadassah University Medical Organisation. Reproduced rom Jewish Renaissance
VIEW FROM AN ANAESTHETIST CAROLYN WEINIGER
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The Sarah Wetsman Davidson Tower Since 2000 Hadassah has been working to improve its inpatient acilities. Occupancy rates currently exceed bed capacities and more space is needed to meet the new paradigm in patient care, including more privacy, adaptable unction rooms, increased amily involvement and patient comort. To maintain Hadassah’s standards o excellence, a new physical plant was needed, both to support the established superior perormance perormance 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 o everyone, rom nurses to surgeons, and is undamental to its “lab to bedside” research philosophy. For this reason the units on the site were moved to allow or the construction o a new integrated surgical tower unit. Consisting o 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 or both the patients and their amilies. Due to be completed in 2012, exactly 100 years since the ounding o Hadassah, the stateo-the-art Sarah Wetsman Wetsman Davidson Tower will be one o the most advanced medical centres in the world. A symbol o the uture
This complex will help Hadassah maintain its reputation as one o the best hospitals in the world. Patients will be oered therapy and nursing care in an all-encompassing environment. Magnicent Magnicent healing gardens will be constructed to create an environment benecial to patient recovery. The new tower complex will acilitate dedicated medical treatment; treatmen t; and encourage pioneering scientic research in everything rom stem-cells to computer-generated surgery, which will be o global importance.
Making the impossible possible
The Sarah Wetsman Davidson Tower has developed well so ar. This is thanks to our loyal supporters and their appreciation o the signicance o this building or Hadassah, the Municipality o Jerusalem and or 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 o a revolutionary new idea, then are ollowed by repeated support in various ways. Hadassah has always been able to ull its ambitious orward-looking orward-look ing 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 o the uture can be ullled. Would you like to link your name to Hadassah? You can do this: or £21,500 you can sponsor a treatment room, a standby duty room or doctors or a nurse’s room bearing your name; £3,000 will buy a Mezuzah or the new tower. Please help us to secure the uture o medicine in the Hadassah Medical Organisation in Jerusalem.
Hadassah UK would like to sponsor, with the help o your donations, a “UK Floor” in the Sarah Wetsman Davidson Tower. We are justiably proud at Hadassah UK to have helped in almost every one o the 130 departments o Hadassah and to have the whole second foor o the Mother & Child Centre paid or solely by kind UK donors. One foor costs £6.25 million. We would like to pledge this sum towards the 2012 completion o 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 o the construction LIVE on the Hadassah Medical Organisation webcam, go to: www.hadassah.org/TowerLiveeed.
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