Rambam June 08-F:Layout 1 15/06/08 11:36 Page 1

ISSUE No.2 JUNE 2008 Rambam Health Care C a m p u s on Call rUth raPPaPort ChIlDreN’s June 2008. In today as in ancient times, the barley and wheat harvest is upon us. The bouquet of early summer rises from bale-strewn stubble fields, permeating the country’s farms and adjacent towns and city outskirts. On hot, dry days, if you close your eyes when anywhere near these fields, you can almost smell bread baking.

The Book of Ruth, read in synagogue on Shavuot (the Festival of Weeks), recalls the grain harvest in ancient Israel and celebrates the Biblical Ruth, a << great-grandmother of King David and a resilient person in her own right, whose name means compassionate friend. for the loVe Rambam Health Care Campus is fortunate to count among our compassionate friends our very own Ruth – Mrs. Bruce Rappaport – and her of ChIlDreN husband and family. “My sincere hope for the hospital bearing my name is that it will care for all the children of the State of Israel without religious, ethnic or gender bias, that the day will come when peace will prevail in our During the Second War of two summers ago, when the city of Haifa and our medical region, and that the parents of our neighbors’ children will seek for them efficient medical care here.” center were under heavy bombardment by the - Ruth Rappaport (pictured with husband Bruce, daughter Irith, and granddaughter Shiri) Hezbollah in Lebanon, Ruth and Bruce Rappaport telephoned Prof. Rafael Beyar, Director General of RHCC, and asked how they could help. ramBam at 70 reUNIoN cont. p2 The story of the intersecting histories of Rambam Hospital (est. 1938) and Kibbutz Gesher Professor rafael (est. 1939) begins in April 1948. The British Mandate over Palestine was Beyar Greets drawing to a close, and the Arab armies were preparing to invade. Located in an isolated spot beside the ramBam’s 70th River, the kibbutz, home to 80 It moves me to greet our adults and 50 children ages 0-5, and friends on the State of Israel’s the neighboring Arab villages focused 60th anniversary and Rambam’s their hopes and fears on a nearby British 70th anniversary. police fortress built in 1943 to control a strategic the kibbutz fields toward the compound from crossing. Who would take the one direction while Arab villagers and Jordanian Our formerly British hospital became stronghold when the British left? Legionnaires came running from the other. an Israeli government hospital in 1948 with the State’s founding. In that year, On April 27th, the tense watchers saw As night fell and the struggle for the fortress the children of Kibbutz Gesher took equipment-filled trucks leaving the fortress. At 5 escalated, the kibbutz plucked its 50 youngsters refuge here in wartime. They received p.m., the Union Jack was quickly lowered and the from sleep and dropped them out the back warmth, security, a playground and British fled. Jewish farmers came running from window of the children’s house cont. p2 an education. They ran through the corridors and sought adventures, just as today we seek adventures in the lab. INterVIeW: “Here at Rambam we integrate science, love of humankind and curiosity. ese are also the country’s Professor Karl sKoreCKI foundations and will give Israel direction for the future.” DIreCtor, meDICal aND researCh DeVeloPmeNt, ramBam health Care CamPUs Director, Rappaport Family Institute for Research in the Medical Sciences, Technion-Israel Institute of Technology Rambam became linked to the Technion’s Annie Chutick Professor and Chair in Medicine (Nephrology), Rappaport Faculty of Medicine, Technion-Israel Institute of Technology Rappaport Faculty of Medicine in 1979, and this is what we had sought – a university Q You are a medical Q What attracted you to nephrology? affiliation and the donors to make such growth doctor, molecular A First, although kidney diseases are serious, life possible. In 2004, Israel’s first Nobel Laureates, geneticist, chaired sustaining treatments are available – dialysis or Profs. Aaron Ciechanover and Avram Hershko, professor, and transplantation. Secondly, the nephrologist also came from this campus. A simple laboratory, Director of Medical acts as the ’s primary healthcare provider brilliant thinking and creativity – this is what and Research because with kidney disease have brought the Nobels. Development at symptoms in all their organs. This enables Rambam Health Care nephrologists to cultivate and sustain a special In 2006, the Second Lebanon War taught us the Campus and of the and longstanding interaction with their patients need for an underground emergency hospital Technion’s Rappaport Research Institute. and compels nephrologists to maintain a broad and fortified above-ground structures, and to Which comes first? mastery of general medical knowledge. our good fortune, Rambam’s friends in Israel and A First and foremost, before all of these, is to try to abroad are committed to helping us reach these be a mensch. Without this, the professional and Q What do you mean by the kidneys’ goals as well. We are most grateful. academic activities will not work. At the professional being elegant? level, my primary vocation is a physician. I’m a A There are two levels of elegance. Level 1 is the nephrologist – a kidney specialist – and I love that exquisite architectural structure of each functional News in Brief P4/5 because the kidneys are an intelligent organ; they unit, or nephron, of the kidney. There are 2 recent renovations P5 selectively clean the body of unwanted and surplus million of these nephrons, 1 million in each products and have an elegant architectural and kidney. What is stunning is that each nephron is friends help Build a hospital! P6 functional layout. Unfortunately, however, people composed of 25 different, specialized cell types star spangled events P7 do suffer kidney disease. functioning as a symphony orchestra in harmony. Level 2 elegance is the architectural layout of the african alliance P8 nephrons in relation to each other: they are tiled cont. p2 Rambam June 08-F:Layout 1 15/06/08 11:36 Page 2

rUth raPPaPort INterVIeW: ChIlDreN’s hosPItal Professor Karl sKoreCKI

That telephone call initiated a drive to build a into each other, and each nephron knows what its Obviously, people are interested in these historical 21st century children’s hospital on the Rambam neighbor is doing and works based on what its insights, but for me as a physician what is really campus in answer to Northern Israel’s obviously neighbor is doing. It knows if it should be absorbing important are the medical implications, and the urgent need for improved conditions for sick or secreting more sodium or water, for example. key term here is barcode – I’m using it as a children and their families. That’s also true for potassium, protein metabolism metaphor but it’s creeping into medical jargon. P2 products and a whole host of other ingredients. The These 4 vignettes that I’ve given you are all based Construction of the 9-story, 15,000 square meter juxtaposition of the nephrons in the kidney allows a on analyzing genetic markers, which constitute a Ruth Rappaport Children’s Hospital is due to person to survive at one extreme in the dry barcode for shared maternal or paternal ancestry. commence on October 1, 2008. Of the new conditions of the desert, where the main challenge hospital’s overall anticipated cost of $36 million, would be to excrete as little water as possible, and Q And if I – or you, as my physician – $18 million (50%) in matching funds has been at the other extreme in a plentiful, humid know my barcode, how does that help? pledged by the Rappaport Family Foundation. environment while drinking lots of fluid. A million A Just as there are barcodes for shared ancestry, An additional $18 million is sought. of these nephrons have to be exactly stacked and so too, throughout the genome, there are juxtaposed, and if the structure isn’t perfect, the barcodes for disease predispositions or drug kidney doesn’t fulfill its function. response. They answer the question of why ramBam at 70 reUNIoN person A has an excellent response to a certain Q Where does molecular genetics treatment and person B has side effects. come into the picture? into a cramped bomb shelter, whose makeshift A In order to understand almost anything in Our current challenge is to identify these barcodes walls were constructed of trees reinforced by sand medicine today, it’s important to understand that predispose an individual to a certain disease, packed between two sheets of tin. The noise of something about genetics. For example, kidney and then to prevent the person from getting the explosives and the screams of the wounded disease is related to hypertension, and disease – not in an empirical or trial and error way reached the children underground. With every hypertension is heritable; the genes that are but rather by using the DNA barcode to pick the concussive blast, dust clouds and the mixed smells related to salt retention don’t function properly, most appropriate treatment for that person. This of urine and scorched earth filled the shelter. so you can treat the kidney problem by handling is called pharmacogenomics – the popular name the salt problem. From clinical practice and is personalized medicine – and that’s really where On April 28th, Gesher determined to evacuate its teaching, you move into the research arena, and we’re headed. youngsters to safety under cover of darkness. once you start learning about genetic principles, Because the three supply buses intended for this it’s addicting. Say you’re looking for a gene that’s Q Won’t personalized medicine be mission arrived with wounded drivers in burnt and involved in a certain kidney disease – by prohibitively expensive? bullet-riddled vehicles, the children were instead serendipity, you may find genes affecting other A It makes medicine less costly. Nothing is more escorted on a dangerous, utterly silent 5-kilometer organ systems. costly than suffering and mistakes, certainly in trek through rain-soaked mud and across thorns terms of human pain and misery, but also in dollar and thistles. One child, who had hidden his shoes Now what happened was that I became terms. It’s almost a paradox: DNA, computers, inside the shelter wall, couldn’t find them in the interested in not only the individual patient, which tests – it doesn’t sound personal, it sounds dark and made the trek barefooted. The children is the prime focus of course, but also in technological, so I think it’s important to were given sanctuary at Rambam in an populations – in two related research areas called emphasize that it doesn’t replace the individual abandoned 19th century French monastery population health and population genetics. There physician-patient relationship. A DNA sample will adjacent to the hospital and lived there for 22 are certain disease predispositions that are more be taken from a blood test or a saliva test, the months, cared for by a rotating team of mothers. common in certain populations – chronic kidney patient will come with the results to the physician, disease in African populations, for example, or and management plans will be made. The On April 28, 2008, the grown children of Gesher Gaucher’s disease and certain forms of cancer in physician will say, “We think that in your were reunited at Rambam. Amos Amitai – the the Ashkenazi Jewish population. particular case, drugs x, y and z won’t work so brave little boy who had lost his shoes and walked let’s go directly to drugs d and e.” barefooted through mud and thorns in self- It’s also the case that in order to conduct disease- restrained silence, and who grew up to become a related research appropriately, and in order to offer Q What is the rationale for a Medical and vigorous kibbutz elder, father of four and genetic counseling appropriately, it’s important to Research Development program at Rambam? grandfather of nine – took Spencer Auditorium’s unravel the population genetic structure. This has A For the past two years, we have had a very stage to share the children’s collective memories of led us – researchers and many brilliant students in specific plan for the development of a hospital- this place: “For us children, it was fantastic. Our at least 20 research groups around the world – to based research institute at Rambam. I already fathers weren’t there, sometimes our mothers study the variation in DNA sequences among direct the Technion’s Rappaport Institute on weren’t there, and everything was permitted. We peoples, mostly with this medical justification in campus, and in the past, healthcare physicians at played hide-and-seek in the monastery, would mind, but it turns out that just like archeology, Rambam have carried out their research there, in climb on the roof to sing vulgar songs at passersby linguistics, and archival records, studying DNA is a the Faculty of Medicine, but the research agenda and escape through the cellar if anyone chased us, tool for understanding history. in a university faculty and the research agenda in and played a game of trying to glimpse the hidden a hospital, though highly interactive and faces of the nuns in the neighborhood whenever Q For example? complementary, are somewhat different. At they went outside to collect milk, vegetables, bread A [Counts off on his fingers] 1 – we have Rambam, we have a cohort of physicians whose and kerosene from horse-drawn carts. We sampled demonstrated that the Druze population of research is more appropriately done at the pine nuts from the trees and, one day, decided to northern Israel and neighboring countries patient’s bedside – for example, investigations eat from the castor-oil tree and got such bad represents a “snapshot” of the diverse population into imaging technology or interventional device stomachaches that all of us were sent to Rambam genetic architecture of the Near East in antiquity, technology, whereas in a faculty of medicine it Hospital. In the summer, it was fun every day and antedating by many thousands of years the faith’s would be basic cell or molecular biology, all day – we went to the [historic] Casino in Bat founding revelation in 1017 CE; 2 – we are able biochemistry, immunology. Galim and to the sea. It was a children’s kingdom, to show in the DNA markers on the Y and I’m sure that even today not all the people at chromosome – the male father-to-son Q How long ago and from where did you Rambam are aware of all the hiding places.” chromosome – that, consistent with Jewish oral immigrate to Israel, and why did you choose and Biblical tradition, the majority of modern-day Rambam Health Care Campus as your male Jewish priests [Kohanim] are descended professional home? Rambam from a single common male ancestor; 3 – A My wife Linda and our children and I moved to working with colleagues in the United Kingdom, Israel from Toronto, Canada twelve years ago out on Call we have been able to verify the unwritten, oral of a societal, historical and religious imperative. Published by the Department of International tradition of a far-flung tribe living in Northern Professionally, what is attractive is this very Relations & Resource Development South Africa and Zimbabwe, the Lemba, who powerful and synergistic interaction between claim that their male ancestors emanate from the Rambam as a hospital and the Technion and its Talia Zaks International Relations ancient kingdom of Judea, [and] while historians Faculty of Medicine as a university. As importantly, & Resource Development have scoffed at that claim, DNA evidence has Rambam is a microcosm of what Haifa is – the Elya Cohen Assistant to Ms. Zaks Dvora Kreda Writer & Editor proved it to be correct; 4 – my same team at least polarized cosmopolitan city, metropolis and Castronawy Paris Design Rambam that developed an experimental model region in the Near East along secular-religious and Photos Pioter Fliter; Herzl Shapira using stem cells to advance cancer research and Jewish-Arab-Druze-Bahai and other ethnic lines; I (Rappaport Family, P.1) test anti-cancer therapies has discovered that find that to be very attractive, and Rambam is the Nurit Naeh Director, Public Relations 40% of Ashkenazi Jews are descended from four epitome of that. Yaffa Perez Assistant Director, RHCC David Ratner Spokesman founding mothers who lived in the Rhine Valley in Europe 1,000 years ago. Rambam June 08-F:Layout 1 15/06/08 11:36 Page 3

Rambam on Call

rUth raPPaPort ChIlDreN’s hosPItal DoNors’ VIsIoN

To their vision for the Ruth Rappaport Children’s Hospital, the Rappaport family has brought deep, respectful insights into the needs of youngsters and parents. They have rUth raPPaPort ChIlDreN’s called for a building whose design:

Places the child and parents at hosPItal arChIteCt’s VIsIoN the center of a holistic healing process “All architects I have known, in good times or bad, have felt like that – Facilitates a return to family medicine’s waiting forever for a generous, loving client who will let them become emphasis on the personal relationship the elated artists they were born to be.” between doctor and patient - Kurt Vonnegut, Jr.*

Is colorful and emphasizes comfort The architect says that he is particularly intrigued and serenity by a hospital’s potential for mediating the conceptual and physical relationship between Balances youngsters’ needs for both private and public experiences, and thus has privacy and access to the outside planned an interior meant to contain, in his world, recognizing the contribution of words, “three grades of activities and intimacies,” both to children’s cognitive, working outward from the privacy of the rooms emotional and social development to the semi-privacy of wards and corridors and thence to open, communal spaces. Relates to the hospital environment as inseparable from both the surrounding The hospital’s 120 inpatient beds will be distributed community and the hospital’s natural among approximately 60 double-occupancy (and setting – in Rambam’s case, the adjacent some single-occupancy) rooms, each with a divider Mediterranean Sea with its capacity for for privacy’s sake. Parents will be provided with a soothing and healng the soul wall bed, generous storage space, and a computerized work station so that they may stay in touch with their places of employment while n planning the new Ruth Rappaport Children’s keeping vigil over their children. game board for checkers or chess, a design Hospital, Tel-Aviv based, internationally inspired by the Renaissance-era outdoor piazza of Iaccomplished architect Arad Sharon is All rooms will provide a maximum view of the sea. Marostica, . The hospital piazza is intended to fortunate to have found in RHCC’S leadership and Moreover, each hospital floor will be color coded provide young outpatients with an open expanse the Rappaport family generous patrons and decorated to express a particular theme from for free play, offer pedestrian traffic a sociable appreciative of his artistry. nature; the names when translated into English – alternative to using the corridors, and serve as a e.g., the blue “Ocean Floor” and green “Forest stage for public performances. Some rooms will He has translated the donors’ vision for the new Floor” – evoke fairy tales where children make jut out above the piazza like theater boxes, whose hospital into the language of contemporary brave, magical journeys of self-discovery through tops will provide open balconies for the rooms structural design and added his personal love for worlds hidden from adult perception. above them. All such rooms will feature the world of theater. The building he has planned acoustically insulating shutters for those patients is intended, he says, to be playful but not infantile The architect suggests that one way of who desire privacy or quiet. and to appeal to children’s intuition and understanding the building’s use of interior space spontaneity. is to imagine an avocado whose pit has been The upper atrium’s ceiling will provide the removed. Wards and rooms will rise in tiers along foundation for the 7th floor Hemato-Oncology The new hospital will be approached from the the sides and back of the interior while the empty Department, which will, in the architect’s words, southeast through healing gardens. From this center will be filled with 2 atriums, one on top of “close the avocado.” This department represents angle, its aluminum-cladded, glass-curtained the other. a special design challenge because youngsters façade is meant to suggest a simple, white box undergoing bone marrow transplantation, blood (perhaps even a toy box) whose sheer front will The ground floor of the 3-story-high lower atrium transfusions and chemotherapy have partially reveal the activities within. Three exposed will contain a lobby, children’s science museum, compromised immune systems. The floor will pillars – painted or cladded in red, green and blue auditorium for cinema and lectures, internet café, feature a central patio with real trees, whose to suggest the children’s game of jackstraws – will and shops. beauty will also be accessible to view from the rise 7 flights to support the building’s cantilevered building’s top-floor Child Development Center. uppermost 2 floors, which will close the top of the The 4-story-high upper atrium’s piazza will be box like an overhanging lid. paved in large red and white squares to suggest a

* “Sleeping Beauty,” Architectural Digest: A Literary Collection (2007): 85. Rambam June 08-F:Layout 1 15/06/08 11:36 Page 4

NeWs IN BrIef

ramBam eXPert DIaGNoses haIfa hoNors AFGHANI GIRL WITH RARE DISEASE Prof. ora Israel

Prof. Amos Etzioni, Director LAD is an extremely rare The American doctor, who ON INTERNATIONAL of Meyer Children’s Hospital genetic disease that prevents contacted Prof. Etzioni after at Rambam, recently received the body’s white blood cells having read several of his WOMEN’S DAY an urgent request from an from leaving the blood vessels published articles on the P4 American doctor at the in order to do their job of subject, arranged for a sample American Hospital in Kabul, defending the body against of the girl’s blood to be flown Afghanistan on behalf of a infection. It currently affects from Afghanistan to Israel via sick girl. several hundred patients France. Within several hours, worldwide, a small number of lab tests performed by Prof. The doctor, stumped by the Israelis among them. Untreated Etzioni had confirmed the child’s unusual symptoms but children with LAD die at the American doctor’s hunch, a first suspecting leukocyte age of 2 or 3; the disease’s only step in saving the girl’s life. adherence deficiency (LAD), cure is bone marrow turned to Prof. Etzioni, the transplantation. Amos Etzioni, M.D. world’s leading expert on this Director, Children’s Hospital, disease, for his diagnosis. Rambam Health Care Campus Professor of Pediatrics and Immunology, Rappaport Faculty of Medicine

Prof. Ora Israel, Director of Research Operations and of the Department of Nuclear Medicine at Rambam Health Care Campus, was honored with a Certificate of Breakthrough Achievements by the Municipality of Haifa at an awards ceremony marking International Women’s Day 2008. The event, held at Krieger Auditorium on the French Carmel, saluted a group of pioneering professional women living and working in Haifa whose accomplishments in the fields of industry, academic research performed at the Technion and the University of Haifa, and medicine have significantly contributed to the city and its people. Prof. Israel was recognized for her leading role in the development of hybrid imaging, which has brought about a transformation in methods used throughout the world for diagnosing and treating patients with cancer.

hIs Brother’s KeePer lIQUID GolD

A pump feeds anticoagulants What if a BMT patient lacks a into the centrifuge to keep nearby or sufficiently large the blood from clotting family, or no match among during collection. family members is found?

“We are harvesting Sergey’s Dr. Bonstein explains that young stem cells, the factory although red-cell and platelet for all the blood cells,” units are available for purchase explains biochemist Dr. Lilach from Magen David Adom “Neither shalt thou stand idly Bonstein, Deputy Director of (MDA), BMT patients consume by the blood of thy neighbor” (Leviticus 19:16): a member of the Blood Bank and Apheresis blood products, especially Haifa’s Vizhnitz Hasidic Unit at Rambam. platelets, in huge quantities community donates healthy throughout their 1-2 month platelets to save a stranger’s life. His brother won’t require recuperation. prefer Sergey’s red blood cells but, apheresis single-donor platelet of course, Sergey does, so units whenever possible they’re flowing from the because one such unit equals centrifuge back into his body 6-12 portions from MDA and Sergey, 36, a Russian-born If you’re thinking Bloodmobile “Do you remember the last via a catheter taped to his left goes easier on patients’ mechanical engineer from with the juice and the time you had a serious flu?” arm. On this warm day, compromised immune systems. New York, reclines in bed in cookies, think again. Sergey asks rhetorically. Sergey has pulled a blanket “For us,” she says, “single- the Apheresis Unit at “That’s what [an excess of up to his chest. A film of cold donor units are like gold.” Rambam. He is hooked up to First, a sample of Sergey’s white-cell production in the sweat glistens on his an imposing machine with blood was type-tested for bone marrow] feels like forehead. He’s cold because Whenever Dr. Bonstein needs dials, sensors, and tubes that compatibility with his without the fever: aching his blood isn’t being returned platelets or other blood feed their viscous red, pinkish brother’s blood. Luckily, the bones and joints.” to him at body temperature. products on behalf of a and yellowish contents into two men fell into the 25% patient with a small or far- suspended, plastic blood bags. category of siblings that The machine to which Sergey Stem cell collection by away family or no family at match, although Sergey’s is connected is an apheresis apheresis takes six hours, and all, she conveys the patient’s Sergey received word a week brother will nevertheless device. A large steel suction as it progresses, Sergey blood type to the Seret ago that his elder brother, receive high-dose needle taped to his right arm reports feeling better and Vizhnitz Hasidic Community who lives in Israel, had been immunosuppressant draws out his blood, which better: “Imagine you’ve been (est. 1951), the largest Hasidic diagnosed with leukemia and medication against graft- passes through a centrifuge taking medicine to increase population in the North, would receive chemotherapy versus-host disease (GVHD). that separates blood into its your white cell counts and all which immediately sends over followed by bone marrow component parts according to of a sudden, they collect the yeshiva students. transplantation (BMT), an Sergey spent the next five relative densities: yellowish surplus; it’s like flying! But no aggressive strategy intended days injecting himself twice plasma with suspended matter how you feel “They are willing to come to replace a person’s failed daily with Neupogen, a drug platelets (coagulants), young physically during this whenever we need them,” immune system. Sergey that increases the body’s white cells (stem cells), procedure, it’s irrelevant,” Dr. Bonstein says gratefully. booked an urgent flight and production of young stem mature white cells (immune he adds. “People do it for “We use 1,000 units of came to Rambam to donate cells in order to create a system infection-fighters) and their family.” single-donor platelets per stem cells. surplus for harvest. red cells (oxygenators). year, and almost 10% comes from them.” Rambam June 08-F:Layout 1 15/06/08 11:36 Page 5

NeWs IN BrIef Rambam on Call

trIPlets homertoN, st GeorGe’s Lord Stanley Clinton-Davis unveils a plaque celebrating the aND ramBam reUNIte friendship among Homerton University Hospital (UK), St George’s Hospital (Grenada) and Rambam Health Care Campus (Israel).

Their Excellencies Lord Stanley Grenada since 1968 and 1997 Clinton-Davis of the east respectively. Homerton London Borough of Hackney, Hospital, which provides Mr. Joseph Charter, Grenada’s general hospital services to High Commissioner in London, Hackney’s 250,000 residents and Mr. Ron Prosor, and to the City of London and Ambassador of the State of specializes in fertility, fetal Israel to the Court of St James, medicine, obstetrics and gathered in February in neonatology, keyhole surgery Hackney to celebrate a long- and neuro-rehabilitation, serves standing tradition of clinical a large Jewish and Caribbean exchange among three patient population. Since the hospitals: Homerton University 1990s, Homerton has Hospital NHS, St George’s participated in over half a Hospital and Rambam Health dozen exchange visits in which Care Campus. teams of physicians from Hackney has been twinned Homerton, Rambam and St with the city of Haifa and the George’s have shadowed each Caribbean island nation of other and shared expertise.

reCeNt reNoVatIoNs orthoPeDICs a&B ComPlete rehaB

iora, 44, recovering from the cleaners to the from surgery for a surgeon; the place is organized, Lcomplicated leg fracture, pretty, and everything is is propped up in bed in managed as it should be.” Department of Orthopedics A, looking out the window at the The makeover benefiting RHCC helipad and, beyond Orthopedic Departments A and that, at men fishing from the B took place in 2005, funded rocks and almond-shaped by British Friends of Rambam freighters riding an expanse Medical Center and the of calm sea. Conference on Jewish Material Claims Against .

“In the old Department [A], we had brown walls and linoleum floors, only 3 toilets with pill bottles, ampoules and Nurses on their rounds dispense L to R: Dr. Alexander Lerner, Senior Orthopedist; Captain [Reserves] and 2 showers for our entire intravenous-liquid sacs. medications from Salink Dubie Ganish; Physiotherapist Mihiar 28 patients, and insufficient Medicarts, mobile working Ghenaim; Lt. Asa-el Lubetzky. storage space,” Deputy Nurse Larisa points out equipment stations equipped with sliding At Rambam in the immediate Larisa Hoz recalls. designed to provide patients compartments to hold aftermath of the Second Lebanon with relative independence of individual patients’ dosages and War, Captain Ganish and Lt. Lubetzky learned to walk again. Now, the department features movement and to ease nurses’ with Wi-Fi enabled computers a shower and toilet for every 3 physical burden. The hydraulic for reading doctors’ orders and patients; an on-site cast beds feature a trapeze bar entering data. exactly what I need for my workshop, pharmacy and with a suspended triangle to patients, and my wish list was physiotherapy room; a well enable patients to hoist Larisa says that in planning the 100% fulfilled! Look – an appointed nurses’ station and themselves up. The corridor renovation, the nursing staff electric bed for a patient who surgeons’ offices; and plenty walls are fitted with railings. insisted on not only function can’t lie down or get up Deputy Nurse Larisa Hoz of storage space. The – The shower and toilet but also beauty. She points independently; a Sweden aesthetic! really! – pharmacy’s doorways are extra wide for out, for example, the lovely ladder; a stable walker to shelves, drawers and glass wheelchair access, and the backsplash and the mirror exercise the physiological She says, “The service here, doored refrigerator are neatly wheelchairs slide easily over framed by decorative tiles process of walking. And we the way people relate to me, arranged and fully stocked the toilet bowl. above each bedroom’s sink have very spacious equipment it’s really nice, the best.” Her and countertop: “They wanted storage for crutches, exercise friend Ora adds, “I had heard to give us white walls, plain bands and an exercise ball, that this department was walls, but Miri Foox – the weights, CPM [continuous terrible, but when I saw it, I Mother of the Department – passive motion] for the elbow said ‘Wow!’ Everything is and we said, ‘No! It has to and shoulder, and so forth. colorful, clean, pretty and look like a hotel.’ modern. Everything is new.” “The renovation has given me “We said, ‘The white is too the opportunity to practice the In the renovated visitors’ white – it’s depressing; cream profession exactly as I wish waiting room with its round [color] will give warmth to the without limits, and it has given dining tables and self-service patients and staff and goes the patients all they need. kitchenette, Nurit and Gabi of with Haifa’s seaside.’” Today, nothing lacks. We’re Tiberias, visibly worried parents living physiotherapy as it of a teenager recuperating from Physiotherapist Mihiar should be lived.” spinal surgery, are also full of Ghenaim adds, “I [also] sat praise: “We thank everyone with Miri [Foox], conveyed Rambam June 08-F:Layout 1 15/06/08 11:36 Page 6

frIeNDs helP BUIlD a hosPItal!

event, charming the audience shIPPING maGNate sammy ofer with anecdotes of Mr. Ofer’s happening to meet youngsters whose stories moved him, such laUNChes sUB-marINe hosPItal as the waitress who served him a meal or the boy selling national project in answer to a flowers at a traffic intersection, national strategic need.” and whose educations he went on to personally finance. Nobel Laureate Prof. Aaron Ciechanover, Chair of Perhaps the event’s most Rambam’s Scientific Advisory emotional moment came when P6 Board, told the audience that Captain (res.) Tomer Bohadana, Mr. Ofer’s contribution who was seriously wounded represents an occasion both while commanding a L to R: Dr. Esty Golan, Chief happy and sad: “The Israeli paratrooper reserve unit during Administrative Officer and Director government should be the Second Lebanon War, and of Global Resources, RHCC; responsible for building a whose life was saved at Sammy Ofer’s son, Mr. Idan Ofer; fortified underground hospital Rambam, took the stage. Mr. Sammy Ofer; Prof. Raphael Beyar, Director General of RHCC. for the more than 2 million “What did I think of when I citizens of Northern Israel,” he was on the stretcher? I thought chided, while praising Mr. of my unit, and I thought that I When the dignified elderly listeners knew from his was held to honor Mr. Ofer’s Ofer’s largesse and placing it in have to stay conscious because gentleman attired in a tailored generous deeds that this is a $25 million gift to RHCC, the context of a global Jewish at Rambam they, the doctors suit of fine cloth the color of man who means what he says. which he has earmarked for culture of charitable giving. and the high technology there, dark-yellow oriental spices or a two purposes — construction “We’re speaking of an ancient will take care of me,” he said bronze-yellow Mediterranean The speaker was Mr. Sammy of a 750-bed underground culture of philanthropy before publicly thanking sun took the stage at RHCC on Ofer, 86, who grew up poor emergency hospital and motivated by an obligation Rambam’s doctors and nurses May 18th, spread his hands in the Haifa seaside renovation of Rambam’s among community and family and personally thanking Mr. wide, and addressed an neighborhood of Bat Galim Departments of Surgery, members to look after one Ofer: “Soldiers have to know audience of family, friends, (lit., Daughter of the Waves) Urology and ENT. another whether near or far,” that there are people that they business associates, and near today’s Rambam and went he said. can depend on. Although you Rambam leadership and staff in on to achieve fame as a global RHCC Director General Rafael don’t go shoulder to shoulder these few, simple words – shipping magnate, art collector Beyar called construction of the Veteran investigative journalist with us on the battlefield, we “Thank you, I love you” – his and philanthropist. The event underground hospital “a Mr. Rafi Ginat emceed the know that you are with us.“ mssrs. ZUr felDmaN aND yUVal raBIN mUslIm hoUse of DeDICate moBIle heart-lUNG maChINe Prayer oPeNs at rhCC Thanks to Purchase of the new equipment Washington- was made possible by funds Muslim prayer house, the based Israeli raised from the Washington, first to be opened in a businessmen Zur D.C. Jewish community during a Agovernment hospital in Feldman and Yuval mission by Dr. Yaron Bar-Lavie, Israel, was dedicated at Rambam Rabin, the General Director of General ICU, in the on April 17th by Minister of immediate aftermath of the Science, Culture and Sports Raleb (ICU) at RHCC has Second Lebanon War. With the Majadele (pictured) in the recently acquired a active help of Mssrs. Feldman presence of Health Minister Yacov mobile heart-lung and Rabin, Dr. Bar-Lavie was Ben Yizri, Haifa Mayor Yona Yahav L to R: Yuval Rabin, Zur Feldman machine. able to raise $100,000 in a and our medical center’s executive and Tali (Mrs. Yuval) Rabin single night. leadership.

All this activity began ground deepens and widens taChlIs appropriately in the Hebrew while pyramidal mounds of month of Adar (March) when newly dug dirt rise, which – according to the Purim holiday this being Israel – have The December 2007 inaugural tradition, everyday reality turns necessitated work stoppages issue of Rambam On Call upside-down. Rambam strives while several unearthed shared news of generous for a paperless work Byzantine-era mosaic floors investments by Friends of environment, else have been salvaged by the Rambam in RHCC’S 5-10 year, announcements flooding Antiquities Authority. $300 million Vision of Adam employees’ mailboxes in that development plan. month alone would have At the calm eye of this creative generated enough paper to storm is dapper and apparently Mr. Ariye Berkoviz, Head of the Five months later, hopes and insulate the planned new unflappable Col. (ret.) Ariye At these meetings, the neatly Engineering Department, flanked by plans have turned into initial structures: ER has relocated Berkoviz, Head of the arranged seminar table’s coffee fourteen of the forty architects and actions on – and in – the temporarily to basement Engineering Department, who packets and plates with two engineers currently at work on the ground. The Emergency Trauma facilities; the Municipality has brings to his overall supervision of kinds of cake squares are Sammy Ofer Underground Hospital. Center’s fortified new roof has rerouted traffic in the the project a career-military pushed aside by participants to been poured. Moreover, an hospital’s vicinity; your pardon background with responsibility free up space for laptop portable toilets should there be, exposed parking lot and cluster is begged for construction for overseeing all building and computers and unfolded floor and how will we integrate of obsolete bungalows have noise and vibrations, the brief development programs of the plans. Prof. Rafael Beyar and his them with 1,500 parking been demolished to free up 16 disruption of medical-gas Israel Defense Forces (IDF). executive team make the macro spaces? How will we ventilate dunams (16,000 sq m) of land supplies, the closure of on- decisions, but Mr. Berkoviz and the underground facility in for construction of a 3-level campus parking… Several times a week since May his forum of experts make the times of peace and war and underground parking garage 2007, Mr. Berkoviz has presided thousands of micro decisions place the vents so that they whose deepest level can be In compensation, the always over meetings that bring to that go into designing and won’t swallow dropped car converted within 72 hours into a lively Rambam campus has Rambam about a dozen of the building a 21st century medical keys? How will the emergency 750-bed emergency hospital become even more exciting. currently forty professionals at center – and nothing escapes hospital’s laundry and garbage fortified against missile, Vivid orange or yellow work on the project: building their attention. Today, they are be collected? chemical and biological warfare. polyethylene debris chutes and landscape architects, civil refining plans for the The parking garage’s reinforced snake down the exteriors of engineers, and infrastructure underground parking garage Anticipated completion dates ceiling will provide the buildings under renovation. specialists responsible for such and emergency hospital: How for the Sammy Ofer foundation for the proposed Bright yellow excavators, aspects as acoustics, air will we protect the medical-gas Underground Hospital and the new Children’s Hospital, bulldozers, cement mixers and conditioning, electricity, lines against exhaust fumes and Ruth Rappaport Children’s Cardiology and Oncology cranes crunch and roar and elevators, fire safety, plumbing, vandalism and prevent internal Hospital are the summers of Hospital, and Biomedical whir. Corrugated tin fences and waste disposal. corrosion? How many 2010 and 2011 respectively. Discovery Tower. catch the sun. The gouged permanent and how many Rambam June 08-F:Layout 1 15/06/08 11:36 Page 7

star sPaNGleD eVeNts Rambam on Call

Usa Qatar rhCC meDICal PartNershIP PROPOSED BY VISIONARY NEW FRIEND OF RAMBAM SANFORD WEILL

Friend of Rambam Sanford Weill at heard about investigations Gotto discussed with Prof. the Rappaport Research Institute on currently underway on the Beyar a possible 3-way the Rambam campus Rambam campus into medical collaboration among advanced genetics, cardiac Weill Cornell, WCMC-Qatar General Prof. Rafael Beyar electrophysiology, nuclear and RHCC. The idea has P7 and President and CEO of imaging, and the been warmly received here. Iscar Mr. Eitan Wertheimer applicability of stem cells to respectively. Mr. Weill and regenerative medicine. Rambam’s Middle East Dr. Gotto were also guests outreach program already of honor at dinner parties Guests and hosts found includes providing sick hosted by Prof. Beyar and his much in common to discuss. children from neighboring wife Dalia, and by Mr. Both RHCC and Weill Arab countries with medical Wertheimer and his wife Cornell have achieved treatment unavailable to The visit to RHCC of Gotto, Provost for Medical Ariela, at their homes. The recognition as leading them at home; cooperating American financier and Affairs and Dean of Weill Wertheimers are devoted medical centers in their with medical professionals philanthropist Sanford Weill, Cornell Medical College. friends of Rambam and chair respective countries and from the Palestinian 75, and his dramatic arrival our 21st- century capital globally, Rambam by virtue Authority, Jordan and at Rambam by helicopter, The esteemed visitors came campaign. of the extraordinary elsewhere; and participating attracted national media here for two days in cooperation we enjoy with in regional scientific coverage in Israel. February on their way to During the guests’ tour of the Technion-Israel Institute exchange, notably including Weill Cornell Medical Rambam, Prof. Beyar of Technology and the city of the Frontiers of Chemical Mr. Weill, who is Founder College in Qatar (est. 2001), proudly described our Haifa’s scientific high-tech Sciences II: Research & and Chairman Emeritus of which was preparing to medical center’s history, industry, and Weill Cornell Education in the Middle East Citigroup, Inc. and Chairman graduate its inaugural class achievements and vision for with considerable thanks to conference (Malta II). of the Board of Overseers of of physicians. the future, including plans Sanford and Joan Weill’s Cornell University’s Weill The visitors toured the for building a Biomedical magnanimous investment of For our physician-scientists, Cornell Medical College and Rambam campus in Haifa Discovery Tower. Mr. Weill social-venture capital. inclusion of RHCC in the Graduate School of Medical and Iscar Metalworking in and Dr. Gotto also met with Weill Cornell-Qatar initiative Sciences, was accompanied the Galilee (Israel’s North) senior physician-researchers Before departing Israel for would represent a natural by cardiologist Dr. Antonio escorted by RHCC Director in their laboratories and Qatar, Mr. Weill and Dr. next step.

BhlsI 3rD aNNUal haIfa BIo semINar RAMBAM HOSTS BIOTECH STARTUPISTS & INVESTORS

“It was most natural for us to hold internationally market Israeli high-tech healthcare Veteran entrepreneur Shai Levanon, CEO of this event at Rambam. Prof. Rafi Beyar products. Among them were Gilead Fortuna, Rcadia Medical Imaging Ltd. in Haifa, said he has been a leading advocate for BHLSI since its inception, and his Senior Research Fellow of the Technion’s Neaman came not only for the networking and to hear Dr. commitment to enhancing Israel’s Institute and former Vice President of TEVA life-sciences sector and working Pharmaceuticals. “My life is dedicated to the passion of collaboratively with the Boston Israel. I retired 14 years ago from the medical products diagnostic industry, and community has benefited Israel annually registers the world’s entrepreneurs throughout Israel. I decided that I was going to devote my Prof. Beyar, and Rambam as an highest percentage of life-sciences senior years to helping the economic and institution, have opened the door for patents per capita. For this reason, as social development of the State of Israel. entrepreneurs’ seeking to validate Dr. Eli Opper, Chief Scientist of the It’s about letting my children and their science and technology.” Israel Ministry of Industry, Trade & grandchildren and the Jewish community know that we have to continue the - Robin JR Blatt, Director, Labor, told the audience, “promoting Boston-Haifa Life Sciences Initiative legacy of our people.” the industrialization of biotechnology - Steve Doppelt, Co-Chair, is crucial for the sake of our country’s Economic Development Committee In March, Rambam Health Care Campus and its economic future.” of the Boston-Haifa Connection Director, Prof. Rafael Beyar, hosted the Combined Jewish Philanthropies (CJP) Boston-Haifa Life Sciences Early stage entrepreneur and Rambam specialist- Kessler, but also because of the RHCC imprimatur, Initiative (BHLSI) 3rd Annual Haifa Bio Seminar. physician Dr. Itzhak Koifman of the General adding, “To be invited to this program by Intensive Care Unit attended dressed for work in Rambam and Prof. Beyar is like an automotive- The event, subtitled “Israeli Innovations for Global blue hospital scrubs. “I earned my MD at the industry entrepreneur’s being invited to the main Health: Translating Ideas into Winning Products,” Technion, whose technological approach to showroom of General Motors.” attracted 300 Israeli entrepreneurs – CEOs, engineers, physicians and BHLSI was launched in 2004 by the CJP Boston- other scientists, and R&D “If you want to put Haifa on the map in Haifa Connection in collaboration with MATI Haifa the life sciences, then you have to bring professionals – engaged in such investors and companies from all over and other Haifa-based organizations, and aims to fields as biotech, clean tech, the world to see the city and Rambam catalyze business collaborations and enhance medical-device design and Hospital, a world-class resource for the Haifa’s visibility as a leader in the life sciences. pharmaceuticals. life sciences industry and one of Israel’s Sponsors of the 3rd Annual Haifa Bio Seminar most strategic assets.” included Bank Leumi, Ernst & Young, the - Karen Doryoseph, Director, They came to hear keynote Boston-Haifa Connection Massachusetts Office of International Trade & speaker Dr. Larry Kessler of the Investment (MOITI), The Marker, and ZAG/S&W. U.S. Food and Drug Administration’s Haifa Mayor Yona Yahav hosted a festive cocktail Center for Devices and Radiological Health, who medicine has enabled me to find solutions and networking reception. directs the Office of Science and Engineering to clinical problems in situations where Laboratories and chairs the Global Harmonization other doctors are stumped,” he said, “Inventors, scientists and engineers at Task Force. Dr. Kessler addressed FDA regulatory explaining the event’s attraction for him. Rambam Health Care Campus and in criteria for drug and medical-device safety and “I am involved in a startup and came to Haifa can best help public health by working with their clinical and patient- effectiveness. see what these people can teach me – population experts to look to the and they have taught me a lot! Like an challenge for the next 10 years and to The speakers’ lineup also featured over a dozen incubator, this event gives me tools to partner with their colleagues around the venture capitalists and industrialists that advised solve problems in business financing, world and with the relevant regulatory participants about how to successfully raise planning and management.” agencies to make the most important healthcare products widely available.” capital, strategically build a business, and - Keynote Speaker Dr. Larry Kessler, U.S. Food and Drug Administration Rambam June 08-F:Layout 1 15/06/08 11:36 Page 8

afrICaN allIaNCe

Prof. Eli Sprecher with Emmanuel ZamBIaN Boy treateD and his mother, Elizabeth for rare sKIN DIsease

A darling Zambian boy named Emmanuel has Genetics. Prof. Sprecher is recognized as one of returned with his mother Elizabeth to his native the leaders worldwide in the field of genetic skin Africa after a 3-month hospitalization at diseases and, in 2007, received the World P8 Rambam, during which time he was treated for Congress of Dermatology’s Alfred Marchionini harlequin ichthyosis, an extremely rare skin Research Award in recognition of his disease that can cause death at a young age achievements. from dehydration and infections. Normally, a small protein mediates the loading of Emmanuel has returned to Zambia in good lipids into epidermal-cell vesicles, which then condition with plenty of medicine for a number discharge their protective contents, including of months. In another half year, he is scheduled lipids, into the uppermost epidermal layers. People to return to Rambam for an additional series of with the disease, however, lack this protein. As a treatments. result, their bodies are covered with a patchwork of thick scales that recall the diamond-patterned “Caring for Emmanuel was a very special costume of the clown Harlequin from the 16th- experience for me,” Prof. Sprecher says, “as century Commedia dell’Arte and have given the thanks to the generosity of his Zambian sponsor, disorder its name. over the period of his extended stay in Israel we could diagnose the disease, identify the causative “Treating genetic diseases can be frustrating,” Emmanuel reached RHCC because of the unique genetic defect, bestow and assess the benefits of he adds, “as for most of these diseases, specific expertise of Prof. Eli Sprecher, Senior Physician in medical treatment, and provide Emmanuel and his and/or efficient treatment is inexistent. Harlequin the Department of Dermatology at Rambam and mother with all the information and the technical ichthyosis is an exception to the rule because Head of the Rappaport Faculty of Medicine and skills needed to carry on therapy at home. despite its severity, the disease is amenable to Research Institute’s Center for Translational drug therapy.“

NIGerIaN sUrGeoN ComPletes felloWshIP

In April, Dr. Lawrence program’s second half, Dr. there, and the hospitality Akinyoola, an orthopedic Akinyoola’s wife Cynthia, a and readiness to share surgeon from Nigeria in nurse, joined him on the knowledge expressed by Western Africa, completed a Rambam campus for Prof. Soudry and his entire 6-month clinical fellowship advanced training in her staff. Dr. Akinyoola added at Rambam in profession. Pictured is the that he hoped his musculoskeletal and joint farewell ceremony for Dr. experience would begin a replacement traumatology. Akinyoola, who spoke with tradition of our welcoming The advanced training was emotion of his appreciation additional physician provided by our Division of for the Division of specialists from Nigeria for Orthopedic Surgeon and Visiting Clinical Fellow Dr. Lawrence Orthopedic Surgery and Orthopedic Surgery and clinical fellowships at Akinyoola of Nigeria receives his Certificate of Course Traumatology under the Traumatology’s medical Rambam. Completion from Prof. Michael Soudry, Chairman, Division of Chairmanship of Prof. excellence, the high level of Orthopedic Surgery and Traumatology and Director, Michael Soudry. During the training he had received Department of Orthopedics A.

KareN aND JosePh leVINe presentations and the warm and elegant hospitality of their host host aforam reCePtIoN and hostess.

On February 4th, Dr. and Mrs. Rambam’s Scientific Advisory Joseph Levine hosted a dinner Board, and Prof. Karl Skorecki, reception for over 30 members of Director of Medical and Research the American Friends of Rambam Development at Rambam, were L to R: Mr. Richard Kandel; Karen (Mrs. Joseph) Levine; Dr. Joseph Medical Center (AFORAM) at the featured speakers. Dinner Levine; Mr. Harvey Krueger, AFORAM their lovely Manhattan home. guests praised the engaging Vice President; Nobel Laureate Prof. Prof. Aaron Ciechanover, Chair of nature of the speakers’ Aaron Ciechanover; Ms. Candice Joo.

taKe aNother hUG Additional good news: • Aviva Disorder (PTSD) program at to RHCC, earmarked in part for Tessler, President and Founder of Rambam, whose purpose is to the Ruth Rappaport Children’s Maryland, USA-based Operation respond to the long-term needs Hospital capital campaign and in Embrace (est. 2001), has of terror victims. • The New-York part to establish a Post Traumatic IsraelI announced renewed funding for based Women’s League for Stress Disorder (PTSD) Family frIeNDs its Foxman Post Traumatic Stress Israel has made a generous grant Therapy Unit. Thank you!

RHCC congratulates Prof. American Friends of Canadian Friends of British Friends of All Other Countries Yehuda Hayuth, past Rambam Medical Center Rambam Medical Center Rambam Medical Center Main Office President of the University of Haifa and a world authority on shipping and ports, on his election Yair Kagan David Green Anita Alexander-Passe Talia Zaks Executive Vice President President Director International Relations & as Chairman of the Israeli Friends of Rambam 521 5th Avenue, 64 Merton St. 1st Floor North Crescent 10 Resource Development Medical Center and wishes him great success Suite 1749 Toronto, Ontario M4S 1A1 London N3 3LL Rambam Health Care Campus on behalf of realizing our shared vision for the New York, NY 10175 Canada United Kingdom POB 9602 USA Haifa 31096 Rambam campus. Tel: 416.322 4003 Tel: 020.8371 1500 Israel Tel: 212.292 4499 Fax: 416.487 5963 Fax: 020.8271 1501 [email protected] [email protected] [email protected] Tel. 972.4.854 2042 www.aforam.org Fax: 972.4.854 2104 [email protected]

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