By: David M. Weinberg
Oct 8, 2014
The Sheba Medical Center at Tel Hashomer in Israel is a global leader in trauma surgery and rehabilitation technologies, all of which have been brought to bear in treating soldiers wounded in the recent Gaza conflict.
A feature article written by David M. Weinberg, Special for THE JERUSALEM POST MAGAZINE, Friday October 3, 2014.
Prof. Zeev Rotstein, director of the Sheba Medical Center at Tel Hashomer, was in the wartime command center below the hospital emergency room, when the call came in.
It was the first phone call in three weeks from his son, Roi, a deputy company commander in the Golani Brigade, who was fighting in Gaza.
“I’m fine,” said Roi to his relieved father, “but I have a job for you. I need you to take care of some of my soldiers who were badly injured in Shejaia. Some are on their way to you at Sheba/ Tel Hashomer, while others apparently are at Beilinson hospital. Can you please look in on them?” Roi asked.
Rotstein did as his son requested, driving to The Rabin Medical Center-Beilinson Campus in Petah Tikva to send love from his son, the commander, to the wounded troops of his unit. Two of Roi’s troops were later transferred to Sheba for rehabilitation.
Throughout the war, wounded Golani soldiers who were helicoptered into Sheba for treatment brought “regards” to Rotstein, the hospital director, from his son deep inside Gaza.
He has attended to IDF wounded from Gaza as if they were his own sons. After all, three Rotstein children, including Roi, are serving in the IDF.
“There but for the grace of God go I,” he says.
“I see, feel and share the pain of the parents who huddle with their battered and scarred sons in the wards of our hospital.
“It is my commitment; it is our commitment, to heal these heroic young men, and to deliver them back to their families as whole and as healthy as possible. We don’t give up on anybody, no matter how long and complicated the care or the rehabilitation process may be. IDF soldiers are reborn here.”
MORE THAN 120 soldiers wounded in Gaza have been treated by the Sheba Medical Center, and 50 soldiers from all other medical centers across the country have been secondarily referred to Sheba’s Rehabilitation Hospital.
The Rehabilitation Hospital is the main rehab facility in Israel for the IDF and for victims of terrorism.
It is one of the largest and most advanced facilities in the world, with over 700 beds and some of the world’s top orthopedic, neurological and respiratory rehabilitation doctors. A global leader in specific trauma surgeries and rehabilitation technologies, all resources have been brought to bear in treating soldiers wounded in the conflict.
A case in point is the story of Col. Yonatan Rom, commander of the Egoz Reconnaissance Unit, who was almost fatally wounded in Shejaia.
Fragments tore a major thoracic artery, gunfire shattered his shoulder and an explosion impacted on his brain. He was miraculously saved at Soroka University Medical Center in Beersheba by an emergency angioplasty stenting procedure on his subclavian artery.
When Defense Minister Moshe Ya’alon visited him in the hospital, Rom insisted on being transferred to Sheba, saying that “it has the very best rehab center.”
And indeed, one month later, he is working out in Sheba’s Virtual Reality Training Facility to overcome his brain injury. The three-story domed rehabilitation facility – the world’s first medical simulation training laboratory of its kind – contains a motion platform that enables manipulation of the surface on which the person is standing, wrapped within a 360-degree IMAXlike surround-screen.
The lab simulates activities like taking a walk in an urban environment, driving a car, hiking up and down a mountain or driving a boat. The patient is immersed in a fully reactive virtual environment and is forced to adapt to the changing scenery and the moving ground surface, while a real-time motion capture system records his every step and misstep for doctors and physiotherapists. It is the ultimate use of simulation technologies for rehabilitation medicine.
Indeed, rehabilitation experts from the US, Canada, Asia and many countries in Europe, along with the American military and Veterans Administration, have visited the VR facility at Sheba, and sent their personnel for training.
MANY SOLDIERS sustained severe limb wounds in the war, especially in the hands.
“Ceramic body armor and good helmets protected many troops from internal injuries,” explains Rotstein, “but the bones, ligaments and blood vessels of the extremities took many hits. Our orthopedic and vascular surgeons have conducted dozens of microsurgeries to reimplant nerves, sew ligaments, replace bones and connect blood vessels. Dr. Batya Yaffe, Israel’s leading hand surgeon, and her team, in particular, have worked around the clock.”
“R,” a fighter in an advanced Givati unit, has had three operations on his smashed right hand and upper arm, and has several reconstructive surgeries still ahead of him. To overcome the extreme pain associated with such injuries, the Sheba pain specialists have used a new “blocking” technology. They implanted a small device in R’s arm that allows him to pump in local anesthetics, as needed.
This innovative pain reduction system has dramatically reduced the need to use morphine and other narcotic drugs in patients suffering from severe trauma in their extremities. The system was used for all soldiers in the conflict.
SEVERE SKIN burns were another result of the recent Gaza conflict. “A” and “G” were combat engineering soldiers driving a Caterpillar D9 armored bulldozer when a transformer pole full of oil collapsed on them, igniting the heavy machinery and burning them badly.
Both are hospitalized in Sheba’s hi-tech National Burns Center, which opened only several months ago.
Sheba took upon itself the building of the sophisticated $5 million burn unit after the disastrous Carmel Forest fire in 2010, in which dozens of firefighters and civilians died from lack of adequate burn treatment facilities and technologies. The hospital’s friends in the United States, Brazil and around the world provided the necessary funds.
The new burn center contains six intensive care treatment rooms for severe burn victims, and an additional two step-down inpatient rooms for four patients – all with sterile, temperature and humidity-controlled facilities. A multidisciplinary team of psychiatrists, infectious disease specialists, occupational therapists, physiotherapists, dietitians and social workers dedicated to burn treatment staff the center.
Prof. Josef Haik, a plastic surgeon and expert in reconstructive burn injuries and critical care, planned the center and leads its team. He trained at the Firefighters’ Burn and Intensive Care Unit at the Alberta University Hospital in Edmonton, Canada.
“These combat engineers burned in the D9 bulldozer incident would not have survived without the special care facilities we now have here at the hospital,” Haik says. “Their injuries require intensive care and mechanical ventilation, along with repeated skingraft surgeries. They have a difficult convalescence ahead of them. Fortunately we are now equipped to provide them with an international level of care, and we’re determined to rebuild their bodies and return them home as whole as possible.”
Sheba’s plastic surgeons have been working overtime to treat the many soft tissue and skin wounds, particularly face wounds, caused by fragments and debris.
The wounds often leave deep blue-charcoal staining on the deepest levels of skin. Plastic surgery chief Prof.
Eyal Winkler and Haik have employed a unique technique of deep tissue scrubbing to surgically remove these skin stains.
Winkler has tried a new facial peeling technique to smooth the cheeks and foreheads of scar-pocked soldiers.
“Giving them back their face is one way of giving them back their lives,” Winkler says proudly.
TELEREHABILITATION technologies are emerging as the next wave in medicine, and some of the wounded soldiers from Gaza are among the first to benefit from these advances.
“E” from the Givati Brigade took a bullet in the neck, which smashed through his left ear and right eye but miraculously missed his brain. Transferred to Sheba from Beilinson, he has many months of reconstructive surgeries in front of him to repair his smashed facial bones, nose, eye socket and ear. But already he is learning to improve his hand/remaining eye coordination by “playing games” on a telerehab medicine console developed by Sheba’s Gertner Institute and now in clinical trials.
Dr. Ofer Keren, head of brain/head rehabilitation, explains that the computer console system allows the patient to do occupational therapy work himself from home, accompanied remotely by a therapist at the hospital. The system monitors his cognitive and motor skill advancements, and accordingly adjusts the difficulty level of the tasks for him to perform.
MEDICAL CENTER director Prof. Zeev Rotstein is never satisfied with the facilities and technologies at his disposal.
“We are the largest and most comprehensive hospital in the Middle East, treating more than 1.5 million patients a year from Israel and around the region and from Eastern Europe,” he says. “Demand for our services is constantly growing, and I insist that we also have the latest, most forward technologies with the finest technicians, clinical staff and medical scientists.
So we need to constantly upgrade, grow and expand.
“Right now, one of our top priorities is tripling the size and improving the facilities of our emergency medicine center. We see over 200,000 patients a year in the emergency room. Especially in wartime, we feel the crunch. Our plan is to build an $18 million new emergency medicine center on three floors, including a bomb-proof underground level with 12 protected operating rooms. The global Friends of Sheba associations will hopefully assist in making this possible.”
The strain of it all shows on Rotstein’s face, yet a hug and a smile for the parent of a wounded soldier or an exhausted nurse is never far away. He prides himself on the medical center’s human touch.
“Three weeks ago, in the middle of the war, we held a massive Friday night prayer service and dinner for wounded soldiers and their families in the lobby of the main hospital tower,” Rotstein relates. “The event was meant to lift everybody’s spirits – patients, families and medical staff.”
Yahav Erenboim catered the event free of charge, with celebrity chefs Jonathan Roshfeld, Shaul Ben-Aderet, Golan Gurfinkel, Aviv Moshe and Eyal Shani doing the cooking and baking. Harel Skaat led prayers for Shabbat and for the IDF, and the singing.
“Hundreds of people attended, and many of us cried,” Rotstein says. “Everybody ate and drank well.
Everybody enjoyed the feeling of togetherness and solidarity. It was a way of saying, ‘We shall overcome.’ That is the Sheba spirit.”
The writer is a Jerusalem Post columnist who consults on public affairs for many institutions, including the Sheba Medical Center.