Growing with Israel: 70 years of Sheba success

Sheba Medical Center, Tel Hashomer has come a long way from its humble beginnings as “Army Hospital No. 5” in 1948 to become the glistening, hi-tech innovative medical center that is changing the way patients are treated in Israel and around the world. The growth of the hospital can be compared to that of Israel itself, which in 1948 was only a dream shared by the Jewish people, and today is the Startup Nation. Sheba's first patients were members of what became the Israel Defense Forces and civilians wounded during Israel's War of Independence. The fledgling hospital was built out of a cluster of abandoned barracks erected by the US military in 1941 and subsequently occupied by a British army hospital. The wounded were carried on old-fashioned stretchers through the windows of metal Quonset huts to be treated on army cots. But Sheba, originally named as Tel Hashomer Hospital – the “Hill of the Guardian” – by prime minister David Ben-Gurion, “quickly evolved from a military medical center to a medical center for the State of Israel,” said Sheba Director- General Prof. Yitshak Kreiss. During the past 70 years, Sheba Medical Center has grown from hundreds of beds to almost 1,900, and from 2,000 employees to close to 8,500. The hospital provides assistance to 1.6 million people per year. The barracks are gone and in their stead is a state-of-the-art facility with high glass windows, arched ceilings, artistic corners and the Topor Sculpture Garden. “When a patient is hospitalized, he might forget he is in a hospital and instead assume he is in a museum, which may offer some relief for his suffering,” said Gideon Rechavi, founder of Sheba's Cancer Research Center. Yet Sheba has not abandoned its roots. Kreiss, like the hospital's namesake, Professor Chaim Sheba – who founded the hospital and oversaw its' transition into a civilian facility in 1953 – is a former IDF surgeon general. Kreiss's mother worked as a nurses' assistant at Sheba for 40 years and he was raised “between the barracks” during Israel's pivotal wars. He told The Jerusalem Post that it is his “mission in life” to lead a hospital that can provide continuity of medical care to civilians and soldiers alike. “When I was in the army and until today, Sheba was a hub for soldiers,” said Kreiss. “We knew that whenever we needed centers of excellence for members of the IDF we could find them at Sheba, whether it be a trauma center, burn center, the center for heat tolerance and heat stroke, or the center for warrior and combat medicine, which is a joint project between Sheba and the IDF.” In 2011, in his role as surgeon general of the IDF, Kreiss spearheaded an initiative called “My Brother's Keeper” to reduce battlefield mortality – the number of soldiers who die of their wounds in the field. Partnering with the health system in Israel, IDF soldiers were given special tourniquets and educated in treating themselves. Combat medics were trained and physicians and paramedics were added to each platoon, trained to immediately stop any hemorrhaging. “We needed to recruit hundreds of physicians and paramedics, but in Israel we can do that because we have reservists,” said Kreiss. During the 1948 War of Independence, 48% of wounded soldiers died. Those numbers gradually dropped from 33% in the 1973 Yom Kippur War, to 22% in the 1982 First Lebanon War, and 15% in the 2006 Second Lebanon War. In Iraq and Afghanistan, the US Army's battlefield mortality rate was about 10%. During the Operation Protective Edge Israel–Gaza conflict in 2014, the battlefield mortality rate was reduced to 9.2%. “I say, 'Go protect the State of Israel and we will be here for you at all times, in any scenario, in every case,'” Kreiss said. EYE ON INNOVATION Sheba is innovative not only when it comes to the military. As Israel's largest hospital, Sheba is a hub for research and cutting-edge medicine. “Wherever there are two Jews, there are three synagogues, four opinions, five strategies and 10 crazy ideas,” Kreiss quipped. “I have 8,000 employees, so at Sheba we have thousands of ideas that can generate and develop our vision of innovation.” The combination of research and clinical work, or what Rechavi calls “translational medicine,” sets Sheba apart from other medical centers, according to those who work there. Dr. Yehuda Shoenfeld, who has been with Sheba since 1985 and heads the Zabludowicz Center for Autoimmune Diseases, said, “We go from the patient's bed to the laboratory bench and back to the patient. The system starts with trying to solve the problems of the patients, then we go to the lab to find a solution – a drug or some equipment – and immediately we can test or install it to benefit the patient.” Perhaps one of the most well-known examples of this is the CAR-T treatment for leukemia developed by Rechavi's lab. CAR-T uses a patient's own immune cells to seek and destroy cancerous cells. After some blood is taken from the patient, the T-cells, a type of immune cell, are removed from the sample. Using advanced genetic engineering techniques, the T-cells are then modified, causing them to create chimeric antigen receptors (CARs). These CARs program the T-cells to find and destroy cancer cells when injected back into the patient. Sheba is the only hospital in Israel that offers the treatment. “We are among the pioneers for translating this idea into reality and administering it to patients,” said Rechavi. In addition, Rechavi's lab is among the pioneers in the field of epitranscriptomics, the role of RNA editing and modifications in normal development and their derangement in cancer and neurodegenerative disorders. Rechavi said recent findings have already shed light on the role of these RNA modifications in early development and on the effect of their changes in diseases, such as cancer, obesity and neurodegeneration. Shoenfeld's autoimmune disease center is the first of its kind in the world, centralizing under one roof all aspects of autoimmune research and treatment, and bringing together physicians and researchers from multidisciplinary fields such as internal medicine, clinical immunology, autoimmunity, rheumatology, ophthalmology, neurology, obstetrics and gynecology. The center is doing research on more than 80 autoimmune diseases. In less than a decade, Shoenfeld has recruited more than 100 medical fellows from all over the world to come and work in his center. “They become Zionists,” he said. “Most of them refer to Sheba Medical Center as the dream hospital, because of its beauty, its superior level of treating patients, its research and progress.” Shoenfeld's own daughter was treated at Sheba Medical Center in the 1990s, when as a child she was run over by a bus and nearly died. She underwent 20 operations at the hospital and spent months in the intensive care unit. As a senior medical doctor at Sheba, Shoenfeld was offered the opportunity to recruit specialists from outside of Sheba to help his daughter. “I wondered why I would need outsiders when I knew the best doctors are at Sheba,” Shoenfeld recalled. Today, his daughter is a healthy mother. “This is a heroic study of what the hospital can do.” Rechavi also has deep ties with Sheba. A black-and-white photograph of a younger Rechavi sits in a frame within the professional offices of the medical center. In the picture, Rechavi is lying in a hospital bed, having been badly wounded during the Yom Kippur War. At his bedside is none other than the war's hero and former prime minister, Ariel Sharon. Rechavi remembers that Sharon and his wife, Lily, came to visit the wounded soldiers at Sheba. He spoke with Sharon and then spent two hours dialoguing with Lily Sharon about the iconic book Catcher in the Rye, which was her favorite novel and is seen in Rechavi's hand in the photograph. “Sheba was physically a very different place back then,” said Rechavi. “I started recovering in the army barracks with very minimal conditions. Sheba turned into the country's leading hospital, with very advanced technology and much better conditions. But what is important about Sheba has stayed the same: it is a friendly hospital and they treat you with respect.” Rechavi credits Sheba for his medical career. He said he was planning to study physics after the army. However, due to the care he received during his long recovery at Sheba, he opted for medical school instead. INTERNATIONAL INFLUENCE Today, Sheba influences the entire State of Israel, said Kreiss. In its efforts to serve all the people of Israel, it has opened satellite facilities in the periphery. The medical center works with ALEH Negev, supporting the country's most severely physically and mentally disabled. And late last year, when Hadassah University Medical Center's pediatric oncology unit closed, Sheba stepped up to help those patients. The care goes beyond the State of Israel, too. Prof. Chaim Sheba dreamed of an Israel in which the finest medical care would be available to all who sought cure and comfort and would be a constant reminder that it is possible to treat all men, women and children equally, regardless of their ethnic, religious or geographic origin, explained Kreiss. As such, patients come to Sheba from across the Middle East. “Sheba has evolved into a center that extends a helping hand to anyone in need in the world, beginning with our region,” Kreiss said, noting that Sheba readily provides medical care for Palestinians from the West Bank and Gaza, especially in complex cases in which the patient would not be able to get the level of care required in his or her own community. Sheba serves patients from Kurdistan and Syria, and hospital emissaries regularly travel abroad to provide patient care, support, supplies, relief and training to underserved countries around the world. Doctors and nurses have been in Argentina, Armenia, Azerbaijan, Brazil, Cambodia, Equatorial Guinea, Haiti, Ivory Coast, Kosovo, Mongolia, Nigeria, Papua New Guinea, Peru, Russia, Rwanda, Sri Lanka, Tanzania, Zambia and many more places, with medical teams also coming from overseas for training at Sheba. Kreiss himself served in Kosovo in 1999 and Haiti in 2010. He was the surgeon general on a special humanitarian mission for victims of the Syrian civil war in 2013. Last year, Sheba launched the Israel Center for Disaster Medicine and Humanitarian Response under the direction of Prof. Elhanan Bar-On, who said the center has opened new horizons in humanitarian aid. By taking new initiatives and building collaborations with the Foreign Affairs Ministry and various international organizations, it has increased the staff's operational capabilities, better enabled medical volunteers to reach remote areas and allowed for greater sustainability of the hospital's humanitarian work. “The center has given us the capability to mobilize and recruit people and equipment at short notice, and to be first responders in times of crisis without disrupting continued delivery of care to the people of Israel,” said Bar-On. Most recently, the center sent the first international team to respond to an urgent call for assistance with the outbreak of cholera in Lusaka, Zambia. A team of eight people was on the ground for two weeks, working shoulder to shoulder with the Zambian teams, treating patients and setting up a laboratory at Lusaka's national soccer stadium, which was transformed into a field hospital. “We know that this collaborative effort, as well as the diagnoses enabled by the laboratory we brought, saved lives,” Bar-On said. HEALTHY HORIZON The medical center is once again undergoing a transition, Kreiss said, as it works toward a new vision of transforming itself from a hospital – in Hebrew, a house for sick people – to a “City of Health.” He said he wants to augment Sheba's patient centered, holistic care through a comprehensive medical approach involving prevention, treatment and complimentary medicine – considering the physical, mental, emotional, social and spiritual aspects of a patient. “We will be the model for how to cope with the growing need for integrated, coordinated and comprehensive care,” Kreiss told the Post. “We will be the first city of health in Israel and the region.” This article was written in cooperation with Sheba Medical Center.

Growing with Israel: 70 years of Sheba success

From army hospital No. 5 to a world-renowned medical center, a look at how Sheba Medical Center and Israel's history are uniquely intertwined.

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