Health + Medicine
The Future of Rehab
Deafened and blinded by explosions all around, blood pumping from wounds in his leg, arm and shoulder, infantry reservist Yossi Shlomo remembers silently thanking God for his 36 years of life and preparing to die in the dust of Beit Hanoun in northeast Gaza. Seconds later, finding himself still alive, he recalled saying to the Almighty: “Maybe I can have a little longer?”
Every harrowing moment remains clear in his mind. “I tried to crawl, and my buddies saw me,” he said. “They gave cover fire, dragged me away, put a high-pressure bandage on my severed femoral artery and eventually got me to a helicopter. I was transfused inflight to Hadassah and kept conscious.
“That’s when I knew I’d live,” he recalled. “I didn’t care if I lost my leg, my arm, my sight. I’d hold my wife and children again.”
That was November 16. Months later, Shlomo’s wounds are largely healed, and following intensive rehabilitation, he is walking again and has regained partial function in his left arm.
Shlomo was one of the first patients to be treated at the Hadassah Medical Organization’s newly opened state-of-the-art Gandel Rehabilitation Center at Hadassah Hospital Mount Scopus. Still under construction when Hamas launched its savage attack on Israel on October 7, and Israel declared war on the terrorist group, the center rushed to open its neurology and orthopedic/spinal cord injury departments in early January. Named for its principal donors, Australian philanthropists John and Pauline Gandel, the opening is the first stage of a multifaceted expansion that will triple the Mount Scopus campus in size and increase HMO’s rehab facilities by 250 percent.
Before he arrived at the Gandel center, Shlomo’s first-line treatment were surgeries by orthopedic trauma specialist Dr. Yoram Weil and hand and microvascular expert Dr. Shai Luria, at Hadassah Hospital Ein Kerem. From there he went to rehabilitation at Hadassah Mount Scopus, initially to a temporary facility set up in the hospital’s gynecology department.
Recovery has been hard work, he said. “The staff challenged me with long, difficult hours of therapy to restore use of my right leg and to mitigate the nerve damage inflicted on my arm by an RPG.”
Shlomo is among some 380 wounded who have been treated at HMO during the war’s first three months; that number is increasing by around three soldiers every day. Their injuries are complex and severe—combinations of burns, blast injuries and close-range gunshots—and many will need weeks, months, even years of rehabilitative care.
“Rehab will be one of the most heavily used words in Israel’s medical vocabulary,” said Dr. Isabella Schwartz, head of Physical Medicine and Rehabilitation at Hadassah Mount Scopus. She said this early on the morning of October 8, when she was talking with Dr. Tamar Elram, head of the Mount Scopus hospital, about Israel’s future medical needs at one of two critical meetings held at HMO that day.
While the Jewish world was reeling in shock and horror at Hamas’s horrific assault on southern Israel, the two physicians were planning for “the overwhelming needs of this new cadre of wounded and the changed reality of the rest of their lives,” Dr. Elram recalled. One immediate need was additional rehab beds and teams.
At that point, there were 780 rehab beds in all of Israel—only 60 percent of the Organization for Economic Co-operation and Development average, and this in a country where ongoing regional conflict adds to rehab needs. Two thirds of Israel’s rehab beds were in the Tel Aviv area.
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Hadassah Mount Scopus was and is the sole rehab facility for the 1.2 million people of Greater Jerusalem, and had just 38 beds. “We scarcely met 30 percent of the need even before the war,” Dr. Elram said.
As the war-wounded started streaming in, gynecology department beds were assigned to them as a temporary solution, “because the department is newly renovated, and our soldiers deserve the best,” Dr. Elram said. Months later, even after the opening of the Gandel center, part of the department is still being used for rehab, with the sign above the entrance, Machleket Nashim (Women’s Department), eliciting chuckles from recovering soldiers and their visitors.
The second crucial meeting on that grim October 8 morning was at the Ein Kerem campus and had been convened by HMO Director-General Dr. Yoram Weiss. It, too, was about rehab, but focused on the long term.
“We’d been working for a decade to increase our capacity,” explained Dr. Weiss, “championed by Hadassah’s chair of the board of directors, Dalia Itzik, after she met a soldier who was traveling from Jerusalem to Tel Aviv every other day for rehab care. On October 8, our new eight-story Gandel Rehabilitation Center was still some six to nine months from completion.”
With the new urgency, the early morning meeting was about how to move up the timeline for its opening. “We brought in labor from abroad and worked around the clock,” Dr. Weiss said. “With dedication, determination and against all odds, we managed to complete two of its four departments less than three months later.”
Igor—his last name has not been released by the army—was also among that initial group of patients moved from the gynecology department into the Gandel center on January 2.
“I’d been in Gaza only 12 hours when a missile hit my tank,” related the 27-year-old Israel Defense Forces reservist. “I knew immediately I’d lose my leg. The question was how much of it I’d lose.”
Igor, who volunteered as soon as news of the Hamas bloodbath broke, remains positive despite amputation of his right leg below the hip. With Hadassah’s occupational and physical therapists, he has spent weeks, with many more ahead, learning to walk again, focusing on gait training and how to balance and transfer his weight with a prothesis.
With the loss of a leg, Igor always understood his rehab would be lengthy. In contrast, 27-year-old Saar, also hospitalized in the Gandel center, had “no idea how long a journey it would be,” he said. Saar, like Igor, had packed his bag immediately after the Hamas attack, even before the official IDF mobilization. “Our unit went into northern Gaza and was battling dozens of terrorists,” recalled Saar, whose last name has also not been released. “I sensed a missile coming at me and flung myself to the side.”
All his limbs were hit, and five tourniquets were needed to stop the bleeding. At Hadassah Ein Kerem, the shrapnel was painstakingly picked from Saar’s wounds, his ruptured tendons sewn and his multiple fractures set. Then he was transferred for rehab at Mount Scopus to work on restoring use of his badly damaged arms and legs.
“I was expecting to spend a few days there to finish healing, and then go back to fight,” he said.
“Saar had a hard time with the gap between his expectations—a quick rehab and regained independence—and the slow reality of healing, and our strict protocol to return his function without further damaging his muscles and tendons,” said occupational therapist Hagit Gal.
Weeks later, his perseverance has started to pay off. “I feel real improvement in everything related to moving my arms and legs,” said Saar, who still has many weeks of recovery ahead of him. “It’s an overwhelming relief.”
Located in its own building set apart from the main Mount Scopus campus, the Gandel center is “more a place of recovery and well-being than a hospital,” said construction coordinator Yuval Adar, deputy director-general and CFO of HMO. “Even a decade ago, the need for it was so urgent that we began building with less than a quarter of the funding in hand. We put up its shell and began on the interior as contributions came in—with special impetus, of course, from the Gandel Foundation of Australia. We still don’t have sufficient funds to complete it and must wait for further donations.”
The Gandel center is designed as a “home away from home” for patients, said the center’s architect, Arthur Spector, whose dozens of projects in Israel include Hadassah Ein Kerem’s Sarah Wetsman Davidson Hospital Tower. The patient is the Gandel center’s focus, provided every kind of care and therapy by an anticipated team of close to 300 physicians and nurses; occupational, physical and speech therapists; psychologists and social workers; and dietitians and administrators. Open and spacious, natural light pours in through the building’s large windows and wide balconies. Hoists in all its single and double inpatient rooms help patients from bed to bathroom and back.
Once fully open, the Gandel center will accommodate 140 inpatients and 250 outpatients. It will also have onsite dialysis, imaging facilities and a post-traumatic stress disorder center. High-tech walking labs will use robotics and computers to analyze problems not apparent in clinical exams, with equipment that includes adaptations of a machine that teaches astronauts to walk in zero gravity. Its two hydroptherapy pools, scheduled to open soon, will have floors that lower for wheelchair access.
There will also be two dining rooms, prayer rooms on each floor, overnight facilities for families and a rooftop healing garden. The building’s underground parking levels, accessed by ramp, can be converted into a sheltered hospital in times of emergency.
“We’ve worked to define and meet the needs of the next 50 years,” said Ilan Levi, HMO’s director of planning, building and maintenance, and the new building’s chief of design and construction. “We’ve even provided for an onsite technological incubator.” Similar to Hadasit, HMO’s technology transfer company, the incubator will bring in commercial companies to develop cutting-edge rehab technology.
Shlomo, the infantry reservist still contending with nerve damage to his arm from an RPG in Gaza, is spending his final weeks of inpatient rehab in the Gandel center. “It’s not easy being injured, in pain and dependent, but the Hadassah team makes it as good as it can be,” he said. “The cheeriness, openness and roominess of the new building is a different world from Mount Scopus’s old rehab department—for me, my wife and our three little ones who visit.”
“For me, the Gandel center is the best rehab facility anywhere, and I expect it still to be the best 10 years from now,” said Mount Scopus rehabilitation head Dr. Schwartz.
“It’s rare when your own dream is a national priority,” added Dr. Elram, the Hadassah Mount Scopus director. “We’ve planned this center for years and have opened it when Israel needs it most. I pray it’ll help our patients redefine hope, health and life, and rehabilitate the bodies, minds and spirits not only of those whom we treat but of our entire nation.”
Wendy Elliman is a British-born science writer who has lived in Israel for more than four decades.
Andrew Krupp says
I had the honor of visiting the rehab center on Jan 25th and meeting with some of the people featured in the story. The soldiers were in great spirits and we even spent time laughing about the absurdity of it all, but they were steadfast in their desire to heal and get back to the front.