REUTH NEWS DURING TIMES OF PANDEMIC 5781/2020 SEPTEMBER EDITION
LETTER FROM THE HOSPITAL'S DIRECTOR Dear friends, The past year has been one of the most challenging Israel and has ever known, as it faced the coronavirus pandemic together with the rest of the world. We are dealing with a completely new virus, and still learning its characteristics. The pandemic has compelled us to adapt our hospital routines and adopt new procedures in the interaction between patients and staff – always keeping in mind the most important task of all: protecting the lives and health of both patients and personnel so that we may continue to provide top-quality rehabilitation. We always meet our patients and their families at a point of crisis in their lives. But under the pandemic the patients' emotional needs, addressed by our staff, become even more complex, aggravated by new directives, fewer visitors and distancing from loved ones. Some of our patients are recovering from severe cases of COVID-19, after being ventilated for weeks. Thanks to our intensive and comprehensive rehabilitation, they regain their independence, overcoming severe difficulties and returning to their families and normal lives. The strength of an organization is tested in times of crisis and I am proud to say that our staff - doctors, nurses, health professionals and administrative personnel - has once again proved the hospital's high professional standards, commitment and dedication. At the same time, with the help of our friends worldwide, we continue to develop the hospital's infrastructures: We added more beds for respiratory and geriatric rehabilitation; We expanded our online rehabilitation services, enabling the public to receive professional care at home through Reuth Online, and extended our services southwards, through the Reuth Community Medical Center established in Kiryat Gat. I truly hope that in the coming year we will prevail in our battle against the coronavirus. May you and your loved ones enjoy a good year of health and prosperity. Shanah Tova and happy holidays! Dr. Dov Albukrek Director Reuth Medical and Rehabilitation Hospital, Tel Aviv
REUTH NEWSLETTER TABLE OF CONTENTS
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ELI BEER'S MIRACLE
WEDDING DURING COVID
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ON MY FEET
PEOPLE
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UPDATES FROM I SWR WA WE L. A M E R I C A N F R I E N D S O F RI NE UF TOHR. MO RAGT I O N
MIRACLE
ELI BEER'S MIRACLE
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Eli Beer, 46, President and Founder of United Hatzalah, was raising funds in Miami last March, when the coronavirus pandemic broke out all over the world. After traveling to several states in America, Beer attended a reading of the Book of Esther at a Miami synagogue on Purim. The next day he began to suffer from symptoms that eventually turned out to be COVID-19. Beer was hospitalized in an isolated intensive care unit at a medical center in Miami. When his condition deteriorated rapidly, the staff had no choice but to anesthetize him and put him on a ventilator. "The moment the doctors told me that I would be anesthetized, I remembered the hundreds of patients I had read about, who had been on a ventilator and then died," recalls Beer. "I thought the end was near. I felt sad and angry and frightened, and wanted to say goodbye to my beloved wife and five children. I asked them to continue doing good in the world, to carry on in the spirit in which I had raised them. I asked them to pray for my life." Only a month later, when his condition became stable, the hospital decided to wean him from ventilation. Beer woke up into a nightmare. "I couldn't figure out who these people were, standing around me in masks and spacesuits, so I can't see their faces." Returning to Israel last April, he was met at the airport by his family, and the reunion received a great deal of emotional media coverage. Beer had to be carried off the airplane, extremely weak and exhausted. Shortly after his return, Beer began an intensive rehabilitation process at Reuth's Day Rehabilitation Center made a full recovery and reunited with his family in Jerusalem. COVID-19 leaves severe patients who had required prolonged ventilation under anesthesia, with physical damage that necessitates comprehensive rehabilitation, to help them regain their functional independence and quality of life. Damage is extensive: lower cardiopulmonary functions, shortness of breath, loss of up to 30% of the muscle mass and considerable
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weakness, alongside emotional implications resembling posttraumatic stress syndrome all of which require professional care. Prof. Rafi Heruti, Head of the Rehabilitation Division at Reuth Rehabilitation Hospital: "The viral infection, combined with prolonged ventilation, leads to multi-systemic damage and considerably reduced functions. When Eli came to us he was suffering from nutritional deficiencies resulting from dramatic weight loss, weakened muscles and low cardiopulmonary endurance. His comprehensive multidisciplinary rehabilitation emphasized various functional aspects: physiotherapy for strengthening his muscles and improving movement, nutrition, occupational therapy, improving his memory and cardiopulmonary endurance, and emotional support that helped him process his anxiety and regain his self-confidence. People who recover from COVID-19 have experienced trauma. All at once, their lives had been turned around. They had been totally cut off from their normal lives and surroundings, and many had been on the brink of death. Emotional therapy given by rehabilitation psychologists and social workers is essential. We are very happy about Eli's successful rehabilitation."Right before leaving Reuth, Eli Beer summed up his experiences: "At Reuth I received wonderful care. I walk out of the hospital both strong in body and empowered in spirit, returning to my normal life. I can hardly believe it. I'm going back to my family in Jerusalem."
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WEDDING
A WEDDING IN TIMES OF PANDEMIC
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Shmuel Garcia, undergoing rehabilitation following a major stroke, married his fiancé on the roof of Reuth Hospital, in a most emotional event relayed through Zoom to their relatives in Colombia, Mexico and the US. While coping daily with the challenges of COVID-19, the Reuth Rehabilitation Hospital was also able to grant an unusual request: Allowing a patient and his fiancé to hold an intimate wedding ceremony, attended by the ward's staff and under the directives of the Ministry of Health. Shmuel Garcia, 53, who suffered a major stroke about a year ago, married Bat El, his partner of several years, one day before his release from hospital. The wedding took place in a very special venue: on the roof of Reuth Rehabilitation Hospital, used as a playground by children from the pediatric ward. The playground, inaugurated just a few months ago, was established with the support of Daniel Arison Dorsman of the Ted Arison Family Foundation. Shmuel, who lives in Tiberias, suffered a stroke in September 2019, while working on the shore of the Sea of Galilee. He was taken to the Poriya Medical Center, suffering from convulsions, paralyzed limbs, speech impediments and swallowing difficulties. Due to the severity and complexity of his condition, he required ventilation. Last March, finally stable and weaned from the ventilator, he was transferred to Reuth's Head Injuries Rehabilitation Ward. Born in Colombia, Shmuel immigrated to the US at the age of 14. For ten years he served in the US Marines, traveling to dozens of countries as a VIP close protection officer. 13 years ago he converted to Judaism and made aliya. In Israel he met Bat El, also a recently converted Jew from Colombia, and the two fell in love. For both of them, this is their second marriage.
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WEDDING
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The severe stroke completely changed the course of Shmuel's his life. During his months of rehabilitation at Reuth, Bat El remained at his side, taking an active part in the process. Since both Shmuel and Bat El observe the Jewish traditions, Bat El asked the staff whether they could get married at the hospital, before moving in together. All of Shmuel's therapists participated in the exciting wedding preparations: The occupational therapist worked with Shmuel on writing a speech by improving his manual functions; the physiotherapist helped him practice breaking the glass under the huppah; and the team at the therapeutic garden helped him pick flowers for both the bridal bouquet and a wreath for his daughter. During the moving wedding ceremony, the occupational therapist read out the speech that she and Shmuel had prepared together. Held under the strict coronavirus directives of the Ministry of Health, the ceremony was attended by only a handful of Reuth personnel, the couple's children and a friend who relayed the ceremony live through Zoom to friends and family in Colombia, Mexico and the US. Dr. Frida Shemesh, Director of the Head Injuries Rehabilitation Ward at Reuth: "At the Head Injuries Rehabilitation Ward we treat people with different levels of brain damage. Most patients have considerable difficulties in communication, daily functions and mobility. Families play an important part in the rehabilitation process, receiving full professional support from everyone in our team. Shmuel came to us suffering from the locked-in syndrome: full paralysis of all muscles, leaving the patient with only eye movements, and in some cases head nodding as well. The most common cause for this syndrome is stroke, and rehabilitation is a great challenge. Happily, some of Shmuel's motor functions have improved: He can now move his right hand, swallow, get around in a wheelchair and communicate. His intensive rehabilitation was multidisciplinary, including rehabilitation medicine, nursing, speech therapy, occupational therapy, physiotherapy, supervised nutrition and continual support for the family. Shmuel's story proves that even in severe and complex cases, a wellplanned rehabilitation process can enable the patient to go back to his home environment, to his family and friends. We are happy that even in these trying times of pandemic, we were able to provide a full response to Shmuel and Bat El, his wonderful new wife, who supported him throughout his rehabilitation, and is now going back home with him. We wish them both lots of love, health and happiness."
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"IT'S GREAT TO BE BACK ON MY FEET"
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Maoz Porat who recovered from COVID-19 came to Reuth in a wheelchair and was released following successful rehabilitation. Coming down with severe COVID-19 about six months ago, Maoz Porat from Bnei Brak was anaesthetized and ventilated for two weeks in Intensive Care at the Sharon Hospital in Petah Tikva. When his condition improved, he was weaned from the respirator. Having recovered from the virus, but still in a wheelchair, he came to Reuth for rehabilitation. Maoz Porat: "It's great to be back on my feet. Thanks to Reuth's wonderful care and professional treatment I am walking out of the hospital without any walking aids." Prof. Rafi Heruti, Head of the Rehabilitation Division: "Prolonged ventilation and anesthesia are very exhausting for the body's systems. Maoz's muscles were weak and he could barely walk. Rehabilitation focused on strengthening his respiratory system, cardiopulmonary endurance and musculoskeletal system, restoring his full functions in every respect."
NOT ONLY FOR COVID-19: THE MASK AS A THERAPEUTIC TOOL
Under the COVID-19 directives we must all wear masks in public, as part of the new routine. This new 'dress code' has generated a range of creative designs, colors and models, allowing us to choose how to present ourselves and express our personality without breaking the rules. The mask is a major tool in art therapy. Human cultures have always made extensive use of masks and costumes (such as uniforms), that help us form our identity and present it to others. The mask is a means of self-protection that we all use in our daily lives. As a therapeutic tool in rehabilitation the mask provides the therapist with a creative space in which he can choose which aspects of his personal feelings and identity to reveal, and which to conceal. The creative process enables him to look inside, while maintaining the defenses he needs. In the therapeutic context,
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the patient may feel sufficiently safe to remove some of the masks he wears every day. Art therapy is a relatively young discipline, but its roots go back to the psychiatric hospitals of the late 19th century. The first art therapists recognized the effects of aesthetics on other disciplines: psychiatry, psychoanalysis, rehabilitation, preschool education and art education. The therapeutic encounter combines a range of psychological theories and therapeutic techniques, alongside work with materials and processes from the world of art. The purpose is to provide the patient with a nonverbal tool for expression, thereby opening a window into his inner world in an inviting, nonthreatening way. The language of art also provides an alternative means of communication for patients with damaged functions or difficulties in verbal expression. A mask has two sides, and in art therapy the patient can choose whether to work on one or two sides. In many cases, the outside represents how he reveals himself to the outside world, while the inside represents the hidden aspects of his personality. One patient, for example depicted the happy feelings he shows outwardly on the outer side of the mask: the sun, sky, flowers and renewal. The inner side was divided into hope and pain by a cracked wall symbolizing the emotional crisis brought about by his injury. Another patient painted flowers and soft colors, signifying optimism, on the outside, while on the inside he used dark colors and question marks, painting tears and half a sad mouth protected by the happy half. A third patient chose to use only the outer side of the mask, which she divided into two: one part showed her on optimistic days, while the other represented days when she is overcome by despair, with a naked tree against a grey wintery sky. To give the mask the solid, reassuring foundation she needs, she placed it on a stone base. The process of getting to know and revealing one's inner self is guided and supported by the therapist, who helps patients gain strength and acquire tools for the trying challenges of rehabilitation.
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SERVICES
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SPECIAL SERVICES FOR TIMES OF PANDEMIC Quickly responding to the new needs arising in these unusual times, Reuth Rehabilitation Hospital has established several new services: REUTH ONLINE: REHABILITATION FROM AFAR
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Since the beginning of the COVID-19 pandemic the hospital has expanded its Reuth Online services to include rehabilitation treatments from afar, specially designed for people who require professional rehabilitation but prefer to stay at home. Reuth Online services are offered every day of the week by a range of professional experts: day rehabilitation staff, rehabilitation and geriatric MDs, occupational therapists, physiotherapists, speech therapists, nutritionists, psychologists, social workers, and specialists in biofeedback and rehabilitation yoga. TRAINING THE CONSULTANTS
The hospital led a training initiative for the professional teams of JDC-Eshel's MISGAV (Multidisciplinary Geriatric Rehabilitation Centers) program, on rehabilitation from afar for patients in the community. The training focused on both technological and therapeutic aspects of running the online service, adding individual instruction for health professionals working in the community all over the country, in the fields of nursing, physiotherapy, rehabilitation psychology, speech therapy, social work and occupational therapy. SCHOOL FOR OUR WORKERS' CHILDREN
Last March, during the countrywide lockdown, the hospital opened its own school for the staff's children aged 4-10 years. Operating 5 days a week, the school enabled the children's parents to continue their important work at the hospital in these critical times. The school was opened thanks to close collaboration with the IDF's Home Front Command and the Tel Aviv Municipality, which provided the venue – a spacious kindergarten cluster on HaMa'aracha Street, at a walking distance from the hospital, comprising five classrooms and separate yards equipped with games and fun facilities. Our HR team, together with a nurse, other Reuth employees and soldier-teachers from the Home Front Command received the children every morning and conducted activities all day long, including a nutritious midday meal.
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NEWS
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1MILLION SHEKELS RAISED IN A CROWDFUNDING CAMPAIGN FOR MORE VENTILATORS
The coronavirus has presented our hospital with highly complex challenges. One of these was increasing the number of ventilators. The team at Reuth's Ventilation Division provides dedicated professional care to 135 patients who require intensive multidisciplinary medical care 24 hours a day. A special crowdfunding initiative conducted through JGive, setting the goal of adding 15 ventilation stations that would enable the rehabilitation of additional patients – as many as dozens more every year. The initiative was highly successful, thanks to the staff and friends of Reuth who led the campaign, and thousands of donors, including Microsoft Israel. 1m NIS were raised and these funds will help us purchase crucial equipment for the hospital. KU.GRO.HTUER.WWW
PROFESSOR HERUTI APPOINTED
HEAD OF THE DEPARTMENT OF PHYSICAL MEDICINE & REHABILITATION AT T.A.U.
Prof. Rafi Heruti, Head of Reuth's Rehabilitation Division, was appointed Head of the Department of Physical Medicine & Rehabilitation at Tel Aviv University's Faculty of Medicine, starting September 2020. An alumnus of the Faculty, Prof. Heruti has served in various academic capacities at the Faculty for the past thirty years, and is a cofounder and coordinator of its Human Sex & Sexuality Program. Prof. Heruti is also the Founder and Director of the Sexual Rehabilitation & Treatment Clinic at Reuth Hospital – Israel's largest public clinic in this critical field and a teaching center for students and interns. As a sports doctor he has served for decades as the volunteer medical advisor of Israel's Paralympic swimming team. For the past year he has led treatments for the team as part of the hospital's medical sponsorship. Prof. Heruti lectures both in Israel and overseas, and reviews papers on rehabilitation and sexual health in international medical journals. "This appointment signifies recognition for Reuth's academic community, which makes me proud," said Prof. Heruti. "Rehabilitation medicine is one of the most essential fields both for the individual and for society as a whole. It's extremely important that we train the future generation and strengthen this field within the Israeli Health System."
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In a time where we may not be able to celebrate with our families, make a donation to Reuth Rehabilitation in their honor by clicking below. Wishing you and your family a healthy, happy and sweet New Year!
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