By Lonye Rasch

On a Friday morning about six months ago, my Israeli cousin’s wife was walking home after buying some donuts for Hanukkah. As she was crossing the crosswalk, she was hit by a jeep and trapped under one of its wheels. Her head hit the pavement and her legs were crushed and contorted. After many days in the hospital and a complex, 10-hour surgery to save her legs, she eventually faced her new full-time job as a patient in an inpatient rehabilitation center. She was lucky to get a bed in a quality comprehensive facility near her home.

Of course, both the trauma care she received immediately after the accident and the subsequent surgical interventions were crucial to returning any quality of life to her. But it is her own inner strength coupled with arduous rehabilitation therapy that has brought her to the point of walking cautiously on her own two feet, with the help of a single crutch.

I know from my visits with her that she has worked diligently in therapy, both to gain back her mobility and her short-term memory and cognitive skills. She still has a long journey ahead; full recovery is still a distance away. But her ability to envision a normal life once again is only real because a bed and a multitalented, multidisciplinary rehabilitation team were there for her after that accident.

It is with the image of my brave and determined cousin in mind that I remember my recent comprehensive tour of the construction site of the new Gandel Rehabilitation Center, rising at Hadassah Hospital Mount Scopus.

With Jerusalem’s population growing rapidly, the city desperately needs this new facility, which will increase inpatient capacity from 38 beds to 132 beds. At the current 50-year-old rehabilitation department, there is a waiting list for a bed, even though there are five to six people in a room. The waiting list often stands as a frustrating obstacle to a patient’s optimum recovery.

The Gandel Foundation, led by John Gandel and Pauline Gandel of Melbourne, Australia, provided the signature naming gift, facilitated by Hadassah Australia. Now, a three-way strategic partnership between Hadassah, the government of Israel, and the mayor of Jerusalem is propelling the construction forward.

On average, inpatient rehabilitation requires a stay of 33 to 35 days. “The building has to provide a home away from home,” explains architect Arthur Spector. As such, it will have healing gardens, giving patients the opportunity to be with nature. There will be a rooftop garden, overlooking the Jordanian mountains and the City of Jerusalem, where the patients’ families can host important life events. A synagogue and multi-faith prayer room will be on-site to promote spiritual healing.

Taking practicality into consideration, the facility will contain special lifts that will hoist patients from bed to shower, eliminating the need for medical and nursing staff to lift up a patient.

Temperature-regulated hydrotherapy pools will provide personalized therapy according to each patient’s needs.

Eased by state-of-the-art equipment and beautiful surroundings, rehabilitation is still a journey of ups and downs. Patients must grapple with the psychological trauma of having their regular lives totally disrupted, along with the physical and cognitive injuries they have sustained. It takes “a village” of physical and occupational therapists, social workers, psychologists, and dieticians to restore the patient to health and quality of life.

Sometimes, explains Yulia Portnoy, deputy head nurse of Hadassah’s rehabilitation inpatient ward, therapy can bring patients fully back to where they were before their accident or illness. She remembers one soldier, for example, who was not able to move his arms or legs when he first arrived. But after a few months, he got his mobility back.

Portnoy, who comes from Moscow and has worked at Hadassah for 20 years, recalls another young man, a tour guide who has Guillain-Barré syndrome. When he first came to the rehabilitation department, he could not move his arms or legs either. But after a few months of therapy, he, too, regained his mobility. To show his appreciation, he took the staff on a tour of Yafo. Another patient with age-related degeneration in his back, she relates, was the sole provider for his family and he wasn’t even able to get up by himself. He worked hard in therapy; he prayed hard. And he, also, achieved mobility.

Another patient was run over by a car. He was on the verge of losing his legs, but after two months in rehabilitation, he is able to walk.

“Here, in our department, up to age 75 is considered a young patient,” relates Portnoy. When the patients are older than that, the therapy team consults with a geriatrician to determine the proper personalized therapy.

Portnoy comments,  “It’s amazing to see patients in their nineties, often Holocaust survivors with numbers on their arms, “who have so much spirit and strength to work hard to recover.” 

A typical day of treatment may be comprised of physical, occupational, and speech therapy, hydrotherapy in one of the pools, and various cognitive exercises. Outpatients, who come in each morning for therapy, typically stay until 6:00 p.m. They often leave with “homework” to practice exercises on their own.

Sometimes, ordinary tasks that patients performed before their accident or illness need to be relearned—such as driving. With the help of a driving simulator, patients regain their skills and reaction time. The three-screen interactive program recreates real-life driving scenarios, such as a pedestrian walking in front of the car and trucks suddenly changing lanes.

Portnoy explains that these patients must be recertified before they are allowed to drive again. After working with the driving simulator, the patient is evaluated by a therapist, who then makes a recommendation to the physicians as to the patient’s driving capability. The last step is recertification by the Ministry of Transportation. Sometimes, unfortunately, Portnoy says, the therapists must disappoint the patients by informing them that they are not yet ready to resume driving.

Portnoy, of course, looks forward to moving into the new spacious Gandel Rehabilitation Center, where there will be so much more room to help many more patients. And there will be a larger selection of innovative equipment. “Patients won’t have to wait in line to use the machine they need,” she adds with a smile.

 

Main photo caption: rehab patient using the three-screen interactive driving simulator program, under the careful supervision of a therapist