Herzog Hospital in Jerusalem had the lowest COVID mortality rate of all the hospitals in Israel, a surprising statistic considering Herzog only took people with moderate and severe cases, including children, the elderly and patients who already had another impairment or disability before contracting COVID. In part, this achievement was due to Herzog’s quickly developed, dedicated COVID care unit, and the hospital’s expertise in treating patients on ventilators. Beth Nussbaum, development director for American Friends of Herzog Hospital, attributes their success to something else just as important: compassion.
At a time when most COVID patients were kept isolated and alone, Herzog recruited IDF soldiers to take the place of family members. “These volunteers risked their lives to play games and watch TV with patients, and put their children on the phone with them,” said Nussbaum. “They gave the patients hope.”
Dr. Jacob Haviv, CEO/director general, said there was an outbreak at a group home for disabled youth, where most of the patients were between the ages of 18 and 21. The government advised the shelter to send the sick residents to Herzog as it was the only hospital in Israel equipped to handle them. Herzog also allowed the aides helping the young men and women to stay with them.
Haviv is justly proud of Herzog’s track record in getting patients who had been on ventilators back on their feet. “We just got a short video from a former patient dancing at her grandchild’s wedding,” he said. “She came to us on a ventilator, unconscious. Nobody believed she would survive. We weaned her off the ventilator and she spent 11 months in rehab. She invited the staff to the wedding.”
I spoke with Haviv and Nussbaum (formerly development director for Teaneck’s Ma’ayanot Yeshiva High School for Girls) in March at the Nefesh B’Nefesh Medex recruitment and networking event for medical professionals considering aliyah, at Teaneck’s Glenpointe Marriott. There is a shortage of medical personnel at Herzog and throughout Israel. Herzog is looking for a certain kind of personality: one who has the maturity to care for patients who other hospitals have given up on or aren’t equipped to treat, and who is comfortable with Herzog’s holistic approach to care.
Herzog has six specialized areas of care: geriatrics; mental health, with a focus on schizophrenia and post-traumatic stress disorder (PTSD); the Clinical Research Center for Brain Sciences; rehabilitation for conditions like strokes or car accidents; pediatric chronic respiratory care; and COVID, including the first unit for post-COVID patients with “long COVID.” Herzog is the leading hospital in Israel for treating patients of any age on ventilators.
Since Herzog is a one-of-a-kind hospital, I asked the president, Dr. Yehezkel Caine, in a Zoom interview, where their patients would be if Herzog didn’t exist. The simple answer is that they wouldn’t have survived their trauma or they would be homeless.
Treating psychiatric patients has been part of Herzog’s mission since its founding in 1894 as a shelter for the homeless, known as Ezrat Nashim. The first president was Rabbanit Sarah Herzog, President Isaac Herzog’s grandmother. The hospital was renamed for her in the 1980s.
The hospital’s first patients were primarily young mothers who were suffering from what we now deduce was postpartum depression, but illnesses of the mind were not diagnosed or named in pre-Freudian times. In the 1970s, Israel, the U.S. and other countries threw the baby out with the bath water when they embarked on deinstitutionalization to end the horrific conditions at psychiatric institutions. But the replacement was the street, not a better method of care, a situation that has sadly resumed today. And that’s where Herzog’s psychiatric patients would be once more if there was no Herzog—back on the street.
Treating patients on ventilators requires the proper equipment, training and time, all of which are in short supply at other hospitals. Patients are treated initially in intensive care units but then have to move elsewhere. If they are sent home or to rehabilitation facilities without the right infrastructure, they won’t get better. There is a syndrome, ventilator-associated pneumonia (VAP), that afflicts patients on ventilators who aren’t treated properly. And in too many cases, ventilators are disconnected from unresponsive patients.
Ask anyone who has put an elderly parent or spouse in a rehab facility if they were satisfied with the care. You’re likely to get a litany of uncomplimentary responses. “Most elderly do not get to a professional, dedicated rehab center,” said Caine. “We excel at putting these patients back on their feet. We have a high success rate of rehabilitation of elderly patients, especially after strokes and surgery.”
Herzog pivoted very quickly to using a new sheltered wing for admitting COVID patients. The elderly are particularly susceptible to long COVID, which can result in hospitalization on a ventilator for weeks or months. “We succeed in weaning off the vast majority,” said Caine. “But when they get off they can’t even stand and need rehab. COVID causes severe lung damage. We put them through specialized rehab, which could be five, six or eight weeks, to get them back as best we can.”
Any Israeli with a qualifying diagnosis and an HMO insurance plan can be treated at Herzog. Caine said about 50% of the pediatric patients are Israeli Arabs, and a small percentage come from neighboring countries. But Herzog is a private hospital. All capital investment, research and programs are funded by charitable donations. Herzog recovered from being almost bankrupt in the 1990s through tight fiscal management, and is now raising its profile to attract new donors in the U.S. and other countries.
While Herzog has many Jewish and non-Jewish donors who support the hospital’s mission of specialized care and access for all segments of Israeli society, the hospital has a compelling reason to raise awareness in Jewish communities in other countries. “Many will end up in Israel as retirees and will need our services,” said Caine. “We’re saying, ‘Hey guys, we’re here for you.’ This includes people from Ukraine and the former Soviet Union, none of whom have put money into the system. Anyone can come.”