Moving Forward on the Foundation of the Past
all know how the days of our lives seem to flow seamlessly from past to
present and on into the future. This week, when National President
Marcie Natan visited us for the first time as Hadassah’s highest elected
official, I remembered the many times we had welcomed her in the past,
when we sat together, discussed the latest developments at the Medical
Center and spoke about what lay ahead.
As Associate Director
General Dr. Yair Birnbaum, HMO Board Chairman Yossi Rosen, Marcie and I
walked through the new Promenade, it felt as if we were walking into the
future – Marcie’s future as President and ours. The Sarah Wetsman
Davidson Hospital Tower is the hub of the new Promenade that brings
visitors, patients and staff directly into the Ein Kerem campus. The
model of the Sarah Wetsman Davidson Hospital Tower stands directly
behind the
Information Desk, bathed in the light that streams
through the glass dome of the two-story Art Rotunda. When the Davidson
Tower receives its first patients – in just 31 weeks – we will take a
major step forward into the future. And when Marcie presides at the
dedication of the Sarah Wetsman Davidson Hospital Tower in October 2012,
the model will become a memento of the past. The building, the
expertise it will contain and the skilled care our staff will continue
to provide, will speak for itself.
* * * *
Revisitingthe past while trying to live in the present is a common occurrence for
people suffering from Post Traumatic Stress Disorder (PTSD). Their
thoughts keep returning to the harrowing event they experienced.
Paradoxically, not everyone who experiences the same trauma develops
Post Traumatic Stress Disorder; however for the person who does, it
means anxiety-filled days and sleepless nights.
During the years
of the Intifada, when our Medical Center was filled with victims of
terror, Hadassah became a world leader in diagnosing and treating PTSD
patients. So much so that we were asked to help the survivors of the
tsunami in Sri Lanka and the people traumatized by the World Trade
Center bombings.
It was during those years that Prof. Arieh
Shalev, then Head of the Department of Psychiatry, and his team of
researchers looked for – and discovered – genetic markers for PTSD that
can be identified with a simple blood test. This information enables
psychiatrists to predict which victims will develop Post Traumatic
Stress Disorder and provide immediate therapeutic intervention –
considered the most effective method of reducing or eliminating the
manifestations of PTSD.
Just as we have in so many other parts
of our Medical Center, in our Department of Psychiatry the results of
their outstanding research are combined with the latest technology for
diagnosis and treatment.
“Some people think they’re fine when
they’re not and sometimes conventional therapy is insufficient,” says
Dr. Sara Freedman of the Cognitive Behavioral Therapy Center where she
and her colleagues are taking advantage of the world of cyberspace to
help Israeli bus bombing victims suffering from PTSD.
About the
same time that the diagnostic blood markers were discovered, researchers
developed Virtual Reality therapy to treat PTSD victims – victims of
road accidents, terror incidents and other horrific experiences. This
new form of treatment has many applications. The US Army found that
Virtual Reality therapy helped Vietnam veterans and soldiers returning
from Iraq and Afghanistan. Researchers found the therapy reduced PTSD
symptoms for people in the aftermath of 9/11.
About five years
ago, Israeli therapists began using a Virtual Reality program known as
BusWorld. This application gradually depicts realistic simulations of a
bus bombing in Israel, something we unfortunately have experienced too
many times.
Working with Dr. Hunter Hoffman of the University
of Washington, Dr. Azucena Garcia-Palacios of Jaume I of the University
of Castellón, Spain, and Dr. Naomi Josman and Prof. Tamar Weiss of the
University of Haifa, Dr. Freedman began using BusWorld at Hadassah. “The
effective way to release their stress is to have people tell their
story,” she says, “but some people with PTSD simply can’t or don’t. It
can be difficult to get people to come in and relive their nightmare,
but when they do, BusWorld facilitates the process of dealing with the
trauma, especially where conventional interventional therapy has not
been effective.”
Although it resembles a sophisticated computer
game, Dr. Freedman cautions that BusWorld is anything but. It is a
potent tool that must be introduced and directed by a trained therapist.
During conventional PTSD therapy, patients retell the story of
the traumatic experience in the first person and the present tense. In
Virtual Reality therapy, patients follow the same protocol, but tell
their story while they are inside a virtual world, an immersive
computer-generated program designed to replicate their experience.
Before PTSD patients actually don the special goggles that project the
visual and audio reminders, they meet with their therapist to prepare
them for the experience.
The therapy brings them right into the
environment of the event where – surrounded by the experience – the
patient is cautiously encouraged to recount ‘what happened next.’ As
treatment progresses, the therapist decides which of BusWorld’s twelve
levels of difficulty is most appropriate – from just seeing a bus stop
all the way up to the bus exploding, accompanied by the sounds of
screams and sirens.
At each stage the patient must retell the
experience for an entire 60 minutes. Sometimes patients only manage to
tell their story twice, sometimes they repeat it twenty times. As they
do, bits of the story become more focused; the traumatic trigger more
evident. Dr. Freedman and her colleagues described some of their success
in using BusWorld in a 2010 paper published in the journal Cyberpsychology, Behavior, and Social Networking.
Even
as they are conducting research and embracing the latest technologies
to help our patients, a research team from our Department of Psychiatry
is engaged in a monumental project that examines all the aspects of
diagnosis and treatment for PTSD victims. Last month, the prestigious
journal Psychiatric Services published the results of the first
part of the study, which evaluated current interventional and follow-up
processes for PTSD victims, identified weak spots in the system and
recommended how treatment could be improved.
Just this week, the team learned that The Archives of General Psychiatry,
the leading journal in the field, had accepted their paper on “The
Prevention of PTSD by Early Treatment,” the second part of the study.
The US National Institute of Mental Health is funding the majority of
the research project.
* * * *
Throughout Hadassah, we are always looking for new ways to help our patients, integrating basic genetic research, like the discovery of the
PTSD markers, with promising new technologies, like BusWorld – looking
back at what we have learned to provide our patients with a better
future.
The walk we took through the new Promenade that ended by
the model of the Sarah Wetsman Davidson Hospital Tower was a parallel
kind of journey, a connection between the past and the future. I look
forward to seeing you in October 2012, when that journey is completed
and the future becomes the present.
Shabbat shalom,
Shlomo
Prof. Shlomo Mor-Yosef
Director General
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