BRCA And Beyond At Shaare Zedek


Dr. Jonathan Halevy, whose specialty is liver diseases, has been the director-general of Shaare Zedek Medical Center in Jerusalem for the past 26 years. He is also chairman of the Israel Health Basket Committee, which determines which drugs, medical procedures and technology will be approved and subsidized by the national health care system. Shaare Zedek made news this month when breast cancer researchers there found that women who carry the BRCA1/2 genes are prone to breast and ovarian cancer — even if they have no family history of the cancers. Halevy was interviewed during a recent visit here.

Q.: The breast cancer findings from the center’s Fuld Genetics Department have a particular resonance for Ashkenazi women. What are the recommendations resulting from the research?

A.: Professor Ephrat Levy Lahad [the study’s lead researcher] has made many contributions in the past to better understanding of the implications of cancer genes on human health and disease. The recent publication in the journal PNAS-Proceedings of the National Academy of Science shows that women who carry breast cancer genes BRCA1 and BRCA2 are prone to breast and ovarian cancer even if they have no family history of these cancers. These findings call for screening of all Ashkenazi Jewish women for these genes regardless of their family history, as such screening may contribute significantly to prevention of these potentially deadly cancers.

For 26 years you have shepherded the growth of Shaare Zedek to the point where it is now the largest hospital in Jerusalem and one of the largest in the country. To what do you credit that success?

To the tradition of Shaare Zedek before my time — which was one of compassionate, individualized care. I inherited a very good human infrastructure. … We have a 1,000-bed hospital with two campuses that admit 80,000 patients a year and treat in ambulatory institutes and outpatient clinics a half-million people.

And yet when Americans think of a hospital in Israel, Hadassah Medical Center comes to mind. Does that bother you?

The fact that it bothered me was one of the motivating forces to change this situation. Americans know about Hadassah because it has 350,000 women who belong to its organization. It should be very grateful to the organization for what it did over the years. But as you know, there is a crisis there, and I’m not only talking about a financial crisis but one also with the government.

Hadassah is an Israeli hospital with Israel doctors, Israeli administrators and it is run by an American organization that does not delegate authority. With the advance of medicine that has become so costly and is sometimes over specialized, it has become impossible to run it. … Shaare Zedek is committed in every way possible to seeing Hadassah emerge from this crisis as quickly and seamlessly as possible.

There are many organizations and institutions in Israel that have American Friends groups to raise money in the U.S., including Shaare Zedek. What is your selling point?

Our American Friends group was founded in 1949 and is the oldest Israel hospital friends group here. We have another selling point — Jerusalem — which is dear to many in this country. We are the only major hospital in the geographical center of the country. Hadassah is in the eastern and western sections of the city; we are right in the center, across from Mount Herzl. And when every minute counts, location has implication.

The hospital is preparing to open the Next Generation Building, which will include the Wilf Children’s Hospital and the Matloff Disaster and Emergency Response Center. What will make them unique?

It’s called the next generation building because of the various units that represent our next generation — neonatal, pediatrics, an institute for infertility problems, and maternity. It has one floor underground and seven above ground. Some of the floors are now open and we expect all to be open by the end of the year.

In 2012, Jerusalem’s financially troubled Bikur Cholim Hospital merged with Shaare Zedek, and it was predicted the merged entity would have the largest childbirth center in the country. Has that happened?

Before the merger we had over 15,000 deliveries, which was the most in Israel. Now, we have 21,000, which is probably the most in the world.