July 3, 2008
From Pico to Sheba
It started on a recent Friday afternoon with a visit to Supercuts on Pico Boulevard, located between Young Israel of Century City and Nagila Pizza, right in the heart of the hood.
One of the pleasures of living in a neighborhood is that you're always bumping into people. Well, on the day I took my little boy for a haircut, there in the shop's corner, sitting and waiting patiently while perusing a car magazine, was my friend and neighbor Rabbi Joel Rembaum, the spiritual leader of Temple Beth Am.
When the rabbi heard that I was leaving soon for Israel, he put his magazine down and told me about "amazing new things happening in the field of genetics" at the Sheba Medical Center. I was scheduled to present an ad campaign to the Foreign Ministry on Israel's contributions to the world, so this struck a nerve.
After about my third "You're kidding!" the rabbi saw that I wasn't just being polite, so he put me on the phone with a local philanthropist and member of Beth Am, Marilyn Ziering, who has been very active in this field.
One e-mail led to another, and a few days later, I'm sitting with my Turkish coffee in a laboratory in Tel Aviv talking to Dr. Shlomo Almashanu about phenylalalines, spectrometers, metabolites and other things connected to the genetic screening of newborns -- including the day Almashanu had to plead with an Arab father to rush his sick baby to a hospital.
Almashanu runs the Sigi and Marilyn Ziering National Center for Newborn Screening at the Sheba Medical Center, the largest medical center in the Middle East, which gets more than a million outpatient visits a year.
The key visits to the Newborn Screening Center come in the form of 600 to 800 medical envelopes, which arrive every day at 4 a.m., and contain the blood samples of every baby born in Israel -- Jewish, Muslim, Christian, Buddhist or any of the 100 nationalities that people the Jewish state.
Over the next 16 hours, Almashanu's staff of 10 will care for these blood samples like little jewels and, using the very latest technology, test each sample for 10 treatable genetic disorders.
Because of everything I've heard about Israeli know-how, I assumed the technology had been developed by an Israeli company. It wasn't. It's American.
What Israel has brought to the party is something else: Speed. This is critical because at birth, every day is like a week.
Take, for example, the genetic disease called PKU (phenylketanuria), which can lead to severe mental retardation and neurological disorders. Babies with this condition are unable to metabolize an amino acid (phenylalanine) needed for normal growth development. In infants with PKU, the amino acid accumulates and can quickly wreak havoc on the baby's brain.
This can cause enormous damage in just a few days. But if you can catch the disease quickly, like, say, within five days of birth, the baby can be fed a special formula that contains only a very small amount of the amino acid, and brain damage can be prevented.
Unfortunately, in most hospitals around the world, genetic diagnosis takes about two weeks. Not in Israel.
Over the past year, Almashanu and his team have created a high-tech/low-tech system to get a genetic diagnosis in, yes, five days. I won't bore you with all the details, but the key features are an instant, simultaneous registration of the baby's basic data at the hospitals and the screening center; a customized bar code system based on a social security number given immediately at birth, which minimizes human error and enables instant, centralized tracking of all the steps in the screening process; and, for the low-tech pièce de résistance, a mini-army of private, caffeine-injected couriers who drive through the night to collect the samples and get them to Almashanu's lab by 4 a.m., seven days a week.
In the field of newborn genetic screening, Israel's contribution to the world has been Israeli impatience.
Almashanu himself is a calm man, but there was one day recently when he was not calm at all. His lab had diagnosed an infant with a genetic disorder that can lead to sudden infant death syndrome. The doctor called the father of the baby boy and instructed him to take the newborn to the hospital immediately. For 24 hours, Almashanu kept checking with the hospital, but the baby hadn't arrived. After several more urgent calls from the doctor and the hospital, the father finally brought the baby in. By now, he was barely awake. They saved the baby's life with a few minutes to spare.
Two years ago, before the new system was implemented, the baby probably would not have made it. In fact, the father, an Arab man from East Jerusalem, had lost other children at birth. He assumed he would also lose this one.
Almashanu is obsessed with solving problems. The afternoon I was with him, he talked to the head of a hospital in East Jerusalem about finding more Arab couriers, because many Jewish couriers are fearful of entering East Jerusalem.
It's funny how we can make so much progress with technology, create million-dollar machines that tell us the story of our genes and help save our lives, and still, so much of life comes down to little things like who's available to drive into a neighborhood, or who's willing to make a million phone calls to pester a father to take his baby to a hospital.
And, of course, who you happen to bump into when you take your kid to the local barbershop.
David Suissa, an advertising executive, is founder of OLAM magazine and Ads4Israel.com. He can be reached at email@example.com.