'Israelis Are Ambitious About Saving Anyone's Life': An Interview with Sheba Medical Center Director General Yitshak Kreiss

Published: November 1, 2017

Israel's Sheba Medical Center at Tel Hashomer gained a luminary when it appointed Brig. General (Res) Professor Yitshak Kreiss, MD, MHA, MPA, as its director general in 2016. For more than three decades Kreiss has dedicated his life to saving lives on the battlefield, in Israeli hospitals, and around the world.

Believing that Israelis "are moral and ambitious about saving anyone's life because these are Jewish values, " Kreiss has traveled the world leading humanitarian missions to achieve that goal.

The Jewish Press: Describe your background both in the army and as a doctor. In what way does your army experience distinguish you from other doctors?

Prof. Kreiss: I dedicated my life, until I took over as CEO of Sheba, to two goals. One is to treat and save the lives of soldiers on the battlefield and the second is to extend a hand and treat people all over the world in humanitarian missions. I think serving as a surgeon in the IDF combines professionalism in medicine and leadership, which are the two things that differentiate my career from other physicians.

Serving in the IDF is a privilege by itself. Saving soldiers' lives is another privilege that fosters not only professionalism but also values. My first post in the army was as a battalion surgeon in the paratroopers unit. From there I rose through different posts until I assumed command as the surgeon general in the rank of brigadier general. Parallel to that career I specialize in internal medicine at Sheba and am a professor of medicine at Tel Aviv University and adjunct professor for military medicine at the Hebrew University in Jerusalem.

Why did you choose to work at Sheba Medical Center after retiring as Surgeon General?

Because Sheba is the largest and most comprehensive hospital in Israel and the Middle East and it's unique in that it has all the continuity of care on one campus. Sheba treats one and a half million people each year, so we impact almost 15 percent of the Israeli population in the most important aspect of their lives – their health. And it's the hospital of the state of Israel; we reach out and help other hospitals all over Israel.

But Sheba is not just a hospital. It's a medical center that relies on cutting edge technology and innovation and it's a school for developing the next generation of health professionals in all areas of medicine. For me it was also a natural choice because my mother worked at Sheba for 40 years as a nurse's assistant and I did my residency in internal medicine there.

Are there any conflicts in being an army doctor? A soldier's mission is to take lives while a physician's mission is to save lives. How do you reconcile those seemingly contradictory goals?

It sounds like a contradiction but actually medicine has written the best of its glorious chapters in times of war. Wars contributed to modern medicine's advancements in trauma medicine, vaccines, infectious diseases, nutrition, and physiology. Much of the knowledge we have today was generated during wars and conflicts. So for me it's not a contradiction; it's a double privilege to serve my country as a soldier and to serve my country by saving my brothers' lives.

This is not just typical of the IDF; it's universal. Modern surgery was created by Napoleon's physician, Donimique Jean Larrey. Until then surgery was primitive. Before the U.S. Civil War, Walter Reed found ways to fight infection as a military physician. Military physicians also found the lack of vitamin C in scurvy. In the IDF we created a successful program called My Brother's Keeper, which is a strategy to reduce battlefield mortality. As soon as we succeeded, many pre-hospital civilian organizations and in-hospital civilian organizations adopted our strategies and technologies.

What does the program entail?

My Brother's Keeper began in 2011, when I assumed command as the IDF surgeon general. We set a goal for reducing battlefield mortality, which is measured by how many soldiers die out of the number that are wounded. The better the medical treatment, the fewer soldiers will die. As physicians, we are not responsible for how many people are injured; that's a fact of war. But we are responsible for saving as many lives as we can. In the 1948 War of Independence, 48 percent of wounded soldiers died. It was 33 percent in the 1973 Yom Kippur War, 22 percent in the 1982 first Lebanon War, and 15 percent in the 2006 Second Lebanon War.

When I assumed command we decided our goal would be less than 10 percent. We saw American success in reducing battlefield mortality in Iraq and Afghanistan to about 10 percent in the Special Forces. So we decided that it if can be done in certain units, it can be done for all the IDF. Ninety percent of soldiers who die on the battlefield die from hemorrhage in the first hour. So my task seemed simple – take technologies to stop bleeding and put them as forward as possible in the battlefield.

The medical provider closest to a soldier is the soldier himself. So we gave soldiers special tourniquets and educated them in treating themselves. Then we gave the capability to the soldier's closest medical providers – first his comrades and then combat medics. We also realized we needed physicians and paramedics in each platoon to immediately stop any hemorrhaging. We needed to recruit hundreds of physicians and paramedics, but in Israel we can do that because we have reservists. And they came. In the 2014 war in Gaza, the battlefield mortality was 9.2 percent.

Does your work in humanitarian aid in disaster areas translate into tangible positives for Israel's image?

Yes, of course. The attention we got in Haiti, because we were the first and only advanced capabilities hospital for the first five or six days, generated a lot of very positive PR, especially in the United States because many reporters came to our hospital. They were overwhelmed by the progress and advancements and the level of care we provided. I took a taxi in New York and the driver was Haitian. He asked me where was from, and when I said Israel, he said, "That's the country that saved Haiti."

Everywhere in the world where we sent humanitarian help we got good PR. Whether in Mexico this Rosh Hashanah after the earthquake, in Japan after the tsunami, in Sri Lanka, and in Kosovo at NATO's request, the countries learned about the strength of Israeli medicine and about Israel as a state. And the World Health Organization ranks Israel's field hospital as the world's best.

At Sheba we established a center for humanitarian disaster and emergency medicine, and the demand from other countries is tremendous. We have delegations from China, Africa, Europe, and Russia that come to train. Not every country wants to accept us or allows itself to praise our humanitarianism, but we offer help to anyone in need.

Because of its history of surviving amid constant threats, Israel is always on alert. Has that mentality helped Israel in terms of responding to health emergencies around the world?

Countries ask us how we manage to get to Haiti, Nepal, the Philippines so quickly. There are three parameters guiding us. One is that Israel has made a strategic decision to help any country in need. The second is that we want to do it. And the third is that we are a people with an "on alert" mentality. I can pick up the phone at any time and ask a civilian surgeon in an Israeli hospital to pack a bag for three weeks and be in the airport in three hours. And he will leave everything behind.

Because we have reservists in Israel, we are always on alert. That helps a lot. For most of the countries that provide care to disaster areas, it takes time to recruit professionals. On Rosh Hashanah it took only hours for us to recruit an almost one hundred-person delegation to go to Mexico.

Why do you think medicine is able to overcome the barriers between people that diplomacy typically cannot?

From my experience, living in a tough neighborhood like Israel and extending a hand in many humanitarian missions, I think medicine is the only purely non-political bridge. When you save a child's life, his parents cannot have anti-Semitic hate toward you. They can have conflict and disagreement with you but not hate. When you combine forces with medical professionals in other countries, there are no borders – no obstacles – that cannot be overcome.

Are there any people you come into contact with whom you won't help?

No, never. When we launched the special operation for the victims of the civil war in Syria in February 2013 and decided to provide medical care to the people who arrived at the border of Israel, we couldn't know who was coming – whether he was a civilian or a warrior, which side he was fighting for, etc. So we decided to treat everyone needing our care. The same in 1999, when I was the commander of the medical unit of the Israeli field hospital in Macedonia for the Albanian Muslim refugee victims who ran away from the Kosovo Serbians. In all countries we treat everybody that needs our care.

In helping others all over the world, what stands out as your most memorable experience?

My most memorable experience was in January 2010, during the first two days of our mission in Haiti. The second day we were there we were the only advanced hospital. There was nothing behind us. There were hundreds of thousands of people wounded and all of them needed our care. We felt our mission was to restore hope for the people of Haiti. Everything we did in those few days – saving lives, facilitating the birth of babies, communicating with the community, establishing a system of medical care – was done to restore and create hope for those people. I had a feeling as a person that I had made a tremendous impact on people's lives.

Original Article Published in The Jewish Press