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$150 Million Gift to Children's Aims to Revolutionize Surgery
D.C. Philanthropist Arranges Abu Dhabi Largess

By Susan Kinzie
Washington Post Staff Writer
Wednesday, September 16, 2009

In one of the largest philanthropic donations ever made to a U.S. pediatric hospital, Children's National Medical Center will receive $150 million from the government of Abu Dhabi -- a gift that the hospital hopes to use to dramatically change pediatric surgery.

The donation, which will be announced Wednesday morning, has the potential to transform Children's Hospital, enabling it to hire more than 100 surgeons, researchers and staff members over the next few years, hospital officials said. Its arrival amid a recession has created palpable excitement at the Northwest Washington hospital, which treats thousands of children and performs 15,000 surgeries each year.

Edwin K. Zechman Jr., president and chief executive of Children's, said the money could revolutionize not just his hospital, but also the entire field of pediatric surgery. "Pediatric surgery could look 100 percent different in five to 10 years," he said.

The money comes from the government of Abu Dhabi, one of the United Arab Emirates. The Persian Gulf country has given large sums to Johns Hopkins Medicine and other U.S. institutions. But the gift was arranged by Joseph E. Robert Jr., a prominent Washington philanthropist with deep ties to Children's and personal connections to wealthy members of the UAE's royal family.

Doctors at what will be called the Sheik Zayed Institute for Pediatric Surgical Innovation will collaborate across disciplines to improve surgery for children. That could mean advances such as using genetic research to personalize surgeries and pain management, bringing imaging technology directly into the operating room to guide procedures with greater precision, using nanoparticles to target tumors and, in some cases, eliminating the need for surgery altogether.

"Wow!" said Richard Redett, director of pediatric plastic surgery at Johns Hopkins Children's Center, marveling at the size of the donation and the targeting of one specialty. "This kind of gift almost never happens."

The gift, to be paid over five years, will dedicate $60 million to research and programs, $40 million to improving research facilities, $25 million for a surgical institute endowment and $25 million for other needs at the medical center. The hospital will add $100 million to $120 million of its money for doctors' salaries, new operating theaters and other expenses, bringing the amount committed to the project to more than $250 million.

The scope and ambition of the plan are the brainchild of Robert, 57, a major donor to Children's who is battling brain cancer. About a decade ago, Robert's son underwent a nearly 10-hour surgery at Children's to rebuild his chest wall. The complicated procedure, performed by Kurt Newman, was amazingly successful, Robert said. His son, now 29 and a student at American University, was strong enough to serve in the Marines.

Robert, who has made a fortune in real estate investment and asset management and has given away a fortune to local charities, donated $25 million to Children's and led a fundraising campaign for a new surgical center, which is named after him.

About four years ago, he invited Newman, Zechman and others to his home for breakfast and asked them how to turn the hospital into the premiere pediatric surgical center in the world.

"I said to Kurt specifically: 'Forget everything you've known and been taught and used in terms of the way an operating room is set up and people work together. Take a clean sheet of paper . . . think in the future perfect tense. What's it going to look like in 10 years or 30 years, and how do we speed up to get there faster?' "

Newman, senior vice president of the surgical center, said his first ideas "were pretty lame." He thought of hiring the best people. But Robert kept pushing him and others to come up with something that could transform pediatric surgery.

At one meeting, Julia Finkel, a pediatric anesthesiologist, startled everyone when she stood and demanded a dramatic overhaul of the way doctors measure and treat pain.

"She said, 'I don't want to walk into any more rooms where the children are crying and the parents are full of anxiety,' " recalled Pam King Sams, executive vice president and chief development officer of the Children's Hospital Foundation. "We need to eliminate it. And we can eliminate it."

Pain is difficult to gauge in any patient, but it's especially difficult in infants and children. Managing pain is tricky, too, because the dosing in children is far more precise than in adults. Infants seem to process pain differently, and narcotics and other treatments have different effects on people.

But by drawing on experts, Newman said, they can attack that in new ways. Finkel and others have been developing a device that measures pain. And once they can measure pain effectively, they can develop drugs to target it more effectively.

"I see that as one of the biggest potential breakthroughs here," Newman said. "I think it's achievable within the next five to 10 years" to have a hospital where pain is not inevitable. "We can eliminate that, wipe that out."

"Boy, I haven't heard anyone talk about eliminating pain," Redett said. "I've heard a lot of people talking about easing pain and suffering in health care. I don't know if that's an attainable goal or not," especially within a short time frame.

Newman still has a piece of paper on which he and Robert diagrammed some of the changes they could make to deliver care more effectively and collaborate across specialties. Robert loved the idea -- and after a presentation from Newman and others, he sent them back to draw up a detailed business plan.

Robert turned to Sheik Mohammed bin Zayed Al Nahyan, whom he had met about five years ago on a business trip when the crown prince held a dinner in Abu Dhabi for executives working on national security. They hit it off, became friends and now go on hunting trips together.

Robert pitched the idea of the surgical innovation center at the prince's home one night while they were watching TV and eating dinner.

The Abu Dhabi leader did not consent to an interview -- he has rarely spoken with Western media, a spokesman said. But Robert said the idea appealed to him immediately because he could see that it could have a major effect on children's treatment and that it could happen quickly.

"What really impressed us about Children's was their vision of a significant leap forward and rethinking pediatric care," said Yousef Al Otaiba, the UAE's ambassador to the United States. "This isn't going toward buildings, to bricks and mortar and a big sign on a building -- it's going toward research in pediatric care."

The gift was made in honor of the prince's father, the late Sheik Zayed bin Sultan Al Nahyan, who founded the UAE. In addition to creating the Sheik Zayed Institute for Pediatric Surgical Innovation, the medical center will name its campus the Sheik Zayed Campus for Advanced Pediatric Medicine at Children's National Medical Center.

Children's is also working toward a partnership to build and operate a pediatric hospital in Abu Dhabi.

For Robert, the gift represents a triumph. Recently he received a diagnosis of the same type of brain cancer that afflicted Sen. Edward M. Kennedy (D-Mass.). After giving away millions and raising millions more for charity, he compares his current philanthropic efforts to playing basketball at an arcade.

"I'm trying to get as many scores, put the ball through the hoop as many times as I can with the limited time I have left," he said.

At the hospital Wednesday, when the ambassador, the executives and the doctors gather to talk about how much the institute will change pediatric medicine, Robert said he will be thinking, "What needs to get done next?"

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