November 13, 2018

Accepting the end

The hospice patient, an innovative leader in his profession, was in his last moments of life. His eyes rolled back into his head, and his breath began to catch in his throat. His devoted wife was not ready for him to go. She climbed up onto his bed, grabbed him by the lapels of his pajamas and shook him, screaming “No! Do not leave me!”

The patient’s gaze returned, and, as his wife later described it, she could see through his eyes into eternity. They held each other’s gaze for several minutes, and then his eyes closed for good. He was gone.

The wife told this story at the patient’s funeral, feeling that it captured something important about her beloved. She was pleased. But our ancient rabbis and commentators, I thought to myself, would have been shocked. For them, this is not the proper way to treat someone as they die.

Judaism is very clear about the precious, holy time of transitioning from this world into the next. Known in medical circles as “actively dying,” it is characterized by raspy breathing, slowing vital signs, and a lack of interest in food and water. It can last from a few hours to several days. 

Judaism has a name for this important stage of life: goses (rhymes with “no less”). As it says in the Talmud (Shabbat 151b), when someone is a goses, they are like a candle whose flame is flickering — if you reach out to touch it, you may put it out. 

So many people today die in hospital rooms, surrounded by beeping machines, yammering televisions, and teams of medical professionals that flood in to administer electric shocks and break bones. This all flies in the face of what Judaism says God wants us to be doing for the dying patient. 

Of course, there are times when modern medical interventions are appropriate to “save” a patient from death, but suffice it to say there are times when it can do no one any good. It is in the latter situation, when the end of life is nigh, that Jewish teachings want caregivers to adopt a very specific attitude: Keep at the forefront of your mind the idea that any action could either hasten or delay death, so it should not be taken. This is a time for self-restraint. Be tender and quiet, and let the death follow its natural trajectory. Let go, so that the patient can as well. 

The rules of goses, and how I suggest the Jewish families I work with observe them (when they are open to them), are as follows:

• Minimize sound. Turn off machines and televisions. Speak quietly. Play only quiet, gentle music or sing sweetly to the patient.

• Minimize touch. Gentle kisses and strokes are fine, as is dabbing the patient’s mouth with a wet sponge to keep it moist. But do not shake, jab, squeeze or move them. Don’t call 911 and rush them to the emergency room, nor rush them home from the hospital (lest they die in the ambulance). Don’t even change their pillow or their diaper — unless you are confident that it is an impediment to comfort and ease that needs to be removed.

• Do nothing bracing. Do not wipe the patient with a wet washcloth or put an ice cube in their mouth. Do not squeeze or pinch them, such as with a blood pressure cuff or an IV needle. It is clear that they are dying; it is not necessary to track each step of it on a medical chart. Hospice nurses should be amenable once you explain that this is a religious preference. But if the patient is in a hospital, it may take stationing someone in the room to negotiate and actively refuse interruptions to the patient’s peace.

• Speak gently. Offer words of reassurance. Do not order the patient not to die, nor to die today. Tell them everything is fine with you, and that they are safe, and that death will be the right thing for them to do, when they are ready to do it. All is well.

I have known people who held on long after they should have died — for months — even though they were being tortured by their health condition. It seemed they were fulfilling a demand, telegraphed to them by their families, not to leave. It’s just not a fair thing to ask.

Dying is not inconceivable or bizarre. We have made it a taboo in our culture, but dying is just as normal and normative as having sex, giving birth or even going to the bathroom. It is something we need to relax and let our bodies do. We need not fear it. It will come when the time is right, and then it will be up to everyone to face it with respect, and let it unfold with grace.

The Talmud (Ketubot 104a) tells the story of Rabbi Judah, who was dying and in pain, but who was so beloved by the community that the rabbis declared a public fast and offered prayers, day and night, to keep him among the living. His housekeeper saw his suffering, however, and interceded. She threw a jar off the roof, and the praying rabbis paused in unison. In the silence, the rabbi died. 

The story is told in praise of the housekeeper. The commotion and pleading of the rabbis was in its own way torture to Rabbi Judah’s soul. It just needed some peace and quiet so it could move on.

The rabbis of old may have had it easy, believing as they did that even reaching out and closing the eyes of a goses could be punished in the afterlife as murder. Today, it takes real bravery to contain one’s inclination to interfere.

Perhaps remembering the rules of goses, and the needs of the soul to return to That From Which We Came, can help give us this strength.

Rabbi Avivah W. Erlick is a board-certified health care chaplain working in home hospice and institutional settings. She owns a referral agency for clergy in private practice (lacommunitychaplaincy.com), and is a provider of creative Jewish after-death ritual (sacred-waters.com). 

Untangling autism

There’s a popular saying in the autism community: If you’ve seen one person with autism, you’ve seen one person with autism. That is, each child manifests the condition uniquely. In fact, autism — also referred to as autism spectrum disorder — encompasses a group of complex conditions. 

Ilan Dinstein, an autism researcher at Ben-Gurion University of the Negev (BGU), believes that just as there are different ways of expressing autism, there are different biological mechanisms behind these variations. Identifying these mechanisms, he hopes, could facilitate development of treatments targeted to specific variations. 

In BGU’s newly established neurophysiological autism lab, Dinstein and his colleagues are looking at brain function and brain structure to identify differences associated with autism, and to rule out those that don’t play a role. Their data come from functional magnetic resonance imaging, which measures brain activity; electroencephalograms (EEG), which track brain wave patterns; tracking eye movements; and motion capture to study motor control. They are correlating these results with other patient information, such as genetic profile and behavior, looking at a multiplicity of variables rather than a single one. 

“I’m totally convinced that autism is multiple disorders with different types of biology,” Dinstein said, speaking in Los Angeles in February at a program for the American Associates of BGU. “The idea is to use MRI and EEG to enable us to identify specific subgroups with the goal of having different treatments for each subgroup.”

Autism disorders are characterized by difficulties with social communication and interaction, as well as the presence of repetitive behaviors. About 1 in 68 American children are identified as being on the autism spectrum, according to the U.S. Centers for Disease Control and Prevention. Children may be diagnosed with autism as young as 18 to 24 months, although many are identified later. The diagnosis is based on behavior and development — there is no medical test for autism. 

“Our goal is to understand what happens in the brain early on in development — during the first four or five years of life,” said Dinstein, who has a bachelor’s degree in biology from Tel Aviv University and a doctorate in neuroscience from New York University.

Such knowledge, he said, could eventually lead to the development of ways to identify autism, perhaps even before behavioral symptoms start. He believes that using brain changes rather than behavior to diagnose autism would enable earlier diagnosis and more targeted interventions.

Eric Courchesne, co-director of the UC San Diego Autism Center of Excellence, said Dinstein’s team — as well as his own — are “among the small pioneering group doing research on the early biomarkers of autism.” 

“There are lots of people doing research on older children, adolescents and adults with autism, and that’s important,” Courchesne told the Journal. “But it’s a challenge to see during the first one to two years of life, what’s going on in the brain that causes the symptoms of autism.”

Courchesne and his wife, center co-director Karen Pierce, invited Dinstein to join their lab, but Dinstein chose to start his own at BGU. Still, he and the couple have shared data and experiments and have published papers together. 

So far, their research has not identified meaningful differences in brain anatomy between children who have autism and those who don’t, Dinstein said. But it does point to differences in brain function. 

Toddlers with autism show less synchronization, or symmetry, in brain activity between the two hemispheres of the brain. They also seem to have “noisier” or more variable brain signals in response to visual, auditory and touch stimuli. In babies with autism, eye movements appear to be jerkier and less accurate.

Dinstein said most autism research focuses on a single factor rather than identifying a constellation of factors. “There’s very little work that looks at relationships across variables,” he said. “You need data for a large number of children to do this.”

To gather that data, he has joined six colleagues — a pediatric psychiatrist, epidemiologist, geneticist, computer scientist, molecular biologist and a physician. The team has begun creating a regional autism database for the Middle East to collect and eventually correlate multiple types of information for each child. It includes as much information as possible about each patient’s genetic profile, medical history and behavior measures, as well as biological measures such as MRI, EEG and eye-tracking data. The effort, which started in January 2015, collected data from about 150 children last year.

Gathering such a diverse constellation of information is a formidable task, but Dinstein and his colleagues have unique advantages because of BGU’s proximity to and relationship with the Negev’s Soroka Medical Center. Not only does the medical center sit across the street from the university, it also is the only hospital in Southern Israel. Ninety percent of children diagnosed with autism at Soroka also were born there.

This makes it possible for the team to collect data that would otherwise be difficult to obtain. For example, BGU researchers have access to information such as birth weight, gestational age and mother’s age at delivery. Because the majority of children will receive clinical care at Soroka over a long period, their development can be tracked over time. Israel’s centralized health care system — there are only four health plans in the country — also makes it easier to obtain data. 

In addition, the Negev is home to the nation’s Bedouin population, which engages in interfamilial marriage. Twelve of the children in the database are children of first cousins. “First cousins have very similar genetics, so it’s a lot easier to identify genetic abnormalities in their children,” he said.

Dinstein acknowledged that building the database will take time. 

“It will take several years to get this going,” he said. “But we don’t have to wait. We are starting with the pieces of information we have now to … look for correlations and see whether there are specific subgroups of kids with autism.

“This is a work in progress,” he continued. “I’m in this for the long haul.”

Telehealth devices offer new ways to be ‘seen’ by doctors

Your preschooler wakes up with an earache and fever. You tell your boss you’ll be late to work, finagle a pediatrician appointment, bundle up the sick kid, sit in a waiting room full of other sick kids, spend five minutes with the doctor, and leave with a prescription and/or orders to return for a follow-up exam.

All parents loathe this scenario, but Israeli dad and health-care industry entrepreneur Dedi Gilad took the initiative to change it. His vision was a home telemedicine kit to help parents perform standard throat, ear, eye, skin, heart and lung examinations of high enough quality to enable a remote diagnosis by the child’s physician. And it would not be limited to pediatric patients.

In 2012, Gilad and Ofer Tzadik founded TytoCare and spent nearly three years perfecting the technology and design. The Netanya-based company raised $18.5 million from investors such as Walgreens, and now is beta-testing its kits for home and clinical use.

The telehealth platform and home kit includes a modular device with a stethoscope, otoscope (used to look into the ears) and computer-vision camera. Exam results are transmitted to the patient’s chosen clinician via a secure connection.

Alternatively, the user can make a remote appointment with the doctor and perform the exams while seeing and talking to the doctor through Tyto’s video conference feature. This way, patients who feel sick can receive their physician’s feedback when an in-clinic visit isn’t possible. This is expected to help patients avoid unnecessary visits to the ER or to unfamiliar physicians.

“I could have nixed one ER visit tonight if my parent had a Tyto,” said a pediatrician involved in the company’s market research and usability studies with consumers and physicians in the United States. The parent in this case was concerned about a child’s skin rash that had worsened over three days. “I returned their page within 12 minutes, but the mom had already left for the ER so someone could look at it! Just her ER copayment would have paid for a Tyto.”

Telehealth services — encompassing a broad variety of technologies and tactics to deliver virtual medical, health and education services — are booming, especially in the U.S., where such visits comprise about 2 percent of about 700 million primary-care visits annually, according to Ophir Lotan, vice president of product for TytoCare.

“Dedi and Ofer started by analyzing and talking to the U.S. market and found that there is a strong need for lowering the load and cost as well as improving accessibility to healthcare services even from the comfort of consumers’ homes,” Lotan said.

He noted that more than half of all American hospitals currently host a telemedicine program and 90 percent of surveyed health care executives say their organizations have started developing or implementing telemedicine programs. The number of Americans using telemedicine services is expected to increase to 7 million by 2018.

“As the American Medical Association and healthcare community are moving toward telehealth and virtual consultations, they are looking for solutions that allow physicians to conduct examinations and go beyond current audio and video solutions,” he said.

TytoCare is now completing its Food and Drug Administration clearance process to enable marketing the device and the platform in the U.S. market, and the company is pursuing multiple business opportunities and collaborations.

“We will focus on a few pilots in the next few months to validate the product and the business opportunities,” Lotan said.

The retail cost of the kits has yet to be determined, but Lotan said the home version “will be affordable for a regular consumer to buy and may be subsidized in the future by insurers or employers for certain populations.”

The TytoPro kit, a more robust version that integrates images, audio recordings and notes into existing electronic health records, will cost closer to similar professional tools used by clinicians. This device enables physicians to examine patients in their clinic or in a home visit and utilize the information for patient education, motivating follow-up care, comparison over time or sharing exams with other clinicians for a second opinion.

Both versions will be made by a multinational medical-device manufacturer.

As for competitors, Lotan said another company is developing a similar concept but is at an earlier stage than TytoCare.

“There are smartphone add-on companies whose product usually deals with a specific exam (e.g. ears), but they do not provide smart guidance capabilities, online sessions or a complete telehealth platform and a modular examination tool.”

TytoCare has 25 employees, mostly working in R&D, and expects to increase its numbers by a third in 2016. An initial team has been recruited to lead the U.S. sales and marketing and operations out of New York City as well.

Fit over 50

Some people, as they age, long to recapture the youth, health and muscle tone of their 20-year-old bodies. 

But not cosmetic dentist and TV star Dr. Bill Dorfman. At 57, Dorfman will tell you that he is in the best shape of his life. 

“I have better abs now than I had when I was in my 20s,” said Dorfman, the featured dentist on the ABC hit series “Extreme Makeover” and a regular on the daytime talk show “The Doctors.” 

“We have a joke when I go to my doctor. He says: ‘What do you think your body fat is?’ And I’m like, ‘Zero,’ and we laugh. My body fat is like 6 percent … I’m more fit, I’m harder, I’m more defined than I was in my 20s.”

What’s the secret? Dorfman, who is active in the world of fitness and beauty, said his recipe for a healthy body at any age is surprisingly simple. He exercises daily, avoids processed foods and gorging on desserts, and checks in with his doctor regularly. 

In fact, the Los Angeles native’s overriding health and fitness strategy could be summed up in one word: consistency. While some people switch between fad diets or let exercise slide when times get busy, Dorfman said he has stuck diligently to the same health and fitness regimen for most of his adult life. 

An athlete since high school, he said he became serious about staying in shape while studying to be a dentist because he realized that unless he worked out, his back, neck and arms would cramp from constantly bending over.

“I really became religious about working out,” said Dorfman, a father of three who grew up attending the Conservative Temple Ramat Zion but considers himself Reform. “It’s just been a lifelong maintenance program. It wasn’t like I woke up one day and said, ‘Oh man, I’ve got to get in shape.’ ”

No matter where he is or what he has on his schedule, Dorfman said, he makes time to exercise every day for one hour. He alternates between two routines: One day he’ll do strength-training using weights, concentrating mostly on his upper body but also doing a few leg exercises. Dorfman said he meets with a fitness trainer every few months to adjust the exercises, giving him an opportunity to work different muscles and to avoid getting bored. On the alternate day, Dorfman said he swims for about 30 minutes and spends another 30 minutes doing an abdominal workout.

Should you do the same program? Not necessarily, according to Dorfman, of Century City Aesthetic Dentistry, who counts Eva Longoria, Katy Perry and Jessica Simpson among his clients. Swimming, for example, can be a tough sport to take up if you didn’t swim earlier in life, he said. The most important approach is to choose an activity or routine that you can realistically do every day or every other day, he said. 

“Don’t go crazy. Do something that you can replicate every day or every other day to start off with, whether it’s walking or doing the treadmill or biking or spin class. Something that you can actually maintain,” he stressed. “You really need to do something that’s sustainable, and for everybody it’s a different level.”

Much like his fitness regimen, Dorfman likes to keep things simple when it comes to diet. He said he’s been eating exactly the same way for the past 30 years.

His basic rules: Eat lots of fruits, vegetables and whole foods. Stay away from processed food, junk food, fried food, heavy creams and desserts. 

“Not that I’ll never have a cookie. I’ll have a cookie once in a while, but I don’t have the whole box, I’ll just have one or two,” Dorfman said. “And it’s not like I’ll never have a piece of pie, but I won’t eat the whole pie.”

He doesn’t eat pizza, he doesn’t eat French fries and he doesn’t drink alcohol.

“My motto is: I’d rather have a six-pack than a keg,” he said. “I personally don’t like drinking. … If you ask me, I’d say you don’t need it. Alcohol is poison after all. If you look at men’s physiques as they age, men who drink a lot of beer don’t have the greatest abs.”

Dorfman’s meal plan is the same every day. For breakfast, he has a big protein shake with whey protein, fruit juice, a little water, flax seed, oat bran and mixed berries. He said he drinks three big glasses of the shake. For lunch, the dentist eats a turkey sandwich and two pieces of fruit.

Dinner is more flexible, but usually consists of some kind of protein (meat or fish) and salad or vegetables. Occasionally he’ll have a little sorbet for dessert. He doesn’t shy away from the breadbasket, either, he said, though he doesn’t add butter.

Although Dorfman said he typically doesn’t snack during the day, if he’s working at night and feeling hungry he’ll have something light, usually red, green and yellow bell peppers with some hummus.

“There’s two kinds of people in this world when it comes to food — those who live to eat and those who eat to live. I’m definitely an eat-to-live guy,” he said. “I like food, but I’m surely not a foodie. I’m the boringest eater ever.”

Dorfman supplements his diet with a vitamin regimen devised by his doctor, and also takes red yeast extract, which is purported to reduce cholesterol. He recommends people also incorporate oat bran and flax seed into their diets as they age. For vitamins, he suggests talking to your doctor to figure out what’s best for you.

Even though he feels physically fit and healthy, Dorfman said he never misses his annual medical checkup. He suggests others do the same, particularly as they age. 

“We get so wrapped up in our lives we forget to do it, but it’s critical,” he said. “If you have a condition, like, in the worst-case scenario, cancer, early detection is critical for success. If they find cancer early, almost any kind of cancer you have they’ll be able to cure. 

“As far as fitness and health, one of the most important things you can do is to get a physical every year.”

Dishes inspired by Wolfgang Puck are delicious and healthful

I have known Wolfgang Puck since he was about 19 or 20 years old and he was working as a chef at Ma Maison restaurant in West Hollywood. I met him at a cooking class, probably the first one he had ever taught.

I will never forget what happened when he rolled out the pastry dough for a raspberry tart. He confidently flattened the dough around a rolling pin and, in one fluid motion, watched it totally fall apart. Then he looked at us and said, calmly, “If this ever happens to you …” and he proceeded to just mold it by hand into the tart shell instead of starting over. 

A longtime fan of Jewish cooking — Puck, a Catholic, has hosted seders and was married to a Jewish woman for 20 years — he inspired me to teach cooking classes using the same method of honesty and creativity that has made him famous. 

Puck went on to open his first restaurant, Spago, on Sunset Boulevard in 1982, and one of the dishes he specialized in was Smoked Salmon Pizza, my all-time favorite. Could a pizza be more Jewish? To make the pizza ahead, bake it for just 5 minutes, then, just before serving, complete the baking and top the pizza with smoked salmon. 

The renowned chef has inspired me in other ways, too. Consider his most recent cookbook, “Wolfgang Puck Makes It Healthy,” which features the methods he uses to prepare nutritious foods. The book includes an inspiring exercise program to follow, and there are photos of Puck, now 66, exercising with his young sons, Oliver and Alexander.

When thinking of healthy cooking, I always include soups and salads that are easy to make. I have adapted several recipes from Puck’s book that can be made in advance, stored in the freezer and served when needed. 

For example, a couple of months ago, my son-in-law, Jay, brought me a large bag of carrots from his garden, and I made a delicious carrot soup, which is similar to the recipe in Puck’s book. It contains only three ingredients — carrots, onions and garlic — and takes only 20 minutes to make. 

His Griddled Potato Pancakes topped with sliced smoked fish are delicious, crispy and healthy. Created simply, the grated potato pancakes are cooked on a nonstick griddle, then topped with smoked fish and low-fat sour cream.

Finally, Puck’s recipe for Vegetable Pizza is really a salad on top of a pizza — a great concept and a meal in itself. What a great way to eat a lot of vegetables! Feel free to vary the vegetable toppings with whatever looks great at the farmers market.

SMOKED SALMON PIZZA

  • Pizza Dough (recipe follows)
  • 1/4 cup extra virgin olive oil
  • 1/2 cup cornmeal
  • 1/2 cup sour cream or creme fraiche 
  • 1/4 bunch fresh dill, minced
  • 3 to 4 ounces smoked salmon
  • 1/2 cup chopped chives
  • Freshly ground pepper to taste
  • 4 heaping tablespoons salmon roe (optional)
     

Prepare Pizza Dough and set aside.

Preheat oven to 450 F. 

Divide dough into 4 balls and, on a lightly floured surface, roll out dough into a 9- or 10-inch circle, with the outer edge a little thicker than the inner circle. Brush a round 12- to 14-inch rimless pizza baking pan with oil and sprinkle with cornmeal. Carefully lift dough onto prepared pizza pan, poke holes in the dough with a fork to prevent bubbling, and bake in prepared oven until golden brown, 10 to 12 minutes. 

Remove dough from oven and set it on a cutting board. Let dough cool, then use a knife or the back of a spoon to spread the sour cream, covering the inner circle, and sprinkle with dill. Arrange the slices of salmon so that they cover the entire pizza, slightly overlapping the raised rim. Sprinkle the chopped chives  and pepper over the salmon. Using a pizza cutter or a large sharp knife, cut the pizza into 8 or 10 slices. If you like, spoon a little salmon roe in the center of each slice. Serve immediately. Repeat with remaining dough. 

Makes 4 pizzas.

Smoked salmon pizza

Smoked salmon pizzaRECIPE: http://bit.ly/1Svxx1D

Posted by Jewish Journal on Monday, March 7, 2016

 

 

PIZZA DOUGH

  • 2 packages active dry yeast
  • Pinch of sugar
  • 1 1/4 cups warm water
  • 1/4 cup olive oil
  • 3 1/2 cups flour
  • 1 teaspoon salt

 

Dissolve the yeast with the sugar in 1/2 cup of the water and set aside until foamy. 

In a large mixing bowl, combine the remaining 3/4 cup water, the olive oil and yeast mixture. Stir in the flour and salt 1 cup at a time, until the dough begins to come together into a rough ball. Spoon onto a floured board and knead until smooth and elastic. Place the dough in an oiled bowl, oil its top, cover, and set in a warm place to rise for about 1 hour, until doubled in bulk. Or prepare pizza dough and cover with a towel until ready. 

Makes 4 pizzas.

VEGETABLE SALAD ON A PIZZA

  • Pizza Dough (see recipe above)
  • 1 tablespoon extra virgin olive oil
  • 1/2 cup eggplant, cut into 1/2-inch dice
  • 1/2 cup zucchini, cut into 1/2-inch dice
  • 1/2 cup yellow summer squash, cut  into 1/2-inch dice
  • 1/2 cup each red and yellow peppers,  cut into 1/2-inch dice
  • 1 cup halved cherry tomatoes 
  • 2 teaspoons sugar
  • Salt and freshly ground pepper to taste

 

Prepare Pizza Dough and set aside.

Preheat oven to 450 F.

Heat a large heavy skillet over medium heat, add olive oil. Add eggplant, zucchini, summer squash, peppers, cherry tomatoes and sauté, stirring frequently until vegetables begin to turn tender, 5 to 7 minutes. Season with sugar, salt and pepper to taste. Continue to sauté until tomatoes soften. Transfer to a bowl and set aside to cool.

Roll out pizza, and poke holes in the dough with a fork to prevent bubbling. Top with sautéed vegetables and bake until pizza is nicely brown, about 10 to 12 minutes. 

Makes 4 pizzas.

CARROT SOUP

  • 2 tablespoons extra virgin olive oil
  • 2 tablespoons unsalted margarine, melted
  • 1 large onion, chopped
  • 2 1/2 pounds carrots, peeled and cut into 2-inch pieces (about 6 cups) 
  • 5 cups vegetable stock or broth
  • 2 large garlic cloves, minced and
  • mashed with 1/2 teaspoon salt (optional)
  • 2 teaspoons fresh ginger, peeled and grated
  • 1/3 cup fresh flat-leaf parsley, finely minced (optional)
  • Salt and freshly ground black pepper to taste
  • Garnish with grated Parmesan cheese, optional

 

In a small stockpot, mix oil and margarine. Add onion and cook until tender and translucent, about 10 minutes. Add carrots and stock. Bring the liquid to a boil, reduce heat and simmer until the carrots are tender when pierced with the tip of a small, sharp knife.

Transfer the cooked carrots and broth to a food processor or blender and puree in batches. Return the mixture to the pot and stir in the garlic paste and ginger. Simmer briefly and stir in parsley. Add salt and pepper to taste. Garnish with grated Parmesan. 

Makes 8 to 10 servings.

GRIDDLED POTATO PANCAKE WITH SMOKED FISH

  • 1 pound russet baking potatoes
  • 1 small yellow onion
  • 1 large egg, beaten
  • 1/2 teaspoon baking powder
  • 1/4 teaspoon salt, add as needed
  • 1/4 teaspoon freshly ground black pepper
  • 2 tablespoons extra virgin olive oil
  • 1/4 cup low-fat sour cream
  • 1 tablespoon chopped fresh dill
  • 1 teaspoon fresh lemon juice
  • 1/2 pound smoked sturgeon, trout or salmon, skin and bones removed, thinly sliced
  • 1/4 cup salmon roe for garnish, optional
  • 1 tablespoon finely chopped fresh chives for garnish
  • 1 lemon cut into wedges

 

Preheat oven to 200 F, its lowest setting. Set a baking dish in the oven.

Line a large bowl with a clean kitchen towel.

Using the fine hole of a box grater, shredder or a food processer fitted with a grating disc, grate the potatoes. Transfer to the prepared bowl and grate in the onion. Twist the towel around the potato mixture and squeeze out as much liquid as possible. 

Transfer the mixture to a clean bowl, add egg, baking powder, salt and pepper and stir with a fork to blend.

Heat a large nonstick griddle or skillet over medium-high heat. Brush with olive oil. Using a tablespoon, carefully place spoonfuls of the potato mixture on the griddle, spacing them about 1 inch apart and pressing down on the mixture to flatten to a thickness of no more than 1/4 inch. Cook pancakes until golden brown and crispy, 3 to 5 minutes per side. Transfer pancakes to the baking dish in the oven to keep them warm while you cook the remaining pancakes.  

In a small bowl, stir together the sour cream, dill and lemon juice. Season to taste with salt and pepper. To serve, transfer potato pancakes to a warm platter or individual serving plate. Spoon a little sour cream mixture onto each pancake and top with smoked fish. Add salmon roe and garnish with chives. Serve immediately with lemon wedges.

Makes about 24 servings.

Judy Zeidler is a food consultant, cooking teacher and author of “Italy Cooks” (Mostarda Press, 2011). Her website is judyzeidler.com.

Y7 yoga is less meditation, more rhythm nation

Tucked between the organic pressed juiceries and high-end fashionista boutiques of West Hollywood, Y7 Studio puts swagger into stretching, offering hip-hop-themed yoga classes where instructors double as disc jockeys. 

During one recent class on a Wednesday evening, the instructor told the packed room of about 20 people, “Tonight’s theme is Beyoncé.” The quaint studio was pitch-dark, except for the flickering light emanating from a row of candles strategically lining the floor. And it was hot — set to a toasty 80 to 90 degrees via infrared heating technology (but much less intense than Bikram).

All the yogis faced toward a black wall branded with “A Tribe Called Sweat” in bold, white letters. Forget about a soundtrack of waterfalls and Buddhist chants; the mantra tonight came care of Queen Bey: “I got hot sauce in my bag, swag.” 

Y7 Studio in West Hollywood. Photo courtesy of Y7 Studio via Instagram

The class of yoga practitioners went through their traditional vinyasa sequences: downward dogs, crows and half-moon poses. There were no mirrors, no artificial lights; it was just the yogis, their mats, and Beyoncé supplying the tunes. 

“We aren’t a peaceful, typical yoga experience. It’s like the furthest thing from it,” Mason Levey, Y7 co-founder, said. 

When he moved from Michigan to Brooklyn, N.Y., in 2009, he started looking for a studio to fill his yogic void. There had been one in suburban Detroit run by a dear friend, who has since passed away, that really jived with him — low lighting, heated room, a badass soundtrack — but he couldn’t find anything like it in the Big Apple.

So Levey, 28, who was raised in a Reform household and has a background in digital advertising, started one in 2013 with his wife, Sarah, 29, whose background is in fashion. Through the studio, he said he keeps his friend’s memory alive. “I think about that all the time. Tons of inspiration from him,” Levey said.

At first, the couple rented a quaint eight-person pop-up space down the block from their apartment. That filled up quickly, so they upgraded to a 20-person space.

“And it just kept growing and growing and growing,” Levey said during a phone interview. 

Y7 now has three locations in New York: Williamsburg in Brooklyn, SoHo and the Flatiron District. Last summer, Y7 did a pop-up in Los Angeles, at retailer Rebecca Minkoff’s new Melrose Avenue location, where they converted her store into a studio. 

“We had an awesome time,” Levey said. Six months later, they opened their first West Coast studio a block away from Minkoff’s store. And soon, they’ll open another location in New York’s Union Square. 

As a result of these expansions, they have become bicoastal, hopscotching between the two major cities every two weeks on a whim. “I buy my tickets last minute,” Levey said.

The world of downward dogs is a dog-eat-dog business, but Y7 appears to be more than persevering. The studio’s clothing line featuring its slogans flies off the shelves, its classes ($25 each) are filled, and celebrities like model Gigi Hadid and actress Jessica Alba are among its patrons.

A typical class has three sequences, each performed in three different flows. The first flow is slow, the second one is faster and the third is free-flow, up to the practitioner to move at his or her own pace, adding or removing steps at her own leisure.

At this particular class, a medley of Beyoncé singles assisted the yogis in their practice, a repertoire that spanned the superstar’s whole career, from Destiny’s Child jams to Sasha Fierce alter egos to Black Lives Matter anthems. Other Y7-worthy artists who get a class dedicated to them include the likes of Drake and Rihanna, holla! 

Despite such heart-pumping energy, the class doesn’t forget what yoga’s all about. During the final moments of the class, the yogis slow down, stretch and prepare for savasana, or corpse pose. Beyoncé sings “Halo” in the background and it’s kind of perfect as yogis settle into their mats, letting their hourlong practice soak in.

“Everyone is super happy and we’re on this rollercoaster,” Levey said, reveling in the unexpected success of a booming yoga studio chain. “We want to go to every major city, so we’re just getting started.”

Minutes after the completion of the recent L.A. class, students filtered out as another class of yogis patiently waited to enter the single-room studio. With drenched shirts stuck to their backs, a group congregated on Melrose, energized from their practice, discussing where to grab drinks — “because we deserve it, dammit” — sauntering down the crowded street, their yoga mats strapped to their backs.

Nonna Gleyzer: Flex and flexibility

Nonna Gleyzer’s West Hollywood Pilates studio has seen the sweat of Natalie Portman, Kerry Washington and a parade of Victoria’s Secret models. Gleyzer has been lauded as “Hollywood’s secret weapon” for body sculpting, and her fitness tips have been praised in magazines including Women’s Health, Marie Claire and Shape. 

Gleyzer’s petite frame is strong, but Gumby-like flexible. While refreshingly genuine and chatty, she is entirely no-nonsense, evidenced by her motto: “If I don’t like you, I won’t be training you.”

“People know me in the industry for the fact that I get rid of A-listers,” she said. “I came to this country to be free and be respected. I’ve experienced enough abuse where I’m coming from.”

It doesn’t matter if it’s actress Amy Adams or a regular Jane off the street looking for a private lesson; Gleyzer said she treats everyone with respect as long as they return the favor. Now settled in Los Angeles, Gleyzer is light-years away from where she grew up in the Ukrainian city of Lwów, during a time when anti-Semitism reigned and signs reading “Kill Jews, Save Ukraine” were posted across town.

Gleyzer’s athletic career began when she was only 6 years old, when a rhythmic gymnastics coach came to her school to recruit promising young athletes.

“My coach came to my school, put me against the wall, started lifting my leg, and my leg went straight up, 180 degrees,” she said. “And that was it.”

With the encouragement of her father, Gleyzer worked hard and was eventually accepted to the Junior Ukrainian National Team. There was only one problem: She’d have to identify as Jewish on her passport, and this could cause major problems when she tried to travel outside the country. Although Gleyzer recalled begging to change her name to her mother’s Polish surname, her mom refused.

“You’re not changing your last name,” she remembered her mother saying. “You’re Jewish, and you’re always going to be Jewish.”

This was a blessing in disguise, Gleyzer said, because at the age of 18, she, her brother and her mother were able to immigrate as refugees to the U.S. with the help of The Jewish Federation of Greater Los Angeles. Once in the states, Gleyzer and her family lived on about $20 per week. They’d wake up at 5 a.m., stand in line at the Social Security office to claim their food stamps, and then head to the market for simple staples of pasta, chicken thighs and oranges. 

Gleyzer set her sights on trying to make the U.S. National Rhythmic Gymnastics Team, but soon injured her back from the intense training and her nutrient-poor diet. On the recommendation of a friend, she began doing Pilates as a way to rehabilitate her body, and inadvertently discovered her life’s work. Gleyzer began an apprenticeship at The Pilates Studio in West Hollywood (which has since closed), where her relationship with the A-list began.

“I barely speak English and here I am helping Jodie Foster, at The Pilates Studio, to train,” Gleyzer said with a grin.

Now 44, Gleyzer has worked on both coasts, has been flown all over the world to work with actors and models on set, and has always been her own boss. She’s also taken courses in physiology, giving herself a boost as part-trainer, part-physical therapist.

Cookie Johnson — clothing designer, HIV-awareness advocate and wife of basketball legend Magic Johnson — has been working with Gleyzer “religiously” for about five years. Johnson had ongoing problems with her knee and Gleyzer figured out a way to help her that Johnson’s doctor couldn’t. 

“I really think Nonna has a gift,” Johnson said.

Gleyzer genuinely cares about her clients, Johnson said, and if she tells you to go home and ice an injury, “She’ll text you to make sure you did it!” 

Model and actress Stacy Keibler is also one of Gleyzer’s devoted clients. Keibler had wanted to know who trained supermodel Gisele Bündchen when she was in L.A., and learned that Bündchen was connected to Gleyzer. 

“She is more than just a trainer. She knows the body so well, she knows how to rehab old injuries while toning and tightening,” Keibler wrote in an email to the Journal.

Gleyzer’s studio is well equipped to handle her A-list clients, with a private restroom inside the one-room studio and a covered entrance for those skirting the paparazzi. Although Gleyzer has longstanding friendly relationships with many of her clients, she’s not over-eager to rub elbows with them outside of work (unless they ask).

“I’m trying to figure out how to live my life, how to fix my life. So the last thing I need to try and figure out is to how to live their lives,” Gleyzer said.

Pull up a chair for pilates

Here are three simple exercises you can do anywhere simply using a chair. Try this five-minute routine in the morning with a kitchen chair, or during the workday with a stable desk chair. 

1. Quad stretch

This gentle, standing quad stretch targets your front thigh muscles and your hamstrings, and helps keep your glutes high and tight.

Stand behind a chair with your feet hip-width apart and hold on to the back of the chair. Contract your abdominal muscles, then bend one knee, bringing your heel toward your lower back. Hold for several seconds before lowering your leg back to the ground. 

Repeat several times on each side, making sure to keep your abdominal muscles contracted. 

2. Supported side stretch

This exercise stretches your oblique muscles, which connect your abdominal muscles to your back. It helps keep these muscles in balance and connected, and opens up the back to avoic spasms.

Stand arms-length behind the chair with feet shoulder-width apart, your right hip closest to the chair and your right hand resting on the back of the chair. Raise your left arm over your head, and stretch up and over toward your right. Hold your peak stretch for 10 to 20 seconds. 

Repeat several times on each side.

3. Strengthening hamstrings and opening back

This exercise strengthens your hamstrings and opens up your back, which benefits your glutes and lower back.

Sit up straight in the chair with feet shoulder-width apart and knees bent naturally. Using both hands, grab underneath your right knee and lift the thigh toward your chest. Straighten the right leg until your toes point directly upward. Raise your leg as far as possible without straining. 

Continue to hold underneath your knee for support and point your toes, then flex your foot. 

Lower your right leg, and repeat two more times with the same leg. On the third repetition, move your hands up toward your ankle. Again, point your toes, flex your foot, and then lower leg. 

Place your right ankle on your left knee so that your right knee is pointed out to the right. Slowly bend forward, allowing your back to round over. Hold for a few seconds.

Repeat routine several times on each side. 

Jewish food is delicious, but healthful? Not so much

I am someone who loves being Jewish and loves to eat. (That’s redundant, isn’t it?) 

The problem with Jewish foods is that while they’re delicious, they can be very dangerous. My favorite Jewish food of all time is pastrami, which is really just a heart attack waiting to happen. Yet every Jew loves the smoked meat on rye — it doesn’t matter your background or denomination. Maybe Mount Sinai was smoky and this reignites something in our collective Jewish souls. 

There’s also challah. I’m a big fan. The problem, though, is that Jewish bakers got all fancy and started offering up cinnamon sugar challah and raisin challah and pumpkin challah and — the biggest culprit of all — pretzel challah with Belgian chocolate inside. Damn! It makes me want to rally up all the fat people so we can talk about being food addicts and march against Big Food. 

Never mind. Fat people don’t march.

Not only are Jewish foods unhealthful, but we’re supposed to eat so much of them. And not just big meals every week for Shabbat — special holidays, too.

Rosh Hashanah: Eat apples and honey. Passover: Eat matzah. Nonstop. For eight days. Purim: Eat and drink until you can’t see straight. Sukkot: Eat outside. Shavuot: Eat cheese. Chanukah: Eat fried food. 

And don’t even think about trying to limit your portions or Mom will set you straight with a stern, “Eat, bubbeleh! Eat!” 

Some Jewish food doesn’t sound appealing, but after the fourth or eighth or 27th time, you start to like it. Like kishka. Or gefilte fish. That’s a funny food. What’s the deal with gefilte fish? It’s not a fish, right? It’s, uh … forget it. I’m not going to be reduced to digging up old Borscht Belt punch lines that were probably used by guys named Morty while entertaining the lunch crowd at Kutsher’s in 1950.

As I write this, I’m actually craving a pickle and a Cel-Ray soda (yes, a celery-flavored soda). Triggers, man, damn it. I always go on diets with the goal that I will be able to get into good enough shape to start eating recklessly again. 

I used to eat terribly every day. I’d have pizza and pastrami, bagels and blintzes. And then I tried to take control of it. I decided I’m going to exhibit self-control and plan ahead. Eat pastrami only on Mondays. It worked, so I kept going. Eat pizza only on Tuesdays. 

I thought I was doing tremendously well until I looked at my calendar and realized I had dedicated every day to another bad food. My week read Pastrami Day, Pizza Day, Blintz Day … oh, my, Blintz Day. Man, I love blintzes. How my grandparents used to make them for me. Is there anything more Jewish than a blintz shmeared in sour cream and applesauce? Is there a word funnier than shmeared?

My family has a dangerous history in the Jewish food business. My great-grandfather worked for Hebrew National and lost his hearing after one of the hot dog machines exploded. He used to talk about how rats would jump into the grinders and get mixed in with the meat. They didn’t used to answer to a higher authority back then — or a health inspector, either, apparently. 

And one summer, I was asked to manage a kosher pizzeria in Long Beach, N.Y. Rather than fire the old manager, they demoted him to work under me, a high school student at the time. He turned out to be an unstable person, and one day he snapped and chased me out of the store and into the street with a pizza cutter. Ah, memories. 

Though I’ve tried, it’s been hard to kick my addiction to Jewish food, despite its dark side. And I’m always dragging people into my tasty habit. I introduce my friends to new delis. I serve chocolate challah on Friday night. I guilt my dogs when they don’t eat my leftovers. 

Recently, when I was filling in a shift for a friend at a local kosher cafe, a woman in her 50s came in and asked what she could put on her bagel. At first I was thinking, if you don’t know what to put on a bagel at this point in your life, I can’t help you, ma’am. But I just kindly suggested smoked salmon and cream cheese. 

She said, “That sounds lovely. What a great idea.”

I watched as she took the first bite and her face lit up. And I smiled.

Danny Lobell is an L.A.-based standup comedian who runs the podcasts “Modern Day Philosophers” and “The Mostly Bull Market,” as well as a monthly improvised storytelling show at the Hollywood Improv called “Bookshelf.”

Spice up your life with these superfoods

Spring is just around the corner — a perfect time to spruce up your spice rack and fortify your pantry with superfoods. 

1. Walnuts: These banana bread staples are filled with heart- and brain-boosting compounds. A single serving provides a day’s worth of alpha-linoleic acid, which helps reduce the risk of heart disease and dementia. Walnuts also have high levels of vitamin E, fiber and healthy fats.

2. Turmeric: Besides delivering an exotic floral aroma to dishes like hummus and chicken tagine, this yellow-orange spice is chock-full of antioxidants and helps fight inflammation.

3. Black rice: Also known as “forbidden rice,” black rice can be used in any recipe calling for white or brown rice. It contains high levels of antioxidants, fiber, vitamin E and natural compounds called anthocyanins, which can help lower cholesterol.

4. Cardamom: This ancient Indian spice gives chai tea its unique flavor and has a host of health benefits: It’s anti-inflammatory and contains oils with antifungal, antiviral and antibacterial properties. 

5. Hemp seeds: With plenty of protein in each serving (10 grams per ounce) and all 10 essential amino acids (including the omega-3 and omega-6 fatty acids that are difficult for vegans to find in whole-food form), mildly flavored hemp seeds can add nutritional oomph to smoothies, salads and baked goods.

6. Seaweed: Boasting a bevvy of minerals and vitamins including B12 and iodine (both important for metabolic and nerve cell health), kelp — a common type of seaweed — is one of the most sustainable crops in existence. Enjoy it in its dried form (nori) for a savory snack.

7. Lentils: These low-cost legumes are high in fiber and protein, fat-free, and take on the flavors of any herbs and spices added during cooking.