HEALTH CARE DECISION — Jews React: Beverly Hills cardiologist and internist


Beverly Hills cardiologist and internist Dr. Reed Wilson – a former member of the Republican Jewish Coalition who helped found its Los Angeles chapter – called the mandate “an amazing breach of the American trust.” Moreover, he said, the law’s finer print contains “rules and regulations” pertaining to doctor reimbursement rates that will threaten physicians’ private practices and health care quality.

“I want to be able to take care of my patients in a way that I think is wise medicine, is good quality medicine. I don’t want to be subjected to rules that I think are detrimental to my patients,” Wilson said.

But “the Supreme Court decision is one we are going to have to live with,” he added.

The Republican Jewish Coalition released a statement shortly after the decision came down, expressing disappointment: “The serious negative effects this law will have on the economy, on jobs, on medical research and development and on the quality of health care in America are very troubling.”

AJ Congress wowed; Shaare Zedek gets record donation; Koufax in the house


Woolsey Wows AJC

It was an extraordinary evening when the American Jewish Congress (AJC) honored former director of Central Intelligence R. James Woolsey at a black-tie gala dinner at the Four Seasons Hotel Dec. 10.

Woolsey received the AJC’s Jerusalem Award for his extensive work on behalf of Israel and the Jewish people. The honor recognized Woolsey’s efforts in combating the United States and Israel’s reliance on oil from the Middle East. His work promoting energy independence has enhanced the security of the State of Israel and the U.S.-Israel alliance.

Woolsey’s political and legal career, including presidential appointments in two Republican and two Democratic administrations, has reflected consistent environmental involvement. He has worked closely with the advisory boards of the Clean Fuels Foundation, the New Uses Council and the National Commission on Energy Policy. He had been adamant in his beliefs and said, “The United States cannot afford to wait for the next energy crisis to marshal its intellectual and industrial resources.”

Special guest of the evening was Richard Perle, former assistant secretary of defense during the Reagan administration. Perle is a former chair of the Defense Policy Board and has served on the board of advisers for the Foundation for the Defense of Democracies and the Jewish Institute for National Security Affairs.

Shaare Zedek’s Healing

Dr. Norman Levan, a 90 year-old dermatologist in Bakersfield, donated a record-setting $5 million to Shaare Zedek Medical Center in Jerusalem to establish a Center for Humanistic Medicine.

The Dr. Norman Levan Center for Humanistic Medicine will seek out innovative and practical ways to further develop humanistic medicine within Shaare Zedek. The center will coordinate and host training seminars for staff from all departments within the hospital while helping to instill the importance of placing compassion as a primary objective in all interactions with patients and guests of the hospital.

In announcing Levan’s gift, professor Jonathan Halevy, Shaare Zedek director general, stated, “This most generous gift will allow us to further expand the legacy of compassionate care that has characterized Shaare Zedek for more than a century.

Levan’s contribution will enable the advancement and expansion of the medical center’s many existing programs.

Score one for the McCourts

The American Friends of Hebrew University hit a home run last week when they honored Dodgers co-owners Jamie and Frank McCourt with the prestigious Scopus Award. Former Vice President Al Gore showed his sense of humor as he spoke to the overflowing crowd in the Hilton Ballroom kibitzing and shooting barbs at Don Rickles, who’d entertained the crowd with his outrageous humor. Gore turned serious when praising the university, noting its three recent Nobel Prize-winning graduates as an example of “questioning intellect combined with a profound sense of moral purpose.”

Gore said he believes that love of knowledge has sustained the Jewish people through the ages and now Israel, as well. He said Israel possesses an abundant knowledge-based economy. Gore’s mood became somber when he turned the discussion to Iran, saying the world can’t ignore the threats and must be proactive, taking necessary action if talking fails.

Throughout the night, whispers of excitement were heard about the attendance of baseball legend Sandy Koufax, who presented the McCourts with their award. Vin Scully, hall of fame broadcaster and “voice of the Dodgers,” served as master of ceremonies.

The dress was formal, but the room was warm with generosity and good wishes as the event raised more than $3 million.

Open to Art

Rain and cold weather couldn’t deter several hundred people from attending the opening reception of the L.A. Art Association annual exhibition, “Open Show,” at Gallery 825 on Dec. 16. Collectors, artists, family members and friends crowded the gallery to view more than 1,400 works submitted by more than 400 California artists.

Only 61 works were selected by Ann Philbin, director of the UCLA Hammer Museum of Art, to be included in the exhibition. Two of the works were by Israeli-born American Sigal M. Bussel, who draws from her experiences in both countries. Bussel received an undergraduate degree from UCLA and a master’s from Harvard University.

The L.A. Art Association is a nonprofit organization whose mission is to provide opportunities, resources, services and exhibition venues for L.A. artists. Seen enjoying the exhibits were Danny DeVito and wife, Rhea Pearlman; actress Mindy Sterling, and Laurent and Bibiana Urich. The artworks will be on display until Jan. 20.

Life More Ordinary


I recently visited a congregant in the hospital and was surprised to find a doctor crying in the hallway. I told her I was a rabbi and asked if I could help. The doctor immediately apologized for her tears.

“It’s been a hard week,” she said, “I’ll be OK.”

She told me she had just presented a terminal cancer diagnosis to a woman in her early 40s. I felt for this doctor, and for her patient, but I also felt pleased at what I saw — a doctor who cries.

Dr. Rachel Naomi Remen, author of the books “Kitchen Table Wisdom: Stories that Heal” (Riverhead, 1996) and “My Grandfather’s Blessings: Stories of Strength, Refuge, and Belonging” (Riverhead, 2000) tells the story of how, as a young intern, she had been reprimanded by her chief resident for crying with a young couple whose baby had just died. Her supervisor told her she had let them down.

“They needed you to be strong,” he told her.

Now a teacher of physicians herself, Remen remains true to her initial impulse and teaches that crying with patients can be an appropriate response, saying, “You can burn out doing ‘meaningful’ work, if you lose the meaning.”

In this week’s double Torah portion, Tazria-Metzorah (Leviticus 13, in particular), God instructs Moses and Aaron on the role of priests when people take ill. The priests play diagnostician. They do not try to cure the sick, but they do examine people stricken with strange skin eruptions. The text — with more than enough description of skin ailments — is a little too graphic for some people. It also often seems irrelevant, as it describes practices no longer done by a priesthood that has long since faded from Jewish life.

But this portion also focuses attention on people who are not well. In order for the priest to evaluate what ails the people who are ill, he must get near to them, probably even touch them. And the priests see those who are ill more than once; they return days later to determine whether the person has recovered.

The daily tasks of the priests described elsewhere in the Torah consist primarily of animal sacrifice and temple caretaking, suggesting that priests are usually apart from the rest of the Israelites. So it is remarkable, and instructive, to imagine the priests — a part of the community — attending to the ill, taking note of those in need. Imagine Aaron, the high priest, coming to see the weak in the midst of the Israelites. Imagine a priest taking the time to speak with the afflicted among the people. Imagine the priest being the one to escort an afflicted person back into the community, declaring them free from contagion and assisting them in offering a sacrifice to God upon their recovery. Simple gestures perhaps, but imagine how welcome they would be to someone who had suffered physical pain and the worry that they might bring illness to others. Imagine how they might have restored someone’s sense of self-worth or desire to remain alive.

This past week saw another Yom HaShoah V’HaGevurah, the day of commemoration for the Holocaust and for Acts of Courage. When the Israeli Knesset years ago chose the 27th of Nissan for this annual day of commemoration, they did so amid controversy. Some would have preferred the anniversary of the start of the Warsaw Ghetto uprising, but that landed (by Nazi plan) on the first day of Passover. Still, the Warsaw Ghetto and its heroes surely figured in the minds of those who selected the week following Passover for this memorial day – the uprising itself lasted almost a month.

Irena Klepfisz, whose parents managed to get her out of the ghetto and whose father died a hero in the Warsaw Ghetto, said in 1988, on the 45th anniversary of the uprising: “What we grieve for is not the loss of a grand vision, but rather the loss of common things, events and gestures…. Ordinariness is the most precious thing we struggle for, what the Jews of the Warsaw Ghetto fought for. Not noble causes or abstract theories. But the right to go on living with a sense of purpose and a sense of self-worth — an ordinary life.”

How poignant to read her words this week as we read of the priests tending to the ill — not focused on the grander work of the Temple or the sacrifices that took place at the entrance to the Tent of Meeting.

As we read in Leviticus of the extraordinary lives of the priests, tenders of the sacred flame, preservers of the religion as it was then, I like to think also about the sense of purpose God gave them in commanding them to offer simple gestures of concern and care; I like to think about the meaningfulness they might have found in their ordinariness and in their tears.

Lisa A. Edwards is rabbi of Beth Chayim Chadashim in Los Angeles, and is also currently teaching Bible at Hebrew Union College-Jewish Institute of Religion.

 

Prop. 73: The Devil’s in the Details


When Californians go to the polls on Nov. 8, many will read Proposition 73 as a proposal to require that health care providers perform the seemingly logical task of informing parents before performing abortions on underage girls.

But the considered opinions of doctors and Juvenile Court judges, as well as a look at the actual text of Proposition 73, reveal that the initiative is fraught with adverse ramifications for virtually all Californians. It also poses particular issues for the Jewish community.

Much of the literature against Proposition 73 correctly emphasizes that many teenage girls will seek underground abortions, rather than have their parents (or guardians, foster parents or other legal designees) learn that they are pregnant. Thus, under the banner, “Protect California’s Teens,” a Planned Parenthood Web page urges that defeating Proposition 73 is essential to ensuring that desperate teenagers retain access to safe and legitimate medical care.

This emphasis is entirely appropriate. But there’s more to object to in this ballot initiative. One of the proposition’s most troubling aspects lies within the fine print. Proposition 73 amends the California Constitution to define abortion as a procedure ending the life of a “child conceived but not yet born.”

This radical definition has profound implications not only for teens, but also for adult women. And this carefully calculated wording should be of particular interest to the Jewish community.

Many Jewish couples undergo genetic screening as part of family planning. Those of us who learn we are dual carriers of genetic mutations (e.g., Tay Sachs) know there is a one in four chance of conceiving a child afflicted with the disease.

Couples who face this risk make the wrenching choice of attempting to have a biological child, while also taking the precaution of undergoing testing after conception. Diagnosis is possible through either chorionic villus sampling 10 to 12 weeks into the pregnancy or amniocentesis in the second trimester. Couples choose such procedures with the hope of having a healthy baby.

But typically, they also have resolved to terminate a pregnancy that would, if carried to term, bring forth a child doomed to endure unconscionable suffering ending in early death. A couple that follows this course of action sometimes has the blessing of Orthodox rabbis who would ordinarily oppose abortion.

Amending California’s Constitution to define abortion as ending the life of a “child conceived but not yet born” has profound implications for adult Jewish couples that rely on pregnancy testing. The proposition’s language would, in effect, shorten the road to outlawing abortion.

Indeed, that appears to be the aim of James Holman, the San Diego millionaire who backed Proposition 73 with $800,000, most of which went to paid signature gatherers to get the initiative onto the ballot. In line with his devout, conservative beliefs, Holman has expressed opposition to contraception, as well as to abortion apparently under all circumstances, including rape and incest.

Defining abortion as terminating the life of “a child that is conceived but not yet born” also could undermine the legality of stem cell research, perhaps the most promising scientific frontier of the 21st century. Here again, the medical implications are heightened for those of us in the Jewish community who recognize that stem cell research may herald the cures for degenerative diseases linked with genetic markers prevalent among us.

This subtle but intentional groundwork for outlawing abortion is reason enough for opposing Proposition 73, but even at face value, this measure would do more harm than good. It is opposed by Planned Parenthood, of course, and other pro-choice organizations, but also by California Women Lawyers, a statewide organization that promotes the general interests of women in society, as well as the California League of Women Voters.

Women’s advocacy organizations are correct to cite the dangers to teens posed by parental notification initiatives. Indeed, efforts to decriminalize abortion in the 1970s were largely spearheaded by doctors, lawyers, and clergy who knew only too well that making abortion illegal did not prevent abortion, but simply made the procedure lethal to many women who sought out illegal abortions.

Today, the American Medical Association, the American Academy of Family Physicians and the American College of Obstetricians and Gynecologists all oppose parental notification laws, citing the risk to teens. According to the American Academy of Pediatrics, mandating parental notification does not achieve the intended goal of family communication, but does increase the risk of harm by delaying access to appropriate medical care.

Parental notification is also opposed by Bill and Karen Bell, who lost their daughter to an illegal abortion in 1988. Although Becky Bell belonged to a loving Indianapolis family, this high school junior pursued an underground abortion, rather than tell her parents. The Bells never had the chance to tell their daughter they were not, after all, angry at her.

Instead, they became outraged at the parental notification law, operative in Indiana, that compelled their daughter to resort to the underground abortion that claimed her life. In the wake of their family tragedy, the Bells became activists against parental notification laws.Proposition 73 contains a supposed answer in its “judicial bypass provision,” which would enable teens to seek court orders excusing health care providers from the parental notification requirement in appropriate circumstances. This provision is unrealistic and unreasonably cumbersome both for teenagers and the courts, which is why Juvenile Court judges have gone on record against it.

To activate this provision, California courts would have to appoint guardians ad litem to speak on behalf of teenagers and, in most cases, to appoint lawyers for the minors, as well. In sum, the law would impose a mandate upon all courts, with no source of funding to carry it out.

Like many of my colleagues on the California Women Lawyers board, my personal choices were for marriage and children. I hope, want and expect that my daughters will come to me, however reluctantly, if they became pregnant unexpectedly. But a sweeping parental notification requirement will affect all families, including vulnerable teenagers in broken and abusive families.

As the tragic example of Becky Bell reminds us, even girls in “good” families may resort to underground abortions. And, a close examination of Proposition 73 makes clear that its language and intentions strike far closer to home than many of us previously thought possible in California.

The Jewish community — and everyone else — should oppose Proposition 73 not only because it is bad for teenage girls we may never meet, but also because it is bad — and dangerous — for adults, including ourselves.

Angela J. Davis is president-elect of California Women Lawyers, an independent bar association that advocates on public-policy issues.

 

Breast Cancer Tips Doctors Don’t Share


My mother recently called me with a request: One of the moms at the elementary school she works at was newly diagnosed with breast cancer. Could I give her a call?

I immediately phoned Susan, a sweet, smart lady in her early 40s. She was weighing her options about surgery and doctors, and gathering information about her course of treatment. She was also terrified. I reassured her about the success of current cancer therapy, but what she really wanted to know were the little things, like does it hurt when your hair falls out? (No, but your scalp feels tingly, like someone pulled your ponytail too tight.) These are the questions that fall under “What you always wanted to know about having breast cancer but were too afraid to ask,” a category that is still too relevant.

This October marks the 20th anniversary of National Breast Cancer Awareness Month. According to the American Cancer Society, an estimated 217,440 people in the United States, almost all women, will be diagnosed with breast cancer in 2004. Despite growing awareness and funding for this disease, the incidence of breast cancer has continue to rise since the 1980s, and while detection methods have improved, there is still no foolproof prevention method.

So, for all those out there who are or will be new members of the Breast Cancer Sisterhood — the sorority no one chooses to join but is, especially in the Jewish community, very popular — here is a list of what to expect during treatment:

Surgery

There are many choices when it comes to breast cancer surgery: lumpectomy, simple mastectomy, bilateral mastectomy. If you decide to opt for the “extreme makeover,” take comfort in the fact that, at least, both sides will match.

The reconstruction process can be uncomfortable and it takes a long time. Be patient.

There are advantages to not having nipples. Clothes look better on you, it’s harder to tell if your breasts are uneven and no one knows when you are cold.

Hair

The best hair substitute for nighttime: ski caps.

The good news, for those of us who have had a close relationship with Gillette since the seventh grade: by the time your hair returns, you will actually miss shaving.

Be prepared for people, especially kids, wanting to touch your bald head.

Wigs are itchy, but if you buy one that fits your appearance, you will look and feel more normal.

Scarves and hats are a lot more comfortable, but they tend to draw attention to you, especially if you are young. However, I’ve noticed on the days when I am wearing a scarf, more people go out of their way to be nice to me — which is a big boost when you’re feeling unwell.

Not-So-Glorious Food

Although it might be tempting to eat your favorite meal the evening before or the day of chemo, don’t. The associations between food and nausea are so strong you might never want that meal to cross your palate again.

Along those lines, the best advice from my nutritionist, Rachel Beller, was to avoid eating good-for-you foods, like fish, around chemo days. Spicy foods and anything too hot or too cold should also be off the list.

Chemotherapy tends to make people anemic, so think Atkins.

You will crave strange things, or only be able to eat a certain food after one chemo session and a different one after the next. (For me, it was the Caesar salad from Sharky’s, alternated with, of all things, pea soup.) If it’s legal and you can eat it, go for it.

Speaking of legal: not only is it a bad idea to fast on the designated holidays when you are undergoing cancer treatment, several rabbis advised me you are not allowed to do so. God will understand.

Emotional Rollercoaster

PMS has nothing on cancer. You will be moody. Forgive yourself for it.

It may sound cliche, but cancer really does give you the opportunity to examine your life and your relationships and make the changes you have been putting off for years.

At least one friend will not be able to handle what you are going through.

Unexpected people will come out of the woodwork to support you. Outside of my family, my two best friends through this whole process have been Ronette K., who teaches at my mom’s school, and Linda C., my brother’s girlfriend’s mother. Ronette sent me funny get-well cards after every chemo (I had 10 courses) and kept me in mystery books during my recovery from surgery; Linda ended her chemotherapy the day I got my diagnosis and was my mentor through the whole treatment process. I wouldn’t have made it without either one of them.

All in the Family

Husbands/significant others are the greatest unsung heroes in this battle. Remind people to check on them instead of you every once in a while.

As with friends, some family members will handle your situation better than others.

Kids can be your greatest allies. For little ones, you don’t have to tell them much, just what they might need to know. Like that Mommy will be living in the bathroom for the next three days.

Beam Me Up, Scotty

Compared to chemo, radiation seems like a cakewalk. Some people do get exhausted from it, so while you may be feeling better, this is not the time to take up lacrosse.

Yes, you will be asked to get tattooed. If this freaks you out, there are alternatives, but a tattoo provides the best record for any possible future radiation. The tattoos are tiny, not the big, rosy “Mother” ones found on certain bikers. Your doctor can give you a note for the chevra kadisha (burial society) if you feel the need.

Know that, even if you do get the tattoos, the radiology staff will draw on you. With a big marker. In dark, purple ink. As if you needed one more thing to make you look strange.

Words to remember: body lotion. Some people swear by aloe vera; I like Aveeno with the colloidal oatmeal (which, by the way, doesn’t mean any kind of special oatmeal — it’s just minced up really fine so they can get it in the lotion).

The machinery used during radiation emits a loud, annoying whine that makes it difficult to lie still. Find a “theme song” you can run through your head to distract you. (Mine is the overture from “Star Wars.”)

Recovery

Just when you start getting good at dealing with the chemo and radiation, it’s over. Thank God.

Wendy J. Madnick was diagnosed with breast cancer in December 2003. She awaits the return of her hair with growing anticipation.

In this, the Jewish Journal’s seventh annual honor roll of high-school graduates, we find that our f


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