Study: Legalizing marijuana would help Israeli economy


Legalizing marijuana would generate more than $450 million annually for the Israeli economy, a new study shows.

The black market for cannabis in Israel is worth $707 million annually, according to the study released Tuesday by the Jerusalem Institute for Market Studies. If the sale of marijuana were legalized and taxed at rates similar to cigarettes, it would add about $268 million in tax revenues and another approximately $198 million in savings to law enforcement directly related to illegal marijuana use, the study found.

At least 275,000 Israeli adults used marijuana in the past year, the study found; the tax revenue estimate was based on that number.

Some 75 percent of those questioned in a public opinion survey analyzed in the study said they believe marijuana has legitimate medical uses. Israeli support for medical marijuana was similar to the level of backing recorded in the United States in a survey earlier this year, according to the institute.

[Related: What Israel can teach America about medical marijuana]

Twenty-six percent of Israelis supported the legalization of marijuana, the survey found, with 64 percent opposed. In the United States, 52 percent of survey respondents supported legalization.

The Jerusalem-based firm Kevoon conducted the survey of 500 respondents reflecting a representative sample of Israeli Jews. The survey had a sampling error of 4.5 percent.

“Recognizing the enormous financial gains that would come from legalization demands that the government take a serious look at the proposal to legalize cannabis use under specific guidelines,” said Yarden Gazit, a co-author of the survey. “There is no disputing that if the public is able to get past the wholly negative misperceptions associated with marijuana usage and appreciate the potential benefits with limited social or health care costs, this is an idea that needs open-minded and serious re-examination at this time.”

Four injured Syrians brought to Israel for treatment


Four Syrians injured in their country’s civil war were brought to Israel for medical treatment.

The injured, including a 15-year-old girl who lost her foot and an 8-year-old girl, were brought to Ziv Medical Center in the northern Israeli city of Safed, according to The Associated Press.

In recent months, Israel has treated 100 Syrians injured in the unrest across the border. Israel has also set up a field hospital on the border to treat wounded Syrians. More than 90,000 people have been killed in the conflict, which began 2 1/2  years ago.

“Our policy is to help in humanitarian cases, and to that end we are operating a field hospital along the Syrian border,” Israeli Defense Minister Moshe Ya’alon told the Knesset’s Foreign Affairs and Defense Committee in June, according to the Times of Israel. “In cases where there are badly wounded, we transfer them to Israeli hospitals. We have no intention of opening refugee camps.”

What Boston hospitals learned from Israel


Minutes after a terrorist attack killed three at the finish line of the Boston Marathon, doctors and nurses at the city’s hospitals faced a harrowing scene — severed limbs, burned bodies, shrapnel buried in skin.

For Boston doctors, the challenge presented by last week’s bombing was unprecedented — but they were prepared.

Many of the city’s hospitals have doctors with actual battlefield experience. Others have trauma experience from deployments on humanitarian missions, like the one that followed the Haitian earthquake, and have learned from presentations by veterans of other terror attacks like the one at a movie theater in Colorado.

But they have benefited as well from the expertise developed by Israeli physicians over decades of treating victims of terrorist attacks — expertise that Israel has shared with scores of doctors and hospitals around the world. Eight years ago, four Israeli doctors and a staff of nurses spent two days at Massachusetts General Hospital teaching hospital staff the methods pioneered in Israel.

According to the New Yorker magazine, every Boston patient who reached the hospital alive has survived.

“We had periods where every week we had an attack,” said Dror Soffer, director of the trauma division at the Tel Aviv Medical Center, who participated in the delegation. “It becomes your routine.”

Techniques that were “routine” in Israel by 2005, and helped save lives in Boston last week, began evolving in the 1990s, when Israel experienced a spate of bus bombings. Israeli doctors “rewrote the bible of blast trauma,” said Avi Rivkind, the director of surgery at Jerusalem’s Hadassah Medical Center, where 60 percent of Israeli victims have been treated.

Much of what Israel has learned about treating attack victims was done on the fly. In 1996, a 19-year-old soldier arrived at the Hadassah hospital following a bus bombing with severe injuries to her chest and esophagus. Doctors put chest drains on her lungs and performed endoscopies twice a day to stop the bleeding. Both techniques are now regular practices.

“We were sure she was going to die, and she survived,” Rivkind said.

Rivkind is an internationally recognized expert in terror medicine and widely considered one of the great brains behind Israeli innovations that have been adopted around the world.

Trained at Hebrew University, the Hadassah Medical Center and the Institute for Emergency Medical Services Systems in Baltimore, he has contributed to several volumes on trauma surgery and post-attack care, and authored a number of seminal medical studies. Rivkind was the personal physician for the late Israeli President Ezer Weizman, helped care for Ariel Sharon when the prime minister fell into a coma following a stroke, and has performed near-miraculous feats, once reviving a soldier shot in the heart who had been pronounced dead in the field.

But not everything Rivkind has learned about treating attack victims comes from a story with a happy ending. In 2002, Shiri Nagari was rushed to Hadassah after a bus bombing. She appeared to have escaped largely unharmed, but 45 minutes later she was dead. It was, Rivkind later wrote, the first time he ever cried after losing a patient.

“She seemed fine and talked with us,” he said. “You can be very injured inside, and outside you look completely pristine.”

Organizing the emergency room, Rivkind said, is as important as treating patients correctly. During the second intifada, Hadassah developed what he called the “accordion method,” a method of moving patients through various stages of assessment with maximal efficiency. The process has since become standard in hospitals across Israel and around the world.

HEALTH CARE DECISION — Jews react: Los Angeles Jewish Home CEO & President


Molly Forrest, CEO and president of the Los Angeles Jewish Home, had surgery to alleviate arthritis in her neck in December 2010.

Stuck in bed for 35 days, she read the entire Affordable Care Act – all 2,080 pages of it. She has since read it again so she knows it well, and she takes it personally.

“If I were unemployed now, I would not be able to get insurance, and I’m not old enough for Medicare,” Forrest remembers thinking after her surgery.

The Supreme Court’s decision today to uphold the law “settles a 100 year debate about whether access to health care is a right that each American has,” Forrest said.

The 1,000 elderly clients who live at the Jewish Home in Reseda, as well as the 1,500 non-residents it serves and the employees the organization insures all will benefit from the law as implementation goes forward, she said.

“Seventy-five percent of our clients rely on welfare programs to support whatever care they receive, and so anything that threatens or affects Medicaid or Medi-Cal dollars is of enormous concern and importance to us,” Forrest said.

Forrest said she supports the one adjustment to the law the court made—prohibiting the Federal government from withholding Medicaid funds from states that do not comply with the Affordable Care Act.

“We already face such enormous challenges with funding programs for the needy in this state, that for us the decisions of the Supreme Court at least removes the threat that the Federal government could penalize the state in any way for not fully complying with the Affordable Care Act,” Forrest said.

Forrest sees many benefits in the law.

Not only will those with preexisting conditions not be denied coverage now, she said, but the law prohibits insurers from charging highly elevated premiums to those with complicated conditions. This will help many disabled adults get private insurance, she said, since previously their pre-existing conditions either shut them out of insurance or made it entirely unaffordable.

She also sees much benefit in removing insurers’ lifetime cap and the annual cap, and in allowing children to stay on parents’ plans through age 26.

“I think there are a lot of good things here,” she said. “I know there is a lot of controversy around this, but this is America, and I think in the end this will work out and American will be better for it. I know the health of American will be better for it.”

Pico-Robertson’s pot prince


In a way, medical marijuana dispensary owner Matthew Cohen is just another small businessman.

For the past five years, he has been working diligently to grow his shop, The Natural Way of L.A., located on Pico just east of Fairfax. Cohen claims to carry the best-quality product in the world, which he says is very important to his clients, many of whom are fellow Jews with discerning taste.

“Jews know good pot,” Cohen said.

Cohen’s shop is one of nine dispensaries active within a mile and a half of the intersection of Pico and Robertson as of press time this week. Like all dispensaries, Natural Way is a nonprofit, and in that highly competitive market, it hasn’t made money yet. Cohen, 43, says that he will “lose less than ever” in 2010, partly thanks to a new ordinance that put some of his competitors out of business.

Cohen relies on quality to distinguish his shop, but he has tried to cater to his fellow Jews, too. He used to carry kosher marijuana-impregnated “edibles,” and although he says he has “many obviously Jewish patients,” he hasn’t carried that product line in awhile. “It did nothing for us,” Cohen said — although the kosher-for-Passover chocolate-covered matzah made with weed was a hit (no pun intended), as were the marijuana macaroons. “They were labeled pareve,” Cohen said. “I’m not sure which rabbi was in charge of that.”

But he insists quality product is of the foremost importance. “The Dutch have been playing catch-up for the past five or six years,” Cohen says with considerable salesmanship bravado, and thanks to his years of growing experience, Cohen’s pot sells out before the next batch is ready to harvest. He believes that he has helped make Los Angeles into the new Amsterdam: “For 10 days every month, we have the finest pot in L.A.,” Cohen said of the product he grows, “which means we have the finest pot in California, the finest pot in the United States, and I can promise you, the finest pot in the world.”

Cohen is a fast-talker, an engaging storyteller and a user of his own medicine — taking marijuana to treat the chronic pain he has suffered from since 2001. Before opening Natural Way of L.A. in 2005, he held a few different jobs, including running a network of veterinary hospitals, working as a radio sportscaster and as Major League Soccer’s first vice president of sales. He later headed the sales staff for the LA Galaxy soccer team.

Wearing mesh shorts and black high-top Nikes when this reporter came to meet with him, Cohen clearly has left the executive suite behind, although his sales patter is still polished and convincing, especially when he talks about the people who grow his pot. Cohen estimates that he’s set up grow rooms for 120 to 130 people in the past two years.

Marijuana buds ready to be sold. Photo by Dan Kacvinski.

“You can get your first harvest from that room in 90 days,” Cohen said. “We set you up with the Cadillac of systems — lights, an airflow system, the works — and it will grow diamond-quality pot.” Cohen charges $5,500 to set up a 144-square-foot grow room, which can produce three or four harvests of 4 pounds each. Cohen buys back quality bud for $3,000 a pound. Even though grossing $36,000 a year out of a spare bedroom sounds great, Cohen takes care to explain that growing pot is hard — but rewarding — work. “You’re gonna feel really good,” Cohen said, “like a real farmer — even though you’re sitting in Century City.”

Cohen estimates that 45 percent of what he sells is grown locally, either in people’s homes or on site at the dispensary, and he’d like to raise that figure to 80 to 90 percent, especially in light of the Los Angeles City Council ordinance that went into effect June 7. That ordinance, which forced three-quarters of the city’s marijuana dispensaries to close, also outlined regulations for the remaining dispensaries, including a requirement that they grow their product on site. “Every real dispensary should be adding lights as fast as they can,” Cohen said, referring to the high-powered lights used in indoor grow rooms, “because the ordinance makes clear for the very first time that we have to grow 100 percent of our medicine.”

What Cohen calls a “real dispensary” — one that grows its own marijuana — has been the exception rather than the rule. He estimates there are between 50 and 80 “real quality dispensaries” in the city growing their own pot. The rest — at one point, there were as many as 600 across the city, by some estimates — don’t grow any of their own stuff. “None of the Russian-owned dispensaries, the Armenian-owned, the Israeli-owned — they don’t grow any of their own pot,” Cohen said. “They’re buying their pot from vendors.”

The ordinance dictated that every dispensary that opened in Los Angeles after November 2007 — some 437 shops — had to close, and by now many already have shut their doors. At one point, 15 dispensaries were located in the Pico-Robertson area. Six appear to have closed, most of them in the past four months, since the ordinance went into effect. Of the nine that remain, only Natural Way of L.A. has been declared eligible to stay open. Many dispensaries are contesting the ordinance in court.

Cohen chalks up his continued legal status to having good lawyers who could comply with the “dirty little tricks in the ordinance,” and to the fact that Natural Way is, with 3,000 active patients, smaller than many other shops. Cohen stayed small because he has never sold to what he calls “the fastest-growing group of patients,” namely, 18- to 21-year-olds.

One reason Cohen doesn’t sell to patients under 21? “I’m a dad,” he said. (His daughter is 8.)

The City Council ordinance is, in practical terms, far more important for the future of marijuana in Los Angeles than the much more widely discussed Proposition 19, the ballot measure that would legalize marijuana for recreational use. Nevertheless, Cohen, who’s a bit of a pot policy wonk, has a lot to say about the proposition.

“I am going to be happy and disappointed whichever way it goes,” Cohen said. “And what I mean is, if it’s voted in — and right now it’s polling ahead, I’m very surprised — if it passes, there is the huge, huge bounce that the entire marijuana issue gets. Legalization, medicalization, everything about marijuana would get shoved right to the forefront, nationwide.”

Cohen plans to vote against the measure because he believes access to medical marijuana will be restricted rather than improved as a result of Proposition 19. “The right thing for marijuana users, both medical and nonmedical,” Cohen said, “is for this to not pass.”

But, Cohen added, “The right thing to push forward marijuana legal reform is for this to pass, because it’s going to push forward the cause across the country.”

VIDEO: Hebrew U and Berkeley scientists perfect tech for medical imagery via cell phones


Professor Boris Rubinsky and his team at Hebrew University and the University of California, Berkeley, have designed a system to transfer medical images via cell phone. Watch how this technology works

Selma’s Sermon


This is a big time of the year for sermons.Last year at this time, I wrote a column called “Words of Awe,” comparing the different styles of Orthodox, Conservative and Reform sermons.I even previewed some of the sermons we could expect to hear here in the hood — and I discussed the Orthodox tradition called Shabbat Tshuvah, which is the biggest and most anticipated sermon of the year, on the Shabbat afternoon before Yom Kippur.

The thing is, though, all these big, important sermons are usually given by rabbis.

They’re not supposed to be given by young, pretty, career-driven single Jewish women with a weakness for Italian shoes and vintage Jaguars.

But that is exactly what happened four years ago, on Yom Kippur of 2003, when a rabbi’s daughter named Selma Schimmel got up to speak. She didn’t speak in a shul in the Pico-Robertson neighborhood, but this is a story that can play in any hood.

Selma spoke right after the Torah reading, and just before Yizkor, in a Studio City shul called Beit Meier. Her sermon, as she recalled it the other day in my dining room with kids playing in the background, didn’t focus on High Holy Days themes like spiritual renewal, forgiveness and personal atonement.

Instead, she spoke about ovaries, genetic testing and the BRCA gene mutations.

You see, Selma had an announcement to make that day. A week earlier, she had undergone a seven-hour operation to treat advanced ovarian cancer, which no one knew except her now-late father, the founder and spiritual leader of the Beit Meier shul.

So she and her father had huddled together and decided she had to say something. This was a small community, and the Schimmel name was revered. People worried easily. Twenty years earlier, Selma had been diagnosed at an unusually young age with breast cancer, and three years before that, her mother, the rebbitzen, had died of ovarian cancer.

This was not a time for family secrets. So there she was, in her tailored suit and Italian shoes, recovering from surgery and groggy from pain medications, in front of a standing-room-only crowd that was waiting for its annual Yom Kippur sermon — and she was telling them about her second cancer.

She explained that about 10 percent of ovarian cancer cases have been linked to genetics, typically through susceptibility genes. As part of the genome project, the two BRCA genes, located on chromosome 17, were the first to be identified as carriers of a predisposition to breast and ovarian cancers. When a woman has a mutation in either BRCA1 or BRCA2 genes, like Selma has, she is at higher risk of developing one of these cancers.

Then she got personal.

She explained how about one in 40 American Jews of Ashkenazi descent — who make up about 90 percent of American Jews — is believed to carry the mutant genes, compared with one in 400 for the general population.

According to a report in the Wall Street Journal, researchers speculate that the genetic mutations arose by chance among the Ashkenazim over several centuries, starting as far back as the 1100s. Under assault by ethnic attacks, millions of Eastern European Jews contracted to a group numbering in the thousands, then expanded again into a population of millions — a “genetic bottleneck” in which random mutations in the small, largely intermarried group are passed down to many descendants.

Selma was one of those descendants, and as she went on with her “sermon” that Yom Kippur day, she seemed to forget that she was in a shul and not a school of medicine. But she was going somewhere with her lecture on mutant genes.

She wanted the people of the community to open their eyes and start asking more questions. She wanted them to look more carefully into their families’ medical histories, and if they suspected anything, to immediately make the necessary appointments.

She also offered to help. As the founder and executive director of Vital Options, an internationally renowned nonprofit cancer support group she started during her first bout with cancer in 1983, she could help answer a lot of questions.

But still, what did any of this have to do with the Days of Awe, the Book of Life or the Day of Atonement?

Selma admits today that when she got up to speak on that day, she came with an agenda. She knew she was about to go in for long-term treatment. She didn’t like the idea of rumors flying around about the rabbi’s daughter. She wanted to put everything on the table, while also enlisting the community in her efforts to help others with cancer prevention and early detection.

In other words, she didn’t really have your basic High Holy Days sermon in mind.

If you ask me, though, I think Selma’s not giving herself enough credit.

Is there a better day than the one when we abstain from all physical sustenance to reflect on the sanctity of the human body and honor the Torah’s injunction that “You shall guard your being”?

During these Days of Awe, when we are instructed to reflect deeply on ourselves and seek personal rectification, is there a better time to be reminded that the miracles that God has given us — which include the human body — also include the gifts of human knowledge, and the obligation to use that knowledge to help care for God’s physical miracles?

We will all hear many sermons during these Holy Days, and I’m sure many will touch on our need to become better Jews and make the world a better place. In the middle of all these noble sermons, however, I hope we’ll remember a simple Holy Days message from a fearless Jewish woman with an antique Jaguar who’s just been diagnosed with her third cancer.

Take good care of what God gave you.

David Suissa, an advertising executive, is founder of OLAM magazine and Meals4Israel.com. He can be reached at dsuissa@olam.org.

Yehoram Uziel: A Lifeline to Mexico


Yehoram Uziel

Barri Evins

Alex Baum

Betty Neymark

Eve Marcus

Fran Rosenfield

Marilyn Harran

Noah Bleich

Rebecca Levinson

Yehoram Uziel

Yoram Hassid

Yehoram Uziel, 56, began volunteering right after he finished serving in the Israeli army as a tank corps officer. First he worked nights at the suicide hotline service, then he moved to the family services center in Haifa.
“I learned volunteering is something that adds to your self-esteem; it’s not just donating — it’s something that benefits you,” he said.

So when he was sent by his high-tech company to America in 1989, it was only natural that he would begin to search for more volunteer opportunities. An experienced pilot, Uziel, 56, began working for various medical aid organizations, flying needy sick people, as well as medical equipment and doctors around the country.

Some 10 years ago, he began devoting his efforts exclusively to The Flying Samaritans, a volunteer medical aid organization that assists clinics in Mexico. In addition to flying personnel and equipment there, he stayed over on weekends to help out. “Once I get there,” he says, “I do everything that doesn’t require a medical license and requires a good pair of hands — fixing handles, overhauling generators, repairing equipment, installing dental chair, roofing, putting in air conditioning, fixing the water supplies and pumps.”

“Sometimes,” he said, “I’ll go play with the kids.”

Last year, when The Flying Samaritans became beset by internal politics, Uziel, who now owns his own business and who is also trained as a mediator, stepped in to resolve the conflict — and found himself nominated president. Now he’s focused on integrating new technology for the “Sams” so they can schedule their 2,500 volunteers at the 20 clinics in Mexico, improving services provided to the Mexicans by conducting a marketing survey and boosting the spirits of the volunteers.

“We want to make sure the service we give is worthwhile to the people that get the service, and, more importantly, when you ask so many volunteers to donate their time and money, you better make sure that they feel valuable.

Otherwise they get worn out,” he said. “It’s really important that volunteers can come back and not say they just threw money at some altruistic cause.”

Uziel, who is married to Rhoda Weisman Uziel and has two children from a previous marriage, was raised a secular Jew in Ramat Gan, Israel. His outlook on life was shaped by his great uncle — the chief rabbi of Israel.

“When my father was ordered to go to World War II, he went to his uncle to get a blessing. The uncle said: ‘I know you’re not going to keep kosher, and I know you’re going to drive on Shabbat, I know you’re not going to follow the etiquette, but there’s one thing I want you to remember: You’re always a Jew.'”

Volunteering one weekend a month in Mexico gives his life perspective.

“I go to Mexico and come back — and no matter how much it costs me it’s better than sitting on a shrink’s couch and whining about how terrible things are,” he said. “We’re lucky. We have a good life. We have so many options — cultural, financial. And when you see what they live through, you get perspective, you appreciate what you have.”

Laura’s Smile


Laura Benichou was born on June 9, 1998, with a hole in her heart. This hole probably saved her life, because she was also born without her main pulmonary artery.

The blood had to go somewhere, so it went through the hole. Her condition would take too long to explain, but one result was the lowering of the oxygen level in her blood to 75 percent and below (normal is 99 percent to 100 percent), which meant that her body had to compensate by producing more red blood cells. This in turn thickened her blood and caused other complications, like periodic brain seizures.

The first major seizure happened before she was a year old. To save her life, the top cardiac team at a major hospital in Los Angeles performed an 11-hour operation that implanted small “pipes and faucets” to help normalize the blood flow between her heart and lungs. This didn’t get the results they wanted, so a few weeks later they went back in to implant larger devices. Laura was not responding well to post-surgery care, which created more complications and led to another operation. After six months and three major operations, Laura was a year and a half old when she returned home.

Laura has never spoken a word, but she can coo, laugh, sigh and cry. At her best, she has taken steps with the help of a walker. She has a thin body with a smallish, sweet face framed by dark-brown hair. She gets 24-hour home care, with three rotating nurses monitoring her breathing and other vital signs.

One of those nurses says that Laura expresses a wide range of “appropriate” emotions, from happiness to surprise to crying for attention. Her favorite movie is “Mary Poppins,” and her favorite TV show is “Hannah Montana.” She likes toys that move, and she has a fondness for anything slapstick.

Oh yeah, and she loves to smile.

It’s that spontaneous smile, which I saw firsthand on a recent visit to her family’s handsome high-ceilinged apartment in West Hollywood, that her mother says “hypnotizes everyone who meets her.”

I think the smile has also helped her family fight to keep her alive. While she was in the hospital for six months, her parents took turns to be with her at all times. Her brother, a very cool-looking 16-year-old who’s a starter on his high school basketball team, is very protective of her and seems to have a knack for making her laugh.

Her mother, Veronique, a thin and perfectly put-together French Moroccan Jew in her early 40s, has become a walking medical handbook. During my late-afternoon visit, while she was serving mint tea in elegant china, she took several hours to calmly answer all my questions regarding their ordeal, and Laura’s medical history, even drawing a diagram to explain one of the surgeries.

Veronique says she “stopped living” when the doctors told her the news about Laura. At the time, she had a thriving international trading business. Her husband Richard, an intense, darkly handsome, French Algerian Jew who is a member of the Pinto shul on Pico Boulevard, ran a successful garment business. They were also going through a major renovation of their home near the Sunset Strip, which they were preparing for the new baby.

It didn’t take long for the house (which they have since sold) and their businesses to take a back seat to Laura. Veronique herself was in a “coma of denial” for the first few months, but once she got out of it, she became quietly unstoppable — whether fighting in court against insurance companies (so far, she has prevailed at the key hearings) or doing constant research on the Internet to make sure that everything medically possible is being done for her daughter.

And God knows she’s done it all, medically and otherwise. She recalls now, with a tinge of disappointment, how vulnerable she was to faith healers of all kinds. She especially remembers the woman mystic from Israel, who spent three days rubbing different oils on her daughter while chanting special prayers. Veronique knew then that because they were people of means, there would be no shortage of miracle workers knocking on their door. But she was too vulnerable to turn them away.

Meanwhile, she was knocking on the doors of emergency rooms at all times of the day and night, whenever Laura had a seizure or some other complication. After a few years, she got so frustrated with the service and long waits that she started a company called SOS Medlink, which coordinates a network of doctors who make house calls (I’ve used the service myself, and if I had a say on the Messiah, I’d nominate a doctor who makes house calls). She is currently looking for partners to expand the business nationally, in the hope that it will help provide for Laura’s future care. Her husband has also gone back to work.

Right now, they’re both hoping for a medical success. They don’t like the option of doing nothing, because Laura’s condition hasn’t gotten any better, which leaves her at risk of another seizure (Veronique won’t elaborate). At the same time, though, an “out of the box” operation to repair Laura’s heart is also delicate. So they’re torn between two risky options.

Veronique and her husband will soon make a decision. In the last few days, they have met with a prominent surgeon, and they are exploring a “middle of the road” option that will hopefully do a little repair of the heart and buy them some more time.

In the meantime, they will continue to care for Laura around the clock, take her to parties and to visit family around town, and enjoy one thing that can always fill the hole in their own hearts.

Her smile.

King/Drew closing spotlights crisis in health care


Asking the 100,000 uninsured residents of South Los Angeles to take an hourlong bus ride for medical services they may not receive is hardly a solution to the current health-care
crisis.

But that is exactly what the Los Angeles County Board of Supervisors did when it approved a plan to drastically cut services at King/Drew Medical Center, the only county hospital serving South Los Angeles, Compton and Watts.

Splashed across the pages of the Los Angeles Times, the problems at King/Drew have been framed as the county vs. a bad hospital, one mired in race politics and lethal incompetence. In this context, the near-shutdown of the hospital might seem a relief.

But the problems at King/Drew are more complicated than they seem, and they do not belong to any one ethnicity or neighborhood. They are harbingers of a systemic health-care shortage, one that undermines our democratic ideals and compromises the quality of care for the insured, along with the uninsured.

Its impact will reverberate far beyond the borders of South Los Angeles, one of our most vulnerable communities. The emerging health-care crisis in Los Angeles should not only bother us as Americans and Angelenos but also as Jews.

Jewish teachings on health care and current health-care service levels in Los Angeles County are a study in opposites. The rabbis in the Talmud mandate that people need to live near and have access to medical services. Maimonides lists health care first on a list of the 10 most important services that must be offered by a city to its residents.

In contrast, the closure of 12 hospitals and 10 emergency rooms in Los Angeles County since 1998 has overwhelmed the remaining emergency rooms and county hospitals. Wait times in county emergency rooms can approach 16 hours, and specialty referrals take six months. Yet these facilities are the only option for the 2.7 million people — 20 percent of the population — in Los Angeles County without health insurance, 1.2 million of whom live in households with incomes well below the federal poverty line.

The county’s failure to provide basic health care to residents without insurance is a catastrophe in South Los Angeles, where more than 50 percent of the population lacks insurance. This region leads the county in lack of education, extreme poverty and highest rates of disease, including infant and child mortality rates. While the need for health care is most pronounced in South Los Angeles, the region has the fewest per capita hospital beds and physicians in the county.

King/Drew Medical Center was to be the guarantor of community-based medical care for South Los Angeles. Over the past decade, this vision has been obscured by patient deaths, quality lapses and accreditation losses. The ultimate authority for King/Drew and public health care in Los Angeles County rests with the Board of Supervisors.

Now, the same Board of Supervisors has approved a heavily criticized plan that will cut 130 beds from the hospital and further shrink emergency room capacity but will not address quality issues at the hospital. The plan will merge King/Drew with Harbor-UCLA Medical Center in Torrance. Almost all specialty services at the King/Drew will be eliminated. No new beds are being added at Harbor-UCLA.

The other day, I decided to see for myself what the tens of thousands of South Los Angeles residents will have to do to see a doctor. I took the bus that residents of South Los Angeles will have to take from King/Drew to Harbor-UCLA Medical Center. The bus runs every half hour and weaves circuitously through Compton, Carson and Torrance. During the hourlong ride, I tried to imagine bringing an ill child on this bus, riding home from a chemotherapy appointment or visiting a critically ill loved one in the hospital.

To be sure, the county is faced with a terrible dilemma: We must choose between the daunting task of providing quality and accessible health care for our most vulnerable residents and the tremendous societal cost of not doing so.

But the Board of Supervisors’ plan will turn basic health care into a luxury for tens of thousands of Angelenos. Preventable medical problems will fill our emergency rooms. In the decision to close, rather than improve, King/Drew, we’ve all just missed the bus.

Catherine Schneider is the assistant director of the Progressive Jewish Alliance.

Spirit and Chocolate Top Temple Emanuel Installation


There was chocolate and music last week when Sue Brucker was installed as president of Temple Emanuel’s board of directors at Shabbat Unplugged. Amid the singing and Shabbat rituals, Brucker was applauded for her talents as a leader, and her commitment and dedication to getting any job, no matter the task, accomplished.

The services were filled with those who enjoy the upbeat Shabbat melodies of singing and celebration Temple Emanuel has become famous for. Known as a “go-to person,” Brucker is always the first to achieve any goal, take on any task and commit to any cause. Brucker, along with her mother-in-law Rita Brucker, will be honored at the Women of Sheba Achievement luncheon later this month and is the immediate past president for the Beverly Hills High School PTSA. She also received the Humanitarian of the Year from Amie Karen Cancer Society. Her husband Barry is on the Beverly Hills City Council and was the former president of the Beverly Hills School Board.

Big Fun in Big Apple

Leaving Los Angeles and spending a month at Yeshiva University (YU) in New York this summer was a fun and rewarding experience for five Yeshiva University High School of Los Angeles (YULA) students. The teens met and mingled with other Orthodox students in New York City, taking in the sights and enjoying the Big Apple. The five students, Michael Bank and Jesse Katz of Los Angeles, Marlon Schwarcz of Beverly Hills, Joel Shuchatowitz of Tarzana, and Netanel Zilberstein of Encino stayed in dormitories on YU’s Wilf Campus in Washington Heights.

Students spent mornings studying Jewish topics, and in the afternoons chose between “The World of Finance and Investment,” a practical experience establishing and analyzing a portfolio of investments and working with traders, financial planners and entrepreneurs; “Explorations in Genetics and Molecular Biology,” a laboratory experience introducing students to the theory and techniques of molecular biology; and political science/pre-law, which exposed students to politics and law through the lens of current issues and by taking trips and hearing from speakers around New York City.

The YULA students toured the area attractions, including a Broadway show; the Museum of Natural History; Six Flags Great Adventure; a Mets game; a double-decker bus tour; a visit to the World Trade Center site; and a tour of YU’s campuses.

“It was great to have an opportunity to feel the YU experience,” said Zilberstein, the first of his siblings to go to college.

He said spending the month at YU took some of the mystery out of the college experience: “You get to feel like you are a college student, taking real college classes.”

Students also spent several days in the Washington, D.C. area, visiting the Capitol building, U.S. Holocaust Memorial Museum, the Spy Museum and spending Shabbat in Silver Spring, Md.

“Many of the students are interested in YU, but want to see more than they would if they just came for a tour,” explained Aliza Stareshefsky, program director.
For more information about next year’s program, e-mail summer@yu.edu.

Rabbi on Board

The Olympia Medical Center recently added Rabbi Karen L. Fox to its board of governors. The group is comprised of 15 community leaders and business executives, and recommends and implements hospital policy, promotes patient safety and performance improvement while helping provide quality patient care.
“We are honored to have someone with Rabbi Fox’s prominence join our board of governors,” board chairman Dr. Sharam Ravan said. “I know that she will be an asset to Olympia Medical Center as we grow to meet the needs of the community.”

Fox, who has served at Wilshire Boulevard Temple for nearly 20 years, graduated from UCLA in 1973. She earned a master’s degree in Hebrew letters from Hebrew Union College-Jewish Institute of Religion in New York and received her ordaination there in 1978. She earned a master’s degree in counseling psychology as well as a doctorate of divinity from Pepperdine University, and is a licensed marriage and family psychotherapist. She published a user-friendly guide to Jewish holidays title “Seasons for Celebration” and has authored numerous articles about women’s experiences and Jewish thought.

Kids Raise the ‘Roof’

The Children’s Civic Light Opera (CCLO), one of the Los Angeles area’s original and longest-established performing arts programs for youth, ages 7-17, celebrated its 19th year with a stellar production of “Fiddler on the Roof.”

Parents and friends shepped naches as 40 talented and dedicated kids rehearsed for eight weeks to present the Broadway-style production complete, with professional sets, costumes, sound, lighting and a live orchestra. Their show was a treat for theater-goers who sat awed by the kid’s spirited performances.

“‘Fiddler’ is a rare and beautiful gift,” CCLO’s founder and artistic director Diane Feldman Turen said. “It is an incredibly powerful piece of theater overflowing with an abundance of learning opportunities on multiple levels. Its universal themes allow us to address and examine the opposing forces that drive our lives and it’s wonderful that our ensemble can apply what they’re learning on the stage and off.”

Special Delivery – When Baby Brings More Than Expected


Sarah Berger had a tough pregnancy. Berger, who asked that her real name not be used, had severe morning sickness for six months, and then was on bed rest for her last 10 weeks. But it wasn’t until her baby came home that trouble really began.

“On the third day, I remember this dark cloud descending on me…. I cried all the way home from the hospital,” she said. As she prepared for her son’s brit milah, “I started falling apart,” Berger said. “I couldn’t eat, I couldn’t sleep and I couldn’t stop crying.”

She called her obstetrician, who suspected that Berger had postpartum depression (PPD).

Experienced by about 10 percent of new mothers, PPD’s symptoms include sadness, apprehension, difficulty making decisions and changes in sleeping and eating habits. The symptoms of PPD last longer and are more intense than the tearfulness and fatigue characteristic of the “baby blues,” which generally subside after two weeks.

“Despite the common belief that motherhood automatically brings … a state of bliss and contentment, in reality the postpartum period is a time of increased vulnerability to psychiatric illness, particularly for women with past histories of depression or serious anxiety disorders,” said Dr. Vivien K. Burt, professor of psychiatry at the Geffen School of Medicine at UCLA and director of the Women’s Life Center of the Resnick Neuropsychiatric Hospital at UCLA. “We don’t know for certain what causes postpartum depression, but we believe it stems at least in part from the rapid decline in estrogen following childbirth,” she said, noting that during pregnancy, estrogen levels rise several hundred times and then drop back to prepregnancy levels within several days following childbirth.

Women suffering from PPD often fail to receive help for a number of reasons. They might be ashamed of their feelings, or they simply might not know where to turn. And not all obstetricians and pediatricians are as attuned to the condition as Berger was.

After she began seeing a therapist and taking medication, Berger quickly responded to treatment. When PPD hit again after the birth of her second child, she knew what to do.

Now Berger helps other women experiencing the condition by volunteering for New Moms Connect, a PPD support program offered by Jewish Family Service of Los Angeles (JFS). Volunteers for this free service help new moms and family members via telephone calls, home visits and referrals to community resources.

With a grant from the Jewish Community Foundation, New Moms Connect was developed as a response to calls received by JFS from new mothers “who were depressed and felt they had no one to reach out to,” said Debbie Fox, director of child and family services for JFS. “Their husbands had no understanding of what was happening, they had no understanding and their families had no understanding.”

“There’s so much pressure to be joyous when a new baby comes,” said Tamar Springer, a licensed psychotherapist who supervises the program’s volunteers. “A woman may be reluctant to come forward with her feelings…. Our goal is to decrease stigma, educate the community and help people understand that this is a medical disorder that’s not something to be ashamed of.”

So far, 10 volunteers, including Berger, have undergone training. One is a nurse and another is a dentist. All are mothers.

Berger said she chose to volunteer because she felt there was a lack of information about PPD both in the Jewish community and the community in general. She was pleased to be part of an effort to “let women know about it ahead of time instead of just getting hit with it afterward,” Berger said.

In her role, Berger listens as the women describe their situations, asks questions and makes suggestions for how new mothers can get support, whether by hiring temporary household help, attending a new mothers group in the area [see below] or seeing a physician. She often refers women to UCLA and Cedars-Sinai Medical Center, both of which offer PPD programs.

So far, she has spoken to about five women over the phone and visited two more in person. Her husband has also spoken with one of the women’s husbands. She advises new mothers “to surround themselves with what makes them comfortable” and to articulate their preferences, rather than let other people decide what’s best.

Berger, who is Orthodox, said that certain factors can intensify the problem in her community. In her lactation consulting practice, she said, “a lot of the moms I deal with … are very young — around 19 or 20 — and are extremely unprepared” to deal with the changes that a new baby brings.

When family and friends learn about PPD, their reactions can vary. Berger said that after a friend heard a mutual acquaintance talking about Berger’s PPD, the friend told Berger that her openness might result in difficulty finding a shidduch (match) for her children.

Despite such comments, Berger felt that the experience also had its benefits. “It’s taught me a lot about myself and about how I want to raise my children and the kind of person I want to be,” she said.

When Mom Needs Help
Symptoms of Postpartum Depression

  • Sad, weepy, anxious and moody feelings that fail to go away after about two weeks
  • Feelings of doubt, guilt, helplessness or hopelessness that disrupt day-to-day functioning
  • Sleeping most of the time or inability to sleep when tired
  • Loss of interest in things that normally bring pleasure
  • Extreme concern about — or lack of interest in — the baby
  • Anxiety or panic attacks
  • Fear of harming the baby
  • Thoughts of self-harm

A New Moms Connect Peer Support Group, which started June 21, is still accepting participants. The six-week session, designed for mothers with babies newborn to six months, meets Wednesday, 9:45 a.m.-11:15 a.m., at The Parenting Place at the Los Angeles Jewish Home for the Aging, Grancell Village, 7150 Tampa Ave., Reseda. The program is also sponsored by JFS and the Valley Beth Shalom Infant/Toddler Program. For information, call Donna Ramos at (323) 761-8800 ext. 1213.

New Moms Connect (323) 761-8800, ext. 1028 (calls generally returned within 24 hours).

The Woman’s Life Center at UCLA (310) 825-9989

Cedars-Sinai Medical Center Postpartum Depression Support Group (310) 423-1510

Postpartum Support International: www.postpartum.net.

Beth Emet Works to Save a Mother’s Life


The 200 closely knit families of Burbank’s Temple Beth Emet, heeding the precept that all Jews are responsible for one another, are accustomed to providing aid and comfort quietly and inconspicuously. But the congregation has been galvanized to very public action by news that the mother of fellow congregant Roni Razankova’s mother, a citizen of Macedonia, has contracted liver cancer and needs urgent medical attention in the United States.

“I’ve never seen my congregants move like this,” Temple Beth Emet Rabbi Mark Sobel said. He reported that Razankova’s predicament — a single woman alone in Los Angeles, newly connected to her Jewish heritage and newly inaugurated as an American citizen, trying to save her mother’s life from 7,000 miles away — has resonated with temple members.

In fact, as soon as Razankova shyly confided the news just before Mother’s Day, the 50 religious school students began rolling out butcher paper and writing get-well wishes to mail to Macedonia to Rachel Razankova, 64. At the same time, the rabbi and the congregation, with the full support of the board of directors, brainstormed ways for their not particularly wealthy congregation to raise money. They created the Rachel Fund and, in about a week, with people taking shifts to photocopy, fold, stuff and stamp, succeeded in mailing out more than 500 letters explaining the situation and seeking contributions from synagogues throughout California and across the United States.

Still, a miracle may be needed. Obtaining a humanitarian visa, which is necessary to bring a foreign citizen to the United States for medical care, is not easy. Razankova, 40, who lives in Valley Village and works as an office manager for an insurance company, must show that she can pay for her mother’s medical treatment, estimated at $50,000 to $100,000. And while donations are coming in — including $100 from Congregation Har Shalom in Fort Collins, Colo., and $25 from an individual in Burke, Va. — to date only $10,000 has been raised.

Meanwhile, an attorney and fellow congregant, who wishes to remain anonymous, is volunteering his services to help expedite the visa. In a two-pronged approach, he has prepared a packet of necessary documents for Rachel Razankova to take to the United States Embassy in Macedonia, part of former Yugoslavia, and has sent a duplicate packet to the State Department in Washington, D.C. At the same time, the office of Rep. Howard Berman (D-Van Nuys) is requesting a visa from the U.S. Embassy in Macedonia.

The time element is crucial. Liver cancer moves aggressively, and Rachel Razankova is not able to get the treatment she needs from the single oncology clinic in Macedonia; it is severely overcrowded, underequipped and lacking in adequately trained personnel. Roni Razankova said that her mother was diagnosed with stomach cancer two years ago and, suffering what may have been a severe allergic reaction to the chemotherapy drugs given her, sank into a 24-hour coma and almost died.

Dr. Marina Vaysburd, a hematologist/oncologist at Cedars-Sinai Outpatient Cancer Center and Medical Center, has reviewed Rachel Razankova’s available records and made multiple unsuccessful attempts via e-mail and telephone to consult with her doctors in Macedonia. Vaysburd has agreed to see the patient once she comes to Los Angeles, to confirm the diagnosis, an important first step, and help as much as she can. “I am trying to save my mother’s life,” Roni Razankova said.

She was a lawyer and part-time journalist in the city of Stip, Macedonia, and moved to Los Angeles nine years ago, attracted to the freedom and different lifestyle. Her move here also marked the beginning of a spiritual journey, as people began to ask about her religion, a question she never encountered in secular and communist/socialist Macedonia.

“I was raised to believe in government and country, not God,” she said.

She was intuitively drawn to Judaism before discovering that her family was Jewish on her mother’s side. For the past six years, she has studied with Sobel, becoming a dedicated member at Beth Emet and, recently, a religious school teacher for fourth- and fifth-graders. Without family in the United States, she has adopted — and feels adopted by — her synagogue.

“Temple Beth Emet is the best temple I have ever seen in my life,” she said. “I’m going to be there forever.”

For more information, contact Rabbi Mark Sobel at Temple Beth Emet, 600 N. Buena Vista St., Burbank, CA 91505. (818) 843-4787.

 

Top 10 Things to Do Before the Change


No matter where you are in the menopause transition, it’s never too late (or early) to get your health act together to ensure the next 40 or so years are as terrific as or better than the first were. Here are 10 things you can do right now.

1. Choose the right health-care provider

Perimenopause is the perfect time to find a health-care provider you can trust to help you manage any serious medical problems, should they arise in the future. Ask your friends for recommendations or check out the NAMS list of credentialed Menopause Practitioners (

Interest Increases as Deadline Nears


Susie Tiffany of Beverly Hills suffers from a rare blood disorder and needs monthly infusions of blood components, which her insurance company ultimately declined to cover. She hoped the government’s new prescription drug benefit would help her out because, despite her ZIP code, she’s a low-income senior.

But the possibilities, were baffling: an array of private insurance plans that covered different things, explanations on the Internet that included terms she never had to know before, additional complexities depending on a person’s income and a confusing interplay of state and federal agencies.

However, Tiffany was able to find assistance in her case from Jewish Family Service. A social worker helped get Tiffany’s treatment covered by new state funds intended to help seniors with the transition to the new federal system.

“It’s a good thing that I had a good social worker,” said Tiffany, 65, who lives in a Beverly Hills city subsidized apartment building for low-income seniors.

“There are quite a number of options, and it’s overwhelming,” said Susan Alexman, director of senior services at Jewish Family Service of Los Angeles.

In Los Angeles County, insurance companies have offered 47 different plans for seniors seeking to enroll in the new federally funded benefit. The plan’s May 15 deadline means seniors must sign up without delay or face increased fees for late enrollment.

For some seniors, the financial stakes are high. But while interest is picking up, for most of the past year, social service groups have had few takers when they’ve tried to help.

“It’s strange, but our office has not had any calls on that,” said Deborah Baldwin, public benefits supervisor at Bet Tzedek Legal Services, when asked in March.

At the Fairfax District office of the National Council of Jewish Women, a Democratic congressman’s field staffer set aside four hours over two days in late January to discuss the new Medicare Part D drug plan with seniors. Hardly anyone showed up.

“Just three,” the staffer told The Jewish Journal. “People are putting it off.”

Health care activists, community workers and groups, including Jewish Family Service, have been holding numerous Part D awareness meetings, especially this spring.

“This has been going on for a year and a half,” said Anita Chun, community education coordinator at the Center for Healthcare Rights in Los Angeles. “Now people are paying attention.”

A Part D meeting in March in West Hollywood, put on by Jewish Family Service, attracted about 120 seniors. Attendance also picked up for a March meeting at Temple Isaiah in Rancho Park — after a sparsely attended February session with social workers and experts.

Some seniors said they expect to come out OK under the new system.

“The health program that I belong to enrolled everybody in it beforehand,” said Encino retiree Janet Siskind. Her Blue Shield 65 Plus coverage gets her quarterly refills of the three to four pills she needs. Siskind’s combined prescription fees will increase, but only by about $10 annually.

“I’m in good hands with this,” she said. “It’s something I can afford.”

Siskind’s San Fernando Valley chapter of the Na’amat women’s group held a recent Part D meeting for 25 people.

“We figured, ‘Well, it hasn’t started yet, perhaps it’ll get easier as time goes along,'” she said. “It hasn’t really been explained too thoroughly.”

With so much Part D information online, many seniors are at a disadvantage, because of their discomfort or unfamiliarity with the Internet.

California’s Medi-Cal program, which had covered poor and low-income seniors’ prescription costs, stopped providing service on Jan. 1, when Part D took over. Yet there were startup problems, which included state and federal computers being unable to interact. Many poor seniors were suddenly being asked to pay full price for medications. The reports of hardship prompted Gov. Arnold Schwarzenegger and the Legislature in mid-January to push through emergency prescription drug funding for low-income seniors until May 15.

“It makes the state the payer of last resort for the prescriptions that they need,” said Schwarzenegger spokeswoman Julie Soderlund.

But only until May 15, which could force Tiffany, suffering from the blood disorder, to navigate the system again.

“Good old Part D, the insurance policy that was gonna change it all,” she said. “It’s gonna take some time for me to get happy about it.”

David Merritt, project director at the Center for Health Transformation think tank in Washington, D.C., said that despite such glitches, Medicare Part D transition problems nationwide have been relatively low, with Americans not upset over Part D the way they are over high gas prices.

“Anytime you have a massive policy shift from one system to another system, you’re going to run into problems,” he told The Journal. “The vast majority [of seniors] had zero problems enrolling or getting medication.”

But to Jews dependent on Medicare for affordable drugs, “it’s unfair for seniors to be expected to maneuver through this incredibly messy web,” said Rabbi Zoe Klein of Temple Isaiah. “Health trumps every other problem in your life.”

“They’re basically saying they’re confused, and they want someone to walk them through it,” Klein said.

 

Botox Treatments Aid Stroke Survivors


Until recently, significant recovery from the physical and mental losses inflicted by a stroke was thought to be limited to a matter of months following injury to the brain, using conventional physical and occupational therapy. Now patients supplementing this with novel treatments, including an innovative use of Botox and a variation on old-fashioned plaster casts, are demonstrating that aggressive long-term therapy can increase the likelihood of complete recovery after a stroke.

One such patient is art curator Meg Perlman, who not too long ago spontaneously applauded at a jazz concert, clapping her hands together for the first time in 19 months. This was another small triumph in her major recovery from a stroke that had initially paralyzed her left side.

Caused by a clot or a ruptured blood vessel in the brain, stroke is the leading cause of severe disability today. In the United States alone there are now some 5.4 million stroke survivors, with nearly one in three suffering from permanent disabilities.

“When I went to medical school, the prevailing view was that you lose nerve cells and that’s it, you’re not going to get better. We know now that’s not true. The brain is plastic. It can remodel itself,” said Dr. Steven Flanagan, associate professor of rehabilitation medicine at New York’s Mount Sinai School of Medicine, and the neurophysiatrist treating Perlman.

One recent study showed that therapy could benefit patients who had suffered a stroke more than a decade earlier.

“It’s not something magical that happens in the brain and everyone will recover,” he warns, “but the brain has a greater capacity to recoup from injury than we thought in the past.”

Dr. Steven R. Levine, professor of neurology at Mount Sinai School of Medicine, admits that medicine “still doesn’t know the underlying mechanisms in different phases of stroke recovery.”

Such understanding would make it possible to individualize treatments for most effective results. On the horizon, experiments in mice and some early human trials show promise for enhancing stroke rehab with stem cells, growth hormone, amphetamines, even Viagra.

“Not everyone will improve,” Levine said, “but you never say never and you never take away hope from people.”

Anatomy of a Recovery

Stricken at the young age of 53, physically fit and intellectually active, Perlman has been a prime candidate for total recovery. She’s come a long way since her stroke in August 2003 while vacationing in the south of France. When she awoke on what should have been another day in paradise, she was semiparalyzed and confused. Her husband, author Doug Garr, immediately understood what had happened.

“Her left side was immobile. The left side of her face was frozen,” he recalled. “I recognized it as a stroke because I had seen my father have a stroke two weeks before he died.”

Perlman spent two weeks in intensive care at one of France’s leading teaching hospitals, then was transferred to Mount Sinai’s brain injury rehabilitation unit for another six weeks. There, days filled with physical and occupational therapy helped her reprogram her nervous system to regain control over posture and movement on her left side, and to relearn vital everyday tasks.

Better known for cosmetic enhancement, Botox injections immobilize key muscles in stricken arms or legs, allowing physical therapy and exercise to extend range of motion and flexibility. Effects wear off, so the Botox is reinjected every three months for a year or more. In Perlman’s case, it was the second dose that allowed her left hand to flex out enough to applaud at a concert, after successful attempts during therapy sessions at home.

With research in rehabilitative medicine generally underfunded, doctors don’t have data from large clinical trials to properly assess new treatments. Often patients proceed by trial-and-error, sampling therapies from the exotic to the high-tech; Perlman has had mixed results with acupuncture and with an electrical muscle stimulation device called a NeuroMove.

Then again, low-tech plaster of Paris has proven extremely effective. Called “serial casting,” a monthslong treatment involves stretching affected muscles with a series of plaster casts on an arm or leg for weeks at a time, followed by physical therapy to secure gains in flexibility. Perlman’s latest leg cast had just come off when she was able to stretch the toes on her left foot out and wear a shoe.

By all her therapists’ accounts, Perlman has shown exceptional resolve in fighting the fatigue, discomfort and frustration that are part of stroke recovery.

She has also had to battle the severe depression that a stroke leaves in its wake.

Flanagan observes that depression should be treated early and aggressively in stroke patients.

“We know that happy patients do better in rehab than sad patients,” he says. “We have to help them get the most out of their time in therapy.”

Fuller recovery from stroke takes a loyal, experienced team of therapists. With them, Perlman still keeps up a rigorous schedule of five physical therapy and two occupational therapy sessions a week at home.

“I expect to be 100 percent back,” she said. “I won’t stop until I am.”

She’s thankful for her “wonderful personal team,” including the friends and clients who rallied to her side after she was stricken.

Also appreciated: an occasional boost from strangers.

“I was walking to a restaurant with my cane. A short, Russian-looking man came up to me and said: ‘Did you have a stroke?’ I said ‘yes.’ He jumped up in the air and said: ‘So did I and look at me!'”

Steve Ditlea writes for the New York Daily News.

Parent Wins School Pesticide Battle


A new law that bans that use of experimental pesticides in schools is the latest achievement of Robina Suwol, a Jewish anti-pesticide activist.

The law, which took effect last month, grew out of a presentation two years ago before an L.A. Unified School District (LAUSD) advisory committee of which Suwol was a part.

As Suwol recalled it, a researcher asked to use LAUSD school sites to test an experimental pesticide.

“The woman said, ‘We use less [pesticides] and they’re stronger [so] therefore they’re safer,'” Suwol said. “We all kind of laughed and politely declined.”

But in the back and forth, the researcher mentioned that a school site had already been secured in Ventura County for the experimental product.

“That haunted me, and I began to research it,” she said.

What Suwol said she found was an arena of murky practices and documentation. It wasn’t clear that experimental pesticides were being used at any schools, she said, but it also wasn’t clear that they weren’t or that they never had been — or that they wouldn’t be tried at school sites in the future. So she decided to do something about it.

Suwol soon met with various environmental and public health organizations to marshal opposition to experimental pesticides in schools: “Everyone was on board that this was a curious loophole.”

Assembly member Cindy Montanez (D-San Fernando) agreed to author the legislation, which became Assembly Bill 405. Assemblymember Lloyd Levine (D-Van Nuys) backed it, as did organizations including the California Medical Association, the state PTA, the Asthma and Allergy Foundation of America, and many others.

An early critic of the effort was the state’s own Department of Pesticide Regulation (DPR), which has responsibility over these matters. At the time, officials there characterized the proposed restrictions as potentially redundant, confusing and over-reaching.

While permission to test can, in fact, be granted to experimental pesticides whose safety has not been determined, these permits “are time-limited, relatively few, and are closely controlled under very specific and restrictive conditions,” said Glenn Brank, director of communications for the Department of Pesticide Regulation.

He added that the department “has never allowed an experimental pesticide project at an active school facility, and we never would.”

Suwol said she had trouble obtaining data from the department about experimental test sites. Brank insisted, however, that such data is publicly available on request.

As it happens, even the researcher whose comment prompted Suwol’s quest contends there was a misunderstanding. This different version of events was reported by a pesticide industry news e-journal on Pesticide.net called Insider, which identified the researcher in question as UC Berkeley entomologist Gail Getty.

Getty told Insider that she did indeed give L.A. Unified a presentation on an anti-termite poison that she was researching called Noviflumuron. But as for the Ventura County school test site, Getty told Insider that it was an abandoned school building fenced off from the public due to extreme termite damage — though she acknowledged that she did not mention this fact during her Los Angeles presentation. She added that her aim was simply to make LAUSD aware that a potentially helpful product was in the works. In the end, Getty told Insider, her test in Ventura never happened anyway. Noviflumuron received EPA approval in 2004.

Whatever the case, as far as Suwol and the legislation’s backers are concerned, it’s better to be safe than sorry.

Lawmakers passed AB405 in 2005 and Gov. Arnold Schwarzenegger signed the bill into law. The Department of Pesticide Regulation says it fully supports the new regulations in their present form. The bill was eventually amended to avoid the problem of creating potential legal hurdles if a school used a widely accepted product, such as bleach, in ways not specifically mentioned in regulations.

Suwol’s interest in the subject of pesticides dates to 1998, when a worker accidentally sprayed her 6-year-old son, Nicholas, with a weed killer as he walked up the steps of Sherman Oaks Elementary.

“I saw someone in white near the steps,” said Suwol, then “Nicholas yelled back at me, ‘Mommy, it tastes terrible!'”

Nicholas suffered a severe asthma attack afterward. Suwol started meeting with doctors and scientists, and she began raising concerns with L.A. Unified officials. At first she was treated like one more crazy mom, but she persisted, eventually getting the attention of the school board, where she got backing from board members Julie Korenstein and David Tokofsky.

In some cases, she made officials consider the obvious: Why should pesticides be sprayed when children are present?

Today, Suwol heads California Safe Schools, an L.A.-based nonprofit that advocates lower-risk pest control in schools, including barriers and natural predators, and keeping parents and school staff informed when poisons must be used. Its advisory board includes directors of various environmental organizations, including Dr. Joseph K. Lyou of the California Environmental Rights Alliance and William E. Currie of the International Pest Management Institute.

At L.A. Unified, her efforts bore fruit in the 1999 creation of the Integrated Pest Management (IPM) system, which recommends a more holistic approach to eliminating pests and weeds than simply dousing them with poisons. It was before the district’s IPM oversight committee, on which Suwol sits, that she first heard from the pesticide researcher and became convinced there was a problem that needed to be addressed.

The governor’s office and others, Suwol said, “recognized that this was a situation that, even if it happened in just a few instances, should be stopped.”

 

Few Females Filling Mohel Role in U.S.


When Dr. Debra Weiss-Ishai watched her son’s brit milah two years ago, she thought to herself, I could do this better. Not just technically, although as a pediatrician she had done numerous medical circumcisions. She felt she could bring a warmth and spiritual beauty to the ritual in ways her old-school mohel, who she said “rushed through” the ceremony, did not.

Last April, Weiss-Ishai completed the Reform movement’s Berit Mila program, an intensive 35-hour certification course for physicians and nurse-midwives at Hebrew Union College-Jewish Institute of Religion in Los Angeles. She now has performed seven or eight Jewish ritual circumcisions in the San Francisco Bay area.

Weiss-Ishai spends hours preparing for each brit milah, working with the family to make sure the ceremony fits their needs, determining the level of Hebrew they want, incorporating friends and relatives and personalizing it with readings and poetry. Doing this work is her way of helping to ensure Jewish continuity, she said.

Weiss-Ishai is one of just a few female mohels in the United States. There are about 35 Reform female mohels and just four trained by the U.S. Conservative movement, as well as a handful who learned outside the United States.

It’s not surprising that throughout Jewish history mohels have been men. Circumcision is, after all, a guy thing. Beyond the obvious anatomical requirements, it’s something the Torah commands a father, not a mother, to do for his son on the eighth day of life.

What is surprising, however, is that while half of all new non-Orthodox rabbis and cantors in this country are women, few women are choosing to become mohels.

Yet unlike rabbis and cantors, there is no halachic prohibition against female mohels. Every Orthodox authority consulted for this story agreed on that point, although most asked not to be quoted. Jewish law states only that if a Jewish male is present, it’s preferable that he do the brit milah.

“It’s a custom, a strong custom, but there’s no law except that the mohel be Jewish,” said Rabbi Donni Aaron, director of the Reform Berit Mila program. “People assume it’s not according to halacha, but they just haven’t encountered it. Some people think it’s a man’s job, that it just feels weird” for a woman to do a brit milah.

Unlike physicians, mohels in the United States are not regulated, and technically, anyone can act as mohel if the parents trust him or her to perform the operation on their infant son. Traditionally, it’s been a profession passed on from father to son; even today, Orthodox and many Conservative mohels learn by apprenticing with a senior mohel, usually in Israel.

The Reform and Conservative movements set up their training programs because there were so few traditionally trained mohels available to serve the non-Orthodox community. The non-Orthodox movements, especially the Reform movement, needed their own mohels because Orthodox mohels generally are reluctant to circumcise the son of a non-Jewish mother.

The Reform program, which has trained about 300 mohels since it began in 1984, and the Conservative Brit Kodesh program, which has trained about 75, both accept only physicians or nurse-midwives who already are experts in medical circumcision. The programs teach them the relevant halacha, rituals and textual background to perform a Jewish brit milah.

The training is similar, though Conservative mohels generally won’t circumcise the son of a non-Jewish mother unless the parents intend to convert the child.

Rabbi Joel Roth, professor of Talmud and Jewish law at the Jewish Theological Seminary (JTS), said there was no problem admitting women to the Conservative program, which is run jointly by JTS and the Conservative movement’s Rabbinical Assembly.

“We considered it, we deliberated it and then we said, frankly it’s easier to train women for this role than to count them in the minyan,” Roth recalled. “We know it hasn’t been done historically, but there’s no earthly reason why we shouldn’t.”

The mohelot interviewed for this article said most clients choose them because of their reputation, not because they’re female.

“It works both ways,” said Ilene Gelbaum, a certified nurse-midwife in Anaheim, who became a mohel in 1986 and has since circumcised both her grandsons.

“Some people are pretty up front when they call,” she said. “They say they chose me because I’m female. And sometimes, you do what you think is a beautiful service and the grandfather comes up to you afterward and says you shouldn’t be doing it because you’re a woman.”

Dr. Lillian Schapiro said she “braced for a backlash” when the Atlanta Jewish Times ran a front-page story on her four years ago. It never came.

“There was one op-ed against me, but I didn’t feel personally attacked,” she said.

Gelbaum wasn’t as lucky. Beginning with a lecture she delivered in 1990 at the American College of Midwives conference in Atlanta, she’s been steadily targeted by the anti-circumcision movement. Protesters showed up at that first lecture bearing placards calling her a baby mutilator, she’s been vilified online and in print, and worst of all, she said, “They called my house, they talked to my children. They said, ‘Do you know what your mother does?'”

Gelbaum said she was targeted because she was so public. Although she’s now stopped lecturing about circumcision, she said it’s still not easy to talk about the campaign against her.

“I knew these people personally,” she said quietly. “And how much of it is anti-Semitism? Not only am I the vocal midwife, I’m the Jewish midwife.”

Female mohels said that as physicians, they feel comfortable doing circumcisions, and want to bring a Jewish aspect to what they already are doing.

Dr. April Rubin, an OB-GYN in Washington, had been doing circumcisions for more than 20 years when she became more observant. Two years ago, she completed the Conservative Brit Kodesh program, and has since done about 70 britei milah.

Some traditionally trained mohels look askance at these physician-mohels.

“They really don’t have a very solid background in the halacha,” said Rabbi Paul Silton, a Conservative rabbi in Albany, N.Y., who apprenticed with an Orthodox mohel in Jerusalem. “They’re physicians who want a sideline in brit milah, and I feel that’s unfortunate.”

The Conservative program requires applicants to be practicing members of Conservative congregations and ritually observant. The Reform program requires applicants to belong to any congregation, Reform or not, but makes no stipulations about ritual observance.

Some people choose a female mohel because of her gender, like Bay Area resident Nicole Sorger, who asked Weiss-Ishai to circumcise her son last November.

“The idea of having an old, bearded man was disconcerting, not being very religious,” Sorger said. Having Weiss-Ishai do the ceremony “broke up the idea of it being a male event, a patriarchal celebration. It made the ceremony so much more accessible to me.”

Dr. Laurie Radovsky, a Conservative mohel in St. Paul, Minn., circumcised her son 11 years ago in rural Wisconsin because no mohels lived nearby. Nine years later, she became a mohel herself.

Her male rabbi told her that women bring “a gentleness, a sensitivity” to the ceremony, but she said there are other advantages.

“With men, when you talk about circumcision, there’s an instinctive protecting of the genitals,” she said. “And as a mother, I can empathize with that mother’s feelings and tenderness toward that child. I can reassure her, perhaps more than a male mohel can.”

At the end of every brit milah, “sometimes surreptitiously,” Radovsky said she kisses the baby’s head to welcome him into the Jewish community.

“I really feel I can make a difference in the world,” she said.

 

Obituaries


Rebecca Smith, Foundation Inspiration, Dies at 27

Rebecca Smith, whose diagnosis at age of 5 of the rare genetic disease affecting the nervous and immune systems known as Ataxia-Telangiectasia (A-T), spurred her parents, George and Pam Smith of Hidden Hills, to establish the Ataxia-telangiectasi Medical Research Foundation (A-TMRF), died on Jan. 22 from complications of leukemia caused by A-T. She was 27.

Through their efforts on behalf of the A-TMRF, the Smiths helped raise more than $10 million. In October of 2004, the Smith family endowed the Rebecca Smith Chair in A-T Research at the David Geffen School of Medicine at UCLA. Dr. Richard Gatti holds the Rebecca Smith Distinguished Professorship at UCLA.

Although Smith’s condition affected her speech and gait, it did not stop her from pursuing an active lifestyle. She attended Sinai-Akiba Academy, Stephen S. Wise High School (now Milken Community High School) and Calabasas High School and was close to completing an Associate of Arts degree at Moorpark College.

For several years, she helped run Becca’s Chic Boutique, a clothing resale store which generated funds for A-T research. Her favorite activities included riding horses, attending concerts and taking an annual trip to Broadway.

When Gatti first met the Smiths, soon after Becca was diagnosed, he was one of very few researchers studying the rare disease. A-T has since become recognized as a potential key to understanding neuro-degenerative diseases, immune system disorders, cancer and aging, and now is studied worldwide. The A-T gene was identified in 1995 by the lab of Tel Aviv University researcher Dr. Yossi Shiloh, who also received early and ongoing support from the A-TRMF.

Becca’s father, George, a leader in Southern California’s real estate finance industry, died in November of last year.

“Although neither Becca nor George lived to witness their goal of seeing a cure for A-T, their efforts guarantee that it will arrive years earlier than it otherwise would have,” Gatti said.

Becca is survived by her mother, Pam; brothers, James and Matthew; sister, Jill Oaks; and nieces, Samantha and Hannah.

Donations in her memory may be sent to the A-T Medical Research Foundation, 5241 Round Meadow Road, Hidden Hills, CA 91302. — Nancy Sokoler Steiner, Contributing Writer


Robert Newmyer, Film Producer, Dies at 49

Hollywood film producer Robert Newmyer died Dec. 12 of a heart attack at age 49, just as his film work was expanding into helping Sudanese refugees via the University of Judaism (UJ).

Newmyer produced more than two-dozen films including, the acclaimed “Sex, Lies and Videotapes,” “The Santa Clause” movies and the Academy Award-winning “Training Day.” He died while working in Toronto on the spy drama, “Breach,” according to The Hollywood Reporter.

Newmyer’s Outlaw Productions company was also in the process of developing a film, possibly for Paramount, about the Lost Boys and Girls of Sudan, a group of 3,900 displaced young Africans whose lives in refugee camps resembled postwar Europe’s Displaced Persons Camps.

Last Memorial Day weekend, the UJ’s MBA nonprofit program began helping the Sudanese refugees create a nonprofit instigated by Newmyer.

“This [‘Lost Boys’ film] project has dominated my life for three years now,” Newmyer told The Journal.

The Bel Air resident said he contacted the UJ to help him help the Sudanese because the UJ was, “right down the street from me.”

Born in Washington, D.C., Newmyer was a graduate of Swathmore College and Harvard Business School, according to The Washington Post, and came to Los Angeles in the early 1980s. He was a production/acquisitions vice-president at Columbia Pictures before creating Outlaw Productions in 1988.

He is survived by his wife, Deborah; daughters, Sofi and Billi; sons, Teddy and James; parents, James and Virginia; and sisters, Elsa (Larry Forester) and Lory (Stephen Cooper).

Donations may be sent to Bobby Newmyer Memorial Fund to help the Lost Boys and Girls of Sudan, care of Outlaw Productions, 3599 Beverly Glen Terrace, Sherman Oaks, CA 91423. — David Finnigan, Contributing Writer


Bradley Jacobs, Dedicated Israel Activist, Dies at 47

Bradley Jacobs, tireless lover of and worker for the State of Israel and citizens of the Yesha communities and publisher and editor of the Israel News, died Jan. 14. He was 47.

Jacobs worked tirelessly in the Chicago community and around the country on behalf of maintaining Jewish sovereignty over Judea, Samaria and Gaza. For years, Jacobs compiled and widely distributed a weekly newsletter with highlights of Israel national news.

He was the devoted son of Doris (nee Freedkin) and Ben; loving brother of Cheryl Jacobs Lewin; adoring uncle of Shoshana Maryam Lewin; wonderful nephew of Irwin (and the late Paula) Freedkin; and outstanding friend to David Abell, Norman Abell, Joel Jacobson and many others.

In lieu of flowers, memorials in his name may be made to The Hebron Fund, 1760 Ocean Ave., Brooklyn, N.Y., 11230.


Shirley Ashe died Dec. 23 at 83. She is survived by her husband, Harry; son, Allan; one grandchild; sister, Hortley Weinstock. Groman

BERTHA BARLAZ died Dec. 26 at 90. She is survived by her daughters, Frederica and Hinda. Sholom Chapels

Manya Berestetsky died Dec. 13 at 86. She is survived by her daughter, Stella. Chevra Kadisha

Barry Breslow died Dec. 23 at 59. He is survived by his wife, Wendy; son, Eric; one grandchild; and mother, Hilda. Groman

Rose Blumberg died Dec. 24 at 101; she is survived by her son, Donald; and four grandchildren. Groman

CHARLOTTE SYDNEY BROWN died Dec. 25 at 74. She is survived by her husband, Maynard; son, Jeff; and nephews Reid Brown and Rob Curtiss. Hillside

ROLF BURK died Dec. 26 at 87. He is survived by his son, Michael (Roxane); and one grandchild. Hillside

BERTHA COOPER died Dec. 23 at 89. She is survived by her sons, Harvey and Charles; and grandchildren. Sholom Chapels

Ayzik Davidovich died Dec. 24 at 76. He is survived by his daughters, Sophia Garfinkel and Elena Barash; and four grandchildren. Groman

Stephen DuBow died Dec. 23 at 60. He is survived by his wife, Ardeen; sons, Matt (Tina) and Nicholas (Leah); two grandchildren; mother, Nettie; brother, Norman (Laura); sisters, Natalie (Greg) Davidson and Michele (Gary) Reynolds. Malinow and Silverman

EDNA EINSTOSS died Dec. 22 at 97. She is survived by her son, Charles; daughte.r Sharon Hall; 14 grandchildren; and six great-grandchildren. Hillside

Joseph Ellenbogen died Dec. 26 at 88. He is survived by his wife, Ethel; daughters, Barbara Rose and Susan; three grandchildren; and four great-grandchildren. Mount Sinai

Charlotte Freiberg died Dec. 25 at 90. She is survived by her son, Gary. Malinow and Silverman

Zvi Reuven Galibov died Dec. 24 at 96. He is survived by his brother, Ze’ev Benjamin; and friends, Larry Frazin and Nickie Rothwell. Chevra Kadisha

Miriam Garian died Dec. 26 at 77. She is survived by her husband, Issac; and son, Ron. Chevra Kadisha

Hyman Getoff died Dec 21 at 88. He is survived by his son, Peter; daughter, Tova; and grandchild, Emily.

Arthur Glanz died Dec. 22 at 87. He is survived by his wife, Muriel; son, Brian; daughter, Nanci Fisher-Levin; and four grandchildren. Groman

Phyllis Goldklang died Dec. 22 at 73. She is survived by her husband, Stanley; daughter Lori (Simon) Furie; one granddaughter; and brother, Richard (Helen) Wendlinger. Malinow and Silverman

David Gorokhovskiy died Dec. 12 at 83. He is survived by his wife, Anna Gorokhovskaya; and daughter, Ella (Peter) Skibinsky. Chevra Kadisha

Eleanor Gottlieb died Dec. 22 at 79. She is survived by her husband, Kenneth; daughter, Jean; and brothers, Bernard and Donald Gordon. Groman

Albert Greer died Dec. 26 at 93. He is survived by his wife, Bessie; sons, Robert (Eding) and John (Guila); daughter, Dahlia; one grandchild; and two great-grandchildren. Groman

Leslie Hyde died Dec. 23 at 59. She is survived by her daughter, Lisa; and parents, Sy and Lucille Fuhrman. Malinow and Silverman

Joseph Karmen died Dec. 17 at 84. He is survived by his niece, Ilona Sherman. Chevra Kadisha

Rozalyn Leybovich died Dec. 25 at 79. She is survived by her husband, Zinoviy Rubenshteyn; daughter, Marina Gurevich; nephew, Leon Belous; and niece, Bella Ratushnyak. Chevra Kadisha

Florence Mozelle Meyer died Dec. 16 at 100. She is survived by her cousin, David (Louise) Ellias. Chevra Kadisha

Miriam Moskowitz died Dec. 23 at 84. She is survived by her son, Marc Forman; three grandchildren; and three great-grandchildren. Groman

Youssef Nourafshan died Dec. 9 at 86. He is survived by his wife, Parvin; and son, Jack. Chevra Kadisha

Betty Orland died Dec. 26 at 87. She is survived by her sons, Jerry, Eugene and Phillip; nine grandchildren; nine great- grandchildren; and brother, Irving Kooba. Groman

Issac Ovsiowitz died Dec. 16 at 85. He is survived by his wife, Emily; son, Leonard (Sharon); daughter, Elaine (Norman) Blieden; sister, Sally Garlick; sister-in-law, Joyce Kron; four grandchildren; and one great-grandson. Chevra Kadisha

Donald Harry Pessell died Dec. 25 at 77. He is survived by his wife, Beverly; son, Robert; daughter, Lori York; four grandchildren; and brother, Sheldon. Groman

Selma Peters died Dec. 22 at 83. She is survived by her son, Laurence (Caren); daughters, Margo (Marc) Weinberg, Berdie (Leonard) Stein and Cheryl (Michael) Glynn; six grandchildren; and sister, Rosa (Harry) Leafe. Mount Sinai

Maryam Pourat died Dec. 18 at 88. She is survived by her brother, Mansour. Chevra Kadisha

Hanna Reif died Nov. 24 at 56. She is survived by her husband, Willy. Chevra Kadisha

Adeline Ritz died Dec. 23 at 90. She is survived by her son, Herbert Klein; and two grandchildren. Groman

Harvey Gerald Rose died Dec. 26 at 81. He is survived by his wife, Esther; sons, Lloyd and Brian Sharaga; four grandchildren; and brother, Merle. Groman

JEAN SACKS died Dec. 24 at 88. She is survived by her son, Calvin (Marilinn); daughter, Sandra (Irwin) Cohn; and granddaughter Lauren Sarabia. Hillside

Barbara Florence Scherr died Dec. 23 at 73. She is survived by her sons, Mitchell, Scott and Mark; five grandchildren; and brother, Stephen Katz. Groman

Morris Sherman died Dec. 13 at 82. He is survived by his wife, Evelyn; daughters, Marcia Fellner, Alyse (David Kirschen) and Susan (Pack Warfield); nine grandchildren; brother, Bernard; and sister, Brynie Curtis. Chevra Kadisha

Joyce Solarz died Dec. 22 at 76. She is survived by her husband, Hal; sons, Neil (Barbara) and Barry (Melissa Holland); and four grandchildren. Malinow and Silverman

Richard Kraus Spero died Dec. 23 at 81. He is survived by his wife, Lorelei; daughters, Melinda and Susan; two grandchildren; and brothers, Robert and William. Groman

MARK STAWISKY died Dec. 25 at 87. He is survived by his daughters, Linda Wolfson and Susan Konheim; eight grandchildren; eight great-grandchildren; and sister, Hannah Rome. Hillside

J.C. Strauss died Dec. 21 at 85. He is survived by his great nephew, Jason Cane. Malinow and Silverman

Roy Stuart died Dec. 25 at 78. He is survived by two nieces, and many friends. Chevra Kadisha

Esther Stella Suissa died Dec. 17 at 80. She is survived by her son, Youssef; and daughter, Mazal Nadia Adida. Chevra Kadisha

Shokat Yazgel Tehrani died Dec. 23 at 97. She is survived by her son, Yousef; daughter, Mahin; 10 grandchildren; 10 great-grandchildren; and brother, Rohollah Adel Ar Jomand. Groman

Riva Velednitskaya died Dec. 17 at 74. She is survived by her husband, Dimitriy Velednitskiy; and daughter, Irina Vishnevsky. Chevra Kadisha

Sadie Welner died Dec. 24 at 98. She is survived by her daughter, Estelle (Bernie) Case; son, Jerry (Sylvia) Welner; four grandchildren; and two great-grandchildren. Mount Sinai

Shirley Annette Wolfson died Dec. 25 at 82. She is survived by her son, Steven; daughter, Shari Allen; three grandchildren; and five great-grandchildren. Groman

Nettie Vickter died Dec. 22 at 90. She is survived by her sons, Sheldon and Marvin; and daughter, Beverlee. Mount Sinai

Candy Weinroth died Dec. 22 at 62. She is survived by her sons, Richard and Joshua; one grandchild; sister, Susan Leifer. Groman

Menasheh Yaghoubzadeh died Dec. 20 at 85. He is survived by his wife, Shoshan; and son, Shahram. Chevra Kadisha

Belle Esther Yarmish died Oct. 28 at 82. She is survived by her daughter, Marcie (Levi) Meier; seven grandchildren; and four great-grandchildren. Chevra Kadisha

 

First Person – A Love Story


This is the story of my friend Valerie, whom I first met just last year. Valerie sent me an e-mail introducing herself as Shira, a Jew-by-Choice who worked as a flight attendant. She wondered if I was the same Rabbi Mark her fiancé Glenn knew from his synagogue’s high school youth group. Glenn and I had lost touch with one another when his family moved to California. Was I the same individual, Val asked, and, if so, would I officiate at their wedding?

Thanks to Valerie, two best friends were reunited after more than three decades apart. More importantly, Glenn and Val had found each other. Their love was intoxicating, with family and friends commenting how happy each was to have found his/her soul mate.

On a sunny October afternoon, I performed the ceremony as Glenn and Valerie married in a traditional Jewish wedding on a yacht in Marina del Rey. We joined with their children, parents, relatives and friends for a joyous ceremony on the deck replete with a wind-blown chuppah. Val’s artistic touches were evident in the wedding program she designed, the ketubah she selected and the extra touches that made the day special. Adding to the festivities were other yachts in the harbor whose captains blew their horns in celebration with shouts of mazal tov from their own passengers.

Two months after that glorious day, Glenn called to tell me that his beloved Valerie had suffered a brain aneurism and was in critical condition in an area hospital. I rushed to the ICU unit, only to find our beautiful, 47-year-old Valerie near death. I sat with Glenn, Val’s daughters, and other family members as a neurologist informed them that Valerie was brain dead and being kept “alive” by machines.

Amid the overwhelming shock and grief, the medical staff gently raised a sensitive but timely subject: Would the family consider donating Valerie’s organs to others? Their initial reply was no, since Valerie had thought that Jewish law prohibited organ donation. They too believed that donating organs was a sin. Fighting back tears, I counseled family members that organ donation is not contrary to Jewish law. In fact, rabbinical authorities from all Jewish movements agree that organ donation is a tremendous mitzvah and the highest form of pikuah nefesh (saving life).

An emotional discussion followed. What would Valerie want her loved ones to do had she known that organ donation is permissible according to Jewish law?

In the end, Valerie’s family consented to donating her organs. I sat with my friend Glenn as a nurse from OneLegacy (the Southern California transplant donor network) completed the paperwork to initiate this awesome mitzvah. I witnessed the OneLegacy team spend day and night painstakingly matching Valerie’s organs with compatible donors, as her family and I made plans for her funeral.

On a sunny December afternoon, we laid Valerie to rest in a local cemetery. We remembered her as a fun-loving, vivacious young woman. Val made friends easily and instantly, from passengers on her flights, to total strangers in stores and restaurants. She lived each moment to the fullest, and radiated warmth and joy to those around her.

In life, Valerie gave 100 percent to whomever she was with and whatever she was doing. In death, Valerie gave the ultimate gift. One of her kidneys is now in the body of a 76-year-old man who had been on dialysis for six years. He is married and the father of three children. His kidney function is now good and he is off of dialysis.

Valerie’s other kidney went to a 50-year-old man. He is single, active and used to ride his bicycle 40 to 50 miles a week. Prior to the transplant, he had been on dialysis. Valerie’s kidney was a “zero mismatch,” meaning that it was a perfect match for this recipient. He told the transplant team that he knows he “won the lotto” by receiving such a perfectly matched kidney. He is doing well and his prognosis is quite good.

These are just two of the fortunate recipients of Valerie’s donated organs. The quality of their lives has improved dramatically since their transplants. In some cases, they are alive because of their transplants.

I will never understand why my friend Valerie was taken from us in the very prime of her life. When I sit and cry with her family, I cannot know their pain and anguish nor can I comprehend their tragic loss. I do know that they find a small measure of comfort in the knowledge that Valerie gave the gift of life to others. Amid the darkness, they have found a ray of light and hope for the future.

Rabbi Mark S. Diamond is the executive vice president of The Board of Rabbis of Southern California.

 

Israeli Government Gets on With It


Israel is resigning itself to politics without Ariel Sharon.

Shock gripped the Jewish state last week when Sharon was hospitalized with a massive stroke, turning to fears for the worst when he underwent repeated surgery.

Doctors said it could take time to ascertain whether Sharon had suffered cognitive damage or permanent paralysis on the left side of his body from the Jan. 4 stroke. At press time, it also was not certain that Sharon would recuperate at all — his condition was such that it could deteriorate at any moment.

Still, a prognosis took shape whereby Sharon could survive but in a form of forced retirement. Sharon’s chief surgeon, Dr. Jose Cohen, said this week that Sharon had a “very high” chance of surviving.

“He is a very strong man, and he is getting the best care,” the Jerusalem Post quoted Cohen as saying. “He will not continue to be prime minister, but maybe he will be able to understand and to speak.”

As the prime minister lay in a post-operative coma Sunday, his temporary replacement, acting Prime Minister Ehud Olmert, chaired the weekly Cabinet meeting.

“We hope that the prime minister will recover, gain strength and with God’s help will return to run the government of Israel and lead the State of Israel,” Olmert said.

While noting that doctors’ reports from Jerusalem’s Hadassah-Hebrew University Medical Center at Ein Kerem had given a “glimmer of hope” as to Sharon’s chances of recuperating, Olmert said matters of state were as robust as ever.

“We will continue to fulfill Arik’s will and to run things as he wished,” he said, using Sharon’s nickname. “Israeli democracy is strong, and all of the systems are working in a stable, serious and responsible manner. This is just as it should be and how it shall continue.”

With general elections looming on March 28, the 60-year-old Olmert has his hands full. But he received an early show of support with a weekend phone call from U.S. Secretary of State Condoleezza Rice.

There was also an internal reprieve from the Likud Party, which decided against resigning from the government, reversing a decision made before Sharon suffered his stroke last week.

“Now is not the time for such moves,” Foreign Minister Silvan Shalom, one of four Cabinet members from the Likud, told Army Radio.

A Channel 10 television survey issued after Sharon was stricken predicted that his new centrist party, Kadima, would take 40 of the Knesset’s 120 seats in the election if it is led by Olmert. But analysts suggested the showing reflected short-term public sympathy.

The political correspondent for the newspaper Ha’aretz, Aluf Benn, recalled the aftermath of Prime Minister Yitzhak Rabin’s assassination in 1995, when opinion polls showed his successor, Shimon Peres, as a clear favorite for re-election. In the end, Benjamin Netanyahu defeated Peres by the slimmest of margins.

“Instead of presenting himself as pressing ahead with Rabin’s path, Peres made the mistake of insisting that he was an autonomous candidate,” Benn said, suggesting Olmert, the former mayor of Jerusalem, was wise to portray himself as a reluctant stand-in for Sharon.

Yet the Channel 10 survey found that Peres, should he lead Kadima, would perform better than Olmert, taking 42 Knesset seats.

Though Peres quit the Labor Party last year to back Sharon, he has yet to formally join Kadima. But he voiced support for Olmert, who advanced the idea of a unilateral Israeli pullout from occupied Gaza prior to Sharon’s public embrace of the strategy.

“He supported the policies of Mr. Sharon and even occasionally was ahead of him,” Peres told Britain’s Sky Television. “The policies for peace, the continuation of the policies of Sharon, will have my full support.”

 

Saul Kroll: Healing Hand at Cedars-Sinai


 

“Our rabbis speak of yetzer hara and yetzer hatov, man’s dual inclination toward evil and toward good, and what you make of your life depends on which you follow,” Saul Kroll observes.

Kroll is a firm believer in yetzer hatov, and the 87-year-old Westside resident translates it into practice six days a week as an emergency room volunteer at Cedars-Sinai Medical Center.

Although “retired” for almost 20 years, Kroll puts in a full workweek doing whatever needs to be done.

“People come into the treatment area and I greet them, help them fill out forms, check what rooms are available and help them undress,” he said in a phone interview.

“I always try to encourage them, to tell them that they are in the best of hands, to lift their spirits,” he said. “That’s the greatest mitzvah.”

Sometimes the work is physically difficult for an octogenarian, as when “you push a 250-pound woman going into labor up a ramp in a wheelchair,” he said.

But Kroll believes in putting his aches and pains, including spinal injuries, aside.

“Either you let your medical problems control you, or you control them,” he philosophizes.

To Dr. Joel Geiderman, co-chair of the hospital’s emergency department, Kroll’s dedication “is unbelievable. He never asks anything for himself. He is selfless, truly one of the righteous.”

While the typical Cedars-Sinai volunteer puts in four to eight hours per week, Kroll’s norm is between 35 to 40 hours. Barbara Colner, director of the medical center’s almost 2,000 volunteers, has calculated that Kroll has worked 24,400 hours since starting his stint in 1987. She isn’t sure whether or not this represents an all-time record.

When Kroll does miss work, it’s often to drive a 90-year-old neighbor with breast cancer to her medical appointments.

He is just as conscientious in his religious observances. “I’ve gone to shul three times a day since my bar mitzvah,” he said, and during High Holiday services at the hospital he is the unofficial greeter, kippot and tallit dispenser, and also chants the memorial prayer.

“Saul is amazing, he conducts his life with the energy of a 20-year old,” noted Rabbi Levi Meir, the hospital’s chaplain.

Kroll also unfailingly shows up at the daily morning minyan at nearby Temple Beth Am.

“He is one of our stalwarts and we take great pride in him,” commented the temple’s Rabbi Joel Rembaum.

The one period during which Kroll missed his minyans was World War II, when he served with a B-29 bomber squadron in the Pacific. But even there, he organized High Holiday and Passover services for Jewish servicemen on Guam.

Kroll was born on the day following the World War I armistice, Nov. 12, 1918, grew up in a small town near Pittsburgh, and started managing a sporting goods store at age 17.

After the war, Kroll went to work rebuilding auto engines and, in the 1950s, he and a partner opened an automotive and body shop.

His wife, Selma, died in 1994. Kroll proudly cites the professional careers of his two children and four grandchildren.

His parting advice: “Don’t tell someone, ‘OK, call me if you need any help.’ Just go on over and help.”

Saul Kroll

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Steven Firestein: Making Magic for Children

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David Karp: A Guide for Unity in Scouting

Lack of One Enzyme Triggers Illness


Gaucher Disease is a rare, inherited disease caused by a hereditary deficiency of a single essential enzyme, glucocerebrosidase, according to the National Gaucher Foundation (NGF).

Because this enzyme is necessary for breaking down aging blood cells, its lack causes some cells to become engorged. This condition eventually crowds the liver, spleen, bone marrow and lung cells and causes those organs to swell, disrupting production of blood cells in bone marrow and causing destruction of bones.

Genetic counselor Amy White of the Lysosomal Diseases Treatment Center in the Genetic Center at Children’s Hospital of Wisconsin put it this way: “Lysosomes are like the garbage disposals of our cells. Their job is to collect and get rid of the waste products.”

Symptoms of Gaucher Disease can occur in childhood or adolescence, but the disease is most often diagnosed in adults, according to the Center for Jewish Genetic Diseases Web site.

An enlarged spleen and liver are often the first noticeable symptoms in children, said White, a member of the National Society of Genetic Counselors.

“And these are pretty noticeable,” she added. “You see a skinny kid with a big belly.”

The most common symptoms in adults are bone breaks, bone infection, unusual bleeding and tiredness, White said. An “easy and accurate blood test” can diagnose Gaucher Disease and identify carriers.

The effects of the symptoms vary, depending on the severity of the disease, but they can be managed with biweekly infusions of Cerezyme, an enzyme manufactured from Chinese hamster ovaries, which are referred to as “cho.”

“It uses recombinant [artificially created] DNA technology that is five to seven years old. It is the oldest enzyme therapy around, so we know the most about it,” White said.

Gaucher Disease is one of three lysosomal diseases treated at the center, and is the only one that primarily affects Jews. The other two, Fabry Disease and MPS 1, also called Hurler’s Disease, strike across ethnic lines.

The prevalence of Gaucher Disease in Ashkenazi Jews occurs because of something geneticists call the “founder effect.” This refers to a genetic trait or disease that has a high frequency in a contemporary population, because the gene was introduced by a founder into a small, often geographically or socially isolated group of people whose numbers then rapidly expand, according to a medical paper distributed by the NGF.

Ashkenazi Jews became susceptible to a variety of hereditary diseases because of their long history of “sudden periods of population contraction — the Crusades, pogroms, the Holocaust — followed by concentration in restricted areas — ghettos, the Pale of Settlement — and then temporary multiplication to large numbers.”

Though Tay-Sachs Disease, which affects one in about 2,500 Ashkenazi Jews, is the most well known of about 10 genetic diseases afflicting that population, Gaucher Disease is much more widespread. One in an estimated 450 Ashkenazi Jews suffers from the disease, and one in 14 is a carrier, according to the NGF.

 

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Growing Girls Whole


“Isaac then brought [Rebecca] into the tent of his mother Sarah” (Genesis 24:67). Rashi reinterprets this verse as: “Isaac brought Rebecca into the tent, and behold, she was Sarah!” Rashi explains that the years Sarah was alive her Sabbath lamp remained lit, her dough stayed fresh, and a cloud of God’s Presence rested upon her tent. Upon Sarah’s death, the lamp guttered, the dough crumbled and the cloud dissipated. Enter Rebecca; return miracles.

Maharal explains that the lamp, the dough and the cloud refer to the three commandments assigned to women: candles, challah and niddah. The candles and the challah are respectively represented by the lamp and the dough. Niddah (menstrual impurity), therefore is linked with the miracle of the cloud, suggesting that the home of a woman who observes family purity laws is enveloped in a heavenly cloud.

The commentary around menstruation however are not always so embracing. Later in Rebecca’s life, Torah tells us of her agonizing pregnancy, and the twins who “struggled in her womb.” From the beginning, Jewish womankind has suffered a duality. One has only to look at halachic lexicon to find the duality of epithets that converge on her physical center, makor (source), eim (mother) and rechem (womb-compassion) speak of life and goodness, while kever (grave) and bet hatorfa (place of rot) speaks of death.

Less than a 100 years ago, the average age of menarche for American girls was almost 16. Today, 12 is considered late. Theories for such early onset range from the amount of growth hormones injected into the food we eat to the amount of electrical light we absorb. Regardless, it creates a dangerous duality in girls which I often see when working with a bat mitzvah. Boys are going through changes too at bar mitzvah, and if a boy’s voice cracks while chanting haftarah there are good-natured smiles in the congregation. But there is something else splitting in girls, nearly invisible and painful to perceive. I watch during the course of a bat mitzvah how often girls begin the service with their hair in barrettes and their faces bright and exposed. By the end of the service they take the barrettes off, and try to hide darkly behind their hair.

In less than a century, girls have gone from corsets to thongs. They are inundated with social pressures from diet pills to plastic surgery. Girls physically mature now earlier than ever, while cognitively and emotionally they are still children. Contemporary society provides fewer social protections, especially with the dangers of Internet. Today, most girls don’t receive a slap on the face from their mothers as initiation into womanhood, but they do learn to call it “The Curse.”

The moment girls become menstruant is a critical moment for protecting their wholeness. Jewish law takes menstruation with the utmost seriousness. For moderns, it is tempting to brush aside the laws as archaic. But with such dismissal, we also dismiss the seriousness of a girl’s coming of age. It is important to consider the sacredness of a girl’s cycle not through a lens of fear, rather through a lens of life-affirmation that is central to our faith and critical to a girl growing up whole.

In many cultures, circumcision is performed on boys as a rite of puberty, at the age of Ishmael, 13. Circumcision in many cultures, it has been argued, is the male inorganic counterpart to menstruation, to the natural blood-covenant girls achieve. In Judaism, of course, circumcision is performed at Isaac’s tender age of one week and a day. Instead, bar mitzvah is the male puberty rite. There is little ritual or liturgy on menstruation. Just as boys undergo brit milah (covenant of circumcision), let us consider the girl beginning menarche as entering brit niddah (covenant of menstruation).

What ritual can surround entering brit niddah? Anne Frank called her period “a sweet secret” in a line that her father edited out of the 1947 Dutch version of her diary, saying that it was unnecessary and unseemly to speak of such things. It is remarkable that this young girl qualified her “secret” with sweet. The higher levels of tzedakah also involve secrecy. It is a perfect opportunity to learn with a girl the eight levels of tzedakah. It would be fitting to associate the monthly periods with an act of giving and gratitude by learning and giving tzedakah from the start.

As menstruation ties naturally with the cycling of the moon, it would be appropriate to consider brit niddah as a part of a Rosh Chodesh ceremony. The blessings for the new moon are appropriately worded: “Our God and God of our ancestors, may the new month bring us renewed good and blessing. May we have long life, peace, prosperity and health, a life full of blessing, a life exalted by love of Torah and reverence for the divine; a life in which the longings of our hearts are fulfilled for good.”

Adolescent girls need all the help they can get in this world. Let them not be burdened at this impressionable age with carrying a “curse,” with a sense of medical infirmity or religious impurity. She, like every human being, is a microcosm of the Supreme One, in which nothing is lacking, and everything is whole and pure. May we all be embraced in clouds of glory.

Zoë Klein is a rabbi at Temple Isaiah.

 

Synagogues Weigh Defibrillator Benefits


After spending the week visiting his family in Phoenix, 73-year-old Benjamin Boxerbaum stood at the airport ticket counter awaiting his flight home, when he suddenly collapsed. The paramedics were called, but Boxerbaum died soon after their arrival.

“Even though there’s a fire department at the airport, it took the paramedics more than 10 minutes to reach him,” said his daughter, Brenda Priddy.

She believes her father’s death resulted from sudden cardiac arrest, a condition that claims about 250,000 lives annually.

Priddy began to research the condition and learned that it is frequently caused by ventricular fibrillation, a disturbance in the heart’s rhythm. She also discovered that other airports kept portable defibrillators — devices that can shock a heart back into normal rhythm — on hand for just such occasions. Priddy began a public awareness campaign to place them in Phoenix’s Sky Harbor Airport and other public locations. Her son, Zach, even took up the cause and raised $2,500 to purchase a unit for the family’s synagogue as his bar mitzvah project.

In the five years since Priddy’s father passed away, portable defibrillators (also called automated external defibrillators) have become increasingly common in public venues. A federal Good Samaritan law protects those who purchase or use the defibrillators from liability, and recommends that the devices be placed in federal buildings. Given that synagogues, Jewish schools and cultural centers can draw hundreds or even thousands of visitors, some institutions are eagerly embracing this technology.

The Union for Reform Judaism discusses defibrillators on its Web site, and provides a series of steps for congregations to consider when setting up a program. The Orthodox Union recommends that all synagogues equip themselves with a portable defibrillator.

Rabbi Aaron Tendler of Shaarey Tzedek said several congregants have specifically asked him whether the synagogue has an automated external defibrillator, which it does. Tendler notes that his congregation includes elderly members with heart conditions, and says it gives him “a sense of confidence in knowing that [the device] is there.”

Some synagogues have been deterred by the $2,000 to $3,000 investment required to purchase such a device. To address this issue, United Synagogue of Conservative Judaism’s (USCJ) business services department has partnered with a manufacturer to provide the devices and training at a discounted rate.

“We’re just beginning to market to congregations,” said Aliza Goland of the Conservative movement’s Pacific Southwest region.

Sinai Temple has two defibrillators, which were purchased before the USCJ program went into effect.

“With 1,000 people present every Saturday and children and staff here almost daily, we felt it was imperative to have one,” executive director Howard Lesner said.

When it comes to restoring heart rhythm after cardiac arrest, “time is of the essence,” said Dr. P.K. Shah, director of cardiology at Cedars-Sinai Medical Center. “Each minute that goes by without the restoration of normal circulation equals a 10 percent chance of irreversible brain damage.”

Revival within four minutes gives the best chance of survival, and few resuscitation attempts succeed after 10 minutes have elapsed. Since it takes seven to eight minutes on average for emergency medical personnel to arrive, the devices enable trained bystanders to deliver defibrillation during the critical period before the paramedics arrive.

Portable defibrillators are designed for ease of use and prompt the user through each step. The user places pads on the victim’s chest. If the machine determines that a shock is needed, it prompts the user to press a button, which delivers the shock. The device will not deliver a shock if it is not needed.

A study published last year in the New England Journal of Medicine found that survival rates were twice as high in locations where participants were trained both in cardio-pulmonary resuscitation (CPR) and defibrillator use rather than CPR alone. The researchers concluded that widespread implementation of public defibrillator programs could save between 2,000 and 4,000 lives each year.

However, to be included in the study, participating facilities needed to have the equivalent of at least 250 adults over the age of 50 present during waking hours (16 hours per day). Few Jewish institutions would reach such a threshold.

Out of 20 local Jewish institutions with sizable constituencies polled by The Jewish Journal, nine had a portable defibrillator on site: B’nai David-Judea, Leo Baeck Temple, the New Jewish Community Center at Milken, Shaarey Zedek, Sinai Temple, Stephen S. Wise Temple, Temple Beth Am, Valley Beth Shalom and Wilshire Boulevard Temple. Others said they were considering a portable defibrillator or planned to purchase one in the near future. Only one synagogue has had occasion to deploy its defibrillator. The patient survived, and the synagogue’s spokesperson was not certain whether or not shock needed to be administered.

Approximately 80 percent of out-of-hospital cardiac arrests occur not in public locations but in the home. Nevertheless, Cedars-Sinai’s Shah believes that the remaining 20 percent constitute a sufficient number to justify placing the devices in synagogues and other gathering places.

And Priddy, whose father suffered cardiac arrest at the Phoenix airport, believes they are a worthy investment. The devices, she said, can “give someone back their life and give families back their loved one.”

 

78 and 79: A Matter of Life and Death


Like many California voters this week, Rabbi Hershy Ten, president of the Bikur Cholim Jewish Healthcare Foundation, is grappling with how to vote on the Nov. 8 ballot. Either Proposition 78 or Proposition 79 could directly affect his L.A.-based foundation’s efforts to provide health-related services and referrals to needy and uninsured. Either proposition could help by lowering prescription drug prices. But even for Ten, it’s hard to peer through the electioneering and rhetoric.

One thing’s certain: Ten realizes a lot is at stake.

“I know of a man within the last three months who suffered irreversible liver disease because he could not afford his medication,” Ten said. “We were called after he went into liver failure to assist him in receiving a transplant.”

The question before voters is whether the drug companies should regulate themselves, as laid out in Proposition 78, or whether the state should be granted authority to pressure drug companies into providing discounts, as specified in Proposition 79. If both initiatives pass, whichever receives the most votes becomes law.

In the contest of marketing, at least, the outcome isn’t a close call. The pharmaceutical industry has spent more than $80 million backing Proposition 78 (compared to $1.8 million from Proposition 79’s backers, most of it from consumer, senior and health groups).

Putting the hype aside, here’s what Proposition 78 would offer: Most Californians earning up to 300 percent of the Federal Poverty Level would be eligible for discounted drugs, including individuals earning up to $29,000 a year and families of four living on as much as $58,000.

But the salient feature of Proposition 78 is that it includes no state enforcement mechanism. In the case of Ten’s liver patient, it would be solely up to the pharmaceutical industry to select the relevant drug for a discount, determine the discount price (if any), and choose the length of time to maintain it.

There are no state-imposed consequences if a company chooses to keep prices high.

So if the process is voluntary, what’s to stop drug companies from lowering prices right now? Conversely, if drug companies aren’t lowering prices now, why would they under a voluntary plan?

The industry’s response is that Proposition 78 is needed if corporations are to lower prices as a group while also avoiding anti-trust violations.

“We feel we have an obligation to make our drugs affordable,” said Jan Faiks, vice president for governmental affairs and law with the Pharmaceutical Research and Manufacturers of America (PhRMA), the powerful industry trade group. Faiks added that voluntary (and legislatively sanctioned) drug-discount programs in 26 states demonstrate the good faith of drug manufacturers.

These voluntary programs in other states typically have stricter eligibility requirements, and critics say few meaningful discounts are being offered. California’s version, Proposition 78, is identical to the defunct Senate Bill 19, an Arnold Schwarzenegger-backed bill that was defeated by Democrats in the state Senate in early 2005. At the time, the governor estimated that SB-19 would provide prescription drug savings of up to 40 percent off retail, close to the price that HMOs pay for drugs. Proposition 78 proponents have adopted those figures as their own.

This isn’t the first time that this Republican governor’s public health policy has mirrored PhRMA’s interests. In October 2004, Gov. Schwarzenegger vetoed four bills that would have provided information for Californians on obtaining cheaper drugs through Canadian pharmacies. A few weeks later, PhRMA donated several-hundred-thousand dollars to Californian Republican legislative candidates.

Consumer advocates don’t like much about Proposition 78, including the anti-trust justification for why the industry argues that it is necessary. After all, there would never be a legal prohibition barring an individual drug company from lowering its prices. Nor is there any reason why drug companies would have to engage in illegal collusion to lower prices, said Doug Mirell, board member of the Progressive Jewish Alliance (PJA), which is supporting Proposition 79.

Added Anthony Wright, executive director of the Pro-79 group Health Access: “No attorney general or judge would rule against them if they came together to lower prices. There’s no [anti-trust] precedent for it.”

Proposition 79 supporters contend that PhRMA’s real aim is simply to block Proposition 79 from taking effect.

Faiks of PhRMA’s doesn’t deny her group’s desire to thwart Proposition 79, but she insists that Proposition 78 is worthy in its own right.

Proposition 79, backed by consumer groups, unions and the American Association of Retired Persons, sets the discount rate for drugs lower than Proposition 78 (approaching the price Medi-Cal pays for drugs). It also includes patients earning 400 percent of the Federal Poverty Level rather than 300 percent. And it forbids drug companies from charging “unconscionable” prices for medication.

“There are 8 million to 10 million more people who will be benefited by Proposition 79 than Proposition 78,” Mirell said.

Perhaps most worrisome to PhRMA, however, Proposition 79 punishes companies who refuse to cooperate.

If negotiations with the state over discounts break down, the state could curtail that company’s business with Medi-Cal, California’s $4 billion drug discount program for the poor. Medi-Cal patients would have to receive so-called “prior authorization” by the state to use any drug manufactured by that uncooperative corporation. Under this system, the state would first try to find a substitute drug from a cooperative company.

In other words, under Proposition 79 the poorest segment of the population (on whose behalf the state bargains) would be used as leverage to lower drug prices for the next-poorest segment (who today have no bargaining clout).

Even under Proposition 79, Rabbi Ten’s liver patient would not have been guaranteed a different fate. There’s no mechanism, for example, forcing the state to drive a hard bargain for any particular medication. But if it did, the drug’s manufacturer would not easily be able to say no.

Each camp has its own collection of horror stories and feel-good episodes supporting its proposition. Proposition 78 is modeled closely on a voluntary program in Ohio. Consumer advocates modeled Proposition 79 on a program in Maine, one that PhRMA claims is not working well.

Faiks provided The Journal with a report, written by an independent Maine legislative committee, detailing patient frustration with various other systems of prior authorization. PhRMA also points to legal and administrative barriers, most prominently the likely opposition from the Federal Department of Health and Human Services.

“[The Proposition 79] program will never be approved,” said Faiks, who is well positioned to understand the leanings of the Bush administration, which has regularly sided with drug companies.

PhRMA provided The Journal with several letters from federal health officials to various state Medicaid administrators who, over the past several years, have attempted to expand Medicaid coverage to new groups (such as people with specific diseases or those who earn slightly-above-poverty wages). The letters suggest that President Bush’s administration is loathe to extend Medicaid funds or leverage Medicaid patients to benefit new groups unless a state has hard evidence that the expansion prevents these new clients from entering poverty and becoming eligible for Medicaid regardless.

Mirell, of PJA, asserts that technicalities will not cripple Proposition 79, at least not permanently.

“The Bush Administration will not be in power forever,” Mirell said. “Policies do change from administration to administration.”

Mirell also pointed to the “severability” provision of Proposition 79, which allows other provisions to survive even if some can’t be enacted.

“The fact that it may take some months of litigation to implement Proposition 79 shouldn’t scare people away from voting for it, when the benefits that could accrue are so much greater than Proposition 78,” Mirell said.

And the presence and influence of the industry Goliath shouldn’t dissuade the Davids of reform. “It doesn’t mean we should give up, saying they’re too powerful,” said Wright of Heath Access.

A late August Field Poll indicated that Californians largely support both measures: 49 percent voting yes and 31 percent no on Proposition 78; 42 percent yes and 34 percent no on Proposition 79. When the participants learned, however, that the drug industry is backing Proposition 78, opposition to that measure rose sharply.

“People need to ask themselves, ‘Do you trust the drug companies to voluntarily discount their own prescription drug rates?'” Mirell said.

That’s a question that voters are less likely to hear posed exactly that way, given the imbalance in campaign spending.

When he spoke with The Journal, Rabbi Ten was still trying to sort out the pluses and minuses.

“This requires further analysis,” he said. “It requires more information than is readily available through typical media outlets.”

Clearing the Air About Allergies


Scary statistic to contemplate: About 10 to 15 percent of kids suffer from allergies, and the rate has been rising steadily for the past 20 years. Though no one knows why allergies are skyrocketing, we do know what causes them. Allergies are an immunological “overreaction” to a substance that enters the body through airborne particles such as pollen, skin contact, or ingested foods. Though this may sound quite simple, allergies are notoriously tricky to diagnose. The symptoms are remarkably diverse, varied in degree, and easy to confuse with other ailments.

1. If your child has cold symptoms that seem to drag on forever, allergies may be the real culprit. Does your child get endless but fever-free head colds — complete with sniffling, sneezing, itchy nose, watery eyes, and noisy mouth-breathing? Could be that she’s suffering from perennial allergic rhinitis, the body’s unhappy response to such year-round allergens as dust mites and animal dander.

How to handle: Talk to your pediatrician about whether your child should be evaluated by an allergist/immunologist; a skin test can identify what triggers your child’s symptoms. Once the results are in, you can work on minimizing the presence of the offending triggers. But unless you plan to lock your child in a mold-free closet for the rest of his life, complete elimination isn’t always possible. Over-the-counter oral antihistamines and decongestants can help, but they can be sedating. Ask your doctor whether the prescription drug Claritin, a nonsedating antihistamine, is an option; it’s approved for use by children age 6 and older.

2. If your child experiences these same symptoms, but they always strike in spring or summertime, you’re probably dealing with seasonal allergic rhinitis. Sometimes inaccurately called hay fever, this kind of allergy can actually be triggered by an array of pollens that become airborne as plants bloom. Need further help diagnosing your child? Look for this give-away, says Dr. June Engel, a biochemist and author of “The Complete Allergy Book”: Since your child’s nose will be itching like crazy, he may well do what’s known as “the allergic salute” — he’ll rub the palm of his hand upward against the tip of his nose to relieve the itching.

How to handle: Electric bills be damned: You may want to shut the windows and run air-conditioning during the height of the season to minimize pollen entering your home, says Dr. Francis V. Adams, pulmonary specialist and assistant professor of clinical medicine at New York University Medical School. Check with your pediatrician for advice on which antihistamines to try, and keep in mind that this medication actually prevents symptoms rather than cures them, so use them at the first hint of seasonal rhinitis.

3. Wheezing, coughing, tightness of the chest, and shortness of breath are usually hallmarks of asthma, an allergic condition in which the bronchial tubes narrow and the lungs become congested due to inflammation. Triggers may be anything from dust mites to mold to animal dander to cigarette smoke. Complicating matters still more, exercise has been known to bring on episodes, and in about 80 percent of cases, a viral infection will kick off the reaction. Typically, a child with asthma will experience his first symptoms before age 3.

How to handle: If your child wheezes or you have any other reason to suspect asthma, contact your pediatrician right away.

Obviously, you’ll want to keep your child away from the specific allergens and irritants as much as possible (warning: this may mean finding the family pet a new home). Beyond that, your child should have a bronchodilator spray available to be used whenever he feels wheezy and take an anti-inflammatory drug on a regular basis to keep his airways open. If your child ever seems to be struggling for breath and his medication doesn’t bring relief, bring him to the emergency room immediately.

4. When raised red patches crop up on your child’s skin, you’re probably dealing with hives. Hives can be an allergic reaction, commonly to an insect sting or food (peanuts, for instance).

How to handle: Of course, avoiding your child’s triggers is the best defense. But if your child is afflicted, be on the lookout for those cases of hives that can turn deadly: “If your kid brushes up against a tree and gets only a hive or two, it’s nothing to be concerned about; treat the itchiness with an over-the-counter oral antihistamine such as Benadryl,” says Dr. Jack Becker, chief of the allergy section at St. Christopher’s Hospital for Children in Philadelphia. “But if all of a sudden he feels funny — that’s how a child will typically describe the sensation — has trouble breathing and is breaking out in hives all over, that’s extremely serious.”

This can progress to a potentially deadly condition known as anaphylactic shock, in which the tongue and throat swell up, cutting off the child’s air supply. If your child ever does show these symptoms, call for an ambulance immediately.

The deadly stage of the reaction might not hit until 10 hours later — when you mistakenly think everything’s back to normal. Also, get a Medic Alert bracelet or some other kind of identification that will let emergency workers know what the problem is in case you’re not present.

Beth Levine is a writer whose essays have appeared in Redbook, Woman’s Day, Family Circle, the Chicago Tribune, USA Weekend and Newsday.

 

Circuit


20 Years of Help

On Feb. 25, the Jewish Family Service of Los Angeles (JFS) celebrated the 20th anniversary of its Adult Day Healthcare Center (ADHC) in style with brunch and an art exhibit at the JFS/Valley Storefront in North Hollywood. Guest speakers included Susie Forer-Dehrey, JFS associate executive director; Jennifer Trotta of Mayor James Hahn’s L.A. Neighborhood Team; and Arturo Gonzalez, field deputy for Los Angeles City Council member Wendy Greuel.

Entertainment was provided by singer-songwriter Craig Taubman who led the more than 75 participants in a rousing singalong. Taubman was recognized for his contribution over the yearsto the ADHC, which provides medical and social services for frail senior citizens and other adults with physical or mental disabilities

Hillel’s Lifers

Supporters of the Yitzhak Rabin Hillel Center for Jewish Life at UCLA, along with dignitaries and rabbis gathered at the Sephardic Temple Tifereth Israel Jan 27 for the Hillel’s annual dinner. The evening honored the lifetime achievements of Dr. Gerald Levey, vice chancellor of medical sciences and dean of the David Geffen School of Medicine at UCLA; and Dr. Barbara Levey, assistant vice chancellor of biomedical affairs at UCLA, and outstanding senior Rona Ram.

All monies raised went to support the ongoing work of the Hillel.

SERVING ISRAEL

AMIT’s annual scholarship dinner on March 6 at the Luxe Hotel on Sunset Boulevard was an elegant evening with a generous spirit. Some 300 guests attended the dinner celebrating “80 years of service to the State of Israel” honoring those who have raised funds for the organization, which is devoted to educating and caring for orphaned and disadvantaged children in Israel.

Daphna Ziman, the founder of Children Uniting Nations, and actress Debra Raffin (“Seventh Heaven”) hosted the ceremony where Mildred Lewin, a 35-year member of AMIT, received the Lifetime Achievement Award. The Guardian of the Children Award went to Max and Sonia Mittleman for “devotion to AMIT with their annual fundraising activities,” said L.A. Council president Debbie Herbst.

Lola Levoy, owner and senior escrow officer of Beverly Hills Escrow, received the Women of Accomplishment Award, as did Stacy Phillips, the co-founder of Pacific Associates. Internationally renowned photographer Evelyn Bernstein, whose work was displayed in the auditorium, was award’sthird recipient.

Also in attendance were Joy Volk, Western Regional vice president, and Jan Schechter, the national president, who flew in from Israel that afternoon to attend. Charles Adicoff, owner of Adicoff Screening Room in Beverly Hills, was the evening’s auctioneer. – Emily Pauker, Contributing Writer

A Special Shidduch

Chai Lifeline recently partnered with Peri Devaney, editor of Ron Rubin’s newly published book, “Anything for a T-Shirt: Fred Lebow and the New York Marathon,” on a special project at the L.A. Marathon Expo on March 5.

Chai Lifeline, an international organization dedicated to providing support to children with cancer and other life-threatening diseases, placed its own posters at the Tribute to Fred Lebow booth.

To honor Lebow’s memory, Devaney committed to contributing a portion of the proceeds from book sales at the booth to Chai Lifeline. And an additional $1 was donated to anyone who mentioned Chai Lifeline when buying the book.

Prior to his death from brain cancer, Lebow, a Holocaust survivor, said, “When I went [to my chemotherapy session], there were two kids…. I can accept that an adult could have cancer but I cannot accept that for these little kids.”

He subsequently endorsed linking the New York City marathons with specific charities – somet hing that he had refused on prior occasions.

The offer also continues post-marathon. A copy of the book can be purchased at

Purim Saga


 

How fitting that the heartbreaking saga of Terri Schiavo is coming to a head during Purim. Granted, the connection to a holiday known for merrymaking is not obvious. On its face, Purim celebrates the rescue of Persian Jewry from certain destruction in the time of King Ahasuerus. They tried to kill us, they failed, let’s eat.

But the Purim holiday is not so simple; it is full of mystery and hidden meanings. It is a religious holiday whose central text, Megillat Esther, never mentions God. Its heroine is a Jewish woman who has intermarried and is urged to hide her identity. The very name “Esther” is said to derive from the biblical verse, “haster astir panai,” “But I [God] will surely conceal my face.”

The Schiavo case is no less murky (see story, page 21). To start with the most disturbing parallel first, there is Terri Schiavo’s face in the video footage. This young woman who most doctors agree is as close to the living dead as biologically possible displays a strained smile. Doctors say this reflex reaction is a result of a still-functioning brain stem, but there it is — a kind of Purim mask hiding both body and soul.

The political firestorm over the case obscures the Schiavo’s family deeply personal dilemma. Doctors have diagnosed the 39-year-old woman as being in a permanent vegetative state. Her parents, devout Catholics, want to keep her alive. Her husband and guardian, Michael, has said his wife made clear to him on two occasions she would not want to live under such conditions, and he has fought for 15 years to have her feeding tube removed.

After a Florida court ruled that doctors could remove the feeding tube that has kept her alive, congressional leaders and the White House intervened. On Monday, President Bush signed the bill passed by the House and Senate, which transferred jurisdiction in the case to a federal judge for review. U.S. District Judge James D. Whitmore immediately declined to order the feeding tube reinserted.

By the time you read this, other events are likely to have played out, including appeals to higher courts and maybe even Schiavo’s death.

A Republican Party bent on undermining states rights is just another topsy-turvy aspect to this case. Are the interventionists’ motives moral or political? Is this Purim-period legislation a model or a masquerade?

“This isn’t about Terri Schiavo. It’s about abortion,” Neal Boortz, a pro-Bush conservative talk show host, wrote on his Web site. “The anti-abortion movement saw an opportunity to take Terri’s tragedy and turn it into a spectacular pageant in support of life. The Republicans in Washington have essentially taken Terri Schiavo hostage — a hostage designed to please their anti-abortion constituency. Can it be said that the Republicans are torturing the soul of Terri Schiavo, and doing it for votes?”

There is no clear-cut, painless resolution of the Schiavo case, as thousands of families who face similar end-of-life decisions for their loved ones know. Jewish opinion on the matter is open to interpretation and disagreement.

A year ago, writing about Schiavo in these pages, Rabbi Elliot Dorff laid out the guiding Jewish principle on end-of-life issues: “We are, on the one hand, not allowed to hasten the dying process, but on the other, we are not supposed to prolong it either.”

Many Jews, especially among the Orthodox, would argue that Schiavo’s feeding tube is a source of nourishment.

“To remove it from a patient whose only impairment is cognitive is simply murder,” Dr. Daniel Eisenberg of Albert Einstein Medical Center in North Philadelphia told a reporter.

But other observant Jews, like Dorff himself, would argue that in Schiavo’s case, a feeding tube should be classified as medicine.

“It does not come into the body in the usual way food does and thus lacks all the qualities associated with food, such as taste and varying temperatures and textures,” Dorff wrote. “Furthermore, one of the natural features of the dying process is that the person stops eating, and so by using tubes, we are effectively force-feeding a patient and thus prolonging the dying process.”

As medicine has advanced far beyond what the rabbinic sages could have imagined, the answers to these questions become murkier, and more critical.

For that reason, we must think about their implications for ourselves and our loved ones, and make our desires explicit before it is too late.

According to her husband, this is what Terri Schiavo did, and the doctors, the courts and the president should respect that choice. It would have helped if Schiavo had clearly documented her wishes, but how many of us do, especially when we’re in our 20s? Now what should have been a private, painful decision has been turned into another macabre skirmish in the culture war.

How very much like Purim: A story begins as looming tragedy and ends as farce.

The Schiavo case, sadly, has managed to become both at once.

Fly the Mitzvah Skies


 

El Al, Israel’s national airline, is the only airline that keeps kosher, observes Shabbat and even gives out doughnuts on Chanukah, but recently it has been doing other mitzvot as well.

On Nov. 3 Edith Krygier boarded an El Al flight to Los Angeles in Tel Aviv because she wanted to visit her children and grandchildren who live here. The plane stopped in Toronto, and as Krygier was standing on the jetway waiting to board again, she suffered a stroke and collapsed just a few feet from the aircraft door.

El Al immediately called an ambulance and got Krygier to the hospital, and in the meantime it also called David, Irit and Karen Krygier — Edith’s children in Los Angeles, and helped them get on a plane to Toronto. In Toronto, the El Al staff sat by Edith’s bed until her children got there, while other staff helped shuttle the children to the hospital. Stanley Morais, El Al’s general manager in Toronto, even visited Edith in hospital just to see how she was doing.

“Even the doctor and the medical staff commented that they had never seen anything like it,” David Krygier said.

Thanks to El Al’s quick action, Edith was able to recover from her stroke quickly and without side effects.

But that’s not all. In early December, some rabbis from the National Council of Young Israel (NCYI) boarded an El Al plane in New York carrying some bulky but holy hand luggage — Sefer Torahs. They were six torahs in all, the final installment of 100 torahs that NCYI brought to Israel over the past three years to donate to IDF soldiers. Not only did El Al not charge freight costs for the Torahs, but they allowed those carrying the Torahs to board first so that they could put them into closets, or on free seats if there were any available.

“From the beginning, El Al was unlike any other airline,” said Sheryl Stein, El Al’s U.S. manager of advertising and public relations. “It’s an extension of the spirit of Israel.”