November 17, 2018

Bad Medicine at Providence Saint Joseph Medical Center

On February 28 of this year I had ananterior cervical discectomy and fusion surgery on my neck at Providence Saint Joseph Medical Center in Burbank. The surgery was a success and I have been pain free since I woke up from surgery. I was not only blessed to have a great surgical outcome, but I wrote about my experience with the clergy at Saint Joe’s because they impacted my experience.

Chaplain Phil Kiehl and Rebecca Stringer from the chaplain’s office both came to pray with me. Phil said a prayer with me and my son before my surgery, and Rebecca came and prayed with me before I went home. They were kind, and loving, and I felt the power of their prayers. They both said prayers tailored to my faith, which I appreciated. The prayers mattered and have stayed with me. I felt lucky to have had such a wonderful experience, both physically and spiritually. Sadly my good feelings about Providence Saint Joseph Medical Center did not last very long. In fact, they went from good, to bad, to disbelief, and now I am angry. Angry and disgusted by what can only be described as unethical and unprofessional practices of Providence Saint Joseph Medical Center.

I have spoken to countless people at the hospital and after the last conversation I had with an employee at Saint Joseph’s, I am left with no other choice than to not only write about it, but hire an attorney because these people are lying at every level and one can only assume I am just a drop in bucket of lies. I am standing up for not only myself, but for those who are not strong enough to stand up. If they are billing me for thousands of dollars of services that were not provided, and I was admitted for less than 24 hours, what is going on with people who are there for prolonged periods of time, or those who don’t have health insurance? As for my insurance, that is another fascinating lesson with this surgery. Medicine is amazing, but it is also very dirty and money driven.

I received a bill from the hospital for $1859.76. There was no breakdown of what it was for, just a lump sum. I had already paid for the anesthesiologist and the surgeon, so I called the hospital to ask for a breakdown of the charges, what was paid by my insurance coverage, and what the balance of $1859.76 included. They provided me with a list of charges, but there was something fishy going on. They billed $7570.51 in pharmacy charges. I was there for less than 24 hours and the only things I took was 3 Vicodin and a package of Halls throat lozenges. They billed $1840.00 for physical therapy, and I never had any physical therapy. There was also a charge of $54211.01 for Medical Supplies and $62900.00 for the operating room. I accept being charged for what they provided, but they did not provide all they have billed for. Period.

The big issues I had however were with the pharmacy and physical therapy charges. I called the hospital and said I was disputing the charges and wanted them to be reviewed. I was transferred to a woman named Jenny Ritchie in the Business Office, and explained everything to her. She told me she was going on vacation and would call me when she got back in a week. She never called. I called her back three times and finally got a hold of her. She apologized for not being in touch and needed me to explain everything to her again. I told her the hospital would not provide me a breakdown of the pharmacy charges. I also explained I was being charged for physical therapy I never received. She told me she would investigate and get back to me. I never heard from her.

A couple of weeks later I receive a letter from Saint Joseph’s telling me they had investigated my bill and determined it was correct and the bill was now due. I called the Business Office but nobody would take my call. While waiting for a call back I received a letter from Wendy Katsiotis, who is a Supervisor with the Inpatient Physical Therapy Department. A woman I’d never spoken to. Her letter let me know she investigated my case and it had been closed. I’m not sure how it can be properly investigated without anyone ever speaking to me, so I called her to ask. I explained I never received physical therapy in the hospital.  I told her I met the physical therapist, but had declined treatment in the hospital as I have been doing physical therapy for a year and was good to go. She told me she spoke to the physical therapist on duty during my stay, and she assured her she not only consulted with me, but took me on a walk around the hospital floor. I assured her that was not at all true and never happened.  She told me there “were a couple people on her floor who she thinks would totally lie, but not the girl assigned to me”. So they lie, but not the girl who met me?

I explained I never received treatment and did not go for a walk. She then told me that I was too high to remember. Considering they charged me for $7000.00 of narcotics, that might make sense, but no. I told her it would make no sense to walk around a woman who was high and had a new neck. Ms. Katsiotis then asked me if perhaps I had an opioid addiction and could function while high. So I was clear, I reiterated that only some of her employees lie and they provide physical therapy to people who are high. She said yes, wished me well with my new neck, and that was that. I called back Ms. Ritchie and got through, only to be told it was my word against theirs and the case was closed. Oy vey with these people. I then called my insurance company to let them know what was going on.

The people at Blue Shield of California were lovely. I heard from Chrystal H., and Dani C., both in the Grievance Department. I then spoke to their supervisor Danielle, who listened. She said they would investigate the charges, but at the end of the day they had a contact with the hospital, so they were able to charge what they wanted and there was not a lot Blue Shield could do about it. I did not have physical therapy, I did not have $7000.00 worth of opioids in less than 24 hours, and there is simply no way that 20 hours at Providence Saint Joseph Medical Center should be billing $152,061.52 when the anesthesiologist and surgeon were paid for separately. This is unethical business practices. They are lying and it shockingly seems to be completely legal. Not cool.

I have called the hospital and asked for arbitration of the bill. I was assured someone would call me, but that was 8 days ago and no call. Providence Saint Joseph Medical Center has billed incorrectly, call me an opioid addict, told me their staff lies, and never once called to ask me what happened during my stay. I can only imagine what they get away with when nobody asks questions. I am grateful and thankful my neck is doing great, but I am not paying the bill because it is a lie. Not only are they charging for things that didn’t happen, they’re smirking while they do it because they’re protected by a contract with the insurance companies. They’ve never come across someone like me however. Don’t mess with an angel, and buckle up when an angel is keeping the faith.

In Search of a Prayer During a Trying Time

Photo from Max Pixel.

Last Wednesday I had anterior cervical discectomy and fusion surgery done on my neck. Two of my discs were bulging so badly they were pushing on my spine. My arm had been numb for several months and even though I did physical therapy for over a year in an attempt to avoid the surgery, I could longer wait and the procedure was finally scheduled. Four hours and six screws later, I am recuperating nicely and the benefits of the surgery were instantly felt. I woke up with no numbness or tingling in my arm, and am thrilled with the results.

My procedure was done at Providence Saint Joseph Medical Center in Burbank. When I checked in for surgery I immediately asked if I could see the rabbi from the Spiritual Care department for a prayer. I clarified that if a rabbi was not available, I would happily pray with any member of the clergy. I simply wanted to pray with someone dedicated to God, and the religious affiliation was not that important. As I sat with my son and told him how much I wanted for the rabbi to come and say a prayer, and he assured me it would be fine and we could pray on our own, but not to worry because someone was coming.

I was waiting for the nurse to arrive to insert an IV when Chaplain Phil Kiehl walked in. He introduced himself and said he stopped by as he had heard I wanted to pray with him. I almost started to cry I was so happy to see him. He sat with me and my son and took time to get to know us. He asked about the operation, who the surgeon was, who the anesthesiologist was, what my pain was, and what the goal was. After we chatted for a few minutes he joined hands with me and my son and gave what can only be described as a perfect prayer.

It was kind and honest and made me feel very safe in my faith. It was a prayer of compassion and blessings. When Phil left the room, me and my son turned to each other and both said it was the most wonderful prayer and had left us feeling happy and at peace. I went into surgery feeling comfortable with my medical team and embraced by God. The following day as I rested and waited for the doctor to give permission for me to leave the hospital, a woman from the clergy office stopped by. Her name was Rebecca Stringer and she was paying me an unexpected visit to check in on me as she heard I was leaving.

She had a beautiful smile and a warmth I could feel. Her soul was visible and I was profoundly moved by her. We spoke about prayer and the importance it has in both of our lives. We spoke about our children and she shared she had lost a child to cancer. Her beloved little boy had passed away and she spoke of him in a way that painted a picture of love. This angel has a remarkable mother who is rooted in prayer and faith. She helped me more than she could ever know. We did not share the same religion, but we shared a life of faith which was respectful and embracing in a way that I wish it could be for everyone.

She held my hand and said a prayer that made me cry. I will forever remember her generosity of spirit and the feeling it gave me. Her words brought me real healing. We may practice different religions, but we pray to the same God and our exchange was special. I am a woman of faith and have experienced many blessings, but this was a rare moment of an authentic spiritual connection to another human being. We were sisters in prayer and I felt God holding onto us. When you can connect through God, without the judgment of religion, it is remarkable.

When Rebecca left my room I had a feeling of gratitude in the wake of her grace. My surgery was a success and I thank Phil and Rebecca for their kindness. Prayer is personal and mine is generally private, but my prayer this week had company and it was lovely. There is power in prayer and when voices join together it is wonderful. I feel great and am getting stronger each day. I was terrified going into the surgery and am relieved it is over and went so well. Life is good and good health is a blessing. I am grateful, happy, healthy, and keeping the faith.

Ilana Angel writes the Keeping the Faith blog at

Motherhood, Surgery, Reflection & Faith

I’m having surgery on my neck tomorrow, and look forward to finally feeling better. It has been a long road to get here and even with all the challenges and difficulties I have faced, this is the first time I feel scared and nervous. I kicked cancer’s ass, but screws in my spine is daunting and has thrown me into a place of deep reflection, mostly about my job as a mother.

Motherhood is a remarkable thing. I remember the moment I was told I was pregnant. I made all these promises to myself about the kind of mother I wanted to be. I had so many plans and dreams for my son before he was even born. I wanted to be a mom from the time I was a little girl and always thought I would have a lot of kids. Life can change dreams.

I have one remarkable son who is a truly wonderful human being. Both because of me, and in spite of me. I am proud of him and it has been my greatest honor to watch him grow up and become a good man. He is 22 years old and has a very bright future. He is a smart kid, but I worry he’ll never fully understand how much I love him. Perhaps he won’t get it until he is a dad.

The anticipation of my surgery has me thinking, and no good can come of that. I remember every time I was unkind or impatient. Every mean thing I ever said about his dad. The times he took care of me because I was sick. The times he watched me cry because my heart was broken. The times I couldn’t afford to get him what he wanted. All of it is vivid and feels heavy.

He will drive me to the hospital and be there when I get out of surgery, which makes me feel both grateful and sad. It is my job to take care of him, but over the past few years he has been taking care of me, and that is hard for a parent to come to terms with. I don’t ever want to be a burden on my child. I want him to be free to live his life and follow his dreams.

I want to hold him tight and tell him a million things, but that seems somewhat morbid. I’m not dying, I’m just having surgery. It is a procedure my surgeon has done hundreds of times with great success. There is nothing to worry about, and tomorrow when my neck is repaired and I feel amazing, I will have forgotten about how scared I was and focus on my blessings.

I will check in with you over the weekend when I am home, and appreciate your prayers and good wishes. I asked the hospital if I could have a rabbi come say a prayer with me before the procedure and they were surprised. Apparently they are not allowed to offer a clergy visit because it is an invasion of privacy, which is a shame. I pray and welcome the visit for a prayer.

The hospital said they would make the request. I let them know if a rabbi wasn’t available any member of the clergy, regardless of their religion would do. I just want a person of faith to pray with me. We all pray to the same God and I asked for an act of faith not religion. How different would our world be if people were able to have faith without religious judgement?

If I can get through the day without crying it will be a miracle. I feel emotional and happy, yet at the same time feel sick to my stomach and am unhappy. To be expected, but not at all a comfortable feeling.  I am going to count my blessings, believe everything will be fine, trust my brilliant son knows how much I love him, and hope he knows he is the reason I am keeping the faith.







My Mid-Life Crisis

New car gift. Clipping path included.

A few weeks ago I decided to buy a new car.  I have had my car for 10 years and even with 115000 miles logged in, she had plenty of life left in her. I am not really a car person, but it was time for me to do something special for myself, so I went with a new car. I found the perfect little car and ordered it exactly how I wanted. I hit a rough patch with the first car salesman I met, but I was set on getting a new car, so when the dealership called to right his wrong, I appreciated the effort and listened.

After going back and forth on the car, I eventually decided against it. I figured the glitches were a sign I wasn’t supposed to get it. I was going to set the car aside for a bit and revisit it another time. Then on Thursday I went to see my doctor, and two and a half years after my cancer diagnosis, there is a little situation that needs to come out. I cried for five minutes, then I sent an email to the owner of Keyes of Van Nuys, Mr. Howard Tenenbaum, who had reached out the week before.

I let Howard know what I needed to be able to pull the trigger on the car. I heard back from him the same day, letting me know he took care of everything. The Sales Manager, Lewis Cook, went above and beyond for me. He worked with my schedule and budget, making it a priority to show me the customer service Keyes strives to provide. I was treated with respect and kindness, and left the lot on Saturday with my new baby. She is beautiful and made me happy on a sad day, which is good because I ain’t got time to be sad.

Louis Venegas the Finance Manager walked me through the process quickly and with expertise. Lewis Cook kept an eye on my signing of the papers and ensured I got VIP treatment. Even Howard came in to thank me for my business. It was a great experience and I will now remember the day because of the car, not because of the medical update. The gentlemen of Keyes were wonderful, having no idea what I was going through, simply wanting my experience to be a good one. Bravo.

Tomorrow I will hit the ground running on my medical situation and get it sorted. There will be tests, and surgery, and God willing many more anniversaries to celebrate. I am fine and my life is blessed. If you pray, throw my name in if you wouldn’t mind. I will keep you posted on what is happening. I am looking forward to driving to my appointment tomorrow in my fantastic new car. It is important to look cute while you kick some ass, and I look super cute in my super cute new car.

Please note I reserve the right to continue my midlife crisis after I deal with the current pain in my ass. Surely a new car won’t be the only thing I do. Maybe I’ll jet off to Australia for dinner. Again. Maybe I will change my hair color. Again. Maybe I will adopt a dog! Maybe I will find the man of dreams. Maybe I know him already! At the end of the day I feel good and my life is blessed. I am thankful, grateful, hopeful, and keeping the faith.


Joan Rivers hospitalized, critical but stable

Acerbic comedian and fashion critic Joan Rivers was rushed to Mount Sinai Hospital in New York on Thursday after she reportedly stopped breathing during surgery on her vocal chords at a nearby clinic, the hospital said.

Mount Sinai gave no details on the condition of the 81-year-old Brooklyn-born celebrity but said it would provide an update as it becomes available.

Ken Baker, an entertainment journalist at E! News, which features Rivers as host of its show “Fashion Police,” said on his Twitter account that Rivers was in stable condition.

“Her family wants to thank everybody for their outpouring of love and support,” said hospital spokesman Sid Dinsay in a statement.

One of America's best-known comedians, Rivers is considered a pioneer for women in stand-up comedy.

New York City Fire Department spokesman Jim Long said a patient reported to be in cardiac arrest had been taken from Yorkville Endoscopy to Mount Sinai by emergency workers responding to the call at 9:40 a.m.

Long declined to name the patient due to privacy concerns, but the NBC television affiliate in New York said it was Rivers and that she had stopped breathing during a procedure on her vocal chords.

Representatives for Rivers did not immediately return calls or emails, and a representative for her daughter, Melissa Rivers, declined to comment.

A representative for E! could not immediately be reached for comment.

Rivers' peers in the 1960s comedy club scene of New York's Greenwich Village included Bill Cosby, Richard Pryor, Woody Allen and George Carlin, but she said she never felt like she was part of their clique.

In 1983, she earned one of the biggest gigs in the business when “The Tonight Show” host, the late Johnny Carson, crowned her as his regular guest host.

Her brash and self-deprecating routine found new life on the awards show circuit and in recent years she trained her biting wit and profanity-laced comment on the fashion faux pas of Hollywood's celebrities.

In an age of political correctness, Rivers' no-holds-barred style has stood out in the crowded world of celebrity TV, as has her ability to make fun of herself, including her penchant for plastic surgery.

Aside from her role on “Fashion Police,” she has in recent years starred alongside her daughter in the WE TV reality show “Joan & Melissa: Joan Knows Best?”

Rivers, a stand up comic and a reality star with a career launched in the 1950s, in recent weeks drew attention for her vigorous defenses of Israel during its war with Hamas in the Gaza Strip.

Replicating revolution: Reut Institute advances 3-D printing for all

Few aspects of Israeli society are dearer to the national identity than its high-tech sector — a class of entrepreneurs so churning with ideas and innovation that they have earned Israel the title of “startup nation.” 

But can this legacy last forever? Research from the last few years has shown that Israel’s startup model is no longer sustainable, according to the Reut Institute, a forward-looking think tank formed 10 years ago by Gidi Grinstein, a former Israeli peace negotiator, to help inform lagging government policy in Israel. 

“What does it take for a country to lead an industrial revolution?” Grinstein asked during an interview at the institute’s sleek maze of offices, located among the tech warehouses of northeast Tel Aviv. “Generally speaking, what you need is broad exposure, broad literacy, a very large pool of talent — and out of this talent come the leaders, the entrepreneurs, the managers.” 

By contrast, Israel’s current model — based on a few bright minds and a limited pool of seed money — “is extremely exclusive,” Grinstein said. “Very few people participate.  So in order to make it inclusive … we went open source.” 

The Reut Institute took action on its findings in winter of last year, embarking on a wildly ambitious mission to familiarize the entire Israeli population with what Reut leaders, and tech experts around the world, are calling the centerpiece of the third industrial revolution: the 3-D printer. 

By layering many razor-thin sheets of a material on top of one another — most commonly using a simple type of plastic called polylactic acid, or PLA, in a liquid form that dries quickly — 3-D printers can render 3-D computer designs into a fully functioning object in a matter of hours. This technology is the closest humanity has come to inventing touchable e-mail, Willy Wonka style: All one has to do is send a 3-D design file and a recipient can print it out on the other end. Some of the machines can even print chocolate. 

And Israel, as the Reut Institute sees it, has the potential to lead the revolution. Reut has so far opened three public 3-D printing labs — in Tel Aviv, Haifa and Bat Yam — part of a rapidly self-replicating Cross-Lab Network (XLN) that uses its own minimalist 3-D printers to print more printers that can populate new labs, at very low cost ($400 to $600 per printer, according to lab managers). The “great-grandmother” of the printers, which to the untrained eye looks like a high-tech Tinkertoy, has a special spot on the shelf at the very first XLN location, in Tel Aviv. 

By the end of 2014, Reut CEO Roy Keidar, head of the XLN, said he hopes to open 15 more labs across Israel. And five years from now, the goal is to expand to between 30 and 50 locations. 

The Tel Aviv workshop, a bright-white basement littered with plastics and computer chips and half-built gadgets, recently celebrated the first graduating class of its weeklong “Maker’s Academy” — a crash course in 3-D imaging, printing and programming that Reut hopes will bring together and train the future leaders of the network. At the event, one 14-year-old from Haifa showed off his robot, which waves its hands when a motion sensor tells it someone is near, and L.A. native Ari Platt unveiled complex plans for a medical device that uses spatial recognition to help doctors improve their precision during surgery. 

Seen from above, this image shows an open-source 3-D printer built and used by Reut Institute’s XLN Initiative. Photos courtesy of the Reut Institute

“I came here, and they really taught me the basics of programming,” said Platt, who added that he had barely any technological experience before the course. “Now I understand [the technology], and I feel much more comfortable using it. I wouldn’t mind going online and trying to teach myself. Before, I would never have gotten close to it. 

“Once you get down to the basics,” he said, “you realize it’s not so hard. People get afraid of things that are unknown.” 

Scientists have predicted that in the not-too-distant future, 3-D printers will be capable of spitting out full-scale buildings, space bases, working human organs and beyond. 

This news, of course, comes as no surprise to the Internet’s tech-nerd community, which has been sharing open-source 3-D printing designs on Web sites like for years now. The Massachusetts Institute of Technology also jumped on board in 2001, and started setting up a series of professional-level 3-D fabrication laboratories, or “fab labs,” around the world — of which there are now almost 150, including one in Jerusalem and one in the Israeli suburb of Holon. 

But in the last year, world leaders have started to take notice as well. 

“A once-shuttered warehouse is now a state-of-the art lab where new workers are mastering the 3-D printing that has the potential to revolutionize the way we make almost everything,” U.S. President Barack Obama said in his 2013 State of the Union address. “And I ask this Congress to help create a network of 15 of these hubs and guarantee that the next revolution in manufacturing is made in America.” 

Earlier this summer, the commercial potential of 3-D printing reached new heights when the largest manufacturer of 3-D printers, Stratasys — co-headquartered in the United States and Israel — bought up MakerBot, a more low-end 3-D printing company that got its start selling home-assembly 3-D printer kits. Together, analysts have predicted that the two companies will vastly expand 3-D printing at the consumer level. 

Another Israeli startup, Something3-D, has big plans to “put a 3-D printer in every home” in Israel, according to business journal
The graduating class of the first Makers Academy. Among those in the class are: back row, left, Etai Evenhaim, and back row, third from left, Ari Platt, both of L.A. Standing, far right, is Arnon Zamir, XLN’s Chief Operating Officer. Second from left, third row, is Sefi Attias, XLN’s Chief Technology Officer, a graduate of YULA in Los Angeles.

Reut also has put a strong emphasis on designing cheap and customizable devices for people with special needs: In late August, the institute will host an intensive 3-D-design competition for special-needs devices. Competitors are currently pulling all-nighters in the lab, shaping entries such as a hearing aid that can attach to a smartphone, a computer mouse for a person with arthritis and customizable glasses for kids. 

The only rule: Entries must remain open source. 

“Our purpose is not to build a high-end printer that will compete with $20,000 printers,” Grinstein said during a tour of the lab in Tel Aviv. “Our objective is that you’ll have Israelis from all over the map understanding what is a 3-D printer, building one, designing stuff, participating — and those who take to it will eventually become the leaders and the entrepreneurs.” 

Experts at the Reut Institute aren’t the only ones to warn of the potential downfall of startup nation, if access to modern technology and cutting-edge education does not become available at all levels of Israeli society. A recent Google Israel study, whose results were published by Israeli newspaper Haaretz, found that “in the last decade, an unacceptable gap has developed between the integration of ICT [information and communications technology] into all aspects of life and the reality in Israeli schools, and between Israeli schools and those in the other countries.” 

To meet this challenge, the Reut Institute is working with schools and other learning institutions across Israel to set up 3-D printing labs within existing structures, with financial help from city governments. The lab in Bat Yam, for example, is a collaboration with the Branco Weiss School for At-Risk Students. “The students really responded to the machines,” Keidar said, “and to this method of using their hands.” 

Reut hopes to reach every level of Israeli society by setting up 3-D labs in unlikely places, such as the low-income kibbutz town of Kiryat Shmona, the heavily Arab town of Sakhnin, the heavily Orthodox town of Tsfat — even one day in Ramallah in the West Bank. 

“The [economic] model of the Israeli government failed to deliver on the pledge that growth will trickle down, so our challenge is to generate inclusive growth — growth that includes all the population,” Grinstein said. 

At Reut’s Tel Aviv location, that dream is having growing pains. At the first Maker’s Academy graduation, of almost a dozen participants, Grinstein noted that no women were present but was proud that about 20 percent of graduates were in the racial minority.

“Next time, if we still have 100 percent males in the graduating class, it will be a problem,” Grinstein said. He explained that in order for women — especially religious women — to be attracted to the XLN, “they need to trust the environment.” 

These nameplates were produced by pupils at the Branco Weiss School for At-Risk Students during their first course in 3-D printing.

Reut is also fighting fears that the 3-D revolution could be more of an apocalypse. The sexiest controversy of the 3-D printing era, both in the United States and Israel, has been the big 2013 reveal that the printers can print gun parts that would otherwise require a license to buy in a store. Cody Wilson, a Texas law student, opened up a fiery debate about the future of tech crime this spring when Forbes published proof that his 3-D-printed firearms were fully functional and downloadable from the Internet. Although he has since removed the code for the gun from his Defense Distributed Web site, it is by now hosted on countless other sites — perfect proof that lawmakers can’t fight open-source sprawl and will need to find new ways of policing the products of the 3-D era. 

In Israel, this July, Channel 10 news reporter Ori Even sneaked a plastic, 3-D-printed pistol into parliament and pointed it at Prime Minister Benjamin Netanyahu while a TV crew filmed his trembling hand. The controversial report proved that in security-obsessed Israel, officials must race to fit policy around the future of technology. 

Leaders at Reut said that although 3-D-printed weapons pose a major regulatory challenge for lawmakers, any new realm of technology will have a dark side — and the institute’s mission is to “focus on the good, and the opportunity.” 

The future of Israel as a global economic leader could depend on it. 

“This is about the fundamental learning that Israel’s society and economy need to go through in order to survive and thrive in a world of self-manufacturing,” Grinstein explained, pointing to a dizzying graph of the startup-nation model that had been left up on a dry-erase board in the Reut offices. 

“Our vision here is not just 3-D printing, not just a network of communal technological spaces — our vision is Israel leading the coming industrial revolution.”

Angelina’s breast cancer victory isn’t for celebrities only

Actress Angelina Jolie just announced that she underwent a preventive double mastectomy after learning that she was genetically predisposed to cancer. Her disclosure was a powerful show of solidarity with the more than 100,000 American women who undergo breast removal surgery each year.

But Jolie's story, while inspirational, is different from most women's. She benefited from a relatively uncommon nipple-sparing mastectomy (NSM), a procedure that removes the breast tissue while preserving the breast skin and nipple. With NSM, after reconstructive surgery, breasts are left looking mostly unchanged.

Such procedures are rare — but they don't have to be. Recent advances in medical technology have made NSM and skin-sparing mastectomies (SSM) much safer and easier to perform. And yet, too few breast cancer patients know about these options. Bridging this knowledge gap is the only way to ensure that more women aren't needlessly disfigured.

Roughly 260,000 people are diagnosed with breast cancer each year in the United States. For many of them, the news of their illness is followed by a seemingly unthinkable treatment recommendation: a mastectomy.

The most common form of this procedure, known as a simple or total mastectomy, removes the entire breast, including much of the skin and the nipple. Even if it eliminates the cancer, the disfiguring effects of the surgery can bring overwhelming psychological pain, especially for younger women. As a breast surgeon, I have witnessed the devastating emotional consequences of this procedure all too often. 

It isn't just diagnosed cancer patients who must deal with the distressing aftermath of a simple mastectomy. Like Jolie, many healthy women with a heightened genetic risk of developing breast cancer choose to have some form of preventive breast removal.

From a medical standpoint, there's no reason that simple mastectomies should be the norm. Both NSM and SSM are minimally invasive procedures that, in the right patients, are as effective as simple mastectomies and carry considerable cosmetic and emotional benefits. With NSM specifically, not only can breasts look the same after reconstruction, according to many patients, they may look better.

And yet, NSM currently accounts for about 10 percent of the mastectomies performed. That so many women are being denied the chance to preserve most of the skin and the nipple and therefore a more natural appearance of their breasts is disheartening.

The problem is one of education. Women are often told by their doctors that NSM and SSM are difficult to perform and bring a higher risk of cancer recurrence. In fact, a 2011 study in the Journal of the American College of Surgeons found that SSM and NSM appear to be oncologically safe and did not increase the risk of cancer recurrence. A study in Plastic & Reconstructive Surgery in 2011 examined the results of NSM over 20 years and came to a similar conclusion.

As for the supposed difficulty of the surgery, that too is a misconception. I can personally attest that new technologies like the Eigr illuminated breast retractor system have made it possible to perform NSM and SSM more easily, more quickly, and with fewer complications. Such advances should help these procedures become more widely adopted. 

Unfortunately, many physicians have remained in the dark about recent improvements in breast surgery. Recognizing the need to educate surgeons about NSM, the American Society of Breast Surgeons has launched the Nipple-Sparing Mastectomy Registry to track the long-term results of those patients who undergo this procedure. But this is only a small step in the right direction.

Addressing this knowledge crisis will require women to play an active role by learning about their treatment options, seeking out informed physicians, and asking the right questions. To this end, there are a variety of valuable resources, including organizations like the American Cancer Society and websites like, where patients can weigh various procedures and learn from other women's experiences.

Angelina Jolie's remarkable story should bring hope to breast cancer patients and those at risk of developing the illness. Procedures like Jolie's are available to all women. The challenge now is to ensure that surgeons are trained – and patients are educated – in less-invasive techniques that vastly reduce the psychological and emotional effects of this life-saving surgery.

Dr. Richard E. Fine is a breast surgeon at The West Clinic Comprehensive Breast Center and Associate Clinical Professor, Department of Surgery, University of Tennessee, Chattanooga Division. He is a Past President of the American Society of Breast Surgeons. 

Angelina Jolie has double mastectomy after discovering ‘Jewish gene’

Actress Angelina Jolie had a double mastectomy after discovering that she had the breast cancer gene common to Ashkenazi Jewish women.

Jolie wrote in an Op-Ed in The New York Times that she decided to have the surgery after being told she had the BRCA1 gene mutation and had an 87 percent chance of developing breast cancer.

Jolie’s mother died of cancer at a young age, and Jolie wrote that she wanted to reassure her six young children that she would not die young as well.

“We often speak of ‘Mommy’s mommy,’ and I find myself trying to explain the illness that took her away from us,” Jolie wrote. “They have asked if the same could happen to me. I have always told them not to worry, but the truth is I carry a ‘faulty’ gene, BRCA1, which sharply increases my risk of developing breast cancer and ovarian cancer.”

Late last month, Jolie completed three months of surgeries, including breast reconstruction.

“I choose not to keep my story private because there are many women who do not know that they might be living under the shadow of cancer,” Jolie wrote. “It is my hope that they, too, will be able to get gene tested.

“I wanted to write this to tell other women that the decision to have a mastectomy was not easy. But it is one I am very happy that I made.”

Shimon Peres well after minor surgery

Israeli President Shimon Peres successfully underwent a hernia operation in Tel Aviv on Friday, his office said in a statement.

Peres, 88, was treated at short notice after returning from a trip to Canada and his personal physician said the surgery had been “completely successful”.

The official statement read: “The president has awoken from the operation and feels well. He will remain in hospital during the weekend and is expected to return home on Sunday.”

Though the Israeli president’s role is largely ceremonial, Peres is held in high regard at home and among Israel’s allies as the Jewish state’s elder statesmen. A former prime minister, he was awarded a Nobel Peace Prize for his part in the 1993 interim peace accord with the Palestinians. (Writing by Ori Lewis; Editing by Alastair Macdonald)

‘Dr. Schnoz’ cancels plans for second Jewish nose video

A Jewish plastic surgeon in Miami has dropped his plans for a contest to produce another music video about Jewish noses.

Dr. Michael Salzhauer said he is trying to come up with an alternative contest that would not offend the plastic surgery society or incur possible ethics violations, Religion News Service reported.

Salzhauer is under an ethics investigation for commissioning a Jewish band to write a song about a Jewish teen with a big nose.

Dubbed “Dr. Schnoz,” Salzhauer hired The Groggers, a Jewish punk-rock band, to write a song and make a music video that encourages plastic surgery in a bid to connect to a younger audience. Known as “Dr. Schnoz,” he performed rhinoplasty on the band’s lead singer, L.E. Doug Staiman.

The American Society of Plastic Surgeons called the promotion “offensive and inappropriate.”

“I do understand the ASPS’s point of view, though my intention was not to hurt anyone’s feelings, but to have a little fun,” Salzhauer told RNS.

He is continuing to offer scholarships to Orthodox Jewish singles for nose jobs to help them land a spouse.

Smelling a simcha: Surgeon pushing marriage with grants for nose jobs

A Jewish plastic surgeon in Miami has offered scholarships to Orthodox Jewish singles for nose jobs to help them land a spouse.

Dr. Michael Salzhauer, who is under an ethics investigation after commissioning a Jewish band to write a song about a Jewish teen with a big nose, recently announced his outreach program to help bring couples together—a program that CNN has dubbed “nose jobs for nuptials.”

Salzhauer, 40, mandates that applicants must be referred by their matchmakers or rabbi, who must verify financial need. The patients must meet medical, aesthetic and psychological criteria as well in order to be eligible for surgery, CNN reported.

Salzhauer told CNN that he has 15 potential scholarship patients lined up.

Salzhauer hired The Groggers, a Jewish punk-rock band, to write a song and make a music video that encourages plastic surgery in a bid to connect to a younger audience. Known as “Dr. Schnoz,” he performed rhinoplasty on the band’s lead singer, L.E. Doug Staiman.

The American Society of Plastic Surgeons called the promotion “offensive and inappropriate.”

A recent column in the Jewish Press calling for women to have plastic surgery in order to increase their marriage chances sparked a lively conversation in the Orthodox community.

Israeli injured in New Delhi attack stable following surgery

The Israeli diplomat’s wife wounded in a car bomb attack in New Delhi is in stable condition following surgery to remove shrapnel.

Tal Yehoshua-Koren, the wife of an Israeli Defense Ministry representative to India, reportedly woke for the first time on Tuesday, a day after the bombing. The bomb reportedly was attached to the car by someone on a motorcycle and detonated remotely while she was riding.

Some reports say that Koren realized what happened and began exiting the car before the explosion. She was taken to the hospital by rickshaw, Ynet reported. She could soon return to Israel, according to reports.

The Associated Press reported that the shrapnel was removed from her spine and that she has partial paralysis in her legs.

Also Tuesday, India’s home minister condemned the attack, saying that “Diplomats of every country are entitled to live and work here in peace and security.” He said the attack was carried out by a “well-trained person.”

Indian and Israeli security authorities are cooperating and sharing information, Israel Radio reported.

Israel has blamed Iran for the attack.

Gilad Shalit undergoes surgery to repair abduction injuries

Gilad Shalit has undergone surgery to repair wounds from his 2006 abduction.

The successful surgery Friday at Rambam Hospital in Haifa removed seven pieces of shrapnel in Shalit’s hand, according to news reports.

Shalit was released from captivity two and a half weeks ago in exchange for over a thousand Palestinian prisoners. He will spend his second weekend of freedom at Rambam for observation.

Earlier this week, a lawmaker from the haredi Orthodox Shas Party, Menshulam Nahiri, criticized Shalit for not spending his first weekend in synagogue.

Pollard recovering after surgery

Jonathan Pollard is recovering after successful surgery.

Esther Pollard, the imprisoned spy’s wife, told The Jerusalem Post on Wednesday that he was “conscious and aware” for what she had termed as “urgent” surgery having to do with his kidneys and gall bladder. She also said the surgery was a “temporary fix.”

Pollard, who was sentenced to life in 1987 for spying for Israel, was removed Tuesday from the federal prison in Butner, N.C., for the surgery. He has been in poor health, including a deterioration of his kidney problems.

Esther Pollard had come from Israel to North Carolina to visit him before the surgery.

Israel’s ambassador to the United States, Michael Oren, visited Pollard in prison last week.

Pollard called on Oren to seek his release from President Obama. Pollard was not allowed to visit his father on his deathbed or to attend his father’s funeral earlier this summer, despite appeals from Israeli officials and supporters. Previous presidents have similarly refused such requests.

Pollard was a U.S. Navy civilian analyst when he was arrested in 1985 for spying for Israel.

Rep. Barney Frank (D-Mass.) in a short speech Monday on the U.S. House of Representatives floor reiterated a call he led last year to show Pollard clemency.

“I believe that in addition to the arguments based on the excessive length of the sentence, I think the fact that Mr. Pollard has served for so long, clearly the deterrent effect is there,” Frank said. “We are not asking that he be pardoned, we are not condoning his crime. We are saying that in addition to the personal argument, it would be a sign of U.S.- Israeli relations that I think would help strengthen the climate for peace.”

Frank initiated a letter to President Obama last October calling for Pollard’s release. It was signed by 37 Democrats in Congress.

Since then, a number of retired government officials of both parties and at least two Republicans congressmen have made similar calls for Pollard’s release.

Jonathan Pollard has “urgent” surgery

Convicted spy for Israel Jonathan Pollard was taken to a civilian hospital to undergo surgery.

Pollard has been in poor health, including deterioration in his kidney problems. His wife, Esther, had come from Israel to North Carolina to visit him before what has been described as “urgent” surgery.

Pollard was removed from the prison Tuesday for the surgery, according to Israeli news sites. The federal prison in North Carolina would not confirm that Pollard had been taken to a hospital. 

Israel’s Ambassador to the United States Michael Oren visited Pollard in prison last week. Pollard called on Oren to seek his release from President Obama.

Pollard was not allowed to visit his father on his death bed or to attend his father’s funeral earlier this summer, despite appeals from Israeli officials and supporters.

Pollard was arrested in 1985 and is serving a life sentence.

Surgery Prompts Examination of Jewish Concept of Soul

Surgery is wrong. This was what I convinced myself over a two-year stint of excessive holistic health care. Thanks to an imbalanced reliance on acupuncture, I neglected a herniated disc until it ruptured somewhere between Washington, D.C., and Salvador, Brazil. When I found out I needed surgery, I was forced to evaluate what, exactly, I saw wrong with cutting a human open and realigning her interior.

In my case, I was sliced open near the jugular, a clear 1-inch incision along the front of my neck. The doctor slid my muscles and esophagus to one side, sucked out the ruptured disc with a vacuum, and inserted a dead man’s hip bone, molded to the size of my previous disc. To finish the job, two titanium screws were attached; I was stuck back together and sent on my way.

What was wrong with surgery, I decided, were the negative effects it might have on my Jewish soul. If the body is a temple, what happens when you slice it up and insert foreign particles into its infrastructure? And what about the new disc I was given: Whose bone was it? Most likely, based on statistics, I was convinced I housed a Christian man’s hip bone between my C5 and C6 vertebrae.

I chose my neurosurgeon based on a number of factors — his capability, his reputation, whether his hands looked trustworthy. I also noted how, when I worried out loud about this dead person’s body part taking over my spirit, he did not laugh; rather, he entertained my ideas. The neurosurgeon explained that the energetic body of the bone he would use was negligible, thanks to serious reshaping and a year, at least, sitting in formaldehyde.

This sufficed to keep me on the operating table, but I was not convinced. Images of Whoopi Goldberg in the movie “Ghost” flashed through my head. I imagined myself being overtaken by the spirit of the bone donor, just like a medium channeling the dead. For answers to this conundrum, I contacted rabbis far and near. I wrote the following in an e-mail:

Dear Temple Israel of Hollywood,

I am looking for a rabbi who might be able to help me answer the following questions:

What is the Reform Jewish perspective on using cadaver bones in surgery?

Often when people get spinal surgery they need a cadaver bone placed in their body. What is the rabbinical take on the spiritual entity of skeletal matter? What happens to a Jew when a Christian bone is placed in their body? Is there a piece of someone else’s soul in the new bone? Or is the bone just bone, the body just body, the spirit left intact?

The synagogue was very helpful and sent me on to a professor, who they insisted was an expert on “this topic.” This topic, I am guessing, would be the spiritual entity of bones and their handling. I wrote the suggested professor a letter. It read:

While I am aware of the importance, in lieu of Jewish law, of the preservation of the cadaver and the burial laws therein, I am most curious about the so-called “spiritual entity” of the bones themselves.

What happens when a Jewish woman has a Christian man’s bone surgically placed in her neck to keep her from paralysis? Is there a spiritual shift in the individual? What does a bone hold, energetically, religiously, that may alter the system of the living individual? Is she still a Jew, even with a Christian bone and, in some cases, titanium in her neck?

I received a near immediate response from the professor. The initial answer was glib:

Dear Ms. Gerson:

The subject you raise is of no interest to me and I have never explored it.

But this was followed with the insightful: I believe that when a bone or other organ is transplanted, it becomes part of the host’s body and thus thoroughly and completely part of that

This left me to believe that I was, in fact, channeling the dead Christian man I imagined to have donated my neck bone. Only according to this, he did not visit my body like in “Ghost,” or take it over; he sort of wed my spirit, in the biblical sense. I am no longer alone, or he isn’t; we exist together from my C5-C6 vertebrae on.

What the rabbis I encountered revealed was really the issue not of my soul, but that of the dead person whose hip graft was living in my neck. Reb Nadya Gross of Pardes Levavot, a Jewish Renewal congregation in Boulder, Colo., politely suggested I burn a yahrzeit candle for this person, hoping to unite the soul with the now-dismembered body. This dismemberment of human form was the fundamental issue: Jewish burial law insists a body be buried intact. This means, sans hip-bone chunk, my bone donor was in some sort of Judeo-Christian limbo purgatory.

According to a Central Conference of American Rabbis responsa regarding liver transplants: “The harvesting of organs from deceased persons might well conflict with another central Judaic value, that of kevod hamet, the obligation to respect the dignity of the dead.”

The Halachic Organ Donor Society (” title=””> and


UCLA’s new hospital takes technology to new frontiers

More than eight years and $829 million in the making, the new Ronald Reagan UCLA Medical Center is scheduled to open its doors to patients on June 29. The 10-story, 1-million-square-foot complex — which houses the The Ronald Reagan UCLA Medical Center, Stewart and Lynda Resnick Neuropsychiatric Hospital at UCLA and Mattel Children’s Hospital UCLA — features vast, light-drenched spaces and an airport terminal-sized corridor that connects the three centers.

But what’s more impressive about the new center are the elements that most visitors won’t see. Many of these features involve electronic gear and wireless technology, particularly in the hospital’s 23 operating rooms. Especially striking is how bare the operating rooms look. No equipment sits on the floor. Instead, it is suspended from the ceiling by movable booms. Two flat panel monitors, lights, an anesthesia station and a surgeon’s computer control panel all hang down from above.

During a procedure, surgeons can use a touch-screen panel or voice commands to display and control images, adjust room lighting, or phone a colleague. They can access patient histories, X-rays and lab results, and use their fingers on the console to draw — just like a football commentator — on images displayed on a screen.

Multiple cameras record activity in the room, the operating site, and — using an endoscopic camera when appropriate — the patient’s insides. These images can be saved on DVD, shared with a colleague in the next room or across the globe, or transmitted to medical students in a viewing theater two stories below. The fiber optics and other cables necessary for the room’s extensive connectivity fill a phone booth-sized box located against one wall.

The hospital was designed for “efficiency, control and connectivity,” said Dr. Peter Schulam, chief of the Division of Endourology and a member of the design committee for the operating rooms. He said the design process reflected an unusual collaboration between medical staff and equipment manufacturers.

“The companies we worked with were our partners in designing everything,” Schulam said. “Nothing was off-the-shelf.”

The new hospital replaces the one built in 1951 to herald the atomic era. That facility was designed and constructed at a time before CPR, kidney transplantation or open-heart bypass surgery, and without magnetic resonance imaging, laparoscopy or the Internet. Then, as now, planners had to anticipate the needs of the hospital decades into the future.

Schulam said it was challenging to plan a hospital that would take years to build, not to mention one able to adapt to future decades of technological innovation. To ensure that operating rooms can change as future needs dictate, they were designed to be physically and technologically flexible, allowing reconfiguration as needed.

Already, new developments have occurred since the planning process began.

“When we started design, high definition didn’t exist,” Schulam said.

Now four operating rooms feature HD, complete with 42-inch wall-mounted plasma screens.

He said that while UCLA can currently claim the most state-of-the-art hospital in the country, that will change when the next major teaching university builds a new facility.

“It’s a leap-frog effect,” he said, noting that UCLA benefited from observing previous new research hospitals.

The new medical center came about because of the 1994 Northridge earthquake. The university chose to rebuild, rather than retrofit, the hospital in order to meet new seismic safety requirements. The facility can not only withstand a magnitude 8.0 earthquake, but remain functional after doing so.

The Federal Emergency Management Agency provided $432 million in earthquake relief funding for the hospital, and the state kicked in another $44 million. Private donations accounted for nearly $300 million, and the balance came from hospital financing and bonds.

Reflecting input from more than 500 physicians, nurses and patients, the hospital was designed by celebrated architects I.M. Pei and his son C.C. Pei, along with a team headed by commercial architect design firm Perkins+Will, Pei Partnership Architects and RBB Architects.

Each of the 520 inpatient rooms boasts a sweeping view of Westwood or the UCLA campus, offers wireless Internet and features a fold-out sofa for overnight guests. The rooms can adapt to various levels of care, minimizing the need to transfer patients from one room to another. If patient transport becomes necessary, the patient’s bed — rather than a gurney — serves as the vehicle. Mobile units featuring medicines and IV fluids are also portable, and travel with the patient from one location to another.

A sophisticated electronic records system provides medical staff with immediate access to patient reports, lab results, clinical imaging and real-time vital sign monitoring from any hospital location.

But with all the technology it contains, the hospital is ultimately about the people it serves, according to Dr. James Atkinson, professor of surgery and senior medical director for the transition from the former facility to the new hospital.

In the medical center’s June 4 dedication ceremony program he stated, “Now that we have our building, it is time for us to breathe life into it. It’s up to us to walk the halls, to fire up the machines and to start doing what it is we do best here at UCLA: healing people. Once that happens — once we’ve saved our first life in the new building — we’ll have fully transformed our original vision into reality.”

Jewish women change their destinies by testing for genetic mutation

Erika Taylor didn't want to know whether she had the breast cancer gene.

“My thinking was I would never get a prophylactic mastectomy,” Taylor, 44, said of the idea of removing her breasts as a preventive measure. “I just thought it was horrible thing to do to myself, and if I was unwilling to do that, why bother finding out?”

[RELATED: Women support each other in navigating genetic risk]

Her grandmother died of breast cancer at 56, and her mother battled and beat the disease in her 30s. Taylor, who is single and the mother of a 14-year-old boy, always suspected cancer was in her future, but taking steps to confirm that was not something she wanted to do. Until she got her own diagnosis.

A routine mammogram last November revealed early stage noninvasive cancer cells in Taylor's milk ducts, making information about her genetic status vital for determining her treatment.

“All of a sudden, the idea of 'I would never do such a thing' goes out the window,” she said. “It's astonishing how quickly you go, 'OK, OK, what do I need to do? I'll do it.'” Taylor's mother tested first, and when she was identified as a carrier of the BRCA 2 genetic mutation common in Ashkenazi Jews, Taylor tested next. In January, she found out she, too, carries the gene that makes it likely that even if she were to rid herself of her diagnosed cancer, it would probably recur.

Like a growing number of women, Taylor faced both the gift and the terror of knowledge.

One in 40 Ashkenazi Jews — compared to one in 500 in the general population — carries a mutation that gives women a 50 percent to 85 percent chance of getting breast cancer by the time they are 80. The genetic mutation, discovered in 1994, also increases the likelihood of melanoma and ovarian, prostate or pancreatic cancer. While within the general population about 5 percent of cancers can be attributed to a hereditary syndrome, in the Jewish community, that number is closer to 30 percent.

Surgery Offers Hope to Dystonia Victims

Twelve-year-old Josh Gaskin walks to the front door and shakes a visitor’s hand. While this gesture would seem routine for most adolescents, two years ago it would have been impossible for Josh.

By the time he had reached the fourth grade, Josh’s dystonia caused his right hand to involuntarily clench into a fist so tight that he could only open it by force. His feet turned inward, requiring him to wear braces. The symptoms had forced Josh to quit his baseball and basketball teams after six years of playing, leaving him depressed and angry.

Josh’s mother, Andrea, had read about an unusual procedure that might hold hope for her son. Deep brain stimulation (DBS) involves placing tiny electrodes deep in the brain. The electrodes are connected by wires running internally down each side of the neck to small pulse generators implanted under the skin of the chest.

The electrical pulses disrupt the brain signals that cause involuntary movement. The procedure had been used extensively to relieve Parkinson’s disease symptoms, and had recently been found to help some dystonia patients.

Andrea was intrigued. Still, DBS involves multiple surgical procedures. At the time, few procedures had been done for dystonia patients, and only a handful of them had involved children.

“Deep inside, I knew that this was going to be for us,” she said. “My husband was more hesitant…. You’re dealing with the brain and things can happen.”

But Andrea felt strongly. “The way I looked at it, why let it get worse before I make him better. The more your body starts twisting, the harder you have to work to put it back to what it was,” she said. “I didn’t want him go through any more suffering.”

In April 2004, Josh underwent DBS surgery at Mount Sinai Medical Center in New York. During the procedure, a metal halo was screwed into his skull to assure no movement. The doctor drilled a small hole in Josh’s skull and inserted the electrodes.

Josh was a awake for much of the six-hour surgery, because his doctors needed to ask him questions in order to place the electrodes most effectively. Two days after his surgery, Josh’s doctors inserted batteries into the device.

By the following day, Josh was able to play video games with his father at Times Square’s ESPN Zone. Within a month, he could walk without the foot braces. He began shooting hoops and hitting baseballs.

“I had forgotten how it felt to open my arms,” Josh said. “It felt good to go back to normal.”

Josh suffered a setback last June, when one of the leads caused a leakage of brain fluid, and the apparatus on one side of his body had to be removed. Within six months, his walking was worse than it had been before the surgery.

Last March, he returned to New York to have the device re-implanted, and has been slowly improving ever since. He can write again. He plays basketball and runs track at school. He hopes to re-join a sports league, and is practicing his skills. His speech remains slurred as it was prior to the surgery, but he hopes that it, too, will slowly improve.

Each month, Josh must visit the doctor to have his electrical settings fine tuned. He will need surgery to have his batteries replaced every three to four years.

Nevertheless, neither Josh nor his mother have any regrets. “It’s not for everybody, but for us, this surgery has been a blessing,” Andrea said. “We’ve seen a big improvement.”

Before the procedure, “I was angry, mad and sad. I didn’t know why I had [dystonia],” Josh said. “Now, I have a better outlook.”

As he recounted his story, Josh was asked about scabs on both his knees. They weren’t from surgery. He had been fooling around on his parent’s treadmill, put it on maximum and fell. Just like any other normal 12-year-old kid. — NSS


Laser Heart Surgery

My only decent pair of glasses broke en route from Los Angeles to Israel, and I took it as a sign — it was time to for corrective laser surgery, a.k.a. LASIK.

“Make sure on the day of surgery someone comes with you,” the Israeli receptionist said to me after I set my appointment.

Great. Who would I call on to come with me? If I lived in Los Angeles, someone in my family would have shepherded me. But I wasn’t comfortable asking my family in Israel to escort me.

Since I’d be wearing eye patches after the surgery, I’d at least need someone to pick me up. And since I’d be done at 4 p.m., I asked my friend Tovy to leave work an hour early to pick me up. She said it was no problem.

The surgery day arrived. As I waited on the sofa in the main office, I saw a young woman leave the surgery room with her eyes covered, her boyfriend holding her hand, guiding her.

How nice, I thought. He’ll probably make her tea when she gets home and sing her a lullaby.

I don’t need anyone, I thought. However, I did need a valium, and lucky for me it was procedure to give patients one before the surgery.

The nurse sat me down outside the surgery room and dropped an anesthetic into my eyes. I saw the blurred image of a teenager across from me.

He had just had his eyes zapped.

“How was it?” I asked.

“Scary,” he said.

“Really?” I asked, surprised.

The doctors, technicians and receptionists all made it sound like the surgery was simple, quick and painless.

Then his father took his hand and led him out. That’s OK, I thought to myself. I still didn’t need anyone to hold my hand.

When it was my turn on the operating table, the doctor pried my eyelids open with a metal tool and then stuck some sort of lens onto my eye.

“You shouldn’t see anything now,” he said. “That’s normal.”

A round cylinder latched onto the lens and mechanically cut a flap on my cornea; this created a window for the laser to enter. As the machine cut my cornea, I saw black and white circles, as if it were twisting and turning my eyeball.

He repeated this procedure on the other eye. I dug my fingers into my thighs to channel the pain elsewhere.

“Now, we are moving onto the laser portion of the surgery,” the doctor said. “This will be less painful.”

“You mean it’s not over?” I asked.


I stared above and green and red dots of light seemed to shower my bullied eyes. As the laser sculpted my cornea to perfection, I heard a buzz and felt hot splatters my cheeks.

Done but dazed, I limped to a reclining chair in a post-op waiting area.

“Keep your eyes closed,” the nurse said. “Is someone here with you?”

“She’s supposed to come,” I said.

It was 4:15 p.m. and no sign of Tovy.

Unable to look outside, I looked deep inside: Wouldn’t it be nice to have a dedicated boyfriend right now? A real partner? Why have I shut out love for so long? Wouldn’t life in Israel be easier if I opened myself up to love — not just a romantic thrill — but to a supportive, loving man who will hold my hand in times like these?

Where the hell is Tovy?

Tears started gushing down my face. They were supposed to be a natural side-effect of the surgery, but they seemed exacerbated by my momentary, stinging sensation of loneliness.

“Tears are pouring,” I told the nurse.

“Excellent,” she said. “Make yourself cry.”

This was one of those rare moments when it’s good for your physical health to bawl.

Tovy had trouble finding the office. When she finally arrived, she held my hand and comforted me. The tears continued to stream, but they had transformed from tears of loneliness to tears of healing. I had my health, I had good friends and I no longer had four eyes.

Maybe now that my eyes are fixed I’ll be able to envision a true and lasting romance. But it will probably take more than 10 minutes with a laser beam to smooth out my heart’s irregularities. And yet as I begin to see the world and myself more clearly, I think maybe it’d be nice to have someone hold my hand and, sometimes, wipe my tears.

Orit Arfa is a freelance writer based in Tel Aviv.


C’mon Get Happy


Before she inspired her father’s debut film, “Smile” — a feature about an American teenager who goes abroad to help children with facial deformities — Katie Kramer was a normal, popular student at Malibu High School.

“I had a boyfriend, I had friends, I shopped,” she said. “I lived in a world where a lot of material things were important, but I always knew that other things were important and that there was more inside of me to give.”

Kramer found it when she signed up for a school club, Operation Smile, a Virginia-based charity that provides free reconstructive surgery for children in Third World countries. In 2002, she left her family’s five-bedroom ranch house for a hospital in the Philippines, where she worked 18-hour shifts helping to facilitate operations.

“It was a shock,” she said of her initial experience. “I walked into a room filled with 75 children who had facial deformities, all of whom had been ostracized, some of whom had walked for days to reach the hospital. But I told myself not to cry, because I realized I could help make a difference in their lives.”

Kramer, now 19, returned home determined to become a doctor and to remain active in charitable causes — a change that prompted her father, actor Jeffrey Kramer, to turn her emotional journey into a film.

Unlike the real Katie, who worked to help pay for her black Volkswagen Jetta and also intensely trained as a competitive ice skater, the fictional Katie is selfish and high-maintenance, but she finds her heart as she befriends a Chinese girl who had been abandoned as a newborn because of her cleft palate.

The director learned about dozens of such stories while interviewing Operation Smile personnel — as well as psychological traits he brought to his characters. “The children who come in for surgeries hide their faces, and they hide themselves emotionally,” he said. “Afterward, they feel emotionally free for the first time in their lives.”

Katie Kramer, like “Smile’s” heroine, found her own transformation to be dramatic.

“The typical teenage problems that used to trouble me have become so unimportant,” she said.

“Smile” opens today in Los Angeles.


Breast Cancer Tips Doctors Don’t Share

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

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

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

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


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

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

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


The best hair substitute for nighttime: ski caps.

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

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

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

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

Not-So-Glorious Food

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

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

Chemotherapy tends to make people anemic, so think Atkins.

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

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

Emotional Rollercoaster

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

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

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

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

All in the Family

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

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

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

Beam Me Up, Scotty

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

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

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

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

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


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

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

Teen Victims Tell Their Stories

On June 1, 2001, Larisa Azyaski stood with her best friend Irina Nepomnyaschy among a sea of teenagers clamoring to get into the Dolphinarium, a popular Tel Aviv club. Suddenly, the place exploded. A suicide bomber detonated himself, and Azyaski saw only darkness in front of her. She felt like her head was on fire. Disoriented and separated from her friends, she walked past dozens of motionless bodies and managed to escape the chaos.

The then-16-year-old hailed a cab and rushed to the nearest hospital, where she underwent a six-hour operation to remove pieces of shrapnel lodged in her back, legs and ears. When Azyaski awoke from her surgery, her parents informed her that her best friend was dead.

Unlike Irina, Azyaski, now 18, was among the so-called lucky ones of the Dolphinarium bombing, where 21 people — mostly teenagers — were killed. And while the families of those who died in the blast are left with memories of their loved ones, Azyaski and six other young survivors who visited Los Angeles in early November are still learning to cope and move beyond the impact of that tragedy.

The seven girls, most of whom are Jewish Russian immigrants living in Israel, and a mother who lost her only child in the attack, spent more than a week in Los Angeles as part of the 10 Days of Hope project. The trip was sponsored by StandWithUs, a Los Angeles-based grass-roots organization that supports Israel, and Green Dog Films, a local production company. Staying with host families, the girls and the mother, who came in her daughter’s place, flew to Los Angeles to share their stories with local schools and other community groups. With limited access to medical care in Israel, the girls secured appointments with Los Angeles doctors and dentists who helped to treat some of their injuries free of charge. In addition, they spent time at Universal Studios, Disneyland and in Hollywood — and even had a day of beauty. But even exciting activities and the support of their new surrogate families couldn’t suppress the girls’ thoughts of their troubled past.

"I used to be very happy and full of life," Azyaski told The Journal through a Russian translator while eating at Pat’s in Pico-Robertson. A mixture of sadness and anger filled her pretty blue eyes. "Now I feel like an old, sick antique that nobody wants."

Pain is an everyday reality for Azyaski, who takes Advil every three hours to relieve the pressure of the sharp pieces of metal lodged mostly in her legs and back. The metal is actually nickel, which is difficult to remove. Instead, her body has to naturally expel the material, which can take years. Besides extensive nerve damage, constant pain and hearing loss, Azyaski has a six-inch scar on her left calf, as well as several scars on her lower back where sharp pieces constantly and painfully make their way to the skin’s surface.

Clad in an oversize gray turtleneck sweater, Azyaski seemed self-protective, but it’s clear that the bulk of her suffering is of the emotional kind.

For Karina Krasnopolnaski, 17, who was out celebrating her 15th birthday on the night of explosion, unsightly scars have made the attractive teenager doubt her self-worth when it comes to the opposite sex. Krasnopolnaski was recently devastated when a potential suitor made a negative comment about a large scar on her thigh. Since then, she intentionally chooses clothing that covers her upper legs.

Low self-esteem was a common thread among the young victims. With an abundance of physical and emotional scars, they see themselves as defective, cheated and unwanted. As such, getting back to "normal" means reinventing a sense of normalcy. After the attack, Azyaski’s dreams of joining the Israeli army with Irina and opening a home for abandoned children were destroyed. Her back and leg injuries prevent her from standing or sitting for more than 20 minutes at a time, which makes it hard for her to secure any kind of a job — even part-time work as a waitress or a clerk.

Her options greatly narrowed, Azyaski is currently pursuing the equivalent of a community college degree in accounting, a subject she hates. She is also working through a deep depression that followed her mother’s death from breast cancer last summer. Azyaski’s new life consists of completing her studies and desperately searching for a job to help support her father, her older sister and her sister’s husband, with whom she shares a small apartment in Rishon LeZion. Moving on means trying to let go of the guilt she feels for the deaths of Irina and her mother.

But the teenagers react differently to the bombings.

Unlike Azyaski, Tanya Weiz, 20, says that the tragedy made her stronger. Weiz was standing in line with three friends the night the explosion occurred. The first thing she remembered was touching her neck and finding that four of her fingers slid inside a gaping wound there. A passerby helped her get to the hospital where she endured an eight-hour operation to remove three iron balls that were lodged in the delicate tissues of her neck.

There is an air of proud defiance when she moves her shirt aside to display her scar.

"Before, I used to hang out with people who had no interest in real life," said Weiz, who was not expected to speak again; she is currently studying to be a hair stylist. Since the incident, Weiz, whose jet-black hair and black clothing give her a "goth" appearance, has re-evaluated her friendships.

"My whole perspective changed," said Weiz, who also lost her best friend in the attack. "I believe I was born on June 1."

"In order [for them to have] a fully normal life, we’d have to make sure nothing happens in Israel," said Yan Fisher Romanovsky, a Los Angeles independent producer who served as the trip coordinator, chaperone, translator and personal confidant to the girls during their stay. "Every time they hear about an explosion, [the memories] come back. Also, by living there, you have an everyday chance of getting into the same situation again."

At the age of 18, most Israelis enter the army, but physical limitations force these girls must find a different path. They’re the newest unwitting warriors in Israel’s battle with terrorism, but they are voices that are rarely heard.

One person who wants to help them is Jason Gurvitz, the founder of Green Dog Films. While filming "Internal Exile," an upcoming documentary about young Israelis and Palestinians, Gurvitz and his crew met representatives from several Israeli philanthropic organizations, including the Mikhail Chernoy Foundation, who asked them to make a second documentary about the teenage victims of the Dolphinarium bombing. The project involved bringing the girls to the United States to talk about their experiences and treat them to 10 days of hope and healing. Gurvitz recruited StandWithUs for additional support and hopes that the program will continue for years to come.

"I think that young people’s voices are severely underrepresented," Gurvitz said. "The American public hasn’t heard the personal stories from the people who were involved directly." With the "10 Days of Hope" documentary, Gurvitz wants to inform young Americans about the tragedies in Israel.

"Most young people in the U.S. became aware of the conflict in Israel with the Dolphinarium attack because they hear the word ‘discotheque’ and that’s something they’re familiar with," he said, adding that most public schools don’t even teach students about the Israeli-Palestinian conflict.

For StandWithUs, educating the community at large about terrorism in Israel was one of the goals of the girls’ visit.

"People don’t talk about the pain and suffering for the survivors," said Roz Rothstein, the organization’s executive director. While the girls shared their stories with Shalhevet High School, Milken Community High School, The Jewish Federation of Greater Los Angeles and Temple Beth Am, Rothstein believes that it’s the larger American community that desperately needs this education.

"The Jewish community performs a duty of loving [these victims]. They’re the family," Rothstein said. "But, the broader community needs to learn about it."

Rothstein felt that part of the mission was realized when KTLA broadcast the girls’ story during a recent news segment.

Playing the role of the dutiful family, 200 members of the Jewish community gathered inside the Temple Beth Am ballroom on Nov. 12, the eve of the girls’ departure from Los Angeles. StandWithUs board members, UCLA students from Bruins for Israel, local high school students, representatives from the local Israeli consulate and concerned members of the community at large crammed inside the large room to support the young survivors. Like proud parents, the crowd cheered as each girl made her way to the microphone to thank the host families and other benefactors. The mood grew solemn when Faina Yaakovlev, 16, sang a moving song that she wrote about her memories of the attack. Ma’ayan Friedman and Natalie Naor, seniors at Shalhevet, were so moved by the girls’ visit to their school that they came to see them one last time.

"Your strength invigorates us," Shiran Zohar from Bruins for Israel told the girls. "You are our heroes."

The applause was deafening.

While all the girls commented on how safe they felt during their stay in Los Angeles, none wants to leave Israel and give in to terrorism. "Everywhere is scary," Victoria Aguerenko, an 18-year-old victim, told The Journal in Russian. "There is no 100 percent anywhere."

During her last night in Los Angeles, Azyaski was in high spirits. Clad in a black, sparkling evening gown with her blond hair styled, there was a marked change in her demeanor.

"Being here has changed my life," she said with a smile, clutching her new Kabbalah pendant necklace, a gift from her host family to symbolize their unconditional love. "Here I found a different world and it gave me a lot of strength and power to continue living, and prove to everyone that no matter what, life will go on."

For more information on the 10 Days of Hope program, contact StandWithUs at (310) 836-6140.

Chains of Support

Two days after her radical breast cancer surgery last May, Missy Stein hit that moment where all the emotional and physical implications of her condition came crashing in on her.

But then she remembered Sari Abrams’ words.

In a phone call before the surgery, Abrams, who had a similar surgery four years before, had warned Stein that there would be one day that would be tougher and bleaker than any before it. Just get through that day, Abrams told her, and you’ll be fine.

“It was really so helpful having the preparation and knowing what was coming, so I didn’t have that fear of the unknown going in,” said Stein, a 36-year-old mother of five from Aberdeen, N.J.

Stein and Abrams found each other through Sharsheret (Hebrew for chain) a year-old organization that sets up links between young Jewish women with breast cancer so they can offer support and knowledge gained through experience.

“I strongly believe in the positive effect of social support on the outcome for cancer patients,” said Abrams, who was diagnosed at 30 and again at 33, and had a baby boy when she was 37. “It’s so helpful to know that others are going through the same thing and have gone through it and survived and come out of it OK. I feel like this is my part in this chain, being part of the so-called sisterhood of breast cancer survivors.”

The match between Stein and Abrams is one that Sharsheret founder Rochelle Shoretz holds up as a remarkable success. Not only did the two have similar diagnoses and treatments, but both were the wives of rabbis.

Abrams, the wife of B’nai David Judea’s Rabbi Yosef Kanefsky, answered many of Stein’s questions about the surgery and helped quell some of Stein’s fears about how to tell the community while keeping some measure of privacy when so many people wanted to help. The rabbis also spoke directly with each other.

Shoretz, an Orthodox mother of two, came up with the idea of Sharsheret after she was diagnosed with breast cancer at 28, when she was a clerk to Supreme Court Justice Ruth Bader Ginsberg.

“When I was diagnosed, one of the first things I wanted to do was to speak to someone my age with my background who was experiencing what I was experiencing, and it was very difficult for me to find another young Jewish woman with whom to speak,” said Shoretz, who lives in Teaneck, N.J. Eventually friends put her in touch with Lauryn Weiser, who now serves as Sharsheret’s link coordinator.

“We talked about everything from the side effects of chemotherapy to community support to coping with parents and children and husbands. I used her as a resource for everything I was about to experience,” Shoretz said.

Doing more research, Shoretz found that while there were organizations that linked cancer patients with each other, mostly based on diagnosis, none met the specific needs and experiences of young Jewish women.

“We ask women who call in what their biggest concerns are, what their biggest fears are and what they would like to speak to someone about and we do our best to find them a match,” Shoretz said. “Some women just want to draw religious strength from one another.”

Observant women might share experiences relating to mikvah or sexuality. Single women might want to talk about dating after mastectomy. Young mothers may talk about taking care of the children while on chemo. Some callers have been women who don’t have breast cancer but are carriers of the genetic mutation found in many Ashkenazim that can portend breast cancer.

About 60 women, from Chasidic to unaffiliated, have been paired up through Sharsheret so far, and the organization has fielded more than 500 phone calls from people and other organizations who want to find out more.

In its first year Sharsheret raised and spent about $100,000. Aside from a recently hired part-time administrator, the entire staff is volunteer.

The organization has come to occupy an important place in the cancer community. Early on Shoretz formed an alliance with the American Cancer Society, which she has spoken to on several occasions about Jewish issues. Sharsheret is currently featured on the Web site of UCLA breast specialist Dr. Susan Love ( This month in New York, Sharsheret is sponsoring its first conference, a symposium on fertility and cancer held at Cornell Medical School and co-sponsored by the American Cancer Society, the Cornell Institute for Reproductive Medicine and Hadassah.

At the American Cancer Society’s Making Strides walkathon, Sharsheret has a 100-person team walking in Central Park. This month, Breast Cancer Awareness Month, Shoretz is busy responding to an upsurge in media interest in breast cancer among young women, who face much different prognoses and emotional issues than older women.

About 250,000 women under the age of 40 currently are living with breast cancer, and about 1,300 a year die. Among young women, the disease is often more aggressive, and often caught at a more advanced stage, than among older women.

Missy Stein, whose mother is also undergoing treatment for breast cancer, said Sharsheret’s focus on young women has been important to her.

“We’re all young people with, God willing, long lives ahead of us, and there is a vitality and upbeat attitude that I found in Sharsheret over and over that makes it an important organization for younger women,” Stein said. “To have the opportunity to walk with each other this whole crazy journey is a wonderful thing.”

Joined by a Kidney

On the anniversary of Sept. 11, we offer a pancultural exchange with a happy ending.

Back in November, UP FRONT reported about Patricia Abdullah, a Caucasian woman of Muslim faith who, after leading an unsuccessful search for a type O-positive kidney donor for acquaintance Mike Jones, an African American Christian, ultimately donated her own kidney. The Sept. 25 procedure was performed by Jewish and German surgeons at Cedars-Sinai Medical Center, a hospital founded by Jews.

Nearly a year after their surgeries, Abdullah and Jones are leading happy, healthy lives and stay very connected.

"She’s truly a blessing," Jones, 42, said. "She’s one of God’s angels. She gave me the ultimate gift that a person can receive."

"It’s been amazing," Abdullah, 54, said. "Mike and I seem to share an uncanny knowing of how one another is doing. The doctors told me, the only way we could’ve been a closer match [is] if we had been born together from a single cell."

Following their surgeries, Jones and Abdullah participated in a triathlon to raise awareness and money for the Dina LaVigna Breath of Life Fund. They are now training together for the L.A. Marathon.

Jones is currently working on a book, "One Miracle," and spreading awareness about kidney disease on cable TV ("The Wright Place") and online (

He shares what he has learned.

"If you believe in your God, everything is possible," Jones said.

So why bring all this up again now? Due to conflicting schedules of the two transplant teams, the surgery was rescheduled to Sept. 25. The original date of surgery? Sept. 11, 2001.

A Miracle Worker

Maria Teresa and Maria de Jesus Quiej Alvarez are twins who were born conjoined at the cranium. Headline-makers since arriving at the Pediatric Intensive Care Unit at UCLA’s Mattel Children’s Hospital in Westwood, the twins were separated in a nearly 23-hour surgery on Aug. 6.

“This single case has captured the global community in a unique way,” Israeli-born neurosurgeon Dr. Itzhak Fried said.

Fried is co-director of the Seizure Disorder Center at UCLA Medical Center and heads the Neurobiology of Human Memory Program in the Department of Psychiatry and Biobehavioral Science. The Tel Aviv native came to America in 1972 to pursue his medical education. His Polish father trained as a Reform rabbi in 1930s Breslau — an outspoken Jew who stirred the pot in Nazi Germany.

“He was arrested by the Gestapo for Zionist activities,” Field said. “He got out of Germany just before 1939.”

Field, his wife and three children divide their time between living on the Westside and in Tel Aviv, where Field created an epilepsy program.

“My work is to set up things there that will improve medical technology in Israel,” said Field, whose passion is researching the central nervous system.

As of Aug. 26, both Marias remain in serious condition with stable vital signs. “There’s a very good likelihood” that they will lead normal, healthy lives, Field said.

“We’re dealing with very young patients. The brain has flexibility at this age,” he told The Journal. “They both tolerated the procedure reasonably well. The team has been cautiously optimistic from the start.”

Field is quick to credit his team of neurosurgeon and plastic surgeons, anesthesiologists and nurses. “The work is really a teamwork,” Field said. “It’s the experience of many people pulling together.”

To donate to the twins’ funds, contact Robyn Puntch at (310) 794-5143 or .

Jewish Law and RU-486

How do Jews and how does Judaism view the recent approval of Mifeprex, a drug combination that can replace surgical abortion in many women?

Well, that depends on whom you ask.

Mifeprex, popularly call RU-486, can be used to terminate pregnancies for up to 49 days, counting from the beginning of a woman’s last menstrual period. A woman first takes 600 milligrams of mifepristone, which reduces the hormonal stimulation of the fetus. Two days later, she takes 400 micrograms of misoprostol, a drug that causes contraction in order to expel the fetus.

Two weeks after using the drugs, the woman returns to the doctor to be sure the pregnancy was terminated; the drug is 92 to 95 percent effective. Women who take the drug will get a Food and Drug Administration-approved brochure explaining how the drug works and what side effects to expect.

“The pills are certainly simpler than surgical abortion,” says Dr. Stephen Schuster, a gynecologist and clinical assistant professor at New York Hospital-Weil School of Medicine, who is also a member of the Association of Orthodox Jewish Scientists. “If the abortion is halachically permissible [permissible under Jewish law], then it’s an additional alternative if a doctor feels sure that the patient will contact the medical office immediately if any serious problems develop.”

Not surprisingly, Reform, Conservative and Orthodox Judaism have different ideas on the circumstances under which abortion is permitted under Jewish law.

“By approving mifepristone, the FDA has successfully placed women’s fertility back in the hands of a woman and her doctor,” says Rabbi David Saperstein, director of Reform Judaism’s Religious Action Center. “The Reform movement has long supported a women’s right to make moral decisions about her own life and her own body with privacy and without fear of government intrusion,” Saperstein said. He added that women will now be able to “use their moral and religious conscience in deciding whether or not to terminate a pregnancy within the comfort of their own homes, surrounded by their families.”

Sarrae Crane, spokeswoman for United Synagogue, which represents Conservative Judaism, was more tentative. “Conservative Judaism does not encourage abortion,” said Crane, “but we don’t believe that there should be obstacles put in a mother’s way either. Abortion is a religious and medical decision, not a governmental one.”

The Conservative Rabbinical Assembly Committee on Jewish Law takes the view that an abortion is justifiable if a continuation of pregnancy might cause the mother severe physical or psychological harm or when the fetus is judged by competent medical opinion as severely defective.

Rabbi Moshe Tendler, considered the leading Orthodox authority on Jewish medical ethics, and a professor at Yeshiva University, has reviewed data on the drug for the past 10 years.

Tendler says that Mifeprex must be viewed in the context of what Jewish law says about abortion, which is that abortion is permitted only when a pregnancy places the mother’s life in danger, and in consultation with a rabbinical authority, says Tendler.

In those situations in which Jewish law would allow an abortion and the abortion can be performed within Mifeprex’s time frame, the drugs are the preferred method, says Tendler, because the abortion is performed indirectly – by depriving the fetus of hormonal stimulation – instead of directly; that is, by surgically removing the fetus.

But Tendler is significantly concerned that Mifeprex will be viewed as a form of contraception – “it is much easier to take a few pills a few days after you become pregnant than to take a pill every day in order to avoid a pregnancy,” Tendler says. But that, he says, is halachically impermissible. “Contraception per se is not a free ride when it comes to Jewish law,” Tendler says. “Not for married folk and certainly not for unmarried folk.”

While the drug would be the preferred method for a halachically approved abortion, it is not the preferred method if it is being used as contraception. “In that case,” Tendler says, “it would be the greater of two evils.”

Dear Deborah

Detail from the cover of “Boy MeetsGirl,” a romance comic book, 1947

Suffocating Sweetheart

Dear Deborah,

I am engaged to a wonderful man whose “littleproblem” has become very, very big during the course of our two-yearcourtship and has grown acute during our engagement. He was always alittle possessive when we dated, but, then, it made me feel loved. Iactually thought it was sort of sweet and sexy, and it made me feelprotected.

His possessiveness has grown into what I feel isan invasion of my privacy that seems, to me, to be not sweet at all.It feels controlling — as if he thinks of me as an incompetentchild. He’ll show up uninvited to a girlfriend-only lunch; he’ll tryto find me a job with a friend of his before I even open theemployment ads; he calls my doctors and asks about test results forme.

When I complain, he says that he is just trying tobe helpful, and asks why I don’t appreciate his love and caring. Ido, but I’m worried about feeling more and more “devoured” by his”caring,” and I’m asking for help in how to deal with it because, atthis point, I feel inclined to hide my whereabouts and activities sothat he cannot butt in so freely — even though I have nothing tohide.

Feels Devoured

Dear Devoured,

“As wolves love lambs, so lovers love theirloves,” wrote Socrates. While you found the wolf at first to becompelling, you are now beginning to feel more like a lamb chop thana lamb. Should you marry him without resolving this now, youundoubtedly will be devoured by his controlling nature.

You must tell him that this issue is seriousenough to cause you to call off the whole deal if it is not resolvedimmediately. Explain in as concrete a manner as possible thebehaviors that are not acceptable to you, and why. Listen to what hesays — whether he is defensive or truly understands you. He may beinsecure and need a little help in some areas, he may have somecharacterological issues that are deeply entrenched, or he may notsee the need to change. If you get nowhere with him, get counselingtogether immediately.

It will take courage to face these issues squarelyand at once, but not to do so will ultimately reduce you from lamb tolamb chop to mucky, little divorce statistic.

Mommie Dearest?

Dear Deborah,

My 7- and 10-year-old sons recently sat me downand told me what I was like when I got angry. They said that Iscreamed a lot, acted like a “monster,” frightened them, and wasentirely different from the “sweet mommy” who usually takes care ofthem. I always knew I had a temper, but I had no idea I was havingsuch an effect. My husband thinks they are just spoiled and don’twant to hear about it when they do wrong.

I am a little confused about how to handlethis.

Chicago Mom

Dear Mom,

The Talmud states that if one person tells youthat you have ass’s ears, pay no attention. But if two tell you,you’d better saddle up.

Whether or not your children are spoiled is notthe issue. Whether or not they don’t like criticism is not the issue(who does?). Rather, the fact that both your children experience yourrage as frightening and deemed it important enough to approach you iswhat counts — that, and your ability to hear them with an openheart.

Yelling is not an effective way to discipline.Either children get scared or feel bad about themselves, and,eventually, they become so inured to yelling that they tune you out.Also, they will learn to be yellers from your example. Learning tomanage anger is the task at hand.

First, when you feel the rage coming on, stop.Notice the buildup of anger. Catch yourself before you hit rage.Collect your thoughts before you speak. Then choose a differentmethod, preferably quieter and with less blame. Use consequencesrather than fear. “You may not go out and play until your rooms areclean.” “No TV until the homework is done.” “Here is ashmatte. Now goclean up what you spilled.” In other words, actions should havelogical consequences that teach children responsibility.

If you lack the necessary self-control to stopyelling, there are anger-management and parenting books and classes.If that fails, there is counseling. The fact that you are taking yourchildren’s feelings to heart is a good prognosis.

Mother-in-Law Blues

Dear Deborah,

My mother-in-law has been in the hospital,recovering from surgery for a week. She is a widow and has alwaysbeen an unpleasant, demanding and self-absorbed woman, but she is myhusband’s mother and children’s grandmother, and because I have noremaining parents, I do want to be a good daughter-in-law.Furthermore, my husband is an only child, so there is no one else totake care of her. He works more than full time, and since my job ispart-time, I feel it is my duty.

I visit her every day, bring her anything she asksfor, and, when she is well, take her shopping and to doctorsappointments. I try. Yet she barrages me with complaints about how noone cares about her, no one visits her, and so forth.

She doesn’t understand that I do work, havechildren (which is another full-time job) and have a life. She thinksthat I am her servant, which would be OK if she showed anyappreciation whatsoever. I am at my wit’s end with her complainingand sometimes want to say what’s on my mind, and yet I never say aword.

At Wit’s End

Dear Wit’s End,

There seems to be a rather fine line between”honor thy parents” and “kick me.” I mean, Martyr of the Year is arotten, low-paying job with no benefits and zero glory.

Have you said anything at all when she complainsabout the dearth of visitors, such as: “What am I? Chopped liver? Ihave visited you every day. It hurts my feelings when you say thingslike that.”

Although you are a true mensch for your efforts, thereis no law against directly and kindly saying how you feel. You neednot be abused to be a dutiful daughter-in-law.

Deborah Berger-Reiss is a West Los Angelespsychotherapist. All letters toDear Deborahrequire a name, address and telephone number for purposes ofverification. Names will, of course, be withheld upon request. Ourreaders should know that when names are used in a letter, they arefictitious.

Dear Deborah welcomes your letters. Responses canbe given only in the newspaper. Send letters to Deborah Berger-Reiss,1800 S. Robertson Blvd., Ste. 927, Los Angeles, CA 90035. You canalso send E-mail: