health care

Belief in God gives strength

Author Cheri Tannenbaum gives a talk about her book, A Woman of Few Words. (photo from Gefen Publishing House)

“Happiness is a choice,” writes Cheri Tannenbaum in her book Woman of Few Words: My Creative Journey with Dystonia (Gefen Publishing House, 2019).

No one would blame Tannenbaum for not being happy, for staying in bed, for giving up. But that’s not who she is. “From the first day of my illness to this very day,” she writes, “I wake up each morning, say Modeh Ani (the prayer said upon waking in the morning), push myself out of bed, and consciously and deliberately choose life.”

Born in Edmonton, Tannenbaum is the oldest child of Samuel (z”l) and Frances Belzberg; the family moved to Vancouver when she was 16. With refreshing honesty, Tannenbaum shares her struggles with anorexia, but also some of the ways in which she was a “happy, fun-loving, gregarious, outgoing flower child” when she was in her teens. She writes about how she became religious, and it is her strong belief in God that has buoyed her since she became ill with dystonia at the age of 20, the first sign of which was that her “handwriting suddenly became totally illegible.” As well, her voice became monotonic, and other symptoms appeared, including severe difficulties in walking and, eventually, speaking, a symptom that, very much later in life, was remedied, as the unexpected result of medication intended for another purpose.

Woman of Few Words details Tannenbaum’s life with dystonia, which, according to the Dystonia Medical Research Foundation, which was founded by her parents, “is characterized by involuntary muscle contractions and spasms.” She openly talks about the time she attempted suicide and the difficulties she had in having children. She offers thoughts on living with the illness and lessons she has learned, as well as several pages on dystonia and many inspirational quotes from various sources.

Tannenbaum has a bachelor’s in psychology and a master’s in human development. She has followed her passion – art – in more than one creative direction. She has a long-lasting marriage, three children, grandchildren, and family and friends who care about her, and she has lived in several places in the world, making her home in Efrat, Israel. As she writes, “Dystonia is not my essence, nor does it define me.” It does, however, present many challenges.

“If I didn’t have the belief that there is an all-loving, all-powerful G-d who runs the world and has a master plan, then all challenges are just random; things that happen are just occurrences coming from nowhere…. Most probably, those challenges would feel meaningless and purposeless,” she told the Independent.

Tannenbaum responds to every reader who sends her a note. “The notes I have gotten have been extremely positive, telling me how I have helped them or given them a different perspective, etc.”

She said, “If I were to have gotten only one response that I have touched one person’s soul then I have accomplished what I set out to do – baruch Hashem, I have gotten more than one.”

Tannenbaum’s mother shared some of the ways in which her daughter’s illness affected the family.

“Cheri’s illness was slow in showing itself so, at first, her tripping or falling or dropping things was almost a joke for her siblings,” said Belzberg, who has three other children. “I took her to our family doctor, who said it was just teen angst, then that it was physiological, so she saw a psychiatrist, who said she was fine, so back to the GP.

“As her condition became worse, I began shopping for different kinds of medical advice locally and even to Scripps Clinic in California, and still no answers.

“In the meantime,” said Belzberg, “Cheri met Harvey, married and moved to Los Angeles … and her condition worsened.”

Belzberg said it took almost five years for them to get a diagnosis and a name for her daughter’s condition: dystonia muscular deformans. “There were, at that time, three known patients,” said Belzberg. “Today, we have several hundred on this continent alone.”

With no known patients and no known treatment or cure, Belzberg said, “My husband mobilized with the help of two doctors from UCLA [University of California, Los Angeles], Dr. John Menkes and Dr. Charles Markham; we gathered about five or six known neurologists from across the U.S. and began to do research. Meetings were set up for every two weeks and both my husband and I monitored the meetings between the experts … with the whole purpose of finding everything there was to know about the disease and how to treat it.

“Word got out that this was being addressed and there was more interest from within the research community,” she said. “We got a grant from the NIH [National Institutes of Health], plus our own … financial support, to establish ourselves, and began a series of research conferences with different doctors with different specialties. That was almost 40 years ago and, this June, there will be the Samuel Belzberg 6th International Dystonia Symposium in Dublin, Ireland, the latest in our international annual meetings.

“Through our persistence, as parents, we have created an international research body with a large patient list and researchers waiting to have their grants financed,” said Belzberg. “We also – as parents and ones who are crucially and emotionally involved – started our own scientific board and monitored them ourselves. We set a precedent – no other research board that we know of allows lay people to actually participate, verbally, in the discussions as they ponder their findings.”

Belzberg noted that funding is always a concern because dystonia “is not a well-known disease or a recognizable name, though we fall in the category of MS [multiple sclerosis] and Parkinson’s.”

Asked what advice she would have for a parent of a child with a chronic illness, Belzberg said, “Every family has to deal with their own crises emotionally, spiritually, within their own strengths, and persist in finding answers. Chronic illnesses can be very wearing both for the patient and the family, so it takes a great deal of tolerance and understanding on the part of each to make it through the day.”

For someone who just found out they have a chronic illness, Tannenbaum said, “I would first give them a big hug and sit with them, hold their hands and just listen to them vent – how they feel about the diagnosis, their anger, their fear, their hopelessness, their ‘why me?’

“When they would be ready to hear me, I would tell them that there is a G-d, master of the universe, who loves you more than anyone else loves you in the whole wide world. Everything G-d does is for the good, even though I know it doesn’t feel that way right now. This is a test that G-d knows you can pass; otherwise, He wouldn’t have given it to you…. This is an opportunity for you to grow and to bring out your hidden potential and strengths that you never knew existed within you. Through this test, you can create miracles. Through this test, you can bring good and G-d into the world. Depending on your attitude and perspective, you will be able to help and change other people’s lives. This test is bringing you farther along to fulfilling the potential that only you can do.”

Life with inherited trauma

Dr. Gita Arian Baack, author of The Inheritors: Moving Forward from Generational Trauma. (photo from Gita Arian Baack)

Dr. Gita Arian Baack, author of The Inheritors: Moving Forward from Generational Trauma, was in town earlier this month to speak at the Cherie Smith JCC Jewish Book Festival and hold a three-day experiential workshop with the Second Generation Group in Vancouver.

The Ottawa-based counselor began her festival presentation with a quote from the late Israeli novelist Amos Oz, who wrote, “Our past belongs to us, but we do not belong to it.” For Baack, the quote underscores her message to inheritors of the Shoah – that “we were given life and an obligation to bear witness and honour the martyrs and heroes of the Holocaust. And that we also have the right to live full and joyful lives.”

“Generational trauma stems from devastating events which transpired before we were born,” Baack told the Independent. “In the case of the Holocaust, we have experienced it from birth; it is as if we were there. We carry an unrelenting sadness, sense of absence and betrayal.”

The ultimate question her book explores is: “How can we live a full life despite the difficult trauma we inherited?”

Prior to writing The Inheritors, Baack conducted doctoral research into the subject of intergenerational trauma and resilience, yet what she uncovered did not fit or go deeply enough into either. Often, resilience is described as bouncing back with support from others. But, she said, “You don’t bounce back from the Holocaust!”

She was resolved to unravel answers to these and other questions, such as why are so many of us resilient and compassionate despite our inherited trauma? Do we carry memory from one generation to another? How do we move forward, when the usual therapies for trauma have proven not to work for us?

“We are also faced with the difficulty of piecing together our family stories,” said Baack. “Much of our family stories are full of holes, unknowns and even secrets, our roots destroyed. Understandably, we have strong emotions but don’t know how to deal with them; for example, excessive sadness, fear of authority, worry, lack of trust, lack of safety, etc.”

Further, inherited trauma is often frozen, embedded in the brain stem, also known as the primitive brain – accessing it is difficult, but it can be done, she said.

Baack noted that ancient wisdom, the Bible and new epigenetic scientific research explain that trauma is passed onto generations in the DNA, and even the cells, for as many as seven generations. She strongly believes that this is the case if it is acknowledged and processed; if it is not, then it can take longer than seven generations.

Though Baack’s own experience is being a child of Holocaust survivors, The Inheritors encompasses others who have been victimized: Canada’s indigenous population, survivors of the Rwandan genocide and of several other horrible episodes of recent history. The book also looks at trauma on a personal level, from those who have suffered as a result of natural disaster, an accident, economic hardship, the justice or education system, illness or loss of a loved one.

The intent of The Inheritors is to serve as a tool for moving forward, said Baack. The book is filled with dialogues, poetry and stories from people of different backgrounds. Readers are invited to explore their story, and there are questions at the end of each chapter to help them process that story and, in so doing, transform their pain. At the least, in the end, they will have a written story as a legacy to their descendants.

The Inheritors has had other, unexpected, impacts. For example, the conductor of the North Carolina State University orchestra commissioned composer and flutist Allison Loggins-Hull to write a piece for an upcoming performance and she has chosen to write a work inspired by the book – Inheritors Overture will première on April 5 in Raleigh, N.C.

The group dialogues that Baack conducts offer a means of validation through other people with similar experiences and various experiential tools that can help further a deeper exploration of their trauma stories, the “undiscussables” and the unknowns. Group participants, she said, are often surprised by the creativity, laughter and camaraderie that arise.

The Inheritors is dedicated to (and inspired by) Baack’s two half-siblings. “From my earliest beginnings, I remember carrying a great sadness for my siblings, Henush and Halina Arian, who were only 4 and 3 years old, respectively, when they were killed,” she writes. There was no information about the circumstances of their death or burials, “But their existence was real and has mattered to me in an extraordinary way. And so I don’t fight the sadness; I embrace it. It has a special place. I am the carrier of their memory. This burden is the most cherished of all my burdens.”

At the age of 4 or 5, Baack had what she describes as a “knowing” or “inherited memory.” A “felt sense” told her, even at that young age, that her siblings, two of 1.5 million children killed by the Nazis, had both been shot in the back. When she asked her father how her half-siblings died, he said he didn’t know. Nonetheless, the memory (and feeling) she had inherited persisted, and could be placed on a spot in the middle of her back, with a knowing that her half siblings had been shot in that place.

Her research revealed that the timing of their deaths was before gas chambers had been built, and children under 5 were regularly shot. In 2019, a tour guide in Krakow pointed to the very street where the children and their mother were shot. To Baack, it was a stunning confirmation of her lifelong memory.

Baack has been consulting and coaching individuals and organizations for more than 30 years. She recently founded the Centre for Transformational Dialogue to help individuals and communities that have inherited devastating legacies. She also has written a book of verse, Poems of Angst and Awe, published in 2017.

For more information, visit gitabaack.com. Baack continues to research inherited memory and wishes to hear from others on the subject. She can be reached at [email protected].

Sam Margolis has written for the Globe and Mail, the National Post, UPI and MSNBC.

Using apps and robots – coronavirus

One high-tech solution for patients possibly infected with the coronavirus is a robot that can enter the patient’s room and be controlled by medical staff from the outside. (photo from IMP)

Before the coronavirus arrived in Israel – there were two reported cases at press time – Sheba Medical Centre was preparing for it with different high-tech means: a telemedicine app that enables patients to receive care in the isolation, but comfort, of their own home; and robots that can treat in-hospital patients in order to minimize contact with staff.

Sheba’s Datos Health-In is a telemedicine app that enables patients to remain at home. In the event of an epidemic, with more patients than isolation rooms available, the app can be a viable tool for patients who are not severely ill. With the app, patients can enter vital signs and other information, which is directly accessed by their doctor. Patients can also establish contact with their physicians at any time of day or night.

The program was launched on Feb. 9 and tested on Israelis who had been in China and who, according to Health Ministry instructions, had to be in quarantine for 14 days, the incubation period of the virus. Doctors initialized contact with the patients twice a day.

photo - Sheba Medical Centre’s Dr. Galia Barkai — Sheba Medical Centre’s Dr. Galia Barkai *(photo from IMP)*

“This is one instance where telemedicine protects staff as well as other patients, by minimizing direct contact with those infected with the coronavirus,” explained Dr. Galia Barkai, head of telemedicine services at Sheba.

Another high-tech solution for patients possibly infected with the coronavirus is a robot that can enter the patient’s room and be controlled by medical staff from the outside. Designed by California-based virtual healthcare company Intouch Health, the robots are already in use in other departments, such as in the intensive care unit of pediatric cardiology, and the trauma unit.

“This technology is the perfect solution to provide care for in-patients infected with coronavirus, while protecting staff from contagion,” said Barkai.

Screening for the virus produces results in just a few hours but, with symptoms that are not very dramatic and that are reminiscent of the flu, including fever, cough and shortness of breath, Israel’s Health Ministry is only allowing those who have returned from China and a few other countries in the Far East to be tested.

– Courtesy International Marketing and Promotion (IMP)

Treating children’s asthma

Dr. Allan Becker has devoted much of his life’s work to the study of asthma and how it affects children who have it. (photo from Allan Becker)

As Jewish community member Dr. Allan Becker was starting his career as a general practitioner, his daughter was diagnosed with asthma. As a result, he has devoted much of his life’s work to the study of the condition.

“My interest really started when my oldest daughter began having a wheezing episode at about two years of age,” Becker told the Independent. “It was pretty obvious that this was an infection – something we call bronchiolitis, which is fairly common in young children.”

Becker was working in Dauphin, Man., at the time of his daughter’s diagnosis, in the 1970s, and was beginning to see more and more kids with asthma coming into the emergency room.

“Since 1980, when I returned to academics, I’ve been trying to understand why the epidemic started – what the developmental origins of asthma and allergies are,” said Becker, who is now based in Winnipeg. “And, really, they’re the canary in the coal mine when you think about the increase in chronic diseases.

“Asthma is by far the most common chronic disease in children and it’s the earliest to start,” he said, “but we’re seeing parallel increases of other chronic diseases, like diabetes, inflammatory bowel diseases, various forms of arthritis, and others.”

Over the course of a five-decade career, so far, Becker has seen chronic diseases become more prominent. And, while the reasons for this change remain elusive, it seems clear that it involves genes and the environment.

In the early 1990s, Becker and Vancouver-based Dr. Moira Chan-Yeung embarked on a study of ways to potentially prevent the development of asthma.

“Think about the environment in terms of things we breathe and eat … and things like pets in the home, like tobacco smoke exposure, like pollution, like bad nutrition, Western-style diets, etc.,” said Becker. “We started a multifaceted prevention of asthma program in 1994.”

While that study did not reap substantial results, it did eventually lead to a current study examining the environmental impact on expectant mothers in all areas, including the benefits of decreasing stress, which Becker feels may be the most important factor.

Information about the study, called Canadian Healthy Infant Longitudinal Development (CHILD), can be found at childstudy.ca.

“CHILD started in 2008 and is an observation study, because we don’t believe we know enough to prevent the disease as yet,” said Becker. “We’re now seeing the children at 8 and 9 years of age, and we’re looking way more broadly at the environment. We’re looking at stress very specifically, both for parents and children.

“We’re looking much more in terms of diet, but also at the microbiota, the bacteria and other organisms that live in us, with us and on us, and which are likely extremely important – maybe critical – in helping to shape children’s immune responses in early life.”

According to Becker, there are more bacteria in our gut than there are cells in our body, and microbiota are now being considered as the cause of and potential cure for all sorts of illnesses.

One of the biggest hurdles is trying to determine if a young child who is wheezing has asthma and should be treated as such, or if the child has a respiratory infection that causes wheezing. Becker said part of the problem is how to more accurately define wheezing, which is described as a whistling noise coming from the chest.

“The key thing is that it’s not just the whistling noise in the chest,” said Becker. “It’s also that tugging in, particularly tugging in under the ribs, with the tummy pulling in when breathing. That’s a very good indication that those airways are narrowed and that the child has to work hard at moving air, particularly moving air both in and out. That’s what we teach our trainees to work on with the families they see.

“And, obviously, any time a child is distressed – if they’re looking distressed, particularly if there’s a change in colour of the lips – those are urgent issues. And, some children have such severe narrowing of the airways that you don’t hear wheezing, because they’re not moving enough air, but they will be struggling to breathe. You’ll see them pulling in their tummy and you’ll see their shoulders heaving,” he said. “And you’ll often see toddlers and older kids with their hands braced on their knees, hunched forward, trying to get air in. That type of tripoding is really a worrisome sign, as is a change in lip colour – that’s an emergency. Those children need to be brought to emergency quickly.”

If it gets to the point that the child is given inhalers, Becker pointed out that blue puffers are for particularly bad episodes, while orange or red puffers are for management.

For a bad episode, he said, two inhales from the blue puffer should be taken. “An inhalation and a bit of a pause, and then a second puff and inhalation … in many cases, that will be enough to help control things,” said Becker. “If it doesn’t help make things better, then, in five to10 minutes, it should be repeated. If the child is still distressed, that’s an indication they need to be brought to a hospital.”

The blue puffer should not be used for asthma management, he warned, as the body will develop resistance to it. So, if the controller medications are not providing enough control, he said parents should talk to the doctor who prescribed the puffer to determine a solution.

“If people are needing to use the blue puffer on an ongoing basis, even once or twice a week, week after week, that’s really telling you that you don’t have control of what’s going on and is very worrisome,” said Becker. “There should never be a death from asthma. But, sadly, every year there are some. And, these deaths are – rather surprisingly – not necessarily in kids with the most severe, persistent asthma; they’re in kids who are thought to have mild asthma. But, in fact, when you look at it, if you are using the blue puffer and need to get a new one every month or two, that’s a big red flag … needing to use the blue puffer in the middle of the night, that’s a big red flag. Nighttime symptoms are really a worry – those are kids who need to be seen and properly assessed and, in most cases, they need to be using controller medication.”

Becker is proud of having led the development of a national certification for asthma educators in Canada – Canada was the first country to provide this type of certification.

“We have a children’s allergy and asthma education centre in Winnipeg attached to our children’s hospital,” he said. “It’s one of the only real free-standing ones in North America. The website is asthma-education.com.”

Rebeca Kuropatwa is a Winnipeg freelance writer.

Camp helps lift spirits

A moment of levity during the taking of Justine and Stewart Silver’s wedding photos. (photo from Justin Silver)

The late Stewart Silver was born and raised in Montreal. He had worked as a standup comedian, and moved to Toronto in hopes of furthering his career. Justine Silver grew up in a Houston suburb. In late 1990, she followed her sister, who had moved to Toronto, and, there, she joined Jewish online dating site Jdate. So had Stewart.

“There was a thing where you had to describe your perfect date,” recalled Justine. “Profile after profile included long romantic dinners and were all gushy and gross … but his said, ‘Yeah, after we grab a drink, we step out of the restaurant and trip over a big bag of money.’ I was like, ‘Oh my gosh … that’s the perfect date!”

The couple took their time getting to know each other and, after a year and a half, got married.

To all appearances, Stewart was a healthy 44-year-old. He had biked up hills in Christie Pits Park the day before he had a fatal heart attack while the couple was having a conversation on Nov. 16, 2011.

Left shocked and widowed, Justine embarked on a healing path, including taking a hiatus from her event-planning business.

“It’s been quite some time since then and there’s been grief bursts,” said Silver. “In the early days, there was a lot of therapy and some peer support groups. Then, I found Camp Widow and have been to a few of those. I was pleased it wasn’t at all associated with any religion and was welcoming…. There was one in Tampa, and so a couple of widow friends that I had met up with, here, in Toronto, in a peer support group for young people who’d lost their spouses under the age of 55 … decided to make a whole trip of it. We went to the beach, museum, and then to Camp Widow. It’s a very transformational experience when you feel that you’re surrounded by people who understand the topsy-turvy world that you’re starting to barely understand yourself.”

The first camp Silver went to, in Tampa, was in the spring of 2018. Then, in November 2018 and November 2019, she attended the camps in Toronto. She and her friends have already signed up for the next November 2020 camp in Toronto.

While it’s called a “camp,” the weekend is more like a conference, with people coming together for sessions on various topics.

“One of the neat things I like at Camp Widow is that the name tags, everyone has one, but there are a couple features to it,” said Silver. “One of them, there’s a ribbon at the bottom. For example, in my work as an event planner, if you’re a presenter, your ribbon will say ‘presenter,’ or, if you’re on the organizing committee, it will say ‘organizing committee’ or ‘volunteer.’

“But, these [also] have the number of years ago that your loss occurred. So, for me, that was six years. So, let’s say it’s a teal ribbon. All of a sudden, you notice the six-year people … and there’s a bond, because you’re in a different place than, say, the six-month people. Everyone is compassionate to everyone else, but it’s just a really interesting way to bond with people.”

As far as the camp schedule, there are some group meals, as well as meals on your own. There are various types of sessions offered.

“There are tracks, like for people who are five years out, one year, or one to five,” said Silver. “I can’t remember the exact breakdown, but you can decide to go to everything along a certain track, or you can decide in the moment what you’ll do, which sessions you’ll go to. Then, there are some networking evening events, different ways of getting to know people.”

One is designed like speed-dating, but not for that purpose. You get the chance to talk to someone for a certain amount of time, and then you move on to the next person and chat with them. “It’s really interesting to see where the commonalities fall,” said Silver.

On Saturday night, there is a banquet with a theme and people dress up – some participants may not have gone out since their loss. After dinner, each person says the name of their loved one out loud, while some 200 others quietly listen. Then, there is a dance, which gives the opportunity to destress and socialize. The DJ doesn’t play any music that could potentially trigger anyone’s grief, like slow songs.

At the camp, there are people from their mid-20s to people in their 70s and 80s; people from all religions, cultures and political leanings.

For Silver, Camp Widow “creates community and support amongst widows and widowers…. Sometimes, when you’ve lost someone, it can be very isolating, which can be in different and unexpected ways. I wouldn’t say never, but it doesn’t go away. The intensity definitely lessens and you find new ways to live with grief. And there are plenty of people who, we say, are ‘re-partnered.’ When you’ve been widowed and then you meet someone else and you have a boyfriend/girlfriend, wife/husband or partner, we say you’re ‘re-partnered,’ because we don’t think that means you’re not still widowed.”

The camp provides tools and connections that widows and widowers may not otherwise find on their own.

“I feel camaraderie in sharing my story and being heard, or hearing someone else’s story and being helpful to them,” said Silver. “At this past Camp Widow, I did an art thing. I can do crafty things OK, but I’m not really an artist. But, one of the workshops I went to was all about healing through art and it was just a whole different facet. We all had paint and they set it up so well…. We had a white piece of paper and I got white paint and I painted a white heart. Then, I put a line through it – a squiggly line, like it was broken – and you could barely see it … like you couldn’t see that my husband had a heart problem…. Then, everyone shared in the room what theirs was about. When you do that, it’s like opening up a wound, and then the scar heals better next time.”

Six months ago – eight years into her healing journey – Silver and her older sister, Eileen Jadd, who is a social worker, started the charity Good Grief Bereavement Healing Services.

“We have a roster of counselors in different parts of Toronto for bereaved people,” said Silver. “We’re also offering workshops on eye movement desensitization, which is a thing for trauma victims. It really helps you compartmentalize the trauma, so you can talk about it without being retraumatized. So, we’re doing a workshop on that.

“We’re starting a group on sibling loss and, eventually, will have a physical building. We want to have a centre, so people who’ve lost someone, it’s like a snap of the fingers and they’ll know where to go. When you know there’s an accident, you know to dial 911. We want it to be, ‘Wow, you’re in need, you’ve lost someone, and you know exactly where to go.

“I think widows and widowers need their person’s name to be said. People are so afraid of saying it, because they don’t want to bring it up in fear. But, they want their names to be said, so that’s a big part of it. I happen to talk about Stewart all the time, but a lot of people don’t have those opportunities in their own lives.”

In addition to talking about him when memories arise, Silver said, “Every year, I go to shul and I say his name and a prayer for him, and commemorate it that way. I remind people that we got married in that synagogue, and I remind people that he was a person that existed and stood in that space with me, and that his influence is still there. Just because he’s not standing next to me in that moment … he’s still there. In those ways, we talk about him.”

Camp Widow is put on by Soaring Spirits International. For more information, visit soaringspirits.org, campwidow.org, widowedresilience.org and goodgriefhealing.ca.

Rebeca Kuropatwa is a Winnipeg freelance writer.

Predicting diabetes risk

A new computer algorithm can predict in the early stages of pregnancy, or even before pregnancy has occurred, which women are at a high risk of gestational diabetes. (photo from Weizmann Institute)

A new computer algorithm can predict in the early stages of pregnancy, or even before pregnancy has occurred, which women are at a high risk of gestational diabetes, according to a study by researchers at the Weizmann Institute of Science.

The study, reported recently in Nature Medicine, analyzed data on nearly 600,000 pregnancies available from Israel’s largest health organization, Clalit Health Services.

“Our ultimate goal has been to help the health system take measures so as to prevent diabetes from occurring in pregnancy,” said senior author Prof. Eran Segal of the institute’s computer science and applied mathematics, and molecular cell biology departments.

Gestational diabetes is characterized by high blood sugar levels that develop during pregnancy in women who did not previously have diabetes. It occurs in three to nine percent of all pregnancies and is fraught with risks for both mother and baby. Typically, gestational diabetes is diagnosed between the 24th and 28th weeks of pregnancy, with the help of a glucose tolerance test in which the woman drinks a glucose solution and then undergoes a blood test to see how quickly the glucose is cleared from her blood.

In the new study, Segal and colleagues started out by applying a machine learning method to Clalit’s health records on some 450,000 pregnancies in women who gave birth between 2010 and 2017. Gestational diabetes had been diagnosed by glucose tolerance testing in about four percent of these pregnancies. After processing the dataset – made up of more than 2,000 parameters for each pregnancy, including the woman’s blood test results and her and her family’s medical histories – the scientists’ algorithm revealed that nine of the parameters were sufficient to accurately identify the women who were at a high risk of developing gestational diabetes. The nine parameters included the woman’s age, body mass index, family history of diabetes and results of her glucose tests during previous pregnancies (if any).

Next, to make sure that the nine parameters could indeed accurately predict the risk of gestational diabetes, the researchers applied them to Clalit’s health records on about 140,000 additional pregnancies that had not been part of the initial analysis. The results validated the study’s findings: the nine parameters helped accurately identify the women who ultimately developed gestational diabetes.

These findings suggest that, by having a woman answer just nine questions, it should be possible to tell in advance whether she is at a high risk of developing gestational diabetes. If this information is available early on – in the early stages of pregnancy or even before the woman has gotten pregnant – it might be possible to reduce her risk of diabetes through lifestyle measures such as exercise and diet. On the other hand, women identified by the questionnaire as being at a low risk of gestational diabetes may be spared the cost and inconvenience of the glucose testing. (Visit weizmann.ac.il/sites/gd-predictor to access the self-assessment questionnaire.)

In more general terms, this study has demonstrated the usefulness of large human-based datasets, specifically electronic health records, for deriving personalized disease predictions that can lead to preventive and therapeutic measures.

The work was led by graduate students Nitzan Shalom Artzi, Dr. Smadar Shilo and Hagai Rossman from Segal’s lab at the Weizmann Institute of Science, who collaborated with Prof. Eran Hadar, Dr. Shiri Barbash-Hazan, Prof. Avi Ben-Haroush and Prof. Arnon Wiznitzer of the Rabin Medical Centre in Petach Tikvah; and Prof. Ran D. Balicer and Dr. Becca Feldman of Clalit Health Services.

CHW tickets going fast

Left to right, Sasha Gerson, Joanna Wasel and Frances Belzberg will be honoured by CHW on Sept. 22. (photos from CHW Vancouver)

Welcome to September! A few signals that summertime is ending are the kids going back to school, the Jewish holidays quickly approaching and the return of Jewish community gatherings like the upcoming Canadian Hadassah-WIZO (CHW) Vancouver luncheon.

On Sept. 22 at the Richmond Country Club, CHW is holding an event to honour exceptional volunteers. As a volunteer organization driven by women, which focuses on the welfare of children and women in Israel but is also concerned with the health care of all Israelis, CHW often chooses to recognize the contributions of local women who make a difference to the lives of those in our local community.

This year, the organizing committee of the luncheon, headed by CHW volunteer Toby Rubin, selected three visionaries who have put their considerable talents as organizers, motivators and mentors to work to improve various areas of Jewish life in Vancouver. Sasha Gerson, Joanna Wasel and Frances Belzberg represent three different generations of volunteers and all contribute in diverse ways to the community.

Gerson is well known in the Russian-Jewish community. For years, she helped immigrants settle in Vancouver through her work at Jewish Family Services. Her most public role is as an award-winning radio host. Twelve years ago, she and her partner, Dmitry Shiglik, launched Radio VERA, a weekly Russian-English talk show. Her motivation is to bring Jews together, and her volunteer activities through the radio have included organizing trips to Israel, festivals for children and music events. She interviews people primarily in Vancouver but has guests from Russia and Israel on her show. She is also a CHW volunteer, currently serving as treasurer of CHW Vancouver.

Familiar to those who are connected in any way to Camp Hatikvah, Wasel is known as a volunteer extraordinaire. She is currently serving her fifth year as president of the Camp Hatikvah board and, during her presidency, she has expanded participation in the camp’s programming. One of her most important legacies is the introduction of Family Camp, which was first held eight years ago. This program has brought a camp experience to more than 220 people every year since its inception.

“You’re never too old or too young to be a camper!” said Wasel of Family Camp. She sees the weekend-long experience as a chance for adults to make new friends. “People bond and it establishes a foundation for the Camp Hatikvah community. In addition to being good, quality family time, we see it as a community-building experience,” she said.

Camp Hatikvah is associated with the Young Judaea movement, a Zionist organization that dates back to 1917. Historically, CHW has been associated with Young Judaea, as well, providing funding for national programs including Biluim Canada and Israel.

The third honouree, Belzberg, has had a life-long commitment to philanthropy and Jewish community building. She has been involved with CHW for 67 years, most of those in Vancouver. Having contributed in the early years of her marriage to Hadassah in Edmonton, Belzberg knew that joining a Hadassah chapter when she moved to Vancouver would help establish close friendships in a new city. She continued as a volunteer in many leadership roles, including chair of the Hadassah Bazaar, and on the national board as well.

Belzberg’s dedication to community extends beyond CHW. She also has served as Jewish Federation of Greater Vancouver’s first women’s division chair and has held many other leading fundraising roles, including with St. Paul’s, B.C. Children’s and Vancouver General hospitals. She was a founder of the Dystonian Medical Research Foundation and was recognized for her diverse and numerous efforts with the Order of Canada in 1995. Belzberg has given countless hours as a volunteer, driven by a belief she explained this way: “Without community involvement,” she said, “there will be no future for the Jewish people. It is up to us to combat antisemitism and make sure our communal organizations remain strong.”

Those who attend the Sept. 22 luncheon, 11 a.m. to 2 p.m., will have the opportunity to hear a short address by each of the honourees. Proceeds from the event will benefit one of the many educational projects CHW supports in Israel – the CHW Centre for Clinical Training and Community Care, Hadassah Academic College in Jerusalem, is one of the fastest-growing institutions of higher learning in Israel. It is a pluralistic college with a range of undergraduate and graduate degrees, from health and life sciences to information and computer technology.

Luncheon tickets are selling fast, said Rubin. With more than 100 already sold and capacity at 150, those interested should purchase tickets soon. For more information or to register, call the CHW office at 604-257-5160.

Michelle Dodek is a freelance writer living in Vancouver.

Stories with a message

Michael Klein recently had his first book published. (photo from Michael Klein)

Dr. Michael Klein has published almost 200 scientific articles. Earlier this month, he launched his first book, Dissident Doctor: Catching Babies and Challenging the Medical Status Quo (Douglas & McIntyre).

Klein, who, with his wife Bonnie, splits his time between Robert’s Creek and Vancouver, is professor emeritus of family practice at the University of British Columbia, adjunct professor of family practice McGill University in Montreal and senior scientist emeritus at B.C. Children’s Hospital Research Institute. He was recognized as a member of the Order of Canada in 2016 for playing “a vital role in placing maternity care at the heart of family medicine.”

Klein has had a significant impact on the way the Canadian medical system has come to view midwifery and he played a prominent role in midwives becoming part of the healthcare system, first out east and later in here in British Columbia.

“I’m on the board of Canadian Doctors for Medicare, an organization that is trying to save Medicare from various encroachments from private interests, including U.S. multinationals,” Klein told the Independent. “We are about improving and extending Medicare. We are not about justifying things as they are. But, we are very much unhappy with the way privatization is going, which is a solution that is worse than the disease.”

About his new book, Klein said, “It began as something that I was writing as stories for my children and grandchildren … and, it got out of hand.”

At it happened, publishers at Douglas & Macintyre heard Klein tell a few of these stories and wanted them made into a book.

Klein set about developing them thematically. “I had to find out what the storyline was,” he said. “It’s a great deal about birth, but it’s not a birth book, per se. In many respects, birth is a metaphor.

“It’s about birth, family practice, midwifery, social justice, and about improving our rather challenged healthcare system. At the same time, I’ve deliberately chosen stories that have a message. For example, there are stories about people who were not supposed to get better but did. Many of the stories are actually detective stories. What I mean by that is that I try to make the stories go beyond the actual patient issue…. In what context does this illness take place? ”

Klein feels this approach to storytelling makes the point that, to provide really good care, you need to understand the patient, the full breadth of their situation.

He hopes the book also serves as a primer on how to advocate for yourself and your family in the complex medical system.

“Misunderstandings and mistakes in the healthcare system are actually inevitable,” said Klein. “I talk a lot about advocacy and the importance of making sure that, if things don’t seem right, they probably aren’t right.

“Because of my involvement with Canadian Doctors for Medicare, the whole issue of privatization is explored. For me, I have a special need to express this, because I’m in a unique position. I’ve practised in Canada before Medicare. I’ve practised in the States and ran health centres without Medicare – that wasn’t a lot of fun. And, I’ve practised back in Canada with Medicare.”

The main point Klein wants to impress upon readers is that humane, holistic care in the context of a person’s whole life is the ideal. “I am not putting this out as a dispassionate physician-scientist, but as somebody who really understands the big picture and can situate the patient or the system within a very large context of where we are going as a society,” he said.

The book is almost completely free of medical jargon, although it deals with complicated issues. Klein said the book is equally accessible to medical trainees, people in the profession and to the general public.

The stories he chose, the themes he discusses and the politics, he hopes, will be easily understood by anyone who has ever encountered the healthcare system. “Not just pregnant people and their partners, but anybody; also family physicians, midwives, obstetric nurses, dulas,” he said.

Klein showed the manuscript to people in all these categories, and, he said, “it seems to work for them.”

The feedback Klein has been getting is that people love the book’s advocacy stories. He even includes his wife’s experiences following a series of strokes, when she was told she was inoperable and would die. A surgeon in London, Ont., saved her life.

“There are a series of stories of my patients and other peoples’ patients who defied the odds, and where patient advocacy has been absolutely essential,” said Klein. “Whether they are physicians or laypeople, they became engaged in the right way with the health providers and improved their outcome.

“People relate to that very strongly, regardless of whether they are patients. The experiences they’ve had when their children, spouse or parents were sick and, either they were sidelined by the system or they embraced by the system. It varies enormously with who is providing the care and what their attitudes are. I cover that in the book.”

Other stories in the book tell of how Klein battled with the U.S. army and avoided going to the Vietnam War.

He also delves into his strong support for midwives. “People wondering if home birth is safe are very interested in that section,” said Klein. “Home birth is clearly safe. However, safe in the right kind of system, with the right kind of supports and back up. In other words, an integrated system like we have in British Columbia, as opposed to the chaos of the U.S.”

The launch event for Dissident Doctor took place in Toronto on Oct. 9.

Rebeca Kuropatwa is a Winnipeg freelance writer.

New centre for excellence

Construction on the Centre of Excellence for the Deaf and Hard of Hearing is expected to be complete by fall 2019. (photo from WIDHH)

British Columbians who are deaf and hard of hearing will soon benefit from a state-of-the-art Centre of Excellence for the Deaf and Hard of Hearing that is being built by Vancouver’s Conwest Group of Companies.

The Western Institute for the Deaf and Hard of Hearing (WIDHH), a registered charity established in 1956, together with Conwest, has commenced construction on a new $16 million facility with $1 million in funding from the Ministry of Health. The $1 million in government funding, which was announced Sept. 26, will be applied to an $8 million capital fundraising campaign that WIDHH is aiming to launch to the public early next year.

“From youth to seniors, this new centre will improve people’s quality of life and help prevent those with hearing and communication challenges from feeling isolated,” said David Eby, attorney general and MLA Vancouver-Point Grey.

The centre will provide hearing aids and assistive listening device services, employment counseling, seniors outreach programs and a refurbished hearing aid program for people on limited income. It will also accommodate expansion of WIDHH’s clinical research program within the field of hearing health, telecommunications and accessibility.

“We look forward to using technology in the new facility to reach out and provide unparalleled levels of hearing health care and support to homebound seniors and those living in rural communities across British Columbia,” said Grace Shyng, interim executive director of WIDHH.

Construction on the new centre at 2005 Quebec St., in Vancouver, is expected to be complete by the fall of 2019.

Win 2 free film tickets!

A Heartbeat Away follows Save a Child’s Heart pediatric cardiologist Dr. Akiva Tamir to Africa on a medical screening mission to find children in need of lifesaving heart surgery. (photo from Save a Child’s Heart Canada)

Jewish Independent readers can win two tickets to the Nov. 2 Vancouver premiére of the documentary A Heartbeat Away at Scotiabank Theatre. Simply email [email protected] by Wednesday, Oct. 25, 5 p.m., to be entered in a draw. The winner will be contacted.

A Heartbeat Away, by Tal Barda and Noam Pinchas, follows Save a Child’s Heart pediatric cardiologist Dr. Akiva Tamir to Africa on a medical screening mission to find children in need of lifesaving heart surgery – surgery that is not accessible in Tanzania, where, every day, five children die from heart disorders and rheumatic heart disease. In the documentary, Tamir and his team examine hundreds of children, although only a handful can receive the treatment that will save their lives. When 6-year-old Julius arrives at the clinic in critical condition, Tamir is forced to choose whether to operate on the child, who has very little chance of surviving. Tamir and his team take viewers on an emotional rollercoaster, as they deal with the most serious question of who to treat. The experienced physicians find it hard to detach from the emotional bond they share with their small patients.

The documentary focuses on the challenges of receiving adequate health care in developing countries, and the challenges providers face when so many are in need – how do they pick who to treat?

According to Marni Brinder Byk, executive director, Save a Child’s Heart Canada, “Congenital heart disease is responsible for more deaths in the first year of life than any other birth defect. Due to a high prevalence of acquired and congenital pediatric heart disease in developing countries, and a lack of skilled medical personnel dealing in pediatric cardiac care, there are thousands of children in need of cardiac intervention, and hundreds of medical personnel living in developing countries that require advanced training.”

To date, she said, the Israel-based Save a Child’s Heart has “provided care to over 4,400 children from 55 countries in Africa, Asia, Eastern Europe, the Caribbean, South and Central America, and the Middle East.”

In an interview with Eretz Magazine, Barda, who also directed the documentary, said, “The first thing that the documentary film needs to give the viewer is information. However, for me, the next move is touching the individual’s story…. My dream is to have as many people as possible watch this movie. The story comes from a different world, creates a sense of acquaintance and a better way of coping and looking at things…. There is something very powerful in this story, which is happening in the current dire reality of Israel and the world. It is about people who are taking their professional skills and doing something good with them. They go out of their comfort zone and do something for the benefit of the other. These doctors are taking care of all hearts, simply because they are beating hearts.

“The message here is very powerful, in my opinion,” she continued. “The organization is taking care of all children: Israelis, Africans, Palestinians….” To view the official trailer of A Heartbeat Away, visit vimeo.com/151644429.

The Nov. 2 screening event in Vancouver is chaired by Lana Pulver. It starts at 6:30 p.m. with a wine and cheese reception, followed by the screening of the documentary and a question-and-answer period with a panel of experts on pediatric global health and cardiac treatment. Tickets are $36, with all proceeds benefiting Save a Child’s Heart. To purchase tickets or make a donation, click here or call toll-free 1-844-924-9113.