health

Israeli ventilation invention

Prof. Ori Efrati, left, and Dr. Michael Cohen. (photos from IMP)

With the arrival of the coronavirus vaccine, there has also been a spike in morbidity, clearly indicating that we’re not out of the woods yet. In fact, hospitals in Israel have warned that they are steadily approaching maximum capacity, as the numbers of severely ill COVID patients breaks all records.

When COVID-19 first erupted in March 2020, health authorities warned that a surfeit in severely ill coronavirus patients would overwhelm the system due, in large part, to a lack of ventilation machines – the standard of care for coronavirus patients whose condition deteriorates to pneumonia. In the ensuing months, Prof. Eyal Leshem, director of the Centre for Travel Medicine and Tropical Diseases at Sheba Medical Centre, explained that, in addition to the shortage of ventilators, one of the most pressing issues is the lack of highly trained intensive-care-unit staff to monitor patients attached to those devices.

An innovation by Yehonatan Medical addresses both of these issues.

Yehonatan Medical, in collaboration with Prof. Ori Efrati, director of the pediatric pulmonary unit at Sheba Medical Centre, devised a first-of-its-kind ventilation system that can treat multiple patients.

“Conventional ventilators, aside from being very costly, are limited in that they can only be used with one patient at a time,” explained Efrati. “Their capacity factor and programming functions were designed for single-patient use, and there is also the danger of cross-contamination.”

The new ventilation system resolves issues that corona ICU wards have been grappling with as the number of severely ill patients rises.

“We were able to use the relatively simple and inexpensive BipaP non-invasive ventilation machine as the basis for the advanced ventilation technology,” said Efrati. “Thanks to the high-power output and built-in disinfecting mechanism, the new system can safely treat three to five patients simultaneously.”

Moreover, a system that can treat multiple patients at one time necessitates fewer ICU-trained staff. Thanks to the remote interface, the medical team can monitor patients from a safe distance.

“This tremendous breakthrough is nothing less than a game-changer when it comes to caring for large numbers of corona patients,” Efrati added.

Dr. Michael Cohen, an engineer and scientist and the founder of Yehonatan Medical, said, “All in all, we’re talking about a system that delivers personalized care in a multi-user format.”

Additional features based on artificial-intelligence technology include the ability to have a hierarchy and classification of alerts; the ability for automatic parameter correction according to set criteria; respiratory rehabilitation for the patient by adjusting to changes in the patient responsiveness; and more. The streamlined, relatively low-cost system can be implemented in makeshift clinical settings, such as field hospitals, as well as in step-down units within the hospital, in the internal and other wards.

Yehonatan Medical is the medical department of Mofet Etzion, a company that for more than two decades has developed various security and military innovations for the Israel Defence Forces and foreign armies. Cohen has developed dozens of life-saving innovations, including in the area of cardiology, in collaboration with cardiologists and cardiothoracic surgeons from Israel, the United States and Canada.

“Some of the insights for the development of this revolutionary ventilation system were provided by cardiologists who helped us to devise the various accoutrements and sensors,” Cohen said, making specific mention of Dr. David Adams, professor and system chair of the cardiovascular surgery department at Mount Sinai Hospital in New York; Dr. David Tirone, chief of cardiac surgery at Toronto General Hospital; and Dr. Gideon Cohen, cardiothoracic surgeon at Sunnybrook Health Sciences Centre in Toronto. The development of the system itself took place in Israel, marking the first time that an invasive ventilation machine has been built in Israel.

The advanced ventilation technology is currently in advanced phase trials at the MSR Medical Simulation Centre at Sheba, where it is being tested on artificial lungs, and is expected to be ready for mass marketing in the coming months.

– Courtesy International Marketing and Promotion (IMP)

Cookin’ old school meatloaf

As if the pandemic weren’t enough, I’m supposed to think of something tantalizing and healthy to cook every night? Right. Roger that. My motto is: go with the tried and true. Or, given the times we’re in: go with the tired and true. Translation: something my mom used to make in the 1960s and ’70s. Something delicious but notoriously unhealthy.

Let’s face it, back then, the general public didn’t know bupkas about heart-healthy diets, Keto or low cholesterol. Not even doctors’ families. Nobody measured their BMI (body mass index) at the gym, because no one went to the gym. No one had their goal weight etched in their brain. It was a kinder, gentler time. Albeit with lots more spontaneous and fatal heart attacks and strokes. But still.

Back to the task at hand. It was a dark and stormy afternoon. I was tired. Really tired. Of cooking. But we have to eat. So, I did what any self-respecting accidental balabusta would do: I pulled out my mother’s old National Council of Jewish Women Cookbook. It’s a miracle that it isn’t falling apart after all these decades doing yeoman service. As I was searching for something simple and doable within 30 minutes, I happened upon a dog-eared page. One my mother had probably marked for good reason. Which is ironic, since the standing joke in my family was this – as soon as my mom cooked anything that my dad loved, she never made it again. We’ve speculated on the rationale for years. Was it intentional? Happenstance? Payback for something? Maybe it had to do with the electric can opener my dad gave mom for her birthday one year; or was it their anniversary?

The dog-eared recipe, thankfully, was – drum roll, please – Meatloaf. Yes, Virginia, you heard correctly, Meatloaf. I capitalize it because, well, it deserves the recognition. There is no problem in this world that can’t be solved by a good meatloaf. (Alright, maybe athlete’s foot and world wars, but, otherwise….)

In sync with the majority of the recipes in that cookbook, it called for an envelope of onion soup mix, undoubtedly a staple in those days. Chip dip – sour cream and onion soup mix. Spinach delight – onion soup mix. Apricot chicken – onion soup mix. Being a culinary rebel (ha!), I decided to go rogue and omit the onion soup mix. I had to draw my own line in the sand. And I swapped Panko for breadcrumbs. This recipe makes a moist, dream-of-a-1960s dinner. Once again, you’re welcome. You may be excused from the table.

MEATLOAF

2 lbs ground beef (extra lean)
1 1/2 cup soft breadcrumbs (or Panko)
2 eggs
1/2 to 3/4 cup water
1/3 cup ketchup (or, as they called it in the ’60s, catsup)

Preheat the oven to 350°F. In a large bowl, combine all the ingredients and place the mix into a greased loaf pan. (I covered the top with more ketchup – I know, very radical). Bake for approximately one hour.

It doesn’t get much easier than this. Seriously. Both Harvey and I kept cutting little pieces off, to even out the end. We were insatiable! We easily ate half of this two-pound loaf in one sitting, and polished off the rest the next day in sandwiches. What can I say? We’re dyed-in-the-wool carnivores.

To switch it up a little, and marry old school to multicultural, I also made Greek lemon potatoes. While I could eat meat and potatoes every night of the week, I don’t. And don’t go getting all judgy on me, either – there was broccoli in attendance.

The Greek lemon potatoes were a new thing for me (the making part), and I only made the Greek kind because I had a bunch of fresh rosemary leftover from baking focaccia the day before. (It was delicious!) Plus, we had a truckload of lemons in the fridge getting overripe from neglect (scurvy in our future?). I have to say, the potatoes were simple and simply delicious. Again, Harvey declared them “guest-worthy.”

GREEK LEMON POTATOES
(from recipetineats.com)

2.5 lbs potatoes (about 4 large russets)
1 1/2 cups chicken broth
1/2 cup olive oil
1/3 cup fresh lemon juice
5 cloves garlic, minced (I used 4)
2 tsp salt (I used 1 tsp)
dash of pepper
1 tbsp dried oregano (I used 2 tbsp fresh rosemary instead)

Preheat oven to 400°F. Peel the potatoes and cut into semi-thick wedges. Place in a roasting pan with all the other ingredients; toss well. Roast covered with foil for 40 minutes. Remove foil and turn the potatoes. Roast for another 25 to 30 minutes until the liquid is mostly absorbed by the potatoes. If you like your potatoes a bit crispy, leave them in for another five minutes or so.

They end up super-moist, soft, lemony and fabulous. Oh yeah, and garlicky. Harvey said they were even better than the ones at Apollonia, our favourite Greek restaurant. It was hard to refrain from eating the whole darn batch, but we showed the teensiest bit of restraint. After all, we wanted some left over for the next day. They’re like potato candy, if you will. Except better.

Sometimes, the most obvious recipes are the best. I often consult that Council cookbook. Who better to advise on such Jewish delicacies as honey-glazed cocktail franks, deviled tongue canapes and fruited rice salad? I rest my case.

There’s no question that the NCJW of Canada does many admirable things to enhance the community through education, social action, furthering human welfare and more. Far be it from me to make it sound like all they did was produce a cookbook. But, thank you, NCJWC for having done so – the meatloaf alone is worth the price of admission. And, of course, kol hakavod for all the great work you do.

Shelley Civkin, aka the Accidental Balabusta, is a happily retired librarian and communications officer. For 17 years, she wrote a weekly book review column for the Richmond Review. She’s currently a freelance writer and volunteer.

That glitter gets everywhere

I’ve been thinking about Caillou, a TV show for toddlers and preschoolers. It’s been on television since 1997. Caillou is a little bald French-Canadian kid. He’s broadcast in both French and English, and offers gentle lessons to kids everywhere. My twins watched a lot of Caillou.

The episode I’ve been remembering offers something basic that we should all know. The summary: Caillou’s doing art at preschool with glitter. When he finishes, he doesn’t clean up or wash his hands. The rest of the episode shows off exactly where the glitter ends up, from light switches to friends’ bodies to snack and the table and chairs. That’s why it’s so important to wash your hands after playing with glitter.

The glitter message sticks with kids. It’s also a remarkably easy way to explain germ theory – useful during a pandemic. Glitter, like germs, gets everywhere.

As an early glitter fan, I found this lesson powerful. As a kid, I had several surgeries for birth defects by the time I was 5. I was in the hospital a lot. During one recovery period, I was brought to a big sunny room in the pediatrics ward to do arts and crafts, including glitter, which I loved. My mother still jokes about this more than 40 years later – remembering the day the surgeon came to check my incisions. My mom likely hovered, anxious, as he checked my abdomen and sides. He looked up and grinned when she asked how things were healing. He said things were coming along nicely and were “very colourful!”

What does this have to do with Judaism? I’ve been studying Tractate Pesachim as part of my pursuit of Daf Yomi (a page of Talmud a day). Pesachim’s topic is Passover. In Pesachim 15, the issue is how to burn all the chametz (leavened bread) that we get rid of right before the holiday. It’s considered “impure.”

Impurity here is often defined as something “in the wrong place at the wrong time.” There are many reasons why something is considered impure. The questions the rabbis are weighing are interesting. They wonder, “Is it OK to burn two different kinds of impure things together?” They imagine the Temple priests having to get rid of all this and finish cleaning by the start of the holiday.

The other impure things brought up – and this rabbinic impurity topic is complex – are pigul and nottar, two categories of sacrificial meats that have gone wrong. Jane Shapiro, in introducing this issue on the My Jewish Learning website, explains that pigul is something sacrificed “with improper thought.” That is, something sacrificed in error; that is, the priest thought it was to be burnt or eaten at the wrong time. Nottar was an offering made at the right time and not eaten – basically, leftovers, which are then considered impure. There’s common sense in this. Sometimes we cook things incorrectly (pigul) or, lacking refrigeration, we might just have to get rid of leftovers (nottar) to avoid food poisoning. In these cases, the impurity’s a mess-up. It’s not an unclean animal, another source of impurity, but, rather, a human mistake that leads to the disposing of something.

As the rabbis sort through what can be burned together, they examine how one kind of impurity causes a first-degree impurity, which, if it touches something else, becomes a second or a third degree of impurity. Something in this discussion reminded me of glitter and, then, germ theory.

Even the most careful person can be surprised by a sneeze, or get too close to someone when they are supposed to be social distancing. In fact, keeping oneself safe from invisible germs, like the coronavirus, can be difficult. Even healthcare workers, swathed in protective equipment, can slip up. In a sense, this rabbinic concept of impurity is a lot like catching germs. If we accidently mix items or people inappropriately, we pass along impurity, or germs.

If we visualize germs like Caillou’s glitter or my preschooler hospital craft project, we better understand how tricky a time we’re in. We’re still facing a long haul.

Yes, we hear a vaccine is on its way, but we don’t yet know how long it will take for enough Canadians to be vaccinated. We don’t know how effective the vaccine will be, or if enough people will be willing to take it. Meanwhile, COVID-19 is spreading just like that glitter. It’s everywhere that we are, and it’s scary. There’s every chance that we might encounter the virus through an inadvertent slip up (like the rabbinic impurity of pigul or nottar) but, since it’s germs and not glitter, we won’t know until later. We must act as if we are impure because the virus isn’t visible.

The most poignant part of this whole complicated impurity narrative is that the rabbis just can’t figure it all out. They say more than once that we’ll just have to wait for the prophet Elijah to return to give us the right answers. Reading it, you can imagine their shoulders shrugging as they struggle with what they don’t know and can’t figure out.

Scientists and doctors everywhere are also figuring things out as they go. They have to learn to live with the mystery. We don’t know everything – about the pandemic, how it works, when it will end and about those germs that spread like glitter.

For most, 2020 has been a rocky year. As we turn towards the secular year 2021, it’s important to remember that a vaccine might not be an instant fix. We face the future much as the rabbis faced some of these difficult questions about impurity long ago, and the researchers do today. We don’t know all the answers. We must do our best, square our shoulders, and keep on keeping on.

Yet, every week, as we end Shabbat, we sing about Eliyahu (Elijah) and we welcome him to every Passover and every bris. It’s in yearning for Elijah that we find the faith to keep trying.

Wishing you a happy and healthy 2021! I hope your home celebrations are great – and without glitter!

Joanne Seiff has written regularly for CBC Manitoba and various Jewish publications. She is the author of three books, including From the Outside In: Jewish Post Columns 2015-2016, a collection of essays available for digital download or as a paperback from Amazon. Check her out on Instagram @yrnspinner or at joanneseiff.blogspot.com.

Our rights in the age of AI

Dr. Rumman Chowdhury, chief executive officer and founder of Parity, gave the keynote address at the Simces & Rabkin Family Dialogue on Human Rights. (photo from rummanchowdhury.com)

Data and social scientist Dr. Rumman Chowdhury provided a wide-ranging analysis on the state of artificial intelligence and the implications it has on human rights in a Nov. 19 talk. The virtual event was organized by the Canadian Museum for Human Rights in Winnipeg and Vancouver’s Zena Simces and Dr. Simon Rabkin for the second annual Simces & Rabkin Family Dialogue on Human Rights.

“We still need human beings thinking even if AI systems – no matter how sophisticated they are – are telling us things and giving us input,” said Chowdhury, who is the chief executive officer and founder of Parity, a company that strives to help businesses maintain high ethical standards in their use of AI.

A common misperception of AI is that it looks like futuristic humanoids or robots, like, for example, the ones in Björk’s 1999 video for her song “All is Full of Love.” But, said Chowdhury, artificial intelligence is instead computer code, algorithms or programming language – and it has limitations.

“Cars do not drive us. We drive cars. We should not look at AI as though we are not part of the discussion,” she said.

screenshot - In her presentation Nov. 19 at the Simces & Rabkin Family Dialogue on Human Rights, Dr. Rumman Chowdhury highlighted the 2006 Montreal Declaration of Human Rights. — In her presentation Nov. 19 at the Simces & Rabkin Family Dialogue on Human Rights, Dr. Rumman Chowdhury highlighted the 2006 Montreal Declaration of Human Rights.

The 2006 Montreal Declaration of Human Rights has served as an important framework in the age of artificial intelligence. The central tenets of that declaration include well-being, respect for autonomy and democratic participation. Around those concepts, Chowdhury addressed human rights in the realms of health, education and privacy.

Pre-existing biases have permeated healthcare AI, she said, citing the example of a complicated algorithm from care provider Optum that prioritized less sick white patients over more sick African-American patients.

“Historically, doctors have ignored or downplayed symptoms in Black patients and given preferential treatment to white patients – this is literally in the data,” explained Chowdhury. “Taking that data and putting it into an algorithm simply trains it to repeat the same actions that are baked into the historical record.”

Other reports have shown that an algorithm used in one region kept Black patients from getting kidney transplants, leading to patient deaths, and that COVID-19 relief allocations based on AI were disproportionately underfunding minority communities.

“All algorithms have bias because there is no perfect way to predict the future. The problem occurs when the biases become systematic, when there is a pattern to them,” she said.

Chowdhury suggested that citizens have the right to know when algorithms are being used, so that the programs can be examined critically and beneficial outcomes to all people can be ensured, with potential harms being identified and corrected responsibly.

With respect to the increased use of technology in education, she asked, “Has AI ‘disrupted’ education or has it simply created a police state?” Here, too, she offered ample evidence of how technology has sometimes gone off course. For instance, she shared a news report from this spring from the United Kingdom, where an algorithm was used by the exam regulator Ofqual to determine the grades of students. For no apparent reason, the AI system downgraded the results of 40% of the students, mostly those in vulnerable economic situations.

Closer to home, a University of British Columbia professor, Ian Linkletter, was sued this year by the tech firm Proctorio for a series of tweets critical of its remote testing software, which the university was using. Linkletter shared his concerns that this kind of technology does not, in his mind, foster a love of learning in the way it monitors students and he called attention to the fact that a private company is collecting and storing data on individuals.

To combat the pernicious aspects of ed tech from bringing damaging consequences to schooling, Chowdhury thinks some fundamental questions should be asked. Namely, what is the purpose of educational technology in terms of the well-being of the student? How are students’ rights protected? How can the need to prevent the possibility that some students may cheat on exams be balanced with the rights of the majority of students?

“We are choosing technology that punishes rather than that which enables and nurtures,” she said.

Next came the issue of privacy, which, Chowdhury asserted, “is fascinating because we are seeing this happen in real-time. Increasingly, we have a blurred line between public and private.”

She distinguished between choices that a member of the public may have as a consumer in submitting personal data to a company like Amazon versus a government organization. While a person can decide not to purchase from a particular company, they cannot necessarily opt out of public services, which also gather personal information and use technology – and this is a “critical distinction.”

Chowdhury showed the audience a series of disturbing news stories from over the past couple of years. In 2018, the New Orleans Police Department, after years of denial, admitted to using AI that sifted through data from social media and criminal history to predict when a person would commit a crime. Another report came from the King’s Cross district of London, which has one of the highest concentrations of facial-recognition cameras of any region in the world outside of China, according to Chowdhury. The preponderance of surveillance technology in our daily lives, she warned, can bring about what has been deemed a “chilling effect,” or a reluctance to engage in legitimate protest or free speech, due to the fear of potential legal repercussions.

Then there are the types of surveillance used in workplaces. “More and more companies are introducing monitoring tech in order to ensure that their employees are not ‘cheating’ on the job,” she said. These technologies can intrude by secretly taking screenshots of a person’s computer while they are at work, and mapping the efficiency of employees through algorithms to determine who might need to be laid off.

“All this is happening at a time of a pandemic, when things are not normal. Instead of being treated as a useful contributor, these technologies make employees seem like they are the enemy,” said Chowdhury.

How do we enable the rights of both white- and blue-collar workers? she asked. How can we protect our right to peaceful and legitimate protest? How can AI be used in the future in a way that allows humans to reach their full potential?

In her closing remarks, Chowdhury asked, “What should AI learn from human rights?” She introduced the term “human centric” – “How can designers, developers and programmers appreciate the role of the human rights narrative in developing AI systems equitably?”

She concluded, “Human rights frameworks are the only ones that place humans first.”

Award-winning technology journalist and author Amber Mac moderated the lecture, which was opened by Angeliki Bogiatji, the interpretive program developer for the museum. Isha Khan, the museum’s new chief executive officer, welcomed viewers, while Simces gave opening remarks and Rabkin closed the broadcast.

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

***

Note: This article has been corrected to reflect that it was technology journalist and author Amber Mac who moderated the lecture.

The man behind the curtain

It was a beautiful Wednesday morning. I awoke in a tangle of bed sheets and to an IV stuck in my left arm. I had been in a road biking accident in the city the night before, breaking my now throbbing right leg in three places. The night had been a blur of ambulances, narcotics and doctors bustling around the noisy emergency room. It was quiet now. I had been moved to a shared room on the seventh floor. Long beige curtains had been pulled around my hospital bed, shielding me from the other patients. I could see the sunlight splashing through the window on my left, as I looked out to the surrounding city buildings. It was still summer, but mine was over.

A tired nurse interrupted my thoughts, rushing in with an awkward blood pressure machine and a temperature wand. I wondered if the frequent checks were to ensure I was clear of infection and, perhaps, COVID-19. The ward was eerily empty of visitors. Strict regulations were now in place because of the pandemic, and the impact was evident. Suddenly, with fewer family members visiting, there was more for the staff to do. The nursing station seemed to be a never-ending symphony of ringing, as patients buzzed for attention.

On the other side of my bed curtain, I heard a patient cheerfully chatting to a nurse who had arrived to assist with his medication. The nurse’s smile was audible as she told him about her coming birthday plans at the beach, physically distanced, of course. I eavesdropped that day and I realized that my roommate knew the name of every care aide and nurse who came to his side. He greeted them with enthusiasm as they entered the room, as if welcoming each into his home. He called them by name and asked with sincerity about their families and futures. I never once heard this man whisper a word about his own pain.

That night I wept, overwhelmed by self-pity and my coming trip to the operating theatre, where they would screw my splintered bones back together. I lay still and stared at the ceiling, listening to the hum of the machines around me. I thought about how I was going to get the kids to school, how my work would be affected and all the things I could, temporarily, no longer do. This year was not getting any easier. And then, as I attempted to use my bedpan, it spilled.

I awoke the next day to the sunshine dappling on my starchy bed sheets and the scattered magazines on my bedside table. It was agonizingly early, and the birds were chirping loudly as if to flaunt the beauty of the day. I was disheartened by my bedridden state, my swollen leg wrapped in plaster and the unsightly road rash that covered my body. I sat up in bed and dreaded the lonely hours that lay ahead.

The silence of the room was soon broken by a quiet voice from behind the curtain.

“Good morning,” the voice said calmly, clearly directed at me. “Are you doing OK?”

The patient next to me must have heard my sobs the night before. Hesitantly, I responded. From there, he drew me into a conversation and brought me into his world, spinning my despair on its head.

For days, we talked endlessly through the hanging fabric to pass the time, without seeing each other. Each morning he would greet me with unwavering cheer, found somewhere in the depths of his own being, despite his medical challenges.

“Good morning, Caroline,” he would beam. “You are going to get through this.”

He was almost 80 years old, he proudly told me. He had a wonderful life filled with a loving family, amazing friends and memories. His heart was full. And come hell or high water, he was going to get better and get out of this joint.

This stranger became my unrelenting cheerleader, as if it was his personal mission to lift me up from my melancholy. As I told him about my family, he reminded me to enjoy these precious years with my young children and how fortunate I was to have a partner who was by my side, when the hospital allowed. As we talked through the curtain, he encouraged me to find the best in all difficult circumstances, including this one, and to remember that the glass is always half full. Life is not always easy, he would say, but you have to carry on and look for the positive. His optimism radiated throughout our hospital room.

After our hours of conversation, we asked the nurse if we could see each other. Bedridden, connected to IV poles and draped in matching hospital gowns, we waited in anticipation as the curtain was drawn. As his eyes sparkled, he smiled knowingly and told me that I had so much to look forward to. I felt a sense of exhilaration, seeing him for the first time, after all that had been shared in our intimate room.

Despite his own ill health, he continued to coach me from his hospital bed in the days that followed, gracefully placing my injury in perspective. It was left unsaid that I was one of the lucky ones. I only needed to look over to the third patient in our room, who had been in a motorcycle accident, to count my blessings.

My roommate was wise and unrelenting with his words of encouragement. He was infectiously optimistic and didn’t complain, except about the food, assigning a score out of 10 to each meal. We joked about this often, that and the dismal TV options. My discharge papers were finally signed on the fifth day and I waited eagerly to get home to my family. As I was wheeled out of the room, our eyes met and we said our final goodbyes. I felt emotional, as I knew that I would likely never see him again.

I think of my exceptional roommate often and of what a gift he was to me. The impact he made during those difficult days on the hospital ward still resonates. Everything will be okay and there are brighter days ahead, for all of us. Thank you, Sanford, for being my silver lining, my ray of sunshine. I am grateful.

Caroline Dickson lives in Vancouver. This story was originally published in the Globe & Mail and a Jewish community member shared it with the JI. In recognition of Sanford Cohen’s kindness towards everyone he meets, Dickson is collecting Chanukah gifts from the community for him this year. If you would like to contribute a gift or send a card, please email [email protected]. Drop-off locations are available in Richmond and Vancouver.

Video on healing, light

Loolwa Khazzoom in Iraqis in Pajamas’ video for their song “Cancer Is My Engine,” to be released on Chanukah. (photo by Ailisa Newhall)

With shared themes of finding light in the darkness, Seattle-area band Iraqis in Pajamas is releasing the video for their song “Cancer Is My Engine” on Chanukah.

Amid the global pandemic, volunteer cast and crew drove in from across Washington state, donning masks and practising social distancing, to film the music video against the backdrop of the Olympic Peninsula forest.

The video tells the story of front woman Loolwa Khazzoom’s choice to reject the conventional thyroidectomy treatment for thyroid cancer, despite medical and financial pressure. Khazzoom instead chose to approach the diagnosis as an opportunity for radically transforming her life, such as by going vegan and practising numerous forms of mind-body medicine. (See jewishindependent.ca/healing-powers-of-song.)

After cold-stopping the growth of the nodules for years, through these measures, Khazzoom moved to Washington state from California, returned to her lost love of music, and launched her band, which combines ancient Iraqi Jewish prayers with original alternative rock. Immediately following, the thyroid nodules began shrinking. Through magical realism and metaphor, the music video reveals how, by listening to her inner voice, Khazzoom self-healed through her actual voice, by singing – the ability to do which may have been destroyed by a thyroidectomy, given the proximity of the thyroid gland and vocal chords.

The video begins with Khazzoom standing at the edge of a cliff, singing the opening line of the song, “Cancer is my engine.” As she sings, a candle is lit by her voice. She is transported to a forest, where she is searching in the dark with the light of that candle. She comes across a stuffed bear – representing Khazzoom’s mother – and picks it up, then continues on her quest.

An insurance agent and doctor appear and begin chasing Khazzoom. As she runs from them, she comes to a fork in the road – with the doctor on one side and the insurance agent on the other. She pauses, then runs forward, where there is no path, heading toward the light. She keeps running until she comes to a cliff and jumps off it.

photo - Loolwa Khazzoom in the “Cancer Is My Engine” video — Loolwa Khazzoom in the “Cancer Is My Engine” video. *(photo by Ailisa Newhall)*

She lands in the middle of a drumming circle and starts dancing wildly. A few scenes later, she is drumming in the middle of the circle, and everyone else is dancing around her. Both circles represent the pivotal importance of music and dance in Khazzoom’s healing. The video then shifts from magical realism and metaphor to real-life shots, with the band playing music in a vegetable patch in Khazzoom’s garden, representing Khazzoom’s regimen of juicing daily and eating a whole-foods, plant-based diet. The video ends with Khazzoom standing on the edge of the cliff and singing the last words of the song, in the original a cappella Iraqi Jewish prayer that exalts the power of the Divine.

The video was sponsored by nonprofit Healing Journeys and funded by the Lloyd Symington Foundation, both of which offer programs for people living with and healing from cancer.

Studies on the healing possibilities of music are documented in books like The Power of Music by Elena Mannes and The Healing Power of Sound by oncologist Dr. Mitchell Gaynor, and the National Institutes of Health has launched a series of studies on the healing powers of music. Whether singing lullabies or sacred chants, mothers and religious leaders have known for millennia what scientists are only beginning to understand. Singing bypasses our mental process, both awakening and soothing us at the core. Among other benefits, we are able to access, release and heal from the experience of trauma, without having to recount and risk getting triggered by painful memories.

Khazzoom has had a career as an educator, activist, journalist, health coach, and more, all with the central organizing principle of individual and collective healing. Her work has been featured in media including the New York Times and Rolling Stone; she has presented at venues including Harvard University and the Simon Wiesenthal Centre; and she has published two books, which are taught at universities nationwide.

Iraqis in Pajamas comprises Khazzoom on both vocals and bass, Sean Sebastian on guitar and Robbie Morsehead on drums. The trio opens up audiences to contemplation about trauma, healing and transformation, whether addressing domestic violence, cancer, racism, mental illness, street harassment, family caregiving or national exile.

Scientific breakthroughs

Scanning Israeli news this week has a feel of a sci-fi fantasy. Most eye-catching of all is the assertion by a Tel Aviv University researcher, in a peer-reviewed article, that hyperbaric oxygen therapy can “reverse aging” by lengthening telomeres, the structures found at the ends of chromosomes, by more than 20% on average.

“This means we can start to look at aging as a reversible disease,” Prof. Shai Efrati said, as reported in the Times of Israel. Some gerontologists are skeptical of the claims and some suggest it could open a Pandora’s box of related health issues, but, from ancient times through the 16th-century conquistador Juan Ponce de León to, apparently, contemporary Israel, humankind has dreamed of and sought out a figurative or literal fountain of youth. Whether Efrati’s research will fulfil that dream will be watched closely.

And there are other scientific headlines this week.

Also coming out of Tel Aviv University is news that scientists have destroyed cancerous cells in mice by pinpointing affected cells with “tiny scissors,” while leaving everything around them intact and with no side effects. With trials possibly to begin in humans within two years, they are hopeful that this could be a revolution that could effectively cure cancer.

A third scientific bombshell comes from Israelis in Canada. Eliav Shaked and Roy Kirshon, expatriate biomedical engineers working in Toronto, are developing a speedy, non-invasive diagnostic for patients who are likely decades away from showing symptoms of dementia. While there is no cure yet for dementias like Alzheimer’s disease, the pair believe that an early diagnosis will not only permit individuals to prepare for eventual care but allow doctors to study the progression of the disease and thereby gain valuable insights.

In these pages, we frequently highlight Israeli technological and medical advancements but the news this week really seemed like a dream sequence from a futuristic utopia. Of course, none of these initiatives is a sure bet but they read like a hat trick against some of the most damning health challenges facing our generations.

Is it a coincidence that these are all emerging from Israel? It is no secret that the tiny state is a locus of a massively disproportionate amount of the world’s achievements in a range of fields.

Some books, like Start-up Nation: The Story of Israel’s Economic Miracle, by Dan Senor and Saul Singer, and many other observers have posited that Israel’s successes are achieved not in spite of the adversities the country and its people have faced, but as a direct result of them. So many of the scientific, social and economic advances that have come out of Israel in recent decades are civilian benefits redounding from military research and development, though Israel is by no means the only country for which this is case.

No less significant are the social impacts of compulsory service in a national defence force that some have called the least hierarchical in the world. Individuals who made life-and-death choices for themselves and their colleagues at age 19 or 20 may be less timid in taking major entrepreneurial or other life risks at 25 or 30 than an average North American or European at that age. Not to discount the value of peace and all the benefits it would bring, the circumstances in which Israel exists have created a thoroughly unique social and economic environment.

Coincidentally or not, also in the news this week was a vote at the United Nations in which 163 countries, including Canada, voted for a condemnatory resolution against Israel; five voted against. It is one of 17 resolutions expected in this General Assembly session targeting Israel, while just seven country-specific resolutions are expected to be aimed at condemning every other injustice on the planet. Canadian Jewish organizations and pro-Israel commentators are furious at Canada’s vote, which directly contradicts pledges made by Prime Minister Justin Trudeau, including during the last election campaign.

While many are appalled at the hypocritical obsession with Israel, and certainly Israeli diplomats are in the fray denouncing the vote, average Israelis, it is safe to say, remain sanguine. They have seen far worse attacks than that by the world community in the comparatively impotent global parliament that the UN General Assembly has become.

While it would be nice if the world judged Israel with moral measuring sticks commensurate with those we use for every other country, in the end it doesn’t seem to make much difference, thankfully. Even through the pandemic, Israelis have continued to try and turn science fiction into scientific reality. This week’s news alone included the possibility of cures for cancer, dementia and aging itself. And the benefits of such research do not accrue solely to Israelis, but to all of us – whether the nations of the world at the General Assembly recognize and appreciate that fact or not.

Medical myth-busting

Medical myth-buster Dr. James McCormack speaks Nov. 22 via Zoom. (photo from too-much-medicine.com)

Dr. James McCormack is a bit of an anomaly as a voice in today’s medical debates. In a politically driven climate where most people tend to stand as either “all in” or “all out” with regards to their belief in science and research, McCormack’s approach is more pragmatic.

McCormack, a tenured professor in the faculty of pharmaceutical sciences at the University of British Columbia, a podcast host and a YouTube content creator, is a strong believer in evidence-based medicine. Well-known as a medical myth-buster, he dispels misinformation that often prevents doctors and their patients from making the most informed decisions possible. He will present some of his many thoughts and findings at the Jewish Seniors Alliance Virtual Fall Symposium Nov. 22, 2 p.m., which will be held on Zoom.

McCormack’s presentation will highlight some of the more common myths around what medications are actually effective and how doctors and patients can better work together to make evidence-based decisions. In a phone interview with the Jewish Independent, the doctor said his ultimate objective is to find out what the best available existing evidence is in healthcare to help doctors and patients make shared decisions on treatment plans.

This process is often “tricky,” he said, because of the many false conclusions and deceptive statistics that surround the medical field. For example, there are hundreds of clinical trials showing that statins, one of the most popular drugs in the world, help patients with high cholesterol, reducing the risk of heart attacks among 50-to-60-year-old patients from five percent to four percent.

“If you take a statin you can reduce your chance of a heart attack by about one percent,” he explained. “But what you will hear is that this is a 20% reduction in heart attacks – 20% is not a lie, but it’s misleading.

“If I come to you and say, ‘You have high blood pressure. That’s a silent killer. Do you want it to be treated?’ That’s not shared decision-making,” he argued. “If I said, ‘Your blood pressure is this number and your chance of a heart attack is 10% over the next 10 years and we can reduce it from 10% down to eight percent, what do you think of that?’ If that two percent seems like something you might want to consider, then we can try the drug, start with a low dose, make sure we don’t blow you away with any side effects, and then go from there.”

McCormack hinted at the large amount of medical misunderstanding around the world by noting his belief that at least half of all medical prescriptions are either wrong, unnecessary or the incorrect dose – a problem he says is driven by the challenges pharmaceutical companies face in getting their products to market.

“When a new drug comes onto the market, almost for sure the recommended dose is too high,” he said. “[Pharmaceutical companies] have to show that the medicine works. To show that it works, they have to recommend a dose that everybody responds to because, if you choose lower doses, you might not show enough people responding.”

He likened this process to attempting to estimate how much alcohol any specific person would need to drink in order to get drunk – a question for which there would be almost as many answers as there are people.

“This is a fundamental flaw in how we get a drug onto the market,” he said.

McCormack also brought up the alarming lack of evidence-based research on some of the most popular ideas in modern medicine and nutrition. Some of these myths include what we think about vitamins, the lack of evidence showing the health benefits of green vegetables like broccoli, and even our daily water intake.

“You see the same things with nutrition, where there are so many recommendations that are BS – like the idea of [needing to drink] eight glasses of water a day,” he noted. “Almost everyone in the world knows that’s the number of glasses of water you’re supposed to have every day, but there is not a single study that’s ever looked at that. It’s a made-up number mentioned by someone maybe 50 years ago, but it becomes incredibly powerful when everyone assumes it to be true. The evidence is pretty clear when it comes to water – you drink when you’re thirsty.”

McCormack became a myth-buster when, earlier in his career, he discovered a lack of evidence backing up the so-called facts that many of his mentors presented to him.

“I went looking for the evidence and I wondered why they were telling me this if [there was a lack of] evidence. It didn’t make any sense,” he said. “If good, smart people who are trying to do a good thing are telling me unintentional BS, why is that? So, ever since then, I’ve been very inquisitive.”

While he does his best to provide as much myth-busting content as possible to the public, McCormack warned that there’s no simple solution to helping patients understand the great nuances surrounding medical options.

“It’s very tricky,” he said. “Patients don’t feel empowered to make a decision because that’s not part of the ethos of how we do medicine. There are people who would say to their doctor, ‘Just tell me what to do.’ And that’s totally fine as long as the doctor or the pharmacist knows the best available evidence.”

While McCormack will share some of his key discoveries at the symposium, fans of his work can also listen to any of the 460-plus episodes of his podcast, The Best Science Medicine Podcast, which he has nicknamed The BS Medicine Podcast.

“We take the BS out of the BS,” he laughed, before emphasizing that he and co-host Michael Allan approach their shows with a sense of humour.

McCormack also produces various music video parodies on his YouTube channel under his own name. The videos, he said, are a labour of love. “I do [them] because I’m a tenured professor and I can do whatever I want,” he said, tongue-in-cheek. “Which is kind of nice.”

JSA members/supporters will receive an email with the Zoom link to join the virtual symposium. For more information on and to register for the JSA symposium, contact the JSA office at [email protected] or 604-732-1555.

Kyle Berger is Jewish Community Centre of Greater Vancouver sports coordinator, and a freelance writer living in Richmond.

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Editor’s note: This article has been amended from the print version to include more detailed information on how to access the event on Zoom.

A shidduch like none other

Brad Chenkis shows off a couple Sonovia masks. (photo from Tikva Housing)

It all began when Boris Chenkis, owner of After Five Fashions, was watching Israel Daily TV (ILTV) and saw an interview with Liat Goldhammer, the chief technology officer of an Israeli startup called Sonovia. She was talking about a new fabric-finishing technology for textile manufacturing developed at Bar-Ilan University, explaining that the technology could repel and kill bacteria located on clothing. Because it was in early January, a few weeks before COVID-19 became a worldwide pandemic, Chenkis just listened with interest.

On ILTV March 18, Dr. Jason Migdal, a microbiology researcher in Israel, discussed how the Sonovia technology mechanically impregnates metal nanoparticles into masks that destroy microorganisms in fabric. This was verified by two independent labs. It was also durable and washable. Now Chenkis was very interested.

With COVID becoming widespread, Sonovia had positively impacted Israeli doctors and health professionals by providing them with the technologically advanced masks. On May 12, Chenkis saw another interview about the Sonovia mask technology on ILTV – and an opportunity to get involved.

During his teenage years, Chenkis lived in Israel, studying and working at Kibbutz Rosh Hanikra. With this connection to Israel that never left his heart, he wanted to support an Israeli startup and so he purchased some masks to keep his family, friends and community safe. Soon after, he received an email from Sonovia, offering him an opportunity to help distribute the masks in Canada. Chenkis said yes. The masks were shipped from Ramat Gan to Vancouver and, within days, he was delivering hundreds to friends and family.

One of those who received the Sonovia mask was Yosef Wosk. Being both pleased and impressed with the technology, Wosk, like Chenkis, saw an opportunity to help not only the community here but also Israel. Wosk wondered how the masks could be made available locally to community members who might not be able to afford them, as they cost $65 each.

Wosk spoke with Shelley Karrel, chair of Tikva Housing, who contacted Tanja Demajo, chief executive officer of Jewish Family Services Vancouver. The need for the masks was confirmed and the shidduch almost complete.

Working with Chenkis’s son, Brad Chenkis, and with Wosk’s help, Tikva has acquired and will distribute 500 masks to residents of Tikva Housing, as well as clients of Jewish Family Services. It’s a win, win and win – tikkun olam, tzedakah and chesed.

For more information about the Sonovia masks, contact Brad Chenkis directly at [email protected].

We must plan for our death

While our ultimate death is a certainty, when and how we will die is unknowable. And though death is inevitable, it remains a taboo subject for most. None of us knows what the future will bring. It is better to be prepared, so that if you become unable to make medical care decisions, your designated family members and healthcare providers, if you have talked to them, will have the knowledge and confidence to make those decisions for you.

As long as you are capable of understanding and communicating effectively with your doctor, nurse or other healthcare provider, you will be asked to make your own healthcare treatment decisions. But a serious accident or illness can result in you being incapable of making your own healthcare decisions at the time care is needed. This is why thinking about your preferences and talking to your future decision-makers now is so important. Making an advance care plan is a choice that will help alleviate some of the stress your family and friends could face if they are required to make important decisions for you, including who, exactly, you want your doctor to approach to learn about your wishes.

Advance care planning begins by thinking about your beliefs, values and wishes regarding future healthcare treatment and talking about them with selected family members or friends, as well as your doctor. When people you trust know what is important to you, it will be easier for them to make treatment decisions on your behalf.

Healthcare providers will always offer medically appropriate healthcare based on clinical assessment. They will want to ensure that any symptoms like pain, dizziness, nausea, bleeding or infection are understood and addressed. As long as you can understand and communicate, your healthcare provider will explain the medically appropriate care best for you, including any risks, benefits or alternatives. They will also ask if you have any questions and if you wish to accept or refuse the proposed healthcare treatment.

Some of the hardest decisions deal with the use of life support and life-prolonging medical interventions. These can include a ventilator to help with breathing, tube feeding, kidney dialysis, or CPR to restart the heart and lungs. If you were to have a life-threatening illness or injury, would you want to accept or refuse CPR? All, some, or no life support or life-prolonging medical interventions? A trial period of life support and life-prolonging medical interventions, allowing a natural death to occur if your condition is not improving?

Your advance care plan should at a minimum include these three things:

Having conversations with selected family members, friends, your family doctor and, if applicable, your spiritual leader, about your beliefs, your values and your wishes.
Writing down your beliefs, values and wishes for future healthcare treatment.
Writing down the contact information for the people who qualify to be on your temporary substitute decision-maker list (see below), or, if you prefer, the contact information for the representative you have chosen and named in an enhanced representation agreement, which is the one that allows you to name a person to make personal-care decisions and some healthcare decisions, including decisions to accept or refuse life support or life-prolonging medical interventions for you. (If you choose to have a representative agreement, I recommend you seek legal advice).

Bear in mind that your health and personal circumstances will change over time. As long as you are capable, you may change or cancel your advance care plan at any time and for any reason. Be sure to notify your doctor and your family members/friends of all changes you make.

Palliative care

When thinking about what to cover in your advance care plan, you might want to expressly include your wish to receive palliative care if you are suffering from a serious illness or condition. Palliative care is specialized medical care that focuses on providing patients with relief from the symptoms, pain and stress of a serious illness, whatever the diagnosis. The goal of palliative care is not to prolong life, nor to shorten it. The goal is to improve quality of life for both the patient and the family, and can be provided in a variety of locations, including the patient’s home, in a hospice, in a residential care facility or in a hospital.

Palliative care is provided by a team of doctors, nurses and other specialists who work with a patient’s other doctors to provide an extra layer of support. While often associated with end-of-life situations, palliative care is appropriate at any age and at any stage in a serious illness and can be provided alongside other appropriate treatments.

Many people choose to stay at home right to the end of their lives while receiving in-home palliative care from specialized healthcare providers. But if you are in the last few months of your life and feel that you are no longer able to manage at home, a hospice may be a good option for you. Hospices are meant to feel more like a home than a hospital. They are designed and furnished to provide a peaceful, homelike environment for you and your family while you receive end-of-life palliative care.

For more information on the delivery of palliative care in each of these settings, search the B.C. Health Ministry website or contact your local health authority.

Medical assistance in dying

Medical assistance in dying (MAiD) was made legal in Canada in 2016. It provides eligible patients who are experiencing intolerable suffering due to a grievous and incurable medical condition the option to end their life with the assistance of a doctor or nurse practitioner.

If your beliefs and values allow you to consider MAiD in the face of intolerable suffering, you should start by speaking with your doctor or your local health authority. For a variety of reasons, not all doctors will provide MAiD, and no one is required by law to do so. For some, MAiD may conflict with their personal beliefs or professional ethics. However, a patient can expect to be provided with information on how to access this service. Healthcare providers must not discriminate against patients with beliefs or values different from their own, and must provide an effective transfer of care to another healthcare professional who does offer MAiD.

To be eligible for MAiD, a patient must meet all of the following criteria:

be registered under B.C. Medical Services Plan
be at least 18 years old and capable of making healthcare decisions
have made a voluntary request for medical assistance in dying that was not made under any external pressure. This request must be in writing and signed and dated in front of two independent witnesses
have given informed consent after having been informed of the other means that are available to relieve their suffering, including palliative care, and
on assessment by two independent doctors or nurse practitioners, are determined to have a grievous and incurable medical condition, which means they have a serious and incurable illness, disease or disability; they are in an advanced state of decline that cannot be reversed; the illness, disease, disability or state of decline causes enduring physical or psychological suffering that is intolerable and cannot be relieved under conditions that the patient considers acceptable; their natural death becomes reasonably foreseeable. (On Feb. 24, 2020, the Liberal government of Canada introduced a bill to further amend the Criminal Code to, among other things related to MAiD, allow eligible persons to pursue a medically assisted death whether their natural death is reasonably foreseeable or not.)

A patient who has requested MAiD must be given the opportunity to withdraw their request throughout the process, including immediately before the medical assistance is administered, and this withdrawal need not be in writing or in any other particular form. Just an indication of a change of mind will do. And be aware that only patients who are themselves capable of giving consent can request MAiD. A request by a substitute decision-maker or by way of an advance directive is not valid.

Start the discussion

There is much more information available on end-of-life options than touched on in this article, and many matters not covered herein, but there is enough here to allow you to begin a conversation with those in your life who you want to make decisions for you when you cannot.

This is a lot to cover in one conversation. You can have as many conversations as you need – just get started before unwelcome circumstances make it too late. You will be doing yourself and your loved ones a big favour.

Tony DuMoulin is a founder of the law firm of DuMoulin Boskovich, where he practised commercial and real estate law for 40 years. He has a long history of involvement in Jewish organizations and municipal projects. DuMoulin is on the executive board of Jewish Seniors Alliance, in whose magazine, Senior Line, this article originally appeared in July 2020, Vol. 27(2).