Dr. Noah Alexander was the keynote speaker at the Jewish Seniors Alliance Spring Forum on March 21. (photo from medicalmentorcommunity.com)
Can I Trust That? Evaluating Health Information Online was the topic of the Jewish Seniors Alliance Spring Forum, held virtually on Sunday, March 21.
Gyda Chud, co-president of JSA, welcomed about 100 people to the afternoon event. She reminded attendees of the four foundational elements of JSA: outreach, education, advocacy and peer support. She then turned the mic over to Tamara Frankel, a member of the program committee, to introduce the guest speaker, Dr. Noah Alexander.
Alexander is a practising emergency physician at Vancouver General Hospital. Although he usually works on the front line, he also works to empower patients. He does this through his role as the associate director of digital health literacy at the InterCultural Online Health Network. This organization helps members of many different communities understand and manage their chronic health conditions.
Alexander began his talk by stating that his goal was to provide a systemic approach to health education. He highlighted many elements, beginning with the question, How do you know who to trust in this information age?
When using a search engine (he likes to use Google Chrome), use key words or short sentences to find information. When looking at the search results, consider whose website it is, their credibility and the value of the content. Credibility and content are key to the whole process. For example, who wrote the article or blog, and are they known and respected? How old is the entry? Is it relevant to the question you’re asking? Is it peer-reviewed or is the writer or organization accredited? Check the site’s URL: for example, .com entities are usually commercial and profit-based, whereas URLs ending in .org, .gov and .edu are not-for-profit.
Check both the credentials of the authors and whether they are being paid and, if so, by whom. If the entry has advertisements, there is likely to be a bias involved, Alexander warned. He said people should not trust a Wikipedia entry for important information, as anyone can add their own comments to the post. Rather, use a credible health website such as the BC Centre for Disease Control, HealthLink BC, Vancouver Coastal Health, or any other government agency.
Alexander then presented an interactive quiz based on his presentation, after which Chud thanked him for clarifying the elements involved in seeking accurate health information online. She also summarized the questions attendees posted in the chat and Alexander answered a number of them.
The answer to the question posed about health information online – “Can I Trust That?” – is yes … if you follow Alexander’s suggestions.
Shanie Levinis program coordinator for Jewish Seniors Alliance and on the editorial board of Senior Line magazine.
As the winter blues threaten to sink in, and COVID continues to be a part of life, Canadian Associates of Ben-Gurion University of the Negev (CABGU) has been looking for ways to keep people engaged through a series of virtual events. Each event seeks to offer insights, share research and encourage discussion about varied topics.
For the art lover, A Virtual Art Tour, scheduled for Feb. 7, 8:30 a.m., offers participants a guided stroll through one of the few public art collections in Israel’s Negev Desert. “Ben-Gurion University is home to one of southern Israel’s most dynamic and innovative fine arts collections,” said Maayan Amir, the collection’s curator and senior lecturer in the department of art. “Many of the pieces featured in the collection can be found scattered throughout the Be’er Sheva campus, enlivening the landscape while complementing it as well.”
On the medical front, questions have been raised during the pandemic about ethical decision-making. How do medical personnel make life and death decisions? What type of protocol is followed and how should the vaccine be distributed? Three top doctors from Israel and Canada will participate in a moderated discussion on Feb. 10, 4:30 p.m., sponsored by the Dr. Edward Feldman Memorial Fund. The event is a collaborative initiative between CABGU and the Israel Medical Association. Among the speakers are Dr. Yoram Singer, director of the Negev Home Palliative Care Unit at Ben-Gurion University; Dr. Sandy Buchman, medical director of the Freeman Centre for Advancement of Palliative Care at North York General Hospital; and Dr. Elliott Malamet, lecturer on Jewish ethics and philosophy at Hebrew University.
CABGU also offers monthly lunchtime webinars on STEM-related topics called Webinar Wednesdays. Coming up on Feb. 3, 9 a.m., BGU professor and president Daniel Chamovitz will be joined by Sigal Abramovich from the university’s department of earth and environmental sciences for a discussion about the impact that climate change is having on the environment. Research from BGU that looks at the role cannabis can play in supporting people with autism will be the focal point of a webinar on March 3, 9 a.m.
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)
How Well Do Treatments Prevent COVID-19, Shingles, Heart Disease, Diabetes and Anything Else that Might Ail You? That was Dr. James McCormack’s topic at the Jewish Seniors Alliance fall symposium Nov. 22. And some 100 participants Zoomed in to hear his answers.
Gyda Chud, co-president of JSA, welcomed everyone and reviewed the organization’s foundational goals: outreach, advocacy and peer support. She thanked Jenn Propp, Liz Azeroual and Rita Propp for their hard work in facilitating the symposium, which emphasizes education and advocacy.
Marilyn Berger, past president of JSA, spoke a bit about McCormack’s background, noting how amazing his talk had been when he addressed the JSA a few years ago.
McCormack is a professor in the faculty of pharmaceutical sciences at the University of British Columbia, a podcast host and YouTube content creator. He began his remarks by mentioning his philosophical beliefs, which can be found in detail at therapeuticeducation.org. He emphasized that he receives no money from pharmaceutical companies and his only income is his salary from UBC. His medical podcast covers many topics, including nutrition (the Mediterranean diet is recommended) and anti-aging creams (they are all the same).
Regarding treatments and medications, McCormack recommends being skeptical and checking all information, as some are useful but many don’t work well. For example, many new drugs are not much better than those they are replacing, and many doses are too high. (See jewishindependent.ca/medical-myth-busting.)
The doctor shared a number of popular beliefs that are not supported by evidence and, indeed, which science indicates are not true. Examples included the following myths: it is not good to swim immediately after eating; sugar makes children hyperactive; you lose body heat through your head; eating carrots helps your eyesight; and spinach is strengthening.
Also, there is no evidence that you need to finish all medications, he said. For example, with antibiotics, if you are asymptomatic after 72 hours, you can stop taking them. Although we have some incredible medications, McCormack said the Golden Pill Award, given for breakthroughs in new medication, has not been awarded for the past eight years.
McCormack stated that “so-called diseases,” such as elevated blood pressure, bone density issues and high-glucose levels, should be identified as “risk factors,” rather than diseases. He also said many medications do not alter outcomes. It’s all about the numbers, what is the relative reduction of symptoms after taking certain medications. If the reduction is only two percent, is it worth taking a drug that has many side effects? he asked. He said, in the case of cardiovascular disease, following a Mediterranean diet and exercising may have more benefit than many drugs.
Regarding the serums for COVID-19, McCormack said the work has been outstanding and the oversight phenomenal. Vaccines for contagions are very important, he said.
McCormack concluded his talk by reminding us that tests and treatments can help and/or harm people. It is important to think for yourself, ask questions and have hope, he said, before responding to many audience questions.
Ken Levitt, past president of JSA, thanked McCormack for his presentation and for his emphasis on being alert about medications. The participant feedback was extremely positive.
Shanie Levinis an executive board member of Jewish Seniors Alliance and on the editorial board of Senior Line magazine.
Dr. Liran Levy, left, and Dr. Milton Saute. (photo from IMP)
Sheba Medical Centre in Israel and Canada’s Toronto General Hospital are collaborating to advance the field of lung transplantation in Israel and to enhance medical education in both countries.
In the last year, Sheba’s Institute of Pulmonary Medicine has established a new lung transplant program, headed jointly by Dr. Liran Levy – who, in 2019, completed four years of clinical, research and surgical training at Toronto General – together with surgeon Dr. Milton Saute, an expert in lung transplantation. According to Sheba’s head of pulmonary medicine, Dr. Amir Onn, collaboration with Toronto General will “put Sheba on the map of lung transplantation,” due, in large part, to revolutionary technology that can increase the number of donor lungs by almost 50%.
Toronto General is renowned for having performed the world’s first successful lung transplant, in 1983. They have since expanded their lung transplantation program, both clinically and in terms of research. One of the most groundbreaking discoveries was made in 2013 by Dr. Marcelo Cypel, a staff thoracic surgeon at Toronto General and director of their ECLS (extracorporeal life-support) program. This technique, said Cypel, “effected a change in paradigm for how we do lung transplants.”
The innovation, called ex vivo lung prefusion (EVLP), doubles the amount of time that the donor lungs can remain outside of the body. “Previously, donor lungs could be kept for only six to eight hours,” Cypel explained. “Patients had to uproot their lives to live near a transplant centre, and staff had to race against the clock to transfer the organ from the donor to the recipient, often forced to perform the complex surgery in the middle of the night.”
The valuable hours gained don’t just optimize the logistics of the operation, they actually allow for recovery of the organ itself.
“As a rule, over 80% of donor lungs are unsuitable for lung transplantation, due to poor functioning, infection, blood clots or injury,” said Cypel. By pumping a solution of oxygen, proteins and nutrients into the injured donor lungs, the EVLP system enables injured cells to heal themselves, or to be prepared for more sophisticated repair techniques. “The method doubled the number of lung transplants performed in Toronto in the last seven years,” he said.
With the help of Toronto General, Saute estimated that the EVLP program will become operational at Sheba by the middle of 2021. “We anticipate that [EVLP] will make a huge impact and significantly increase the pool of donors for lung transplantation in Israel, especially now, during COVID, with donors reduced by more than 50%,” he said.
According to Cypel, some of the reasons for the reduction in donor lungs during the pandemic include deaths that occur at home, due to reluctance of patients to seek hospital care, and the fewer car accidents (whose victims supply donor lungs) that occur while populations are in lockdown.
Collaboration will encompass clinical care, as well, including consultations regarding challenging patients, as well an exchange of trainees, in both directions. “We hope to send members of our team to Sheba to learn from their unique expertise,” Cypel said.
Onn added that COVID-19 has created new potential candidates for lung transplant. He is currently treating patients in Sheba’s designated post-COVID clinic who present with an unusual combination of symptoms – shortness of breath, chest pain and forgetfulness. Some, he said, have sustained irrevocable damage to the lungs.
A growing population of “COVID-19 survivors,” are being referred to the lung transplant centre. “We are in the process of identifying those who may be potential transplant cases,” said Levy.
Levy remarked that he is looking forward to working with his former colleagues and mentors from Toronto General. Looking back on his years spent in Canada with his wife and four children, he admitted that it was hard to leave. “The Jewish community made us feel very much at home, and we still miss Toronto,” he said. “But I think we have a very important mission here in Israel.”
When the teams from both hospitals met one year ago to discuss collaboration, Cypel and Saute were delighted to discover that they both hail from the same city in southern Brazil. “Although we didn’t meet in Brazil, Dr. Saute told me that he knew my grandparents quite well, and that was very emotional for me,” Cypel shared. Saute added that they both had the same mentor in thoracic surgery and, thus, “We have the same ideas.”
The scope of research and complexity of cases at Toronto General have made it a national and international source for discovery, education and patient care. Sheba Medical Centre, home to the ARC Innovation Centre, and where 25% of all clinical research in Israel takes place, has likewise distinguished itself in patient care, particularly in the era of COVID-19. Patients in both countries, and worldwide, can look forward to the fruits of this collaboration.
– Courtesy International Marketing and Promotion (IMP)
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.
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.
Following a North American call for submissions and an exhaustive selection process, Jewish Family Services (JFS) in Vancouver has been chosen by the Network of Jewish Human Service Agencies for participation in Year Two of the NJHSA Jewish Poverty Challenge, an offering of the network’s Centre for Innovation and Research. The goal of the program is to help NJHSA member agencies better analyze the marketplace, launch and manage solutions, and implement sustainable measures for success to address the many dynamics associated with responding to Jewish poverty.
NJHSA has partnered with Start Co., a venture development consultancy firm based in Memphis, Tenn., with an expertise in launching startup, entrepreneurial initiatives and engaging municipalities, corporations and nonprofits in poverty reduction responses. The team at Start Co. will provide expert consultation assistance as JFS rethinks and redesigns products and services, adjusting assumptions and organization models. Throughout, special attention will be paid to the impact of COVID-19 on service delivery methods.
“We are so honoured to have been selected to participate in this challenge,” said Tanja Demajo, JFS chief executive officer, in a press release. “The demand for our services has increased during COVID-19 and we have had to pivot quickly. Although we have adapted, we are experiencing growing pains. This opportunity through the NJHSA and with Start Co. is timely in helping us address our pain points in an innovative way so we can be more efficient and can operate at a pace our clients are demanding during this crisis.”
Reuben Rotman, president and chief executive officer of the network, added, “The COVID-19 pandemic has even further heightened the critical need for innovative solutions to the challenges of Jewish poverty. With newly vulnerable clients reaching out for assistance in unprecedented frequency, the agencies are challenged to identify new ways of working and new efforts to achieve sustainable solutions for those in need.”
For more than 80 years, JFS has delivered a continuum of social services to individuals and families of all ages and in all stages of life in the Greater Vancouver area; its pillars of support include food security, counseling and mental health, care management, financial aid and home support.
The Network of Jewish Human Service Agencies is an international membership association of more than 140 nonprofit human service agencies in the United States, Canada and Israel. Its members provide a full range of human services for the Jewish community and beyond, including healthcare, career, employment and mental health services, as well as programs for youth, families and seniors, Holocaust survivors, immigrants and refugees, persons with disabilities and caregivers.
Dr. Mel Krajden is among those who will be appointed to the Order of British Columbia this year. The announcement of the 13 new appointments was made on BC Day, but the investiture ceremony will be postponed due to COVID-19 restrictions and held for recipients and invited guests at Government House in Victoria in 2021.
Krajden is medical director of the BC Centre for Disease Control (BCCDC) Public Health Laboratory and has made significant contributions to fields of research, including hepatitis, HIV, HPV and, most recently, COVID-19.
With the emergence of COVID-19, British Columbia and Canada needed urgent access to rapid, validated tests for the virus. Under his leadership at BCCDC, and relying heavily on his expertise, Krajden and his team were able to rapidly develop an assay for the province to commence testing in January 2020, weeks before other jurisdictions. Access to this test was an essential element in the management and control of the outbreak and the safety of British Columbians.
Krajden created the world-leading B.C. Hepatitis Testers Cohort, which integrates de-identified data on 2.4 million individuals tested for, or diagnosed with, hepatitis B, C, HIV and TB infections, linked to their corresponding healthcare administrative data since 1990, to create longitudinal medical histories. This cohort has produced influential pieces of evidence that shaped clinical and public health guidelines and policy in Canada and globally. He was instrumental in the development and continued progress of the Canadian Institutes of Health Research-funded Canadian Network on Hepatitis C, a multidisciplinary group committed to developing a national strategy for hepatitis C elimination.
Krajden was one of the key personnel in the STOP HIV initiative in British Columbia. This public health endeavour saw the implementation of acute HIV testing, allowing diagnosis during the most infectious period of the disease, resulting in timely interventions and communication to partners to reduce transmission. This undertaking helped lead to the lowest HIV incidence on a provincial scale in decades.
Krajden also played a pivotal role in global public policy changes in human papillomavirus (HPV) vaccine dosing regimen and the associated reduction of financial access barriers to care. Similarly, his work with respect to assessing the utility of HPV testing versus traditional Pap smears is expected to contribute to guidelines that will benefit women worldwide.
In his educational capacity, Krajden has the reputation of being a wonderful teacher and valued mentor, training researchers, health professionals and students at all levels. He is known for his willingness to provide input and advice despite numerous other commitments, contributing to the success of others. His dedication further extends into the clinical realm, where he always has patient interests at heart and never hesitates to devote his own time to make a difference in client outcomes.
In appointing Krajden to the Order of British Columbia, it is recognized that, over many decades, he has demonstrated exceptional innovation, leadership and sustained contributions to the province, country and the world. He is a highly respected visionary, scientist and educator who has inspired countless researchers and health professionals with his clinical excellence, dedication and generosity of spirit.
Tamara Micner, Rembrandt Koppelaar, Karen and Jack Micner and Dr. Talie Lewis are extremely proud to announce the ordination of Mimi Micner to the rabbinate. The virtual ceremony took place June 7 from Hebrew College in Boston. Mimi and Talie live in Watertown, a half-hour drive from Mimi’s new position, rab- bi at Temple Beth Torah in Holliston, Mass.
Mimi is the granddaughter of Kela (z’l) and Lito (z’l) Guincher, who are kvelling on the Richter scale above. She is also the granddaughter of Chaim (z’l) and Susie Micner, who are surely enormously proud as well.
Students and staff of the recent Arrow Project on a tour of Sheba. In the centre is Prof. Eldad Katorza. Student Yair Jalmar is at the far right. (photo from IMP)
Sheba Medical Centre, Israel’s national hospital, enjoys a reputation for medical innovation, but many are unaware that it is also at the forefront of societal integration among various minority groups in Israel. In the past several years, Sheba has integrated hundreds of new Ethiopian olim (immigrants) into the hospital workforce, going as far as providing them with free classes to help them navigate Israeli bureaucracy and improve their language skills.
Recently, Prof. Eldad Katorza, senior physician at Sheba and director of the Arrow Project, decided to give youth from the Ethiopian community a head start by incorporating them into his pilot program.
The Arrow Project (Chetz in Hebrew, the initials of chokrim tze’irim, meaning “young researchers”) is an apprenticeship program for medical students, designed to pave their way into the world of research. Established in 2006, the initiative matches selected students with experienced researchers who serve as their mentors. During once- or twice-weekly meetings, the student-mentor teams work through every stage of medical research, from formulating the initial question, to collecting and analyzing data, to presenting the results at medical conferences.
This year, for the first time, each research duo also included a third tier: high school students from the Ethiopian community.
Katorza believes in the importance of encouraging students to pursue research, noting that, in med school, they do not receive sufficient exposure to research thinking or methodology.
“I believe that research makes a doctor more knowledgeable, more curious, more creative,” he said. “A doctor who engages in research is a much better doctor.”
Employing this premise, Katorza is planning to open several slots for nursing school students in the coming year’s program. “Nursing is also a field that stands to benefit greatly from adding researching to its ranks; it will raise the bar of nursing in Israel,” he said.
In the early stages of planning the pilot program for the Ethiopian high school students, it became evident to Katorza just how crucial, timely – and challenging – his initiative was. “I asked my son, then in 11th grade, to look around his own school in Givatayim for students from the Ethiopian community who might be suitable for the program,” said Katorza. “As it turned out, there wasn’t a single Ethiopian student in his school, nor in any of the good schools in the area.”
The reason can be traced to the socioeconomic realities in Israel today. Ethiopian Israelis have long experienced prejudice and being treated as second-class citizens. By and large, members of the Ethiopian community tend to dwell together in poorer neighbourhoods, where community services, schools included, are more limited. These conditions put Ethiopian teens at a disadvantage from the outset and, due to economic necessity, the youth are pushed to join the workforce at an early age, further perpetuating a cycle of poverty.
“Almost four decades have passed since the first wave of Ethiopian Aliyah,” said Katorza, “yet, judging from their rate of participation in academia, their level of affluence and other markers of social mobility, it appears that the government has failed to take the necessary steps to help them bridge the gaps and facilitate their successful absorption into mainstream Israeli society.”
Anxious to change this negative trend, Katorza decided to include outstanding students from the Ethiopian community in the Arrow Project. However, it wasn’t simple to locate high school students from the Ethiopian sector who met the criteria for participation in the program: high marks in the sciences, high motivation and interest, and living near enough to the Sheba campus to be able to easily attend the weekly meetings. Ultimately, Katorza was aided by an organization called Fidel (“Alphabet” in Amharic), which promotes the education and social integration of Ethiopian-Israeli youth. The Fidel staff welcomed this opportunity to incorporate Ethiopian students in Sheba’s research-mentoring platform, and provided 10 candidates, from which the top five were chosen.
According to Katorza, the pilot program was a resounding success and will be repeated in the coming year. “We found that, once they are freed from the limitations of their environment, the students manifested amazing capabilities,” he said. “We endeavoured to help build their self-confidence, empower them and teach them that they can do anything they put their mind to.”
Throughout the year, in addition to their full participation in research, the Ethiopian high schoolers were also exposed to the clinical activity at the hospital. “At the beginning of the year, the students didn’t have any specific plans for the future,” Katorza said. “Now, they are now seriously considering a medical career.”
One of those is Yair Jalmar, 17, from Beer Yaakov, who participated in a research project with pediatric cardiologist Dr. Shai Tejman. “This project helped me develop my interest in medicine and learn more about the advanced technologies and devices, as well as the various departments in the medical field,” he said.
In the 14 years since the project’s inception, the pool of participants, which in the beginning included only students from Tel Aviv University Sackler School of Medicine, has expanded to foreign exchange students from New York and London, as well as medical students from Ariel University, Bar-Ilan and others. Thus far, former participants in the Arrow Project have gone on to publish their findings in respected medical journals, and several have joined the team at Sheba.
– Courtesy International Marketing and Promotion (IMP)
During the Nazi regime, all references to the great physician-chemist Paul Ehrlich were suppressed. In the 1990s, he was featured on the German 200-mark bill. (photo from the internet)
In the 17th century, the Netherlands was a country of great tolerance, having welcomed the Jews driven out of Spain and Portugal, including renowned physicians. Not coincidentally, this was the Dutch Golden Age, a time of breathtaking advances in the arts and sciences. It was there that the first microscopes were invented. To the eyes of Antoni van Leeuwenhoek in the town of Delft in the 1670s were revealed a veritable zoo of subvisible microorganisms previously inconceivable to even the most fevered imagination.
Throughout the 18th century and well into the 19th, there was speculation among medical men about the possible relation of microorganisms to disease. Certain varieties of these tiny beings seemed to appear in the organs or blood of patients with certain diseases. But there were endless questions: Could these creatures, so primitive, come into being by themselves (“spontaneous generation”)? Were they the cause of disease or were they the product of the diseased body? Could a pathogenic microbe of one disease transform into that of another disease? In diseases known to be infectious, were microorganisms the culprits, transmitted from a diseased body to a healthy one, there to germinate?
A breakthrough heralding the Heroic Age of the “microbe hunters” came in 1840 with the publication of Pathological Researches by the Bavarian medical doctor Jacob Henle, a descendant of rabbis. Using technologically advanced microscopes and deductive analysis of case histories, Henle declared to the medical world: “Contagion is matter endowed with individual life which reproduces itself in the manner of animals and plants, which can multiply by assimilating organic material and can exist parasitically on the sick body.”
A year later, the Polish-German Jew Dr. Robert Remak published the first of his observations that cells – of any living organism, including microbes – can arise only by division of parent cells. Thus, Remak helped put to rest the concept of “spontaneous generation.”
Humankind’s war against transmittable diseases accelerated dramatically in the second half of the 19th century. In the German city of Breslau (today Wroclaw, Poland) the botanist-microscopist Dr. Ferdinand Cohn published his Bacteria, the Smallest Living Organisms in 1872. As the undisputed master of the classification of subvisible life, Cohn elucidated that, while a microorganism of one disease may undergo various transformations, it remained the microorganism of that specific disease and not of another.
Robert Koch, a student of Henle and a protégé of Cohn, of Protestant background, discovered the tuberculosis bacterium and elucidated the mysterious life cycle of the anthrax bacillus.
Such dramatic advances led to the discovery of links in the chain by which the various pathogenic microorganisms are transmitted, and then to measures to break those links: cholera by drinking water contaminated by sewage, sleeping sickness by the tsetse fly, childbed fever by the contaminated hands of doctors and midwives, malaria (literally “bad air” in Italian) by mosquitoes.
To such defensive measures were added an arsenal of aggressive weapons. In Berlin in the 1890s, the Jewish doctor Paul Ehrlich was instrumental in developing serums. The watery part of the blood (after coagulation) of an animal that has fought off a toxin-producing disease such as diphtheria contains powerful antitoxins that can be injected into a diphtheria patient. A brilliant and imaginative chemist, Ehrlich pioneered techniques for selectively staining specific microorganisms to distinguish them under the microscope. This principle inspired him to develop the world’s first chemotherapeutic agent – the arsenical compound Salvarsan, known popularly as the “magic bullet,” which homed in on and destroyed the spirochetes of syphilis. (Ehrlich’s coreligionist Albert Wassermann developed the blood test for the disease.)
A general optimism prevailed as the new century dawned that humankind would soon be free of all serious infectious disease. But there was a missing piece in the puzzle.
It had been known since ancient times that people who survived a given disease were wholly or partially immune from an attack by the same disease. In 1798, the English physician Edward Jenner showed that deliberate inoculation with the pustules of relatively benign cowpox (vaccination, from the Latin vacca, cow) protected the person from attack from the far more virulent and deadly smallpox.
Among the great triumphs in the war against transmissible disease was the development of a new kind of vaccination by the French chemist Louis Pasteur, a devout Catholic. Pasteur showed how inoculating a patient with killed or attenuated (weakened by drying or other techniques) pathogens such as rabies activated the natural immune system against a subsequent all-out attack by the fully virulent disease.
But here was the rub. Unlike the microorganisms of tuberculosis, cholera, diphtheria, syphilis and so many other diseases, no one had ever seen the agents of smallpox and rabies. Pasteur speculated that they were microorganisms beyond the range of the most powerful microscopes.
Around the turn of the 20th century, the Dutch microbiologist Martinus Beijerinck showed how the fluid of an infected plant, after being strained through the finest filter, was able to infect healthy plants. This was an important breakthrough, but Beijerinck erred in assuming the culprit wasn’t composed of solid matter. He called it virus, Latin for poison.
That no one had seen a virus made the fight more difficult. Between 1918 and 1920, as the Spanish flu claimed more lives than all the battlefields of the Great War in the preceding four years, the medical profession mistakenly attributed it to an opportunistic bacterium, visible under the microscope.
The limit of what could be seen was dramatically pushed back with the invention of the electron microscope in the early 1930s, by which viruses, hundreds of times smaller than bacteria, were exposed to the light of day. It appeared that Pasteur was right after all in postulating that the agent of rabies was a microorganism.
But not quite. Research later in the century showed that viruses – unlike living entities (organisms) – can’t multiply or reproduce on their own. Viruses turned out to be packets of genetic material – DNA or RNA – that penetrate, commandeer and destroy living cells in order to multiply.
Poliomyelitis, the dread crippler caused by an enterovirus, was checked in the 1950s (and is now virtually eradicated worldwide) thanks to two vaccines developed independently by the American Jewish medical doctors Jonas Salk and Albert Sabin. (The virus was cultured using the foreskins of circumcised babies.)
AIDS, hepatitis, SARS, Ebola and now corona – new virulent viruses keep emerging. And the weapons to fight them – vaccines, tests, serums, pharmacological “magic bullets” – are in the enduring spirit of the great Jewish microbe hunters.
Dr. Frank Heynick is the author of Jews and Medicine: An Epic Saga (KTAV Publishing House, 2002, still in print). There are some 500 publications of his in the United States and Europe, ranging from academic to popular-scientific, many on the history of medicine and allied fields, including the crucial Jewish role. He lives in New York and has taught the history of medicine at New York University.
Ruth Simkin with her dog, Kelly. (photo by Chris Wilson)
Feminism is really true equality between women and men; nothing more, and nothing less,” Ruth Simkin writes in her new book, Dear Sophie: Life Lessons in Feminism & Medicine, a memoir dedicated to her great-niece.
“There are many people who scoff at the word ‘feminism,’” Simkin adds. “But consider this – when I was in my first year of medical school, I, and any other woman, could not get a credit card in our own name. Until 1974, a husband’s signature was needed for women to have credit cards. At that time, I met women who were teachers who lost their jobs because they and their husbands wanted to start a family and they became pregnant – a no-no for working teachers until 1978. I could go on and on with examples like this to show why feminism was, and still is, such an important part of all our lives.”
Born in Winnipeg in 1944, Simkin has prevailed over many obstacles throughout her life and career. In Dear Sophie, readers join her as she struggles to get into medical school.
“There was stiff competition to get into an innovative medical program launched at the University of Calgary in the late 1960s,” she told the Independent from her home in Victoria. “I was one of 32 of roughly 1,200 applicants to be accepted.”
Admission to the program, however, would turn out to be an easier hurdle than those that were yet to come during her schooling and subsequent training. The length of her time in med school is replete with stories of sexual harassment and discrimination by both fellow classmates and senior members of the faculty.
“Male doctors, on more than one occasion, did all they could to get me expelled from med school, but I stood my ground,” Simkin said.
She managed to complete her residency, despite being blocked at almost every step, and clashing with the established medical community. But she prevailed. She was the first U of C med school graduate to open a practice – one that thrived – while also working as a professor and preceptor at the school.
In the memoir, Simkin details her experiences from that time to the present and uses her account as a way to demonstrate to Sophie, and to other women, how to live a happy, feminist life. She hopes that Sophie, a pre-adolescent during the time Simkin was writing the book, will learn from her experiences before entering adulthood.
Simkin’s long and varied career has seen her undertake many ventures. In the 1980s, she learned acupuncture in Shanghai and, ultimately, became the first physician to be approved by the Alberta College of Physicians and Surgeons to incorporate acupuncture in a medical practice. Later that decade, she went to London, England, to study with Dr. Katharina Dalton, who brought premenstrual syndrome to the world’s attention and also coined the term.
Upon her return to Canada, Simkin opened the first PMS clinic in Western Canada. She also has opened Western Canada’s first hologram gallery, produced concerts, been involved in theatre projects and started the lesbian and gay political action group CLAGPAG.
In the 1990s, she moved to Salt Spring Island, where she became a farmer – growing “yuppie” veggies. A return to medicine saw her become the first fellow to study palliative care at the University of British Columbia. In 2014, she was honoured with a life membership from the College of Family Physicians of Canada.
Among her other published works, Simkin has written What Makes You Happy, a collection of short stories, both autobiographical and fictional; The Y Syndrome, a medical thriller set in 1990s Calgary; and Like an Orange on a Seder Plate, a feminist Haggadah. The Jagged Years of Ruthie J (2012) is an autobiographical account of her experiences in Winnipeg before medical school.
Over the years, she has written scores of medical papers and contributed to textbooks, as well as mixed media presentations. Having travelled extensively, she has an (as-yet) unpublished book, Come Away with Me, about her journeys through China.
Dear Sophie received the 2019 Rainbow Award in the LGBT biography/memoir category. In its review of the book, the prize committee said, “Dear Sophie is a flawless memoir that is not only a story of Dr. Ruth Simkin, but a story of feminism and women in Canada and the field of medicine, skilfully woven together with valuable life lessons.”
Sam Margolishas written for the Globe and Mail, the National Post, UPI and MSNBC.