medicine

Ageism in medicine

“Studies show that one-third of Canadians admit to having been treated differently due to their age,” said Dr. Samir Sinha, director of geriatrics at Mount Sinai and the University Health Network Hospitals in Toronto.

Sinha, who is also a professor of medicine at the University of Toronto and the director of health policy research at the National Institute on Ageing, spoke on ageism in medicine and strategies for patients to combat this form of discrimination in a webinar presented by the National Council of Jewish Women of Canada (NCJWC) on June 6. He noted that the date of the webinar coincided with the start of Seniors Month in Canada, and shared that he was drawn to collaborate with NCJWC because Mount Sinai Hospital was founded 100 years ago “by a dedicated group of Jewish women.”

Sinha defined ageism, also known as age discrimination, as the act of imposing stereotypes, prejudice and discrimination on others or oneself based on age. He said the term was coined relatively recently, in the 1960s, even though it had existed in Canadian society long before then. He emphasized that “51% of Canadians agree that ageism is the most tolerated social prejudice, and 80% of Canadians agree that older adults (age 65+) are seen as less important than younger generations.”

This sense of diminished importance is commonly manifested in three forms: feeling ignored or invisible, being treated as devoid of value or contribution, and facing assumptions that seniors are always incompetent. Such experiences can have adverse psychological and emotional impacts, including social isolation, diminished trust in healthcare providers and negative self-perception. Sinha highlighted that although ageism may present itself universally, its impacts differ, and it “does not affect all older adults equally,” he said. Intersectionality, defined as the interconnected nature of social categories such as race, gender, age and more, can enhance the degree of ageism that a person faces, he said. In Canada, certain segments of the population are especially vulnerable, including immigrants or those born outside the country.

Narrowing in on Canada’s healthcare system, Sinha shared that healthcare professionals often hold ageist attitudes, perpetuating stereotypes that seniors lack agency and are frail, depressed or irritable. “This can ultimately manifest in undertreatment or overtreatment,” he said.

Undertreatment involves withholding resources or treatment options that would not be withheld from younger patients, while overtreatment refers to an exaggerated approach to patient care. Sinha said these issues were amplified during the COVID-19 pandemic, citing examples where older adults were denied access to ventilators due to assumptions about their life expectancies. This demonstrated the arbitrary use of age to determine life expectancy, he said, while other important health factors should also be considered.

Undertreatment is a key issue among patients with dementia – “many people in society consider dementia a normal part of ageing, but it is not,” said Sinha. He described the stigmatization faced by individuals living with dementia, which often leads to ageism in healthcare settings and subsequent undertreatment due to their condition. In cases like these, “labels can kill,” he said.

Referring to himself and his fellow geriatricians as a “rare and endangered species of physician,” as described by the New York Times, Sinha stressed the scarcity of geriatricians in Canada – only a few hundred among the country’s approximately 100,000 doctors. Nevertheless, he affirmed that “the few hundred of us have long advocated for older persons to be properly cared for in a health system that often does not adequately address their needs.” Further, he emphasized that “everyone has a role to play” in combatting ageism. This sentiment was echoed by Rochelle Garfinkel, manager of donor relations at NCJWC, who reminded the audience that “the tree planted today provides shade for future generations.”

“Eighty-five percent of the boomer generation wants their ageing experience to be different than their parent or grandparents,” added Sinha. He suggested strategies such as more comprehensive training for healthcare professionals and acknowledging the disproportionate impacts faced by marginalized groups.

In her introduction to the webinar, Linda Steinberg, NCJWC president, noted that defining the impacts of ageism will be central to NCJWC in the coming years. NCJWC is the oldest Jewish women’s organization in Canada, she said, and is currently comprised of five sections across the country’s major cities, including Vancouver.

Alisa Bressler is a fourth-year student at Queen’s University in Kingston, Ont. She is an avid reader and writer, and the online director of the arts and culture publication MUSE Magazine. Bressler is a member of the Vancouver Jewish community, and the inaugural Baila Lazarus Jewish Journalism Intern.

Battling over-diagnosis

Dr. Shoshana Levin Fox’s An Autism Casebook for Parents and Practitioners: The Child Behind the Symptomswill hold you spellbound. Section I is titled “Children.” These first eight chapters are the stories of Jack, Sasha, Annie and others (all the children’s names used are pseudonyms) – children who came into the Feuerstein Institute after having been diagnosed as autistic. They exited with new hope, not only for themselves, but for their parents, who needed their own emotional propping up.

Levin Fox is a psychologist and play therapist who has worked with children for more than 30 years. In addition to lecturing and giving workshops in North America, Israel and Europe, she worked for 25 years in the Feuerstein Institute of Jerusalem, founded by the late Sorbonne-educated Prof. Reuven Feuerstein.

Levin Fox lived for nearly 20 years in Canada. She completed a master’s at Simon Fraser University and a doctorate in counseling psychology at the University of British Columbia. She worked for many years as a counselor in the Special Services to Children and Families program of the Association of Neighbourhood Houses of British Columbia. Levin Fox was awarded a Social Sciences and Humanities Research Council of Canada post-doctoral fellowship, which enabled her to do research and practical work in the field of autism at the Feuerstein Institute. Coincidentally, for many years, Hadassah-WIZO Canada were prime funders of the institute’s programs related to autism.

I recommend the book, not just for the moving stories of the children who were saved from what proved to be inaccurate assessments, and not only for the intriguing descriptions of the practices of the Feuerstein Institute, which Levin Fox combined with the DIRFloortime method. This book should be read for its critical message to parents who have received an autism diagnosis – or one of learning disabilities, ADHD, or other emotional, cognitive or developmental challenges – for their son or daughter: Believe in your child. Talk to your child. Keep looking till you find her the best and most appropriate help and hope. Don’t let the “experts” get you down, because a true expert will find the formula to lift you – and your child – up.

The idea of plasticity of the brain, writes Levin Fox, entered mainstream medicine several generations after Feuerstein had intuited and created materials and methods based on that reality. Levin Fox decries the fact that “the diagnosis of autism is used as a sacrosanct truism…. I have found that the term ‘autism,’ as it appears commonly in the field, in actuality is being used to describe children who suffer from a vast range of communication difficulties, from extreme shyness to psychotic conditions and just about everything in between.”

The children whose stories are recounted in this book all made significant progress. Levin Fox writes, “Not every child began to speak fluently, to learn at a normative level and to play happily with friends…. However, it can be safely and honestly stated that, inspired and mentored by the professor, my colleagues and I made a huge difference in the lives of hundreds of children originally thought to be autistic.” She sees them, as a team, as having saved many lives.

Feuerstein sought to find a child’s latent strengths, and what he called “islets of normalcy.” Levin Fox explains that “islets of normalcy” include, among other elements, eye contact, human relationships, symbolic play, curiosity, humour and more.” She emphasizes that helping parents understand their children’s challenges, and not to be fearful and depressed about them, is part of the battle.

In Part II, “Theoretical Groundings,” Levin Fox gives the intense and thorough theoretical background to the success stories, which are plentiful. Six more case studies are interwoven in the text to help bring the theory alive.

This section also describes the roots of Feuerstein’s methods. He began by working with orphan children who had been traumatized after the Second World War, decided there were flaws in the standard diagnostic tests and, rather than focusing on performance, he focused on the child’s ability to develop learning processes.

“Current studies on brain plasticity … scientifically substantiates what [Feuerstein] proposed two generations ago – that brain cells are modifiable and respond to the stimuli of the environment,” writes Levin Fox.

One of my favourite stories is in Chapter 15, where Levin Fox talks about Ben, whom she first met when he was 5 years old. The end of the chapter, with the sub-heading, “Ben’s Epilogue,” describes a chance meeting between Levin Fox and Ben’s parents, many years later, at an airport. “Dr. Shoshana!” they called out, and his mother pulled out her cellphone. “The happy faces of Ben and his wife, holding their newborn son, smiled back at me,” writes Levin Fox. “For Ben, the paradigm-shift had indeed been life-saving.”

I found other words to describe the journeys and miracles of the children portrayed in this book: life-affirming.

And hope.

Toby Klein Greenwald is an award-winning journalist, educational theatre director, teacher and the editor-in-chief of wholefamily.com. A longer version of this article appears at jewishlink.news/features/47241-the-child-behind-the-diagnosis and elsewhere online.

A Methuselah update

Methuselah’s roots go back to the time of Masada, and even earlier. (photo from Arava Institute)

For many years, in anticipation of Tu b’Shevat, I have written about a date palm tree in the Arava that fascinates me – Methuselah.

Methuselah’s relatively new beginnings can be attributed to London-born Dr. Sarah Sallon, director of the Louis Borick Natural Medicine Research Centre at Hadassah Medical Centre, and California-born botanist Dr. Elaine Solowey of the Arava Institute for Environmental Studies at Kibbutz Ketura.

According to Sallon, “in 2005, we were interested in rejuvenating lost flora of Eretz Yisrael. One of the lost flora is the Judaean date. I was discussing with some scientists about their work, trying to extract DNA from ancient seeds.” Sallon asked, “If we had ancient seeds, why couldn’t we grow them?”

From 1963 to 1965, archeologists Yigal Yadin and Ehud Netzer excavated the fortress Masada, which was built by King Herod between 37 and 31 BCE and was home to almost a thousand zealots until the Romans breached the wall in 72 CE and found the bodies of the Jews who had lived there and killed themselves, rather than being taken as prisoners. At the site, Yadin and Netzer found date palm seeds, which were subsequently stored at Bar-Ilan University.

Sallon asked Netzer for a few seeds, and received five. She took them to Solowey, who took three of the 2,000-year-old seeds and planted them in January 2005. Other seeds were sent to the University of Zurich, in Switzerland, for radiocarbon dating. They were also tested to see if they had anti-bacterial, anti-viral, anti-cancer, anti-fungal, anti-malarial, anti-oxidant or other medicinal properties.

The date palm is one of the best medicinal trees. Domesticated more than 6,000 years ago, it can be male or female, and produces dates. Medicine of the date palm has been used for lung disease, colds, heart disease, hair growth and other things.

After eight weeks, in 2005, one seed successfully germinated and was named Methuselah, after the biblical person who was said to have lived 969 years.

Initially, the first leaves had white spots because of a lack of chlorophyll. At 15 months, the seedling was transferred to a larger pot. After 26 months, the plant showed normal development.

In 2011, when its exact location was being kept a secret, I was permitted to see a photograph of Methuselah. At the time, it was two metres high and in a “protected quarantine site,” due to its scientific and financial value.

In April 2011, a white flower appeared on the inner part of the tree, indicating that Methuselah was male. In 2017, there was hope for Methuselah to be bred with a female tree to produce the same date variety that was common in ancient Judea.

In December 2019, Solowey sent me an update on Methuselah – he had grown to four metres tall. Also during that year, Solowey had gotten six ancient date seeds from archeological sites: “Adam” from Masada; “Jonah,” “Uriel,” “Boaz” and “Judith” (or “Yehudit’) from Qumram; and “Hannah” from Wadi Makukh, a winter water channel in the Judean desert surrounded by high cliffs and containing a number of caves that were surveyed from 1986 to 1989.

Early that December, Methuselah was pollinated by Hannah and Solowey cultivated 111 semi-dry dates, “really nice, big, blondish, semi-dry dates from her with a honey aftertaste.”

In March 2020, Hannah flowered, and Solowey told me: “we are thinking of making a genetic line from Hannah.”

At the end of November 2021, Solowey wrote to me again. She said, “Well, we got 600 beautiful dates from Hannah (whose seed was 175 years older than Methuselah’s seed) this September. We planted Yehudit, another female, on Sukkot. We are considering tissue culture. I have two males still in the greenhouse.”

Sybil Kaplan is a journalist, lecturer, book reviewer and food writer in Jerusalem. She created and leads the weekly English-language Shuk Walks in Machane Yehuda, she has compiled and edited nine kosher cookbooks, and is the author of Witness to History: Ten Years as a Woman Journalist in Israel.

Making aging healthier

Shira Haas is the featured guest at the July 7 event organized by Canadian Associates of Ben-Gurion University of the Negev. (photo from CABGU)

Israeli actress Shira Haas, star of the popular Netflix series Shtisel and Unorthodox, has been busy in recent months. Not only is she preparing to take on the role of a young Golda Meir in the upcoming series Lioness, executive produced by Barbra Streisand, but she is also the featured guest at the Canadian national virtual gala in support of Ben-Gurion University of the Negev (BGU) on July 7.

An “Unorthodox” National Virtual Gala for Brain Research, organized by Canadian Associates of Ben-Gurion University (CABGU), BGU’s Canadian fundraising arm, will raise money for the Canada Fund to Advance Brain Research.

“We are thrilled to share this exciting announcement with our community,” said Mitchell Oelbaum, national president of CABGU.

“According to the World Health Organization, there are approximately 50 million active cases of dementia worldwide, with an estimated 10 million new cases being added each year. Ten million people battle Parkinson’s each year globally. And, according to the World Stroke

Organization, 13 million people suffer from stroke annually. We wanted to do our part to help improve the chances of finding a cure for these debilitating diseases.”

The numbers are large, and there are no signs of a slowdown. That is why the fund was established by CABGU, with the goal of supporting groundbreaking and cutting-edge research for neurodegenerative diseases at the university’s Zlotowski Centre for Neuroscience.

“We are getting closer to determining the causes of age-related neurodegenerative diseases,” explained Dr. Debra Toiber of the department of life sciences in the faculty of natural sciences at BGU. “It’s an exciting time to be a scientist and uncovering the mechanisms of aging.”

Toiber is one of 67 researchers at the Zlotowski Centre. Her lab recently discovered that the SIRT6 protein is critical for the prevention of neurodegeneration, which can lead to Alzheimer’s and Parkinson’s diseases. Colleague Dr. Shelly Levy-Tzedek’s lab studies the impact of age and disease on the control of body movement and how best to employ robotics to facilitate a fast and efficient rehabilitation process. Meanwhile, Dr. Claude Brodski, also with the Zlotowski Centre for Neuroscience, is currently conducting a study, albeit in its early stages, that may offer a disease-modified drug target to address the impact of Parkinson’s. While these findings are encouraging, more research needs to be conducted.

“CABGU launched the Canada Fund to Advance Brain Research at BGU in April,” said CABGU chief executive officer Mark Mendelson. “Our team has been hard at work ever since, and there is a strong appetite for this subject matter here in Canada. The sad reality is that we all know someone, whether it is a relative, a friend or a neighbour, who is struggling with one of these devastating brain diseases.”

The national virtual gala is already more than 50% sold out. To learn how to become a sponsor or to purchase tickets, head to bengurion.ca.

$100K raised for Sheba

Dr. Joe Schwarcz, director of the Office for Science and Society, McGill University, presented on The Chemistry of Wine and Its Many Benefits, at Canadian Friends of Sheba’s virtual event on May 2. (screenshot)

Canadian Friends of Sheba hosted Sheba Under the Stars on May 2, raising close to $100,000 for Israel’s Sheba Medical Centre. More than 100 guests attended the virtual evening featuring live entertainment, wine tasting and presentations on lifestyle choices from leading world experts.

Guests received a complimentary gift bag of wine and chocolates, and were treated to numerous performances from host Stacey Kay, Juno Award-winning singer/rapper and finalist on America’s Got Talent. The hour-long show also featured live wine tasting with Michael Avery, winemaker at Galil Mountain Winery, in Israel, as well as a presentation on The chemistry of Wine and Its Many Benefits, by Dr. Joe Schwarcz, director of the Office for Science and Society at McGill University.

Prof. Yitshak Kreiss, director general, Sheba Medical Centre, opened the event by highlighting Sheba’s global fight against the coronavirus through its recent support of missions to India, northern Italy, Cyprus and Uruguay, and called on the guests to be “inspired by Sheba’s vision to transform into the city of health.”

Presentations from “Sheba’s stars” included Redefining the Field of Lifestyle Medicine by Dr. Rani Polak, founding director of Sheba’s Centre of Lifestyle Medicine, and from Prof. Michal Schnaider Beeri, director of Sheba’s Joseph Sagol Neuroscience Centre, who shared tips on how wellness and lifestyle affects the brain.

To watch the full recording of the show, visit youtube.com/watch?v=QE2TRvm3G4Q.

Evaluating info online

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.

If an article’s page contains links to other websites, there could be a conflict in that they may be selling merchandise. Red flags should be raised when cures are being offered and sold online, said Alexander. Do not trust simple, non-medically proven solutions, or advice contained in group chats. Make sure that there is a privacy policy.

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 Levin is program coordinator for Jewish Seniors Alliance and on the editorial board of Senior Line magazine.

CABGU online series

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.

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)

Medical myths & facts

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 Levin is an executive board member of Jewish Seniors Alliance and on the editorial board of Senior Line magazine.

Breathing life into patients

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.”

photo - Dr. Amir Onn, left, and Dr. Marcelo Cypel — Dr. Amir Onn, left, and Dr. Marcelo Cypel. *(photo from IMP)*

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)