A goodbye to healers who listened-Squirrel Hill mourns and heals

I was horrified by news that another mass shooting had occurred, this time at a synagogue in a community called Squirrel Hill. A few days later, I realized I had seen that name before. I had met someone who lives and works there.

In early October of 2018 I received an email from a physician I had never met. He had written a book and asked me to read and review it on my blog. I agreed and soon received another email with a PDF copy. I read it and posted a review here.

A couple of weeks later I was horrified by news that another mass shooting had occurred, this time at a synagogue in a community called Squirrel Hill. A few days later, I realized I had seen that name before.

The physician who wrote to me, Dr. Jonathan Weinkle, practices at the Squirrel Hill Health Center. And he is Jewish.

Pitchwerks podcast - #115:Dr. Jonathan Weinkle

Squirrel Hill, Pittsburgh, Pennsylvania

Squirrel Hill is considered a historic center for Jewish life in Pittsburgh. It is home to more than a quarter of Jewish households in the Pittsburgh-area, according to a Brandeis University study of the Greater Pittsburgh Jewish community.

I wrote to him and was relieved to learn he was safe. He had attended a Bat Mitzvah there just the week before the attack.

And as I had feared, some of the victims were friends and colleagues.

I’m not going to repeat the details of the horrific event as it was widely reported in the news. Here is a link to a news report.

How a deadly shooting unfolded at the Tree of Life synagogue

One of the victims I had learned about through our professional organization, the American Academy of Family Physicians, AAFP. Dr. Jerry Rabinowitz’s death was reported on the organization’s Facebook page. He was a friend and colleague of Dr. Weinkle.

Also killed was dentist Dr. Rich Gottfried who worked at the Squirrel Hill Health center where Dr. Weinkle practices.

a building with sign-Squirrel Hill Health Center
THE SQUIRREL HILL HEALTH CENTER

Dr. Weinkle eulogizes his friends

Dr. Weinkle wrote reflections about his two friends and colleagues, shared them with me, and graciously consents to my sharing with you.

 

This message was posted on the Squirrel Hill Health Center Facebook page

Dr. Rich Gottfried

The Hebrew letters often hint at a common object: bet hints at bayit, a house.  Gimel hints at gamal, a camel.  And shin?  Why, shen, of course – tooth.

I like to think that the reason for this is that shin, or rather sin, which is the same letter with the dot moved to the other side, is also the first letter in sameach, happy.  And what do we do when we are happy?  We smile and show our teeth.

My colleague Rich Gottfried smiled all the time; as people spoke at his funeral, or around the office this week, almost all took note of his smile.  He was the Hines Ward of dentists, it would seem – always smiling.

Rich brought happiness to people through their own teeth, too.  Poor dentition is a major source of shame for people, afraid to smile or look someone in the eye for fear of having their decayed teeth be the only thing the other person will see.  For a person without dental insurance, or without substantial means, dental work or even preventive care can be prohibitively expensive.  A Hobson’s choice – shame, or bankruptcy?

Rich listened to that struggle.  Even when he was in full time private practice, he blocked off time to do pro bono work for the uninsured .  And as he and his wife Peg Durachko, who was not only his life partner but his dental partner, wound down their practice as they approached retirement, they brought their services to us, at a community health center that treated many people who had never seen a dentist in their lives. 

They overcame the fear that one dental cleaning might lead to all the teeth falling out, and got things set right for the first time ever.  Culturally competent dentistry – now those are healers who listen.

Shin stands for something else, too – Shadai, the almighty God.  It is the letter on every mezuzah on every Jewish door, reminding us that God has our backs, and that we need to refresh ourselves on what God wants from us every time we enter or leave a room.  And for Rich Gottfried, what God wanted from him was to be a blessing to others around him, through his talents in taking care of their shin-ayim.

a Jewish passover seder plate with a lit cancle
photo from the Lightstock.com collection, an affiliate link

Dr. Jerry Rabinowitz

“Do not console a person whose deceased relative lies before him” Pirke Avot 4:23

Well, now we have begun to bury them; the time of consolation for the families and community of my murdered friends has begun.  They are no longer lying before us and we must begin to fix their memories in our minds.

Among the dead October 27th were two men who epitomized the title of this site: “Healers who Listen.”  A third still clings to life and with God’s help may recover to help the rest of us heal.  Over the next three days I will remember each of them.

Jerry Rabinowitz was laid to rest yesterday, October 30th.  In the hour before the funeral I was with a friend who told me that Jerry had been his doctor.  With a wry smile, he told me,

“The first time I went to him we were in there for an hour and a half – and the first thirty minutes had nothing to do with my health.” 

He listened to get to know the person sitting in front of him before diving into the rabbit hole of the purely physical.

At the funeral, Jerry’s partner Ken Cieselka spoke of “their finest hour” as a practice – the late 1980s, when they began caring for patients with HIV/AIDS.  The disease was then incurable, and the people suffering from it were then considered by many to be untouchable. 

But not by Jerry and Ken.  They listened to the voice of suffering that no one else would ease, and understood it was their responsibility to do so.

At the synagogue, Jerry heard gunfire.  In that sound, he did not hear a warning to get out.  He heard people being hurt, of people who would need his help. 

There is a Jewish concept that the choleh l’faneinu, the ill person in front of us, should get our attention first.  For Jerry even being aware of that person’s illness or suffering, even in danger, even where he could not see them, put them l’fanav, right in front of him, where he had to help them. 

He listened, and met his end as he lived his life, caring for people.

I assume Jerry did not have a chance to read Healing People, Not Patients; it was only published a month ago and he was as busy as I was.  The truth is that he did not need to read my manifesto of compassionate, personal healing.  He lived it; he could have written it himself.

a male doctor talking to a middle aged woman
Dr. Weinkle with a patient

 

 

 

 

Here are profiles of Dr. Gottfried, Dr. Rabinowitz, and the other nine victims of this attack.

Tree of Life Congregation Shooting Victims

Dr. Weinkle concluded his note to me, writing,

“ The good news is that unlike other pogroms that have afflicted my people over the centuries, this one was carried out by a lone wolf and the majority of our neighbors are on our side, not the side of the perpetrators. There is strength and hope in that beyond measure.”

Visit Dr. Weinkle’s website , Healers Who Listen

sharing the HEART of health

Thank you for joining me to honor Dr. Weinkle’s colleagues. Please share this post and my review of his enlightening book, HEALING PEOPLE, NOT PATIENTS.

I appreciate all of you who are following Watercress Words, and if you aren’t I invite you to join the wonderful people who are. You can meet some of them in the sidebar, where you can click on their image and visit their blogs. Use the form to get an email notification of new posts. Don’t worry, you won’t get anything else from me.

Dr Aletha

2019 women’s health update- new meds to control pain and prevent disease

In this post I review some new drugs that treat conditions exclusive to or common in women.

In a previous post I gave you updates about hormones, the heart, and HPV. Here is the link-

Women’s health update, part 1

In this post I’ll review some new drugs that treat conditions exclusive to or common in women.

I’m illustrating this post with covers of books written by women; I have reviewed all of these books on my blog, so I’ll include those links also. Please note these are affiliate links, so if you do happen to use them for a purchase you will help me fund this blog.

Photo by rawpixel.com on Pexels.com

Relieving the pain of endometriosis

Women with endometriosis suffer infertility, excessive bleeding, painful periods and pelvic pain unrelated to periods. In endometriosis, uterine tissue grows outside the uterus. It can be difficult to diagnose, requiring invasive procedures to discover. Treatment depends on the goal, whether pregnancy, pain relief, or both. Short of surgery, hormonal therapy has been the mainstay of treatment.

A new hormonal drug released last year, elagolix, brand name Orilissa, is the first of its kind specifically developed and approved to treat “moderate to severe” endometriosis pain. It does not help with infertility. AbbVie, the pharmaceutical company which developed the drug, has priced it at $844 per month, or about $10000 per year, retail.( per Reuters report) Patients may pay less depending on insurance.

 

Stop bleeding fibroids

Researchers are studying elagolix and another hormonal drug ulipristal for treating uterine fibroids. Fibroids are growths within the uterine that can cause pain and excessive bleeding. Initial trials show both of these drugs can significantly decrease bleeding and pain. However, neither is currently FDA approved for treating fibroid.

Easing dyspareunia

After menopause many women develop atrophy of the vagina, making it thin, dry, and easily irritated, leading to painful sex, or dyspareunia. A new intravaginal medication, prasterone,brand name Intrarosa, can help relieve the discomfort. Studies show it may also help improve sexual desire and arousal, but it is not labeled for this.

Manufactured by AMAG Pharmaceuticals, it is for “moderate to severe” symptoms. Also known as DHEA, it is a steroid that transforms into estrogen in the vagina ,administered as a once daily vaginal insert at bedtime, applied with an applicator. According to goodrx.com,a 30 day supply costs about $213.

DHEA can be purchased as an over-the-counter, non-regulated product, whose effectiveness and safety are unknown. A one-month supply of 50 mg tablets may cost $5.

Other options for treating vaginal atrophy symptoms are oral or vaginal estrogen and/or vaginal lubricants.

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Prevention of migraine pain and disability

Migraine, although not exclusive to women,occurs much more frequently in them than men. For infrequent headaches,non opiate pain relievers are effective and recommended. But for severe, frequent, or persistent symptoms prevention is recommended to improve quality of life. Several oral meds are effective but two new injectable drugs show promise.

Botox, onabotulinumtoxin A, has been FDA approved for treating chronic migraine, meaning patients with frequent headaches and other migraine symptoms for at least 3 months.

Yes the same drug used to treat wrinkles,Botox, can prevent migraine

Manufactured by Allergan, a vial containing 200 units costs $1452, per goodrx.com. For migraine, the drug is injected in the upper facial muscles by a physician specifically trained in its use.

Another novel therapy uses the immune system to fight migraine. Monoclonal antibodies bind to a calcitonin gene-related peptide receptor which is responsible for transmitting migraine pain. The antibodies are produced in a laboratory but work like antibodies naturally produced by the body. They are being used to treat cancers and some forms of arthritis.

Three of these drugs are available

  • Erenumab-brand
  • Fremanezumab-Ajoovy
  • Galcanezumab-Emgality

 

They are administered as subcutaneous injections (under the skin) monthly. According to a Medscape, average cost is $600 per month.

You may want to review my previous post about non-drug ways to manage migraine.

Simple and effective ways to manage chronic pain

Preventing cervical cancer with the HPV vaccine

I mentioned this in my previous post about women’s health but it fits here also.

Infection with the HPV, human papillomavirus, causes genital warts and changes in the cervix called CIN which can lead to cervical cancer.

According to a review of clinical trials by Cochran, vaccination against this virus effectively prevents infection and thus fewer cases of CIN. Since a significant percentage of CIN progresses to cancer, we can expect fewer women will develop invasive cervical cancer, the 4th most common cancer in women worldwide.

The vaccine, Gardasail 9, originally approved for use in females ages 9 to 26 years,received FDA approval for use up to age 45 years.

Stopping shingles with the zoster vaccine

And speaking of vaccines, a new zoster (shingles) vaccine, Shingrix, prevents the painful rash much more effectively than the original vaccine Zostavax. It ranges in effectiveness from 91% to 97% at preventing shingles, depending on age. The first vaccine was 51% effective.

Zoster is a reactivation of the varicella virus that causes chickenpox. It causes a painful rash known as shingles;the pain may continue after the rash is gone. It can happen at any age, but symptoms tend to be worst in older persons.

exploring the HEART of health through books

Thanks for joining me to review new steps in women’s health and review some fine women authors. I hope you will follow the links to my reviews and read some or all of these books. When you do, I would love to know your reaction. I might use your comments in an update.

I appreciate all of you who are following Watercress Words, and if you aren’t I invite you to join the wonderful people who are. You can meet some of them in the sidebar, where you can click on their image and visit their blogs. Use the form to get an email notification of new posts. Don’t worry, you won’t get anything else from me.

Dr Aletha

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