Category: Population

Honor Your Father

We were listening to NPR when the news came on. “The dentist with the greatest name recognition worldwide died yesterday. Dr. Louis Grossman developed modern endodontia (root canal therapy), a technique to save teeth”.
My father, Louis Grossman, was born 112 years ago this month in the little farm village of Teplik, in Czarist Russia. He was the first son of conservative Jewish parents, Harry and Roche (Rose). 1901 was not a peaceful time in Russia, especially for Jews who were often the focus of persecution. They had to live in separate communities where pogroms were frequent. These organized massacres killed and wounded thousands.
In 1905, when my father was just 3 years old, Harry left Russia to seek his fortune in the USA. A year later Harry had saved enough money to pay steamboat fare for my grandmother and father. They came steerage class on the S.S. Potsdam, arriving at Ellis Island after an 18-day crossing. The “Manifest of Alien Passengers” states that my 22-year-old grandmother was able to read and write. It declares that neither she nor Louis was an anarchist or a polygamist, and that they were in good mental and physical health. There is also a column on this document “Whether in possession of $50, and if less, how much?” The sum of $22.50 was crossed out and replaced by $20.
My father grew up in South Philadelphia in a Jewish/Italian neighborhood. Many of his childhood friendships became lifelong. He met for lunch with some of those men on a regular basis, and I got to know them as a kid.
When my father graduated from high school he wanted to be a physician, but his family couldn’t afford the 2 years of college needed at that time for admission to medical school. Dental school only required a high school diploma.
After graduation Louis started his own dental practice and also taught at the University of Pennsylvania School of Dental Medicine. One day he was very taken by a young undergraduate student with a toothache. Emma May MacIntyre would become my mother, but the marriage would have to wait.
Interested in furthering his education, my father had already made arrangements to study in Rostock, Germany in 1928. The course there usually took a year, but he was motivated to return to his fiancée and finished in 6 months. The wedding was a simple civil ceremony, but the marriage lasted 60 years. He didn’t receive his diploma until much later because the rising Nazi power suspected that he was Jewish.
My father never spoke about what happened, but gradually I learned that his family disowned him. Indeed, when my parents married they sat shiva for him. This is a seven-day long Jewish ceremony to mourn someone who has died. He never spoke to his mother after this, and I grew up without much contact with my father’s family. By Hebraic law, a child is the religion of his mother. Since my mother was Christian, my father’s children (my sister and me) would be considered gentiles and lost to the Jewish faith.
Many years later I was invited to a bris (ritual circumcision) in Durango of a baby boy I had delivered. The boy’s dad is Jewish and mom, Christian—the same as my parents. It was with trepidation that I attended: would there be friction between the two sets of grandparents? Indeed, would the paternal grandparents even attend?
My fears were unfounded. Everyone, Christian and Jew, had a great time with smiles and congratulations all around. Only the little boy didn’t seem to enjoy the party when the mohel performed his surgery!
Religions are changing. It is no longer a sin for Roman Catholics to eat meat on Fridays. Not all Muslim women wear headscarves. The Religious Society of Friends (Quakers) used to shun music, art, dance and reading other than the Bible, but now we enjoy all these.
The Bible supports owning slaves (Leviticus 25:44), executing people who work on the Sabbath (Exodus 35:2) and forbids sowing seeds of more than one plant in the same field (Leviticus 19:19) even though we now know that planting beans and corn together is beneficial.
I honor my father who thrived despite his family disowning him. I also honor that the world is changing. So much depends on whether we can change our way of life quickly enough to minimize damage to our planet. Religions must adapt to the vast changes humanity has gone through since many religious rules were decreed.
© Richard Grossman MD, 2013

Two recent columns treated child deaths. The sad fact is that, worldwide, 19,000 children die every day—mostly in poor regions, and mostly related to inadequate nutrition.
The first article told the story of two boys I took care of in Nicaragua when I was in medical school. Miguel hadn’t been fed enough protein and recovered with good food. Van was just skin and bones, and died from starvation.
The second article mentioned that there is hunger in the USA. Our country doesn’t have a universal safety net to catch people in need.
Sending food to poor countries does not help in the long run, because it increases people’s dependence. Indeed, well-meaning people may do more harm than good. This is made clear (in a religious context) in the book “When Helping Hurts”. It points out that many actions that might seem helpful have the opposite effect.
Unfortunately, despite the best of intentions, transferring technology from rich to poor countries can have bad effects. Supplanting breastfeeding with artificial formula is a good example. Contaminated water may be used to mix the formula, and poor parents cannot afford to buy the formula after breast milk has dried up,.
Nepal, where villages had an epidemic of deaths, provides another example of unintended consequences. Metal cookware appeared to be a boon to the Nepalese because food cooked more rapidly than in old-fashioned earthenware pots. This meant less denuding forests for firewood and less smoke from cooking fires. But it also meant that pork wasn’t uniformly well cooked. Pork tapeworms lodged in people’s brains and killed them. Fortunately, cooking pork adequately can prevent this disease, cysticercosis. Sanitary toilets are also important in separating human waste from pigs. We must try to foresee and prevent unintended consequences when trying to help others.
There are many examples of programs that are very effective in reducing child deaths. Brazil, which has experienced a remarkable transformation, is one.
Nancy Scheper-Hughes first went to a favela (Brazilian shanty town) in 1964 as a Peace Corps volunteer. She is now a professor of medical anthropology. Her article “No More Angel-Babies on the Alto” is available at: http://clas.berkeley.edu/research/brazil-no-more-angel-babies-alto
Nancy found that many babies in the favela died, and she was shocked that their mothers didn’t grieve their deaths. The average woman gave birth to 8 children, of whom almost half died. One woman put it this way: “Why grieve the death of infants who barely landed in this world, who were not even conscious of their existence?”
When Nancy returned to Brazil recently she was surprised to find that the under-five death rate in that same city had decreased from 110 to 25 per 1,000. How had this radical drop been achieved? She cites several factors. Brazil’s president’s wife was a strong advocate for women’s rights. They started a system of care for all, including “barefoot doctors” to identify children at risk. The “zero hunger” campaign provides food for the most vulnerable. Safe water supplies and prenatal clinics improved the health of pregnant women. Women’s literacy is a universal theme in social change, especially for improving child survival.
Along with the decrease in child mortality has come an amazing decrease in family size. The average number of children a Brazilian woman will bear is 1.8—less than in the USA, and less than replacement. Each child born can be expected to live to adulthood and is therefore valued from birth. This favela has gone through the demographic transition in less than 40 years!
What is the difference between good aid programs and not so good? The best programs tune in to what the local people want rather than imposing agendas that are not culturally sensitive. They are sustainable—meaning that the aid recipients will be motivated to maintain the work with little or no help from donors.
Back to Nicaragua. People there are still impoverished; it is the second poorest country in the Western Hemisphere, with 80% living on less than $2.00 per day. Fewer than 40% of people in rural areas have improved sanitation. Fortunately the country is receiving sustainable assistance. El Porvenir (a non-profit organization) partners with rural Nicaraguans to build sanitation and pure water infrastructure and protects the water supply through reforestation. Their school hand-washing facilities make kids healthier and increase school attendance by 20 to 30%!
These improvements have raised the standards of living and health. Better-educated women have healthier and fewer children. Development has helped Nicaraguans in many ways, including reducing the average number of children a woman has from 7 when we visited in 1968 to just 2.6 now.
© Richard Grossman MD, 2013