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Program Director Notes

Happy New Year


This past weekend, Jews around the world celebrated the beginning of a New Year – 5781. This New Year (there are four in the Jewish calendar), is a day when Jews reflect back on the year they have lived through and prepare for the year to come. According to Jewish lore, only the most righteous of all people die immediately before Rosh Hashanah. It is these individuals who, being omitted from the last year’s book of life, were destined to die during the year, yet were spared as long as possible because they were so needed by their communities.

It is fitting, then to recognize two important Jewish women lost to us this weekend. One, often referred to as the ‘notorious RBG’ is likely known to you all. As a sage (well, actually Facebook) once said, “Women, if you have a credit card in your own name and your own credit history, if you have leased an apartment or bought property in your own name, if you have consented to your own medical treatment, if you played a sport in school, you can thank Justice Ruth Bader Ginsburg.” It is hard to overstate the role that Justice Ginsburg had in equalizing the opportunities and legal rights given to American women, or the role she played in demanding enlightenment in our justice system. When honored with the Genesis Prize in Israel, in 2018, Justice Ginsberg noted the importance of her Jewish heritage in her work, saying “the demand for justice, for peace, and for enlightenment runs through the entirety of Jewish history and Jewish tradition.” We mourn her passing, and wish she had been with us longer, and yet it is fitting (at least to me) that the timing of her death be a final indication to all that she was most righteous.

Adeline Fagan, MD, PGY-2 in obstetrics and gynecology at HCA Healthcare Houston West, was less well known. I learned of her illness only through Pete Fields, who was her classmate at University of Buffalo, School of Medicine and Biomedical Sciences. She fell ill with COVID in July, spent months in the intensive care unit, on ECMO, until finally succumbing to a brain bleed this weekend. Dr. Fagan was known for her radiant kindness, and her love of her work. We will never know the impact that Dr. Fagan may have had on her patients, students, co-workers, and family. Her death, far from her family, resonates so personally for me.

We all know someone who has had COVID-19. Many of us have cared for patients who have died of the disease. And yet, some deaths hit closer to home than others. I think of Dr. Fagan, and I think of Dr. Antonio Guzman, director of Corpus Christi Medical Center’s Internal Medicine Residency Program, and it is hard not to feel impacted, and a bit afraid.

When we look around the beautiful Upper Valley where we live, it is easy to put aside that hundreds of thousands of Americans have died of COVID this year. Even our local statistics feed into a sense of comfort. The average age of death from COVID is 71. The vast majority of deaths (81%) in New Hampshire were nursing home residents. And yet, health care workers make up a quarter of those infected in New Hampshire.

I have wondered how I could cope with this uncertainty, and with my close identification to Drs. Guzman and Fagan. Preparing to celebrate Rosh Hashanah with my family this year, I listened to the podcast of Rabbi Lord Jonathan Sacks, former Chief Rabbi of the Commonwealth. He described, eloquently, how the Hebrew word for security (bitachon) and that of faith (bitochon) are similar. Rabbi Sacks notes that the way to cope with insecurity is faith. He explains, “what you need in decision-making under conditions of radical uncertainty, is a steady hand, a steady eye and a steady mind. And those are difficult to do in the eye of the storm. And the way to do them, is to have bitochon, to have faith that you are going to come through this. …in Judaism, faith is not certainty. Faith is the courage to live with uncertainty.”

I am not going to argue for any particular faith (many of you know that while my husband and kids are Jewish, I have been a Christian since my 20s). However, I do think having faith—whether it is faith in a religion, spirituality, an institution or in science*—is key to surviving. I, and perhaps some of you, am so tempted, when I hear of another death, to differentiate myself from the deceased—I am so much younger, so much healthier, I would not have made the choice that person made**—death is not coming for me. For me, in this time, faith entails believing in (and participating in) the initiatives that our towns and local government, as well as DHMC have taken to prevent transmission. Faith is the belief that if I do my part—behave responsibly, wear a mask (and shield when necessary), avoid unnecessary travel, etc.—and trust others to do the same, that, together, we will get through this and all will be well.

Stay safe, stay healthy,

* If science is your bag, Meltzer et al. have come out with a study looking at Vitamin D status and COVID-19 test result, indicating that the relative risk of testing positive for COVID-19 is 1.8 times greater for individuals with Vitamin D deficiency. Northern New England winters lead to Vitamin D deficiency in everyone—and this is something that may be remedied through supplementation.

** If this technique is helpful for you and your well-being, both Drs. Guzman and Fagan had serious, chronic auto-immune disorders.

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