CLICK HERE FOR BLOGGER TEMPLATES AND MYSPACE LAYOUTS »

Tuesday, May 26, 2009

Cont'd Dr. Mittman on Health Research

Dr. Mittman continues writing:

" Genetic Assessment
The organization Dor Yeshorim has increased awareness of genetics in the Orthodox community. The testing it provides is one way to alert people considering marriage as to whether, together, they are likely to have children with a specific genetic condition, such as cystic fibrosis, Tay Sachs, Canavan disease, or Bloom syndrome.
In regard to other illnesses and conditions, however, my research has unraveled many erroneous beliefs. Do they constitute a genetic condition or not? As an Orthodox physician articulated to me, “People often call me with genetic questions. There are lots of different disorders, and many people don’t have any idea whether they are genetic, or even important.”

Getting an accurate genetic risk assessment in a quick phone inquiry is rather tricky. First of all, genetics is a complex science, and demands a close familiarity with the rapidly evolving nature of the field and emerging findings of human genome research. Moreover, only a careful examination of the health history of both sides of the family would be reliable enough to be used as a basis for such an important question as “chasana or no chasana?” So, where do we go from here?

The Benefit-Burden Concept
While Dor Yeshorim offers a reliable way to do premarital testing for recessive conditions, it does not guarantee perfect health for a myriad of other conditions that are not recessive. Simply put, there is no such thing as a “free lunch.” Everything we do in life demands some compromise, some work, and yes, risk-taking.

When one gets into a car one takes a major risk for injury and even fatal accidents, G-d forbid, but one takes this risk daily because one needs to get places to carry out our routines. In other words, for the benefit of driving we have to put up with the risks that driving entails: getting lost on the way to our destination, having a flat tire, or, G-d forbid, worse possibilities. In the same way, finding our bashert means taking a chance. We hope that we and our children and loved ones will live to me’ah ve’esrim (120) in wonderful health, but we cannot predict our future, and there are no guarantees. We do not know whether the child will develop asthma, have an attention deficit disorder, or grow up to have hypertension.

The Beauty of Diversity
We have to remember, also, the special value of uniqueness, our diversity is what makes the world such a wonderful place. Having said that, if there are serious health issues in the family beyond those of the general population, it is possible to ascertain genetic risk. Just remember, it is a matter for experts. Call your doctor, and if the doctor is not sure, ask to speak to a genetic specialist. To find a genetic counselor in your area, you can log into the web site of the National Society of Genetic Counseling: www.nsgc.org.

Dr. Mittman is a certified genetic counselor and a public health expert at the Office of Minority Health and Health Disparities in the Maryland Department of Health and Hygiene.

What I want to bring to your attention with this article is that one should be discriminating when doing research on matters of health. Do not reject a shidduch out of hand because of a health problem. Consult with a doctor who can advise you.

Health in research

An important aspect of research is health.

Not just the boy’s/girl’s health, but the family’s physical and mental health.
This is not an easy thing to research, and you might not feel comfortable asking questions about this, but it is nevertheless a very important subject.
Be aware that certain conditions are not genetic, and therefore have no bearing on the future children the couple will have.
If you are not sure about a particular condition, consult with the family doctor.

Unfortunately, scrutiny on health issues tends to be more rigorous for young ladies. One shadchan’s opinion of the problem is that boys are much more marketable than the girls because of the PERCEPTION that there are more eligible girls than boys in the chareidi community, (Would the Eibishter make such a mistake as to have considerably more boys than girls?). What this means is that a boy can have a serious condition, and he will still get a shidduch. And the girl? She can have a pimple, and she won’t!
It’s the law of supply and demand. How sad that we reduce creating a new branch of Klal Yisroel to a marketplace transaction!

Dr. Ilana Mittman wrote an article on genetics and shidduchim. Here are some excerpts from her article: ' "Some may think that a woman bears the child and is therefore solely responsible for the health of the progeny. Nothing could be further from the truth! The term “it takes two to tango” certainly works in the genetic world. Both parents pass on their genetic endowment equally to the next generation. Each one of us carries about 50,000 genes (units of heredity) on 23 pairs of chromosomes. A child inherits half of his or her genetic material from the mother and half from the father." "It is essential, too, to remember that, while genes are certainly important to what we become, they work along with the environment. Unlike Tay-Sachs disease and certain other conditions that are passed directly from parents to children in a simple fashion, most conditions pertaining to health are governed by a host of genes that interact with one another – and most importantly, interact with and respond to the environment in which we live." To give a few examples, having a sibling with a seizure disorder or mental retardation does not mean that a person will have a child with either of these conditions." "Some conditions are acquired because of a difficult birth or subsequent accident or illness, for instance, and not in any way genetic. Others follow a complex pattern of inheritance, involving combinations of many different genes. In addition, and most significantly, Hakadosh Baruch Hu has given us advanced medical technology that provides effective treatment for some afflictions, like diabetes and hypertension, and cures for others." "The bottom line is that none of us is ‘genetically flawless’. It is a fact that all of us, regardless of our ‘stellar’ family medical history, carry a few deleterious genes, whether we know it or not, which may never be expressed. Virtually all of us have a family history for at least one of the following: heart disease, diabetes, hypertension, Alzheimer’s disease, and certain cancers. It is also a fact that two to three out of every 100 newborn babies will have some kind of a birth defect – most commonly, a heart defect. The vast majority of these cannot be predicted by family history, and many of them are not genetic.” "It is also a fact that two to three out of every 100 newborn babies will have some kind of a birth defect – most commonly, a heart defect. The vast majority of these cannot be predicted by family history, and many of them are not genetic. It is important to define the difference between a “birth defect” and a “genetic condition.” A birth defect is an abnormality either in structure, function, or body chemistry that is present from birth and has physical and/or mental consequences. However, a birth defect is not necessarily genetic, meaning it does not “run” in the family line. One common example is Down Syndrome (DS). The vast majority of persons with DS have this condition as a result of an accidental abnormality of chromosomal rearrangement. So, having a family history of DS does not mean that the person is any more likely than anyone else to have children with this condition.

Thursday, May 21, 2009

How much research

Like every thing else, just mentioning the words “shiduchim research” in a group, will bring conflicting and contradictory opinions.

A popular story is the one of the Rov who was presented a case, and after the first side speaks, he agrees with him. Then when the second side speaks, he agrees with him, so the Rov's wife asks him, “How can they both be right?”, and he responds to her, “You are also right!”

So it is with research: there are those who say there is not enough research done and that is why later problems may arise, and they are right. On the other hand, there are those that say that research has gotten out of hand, and people ask questions that have no relevance to the character of the person in question--they are also right. I guess they can both be right.

Research can prevent all sorts of problems later on. Make sure the character presented is truly the character that is (as shown previously). When the couple does meets, it should be just to make sure they have a connection and are on the same wavelength. They should enjoy talking to each other and be able to relate to each other. Going out should not be about general research. All that should be done in advance.

That is how it is possible for a couple to go out 5 or 8 times and say yes. All that has to be discovered by the couple is if they have an affinity for each other. (I’ll return to the subject later when we discuss dating.)

On the other hand, overkill in research is not conducive to a good result. Often inappropriate questions are asked. Another example of an unsuitable question would be: What kind of car do the parents drive? It might indicate the financial level of the family, but there are better and more direct ways to find that out.

Everyone has a "skeleton in the closet" it may be more or less substantial but no one alive can bare their life and come out "roses". Peccadilloes abound. The thing is to know what are peccadilloes that can be ignored and information that will make a difference in our children's lives.

Heath issues, as will be written in a future blog entry, should be always checked out. Rumors should be taken as untrue but followed up to make sure. Stick to facts in all things, assumptions and gossip are not good information.

Someone said that unfortunately, we are living in a culture that makes more of defining a person by the subcategories of subcategories which they fit into than by the nobility of their character. This is indeed a sad state of affairs. And this is what we should avoid doing in our research. Don’t ask question to categorize people; ask questions that will reveal their personality and character.

Researching basics

Whether you take a name out of the girls/boys list or someone suggests a possibility, research has to be done. There are various ways to do research.
One may do in-depth research straight away. Once all the facts are in and you and your child have agreed this offer is worth pursuing, then you advise the shadchan that they may tell the other family about your interest. Naturally, at this point you have to sit and wait. The other family must have time to do their own research.
When one family has done the research and it is your turn, please do not drag your feet. The other side is in “limbo” until they get an answer, yes or no.

In a different scenario, one may do preliminary research to see if the name suggested is what one is looking for. If it is and the shadchan advises that the other side is also agreeable in principle, more in-depth research is warranted. During research, some parents and children will often concentrate on the prospective spouse’s qualities and completely ignore the family he or she comes form. This is not a good idea as a person is part of a family unit, and therefore, we must make sure that our child will be able to integrate with the other members of this family. On the other hand, there are occasions when a friend or a family member will discourage a shidduch simply because of the family the prospect comes from. This is also wrong in principle. Do not categorically reject a shidduch because of the family. It may well be that the prospect is the perfect person for your son or daughter irrespective of the family he comes from. So as in everything else in life, both sides of the question have to be taken into account. Do not discount what you heard about the family, it may help in situations in the future. Do ask a Rov if what you heard should have an impact on the shidduch. Generally the Rov may tell you that one should not hold the children responsible for the "sins of the parents", but every case is different. Always keep in mind that forewarned is forearmed. Check out to see if your child will mesh with the other siblings and family members. If your research of the boy/girl shows they are what you are looking for but you do not like the family at large, do not “throw out the baby with the bath water.” Investigate the prospect further, and make a decision based on the good qualities of the prospect and on the Rav's advice.

Wednesday, May 13, 2009

A word on Timimg

If I am given a name and someone else suggests another, should I look at both or wait and finish with the first one before going on?

It will depend on how you were given the names. For example the first name offered was just a “he is a boy and she is a girl” kind of suggestion, where the one suggesting does not know the qualities and characters of the two. The second name proposed came from a shadchon (professional or otherwise, friend or family member) who actually gave thought to the compatibility of the couple.

In such circumstances, it would pay to follow up on the second name first, even if one already started looking at the first suggestion. If on the other hand, both names suggested are based on compatibility or both names are just names, then one would finish with the first name suggested before going on to the second one.

Nothing is really a rule so if you would like to research the second name because it sounds better, or it has been given to you by someone closer to you than the other one, go ahead, nothing will be ruined by it.

What if you are already started doing research but a very good prospect is offered?
How much research have you done? was the other side also doing research? If you have just started your research and the other side was not told anything and the name you were just offered is really attractive (and I am not talking about looks) then look at the second and if it does not work out go back to the first. But if the other side was already notified and is doing research as well you will have to finish with the first name before starting with the new suggestion.

Calling for References

When you call, you should have a list of specific questions.
In order to receive good answers, direct questions are a must. A written list of questions is necessary. You may think that you know in your mind what questions you wish to have answered, but during a conversation, it is easy to get sidetracked and distracted, and then forget to find out about important points.
With a written list you can check off the questions as they get answered. Take notes of the answers. Ask the person to give you a second as you are taking notes. Even if you have a good memory, it is easy to forget the details. Even more, it is useful to write the exact words (adjectives) you hear, so your mind does not supply its own interpretation of what you heard.

It is easy to be influenced without realizing it. If the person on the other end of the phone is enthusiastic about the prospect, one is easily carried along by the enthusiasm and may interpret what one hears subjectively. If we write the exact words, we can review the conversation without that influence. Although, (yes, I am being contrary) impressions should be noted as well.

Asking what can you tell me about so and so is not an answerable question. First of all as explained previously one can only answer questions that are specific in nature and not general questions. I will give examples of specific questions in a separate blog.

I also believe in making the calls myself and not having another person call for me. This is my personal preference because when you listen to someone’s description, often you can hear between the lines what they are not saying. The tone of voice will give you pointers. The pauses, the type of adjectives used will tell you more than just “Merriam-Webster’s” definition.

For example, you call someone and after the first few awkward explanations, the conversation takes a warmer tone. The person genuinely likes the one you are discussing, and it comes through in the tone of their voice. Or someone is not very familiar with them, so they may sound hesitant. Someone may describe the person as “nice”, “pleasant”, etc. These are “milquetoast” (tame) adjectives, too bland to describe someone who certainly has some admirable characteristics.

The exception to calling references yourself is if the young man or lady calls for herself. That is a much more difficult call. It would be preferred if at all possible that a mashpia or good (married, older) friend make the calls for the one involved. Aside from the reticence involved in asking information for oneself, and the reciprocal reticence of not wanting to tell the person directly involved less than laudatory information, there is the stress of finding out again and again that the name suggested is very far from the requested ideal. Finding out again and again that the proposed shidduch is only a match in the very basic terms (one is a girl and one is a boy) depresses and stresses out the young man or young lady making the calls.

I know of a mashpia who told his mushpa to pass along to him all the names he is offered and he would make the calls. If anything appropriate was suggested then he would pass back the name.

Wednesday, May 6, 2009

Friend references

There are a lot of reasons why the information one may get from a friend might not be of the highest caliber. (Don't get offended out there; it is a fact that references received from friends are not always reliable)

I have heard of friends giving totally "off the wall" information just because they did not like the tone in which a question was asked, or they did not think the question was a worthy one and therefore they felt it slighted their friend. The problem is that although the question might be unworthy, the way it is answered does a lot of damage, which surely the friend did not intend.

So all you friends out there, answer all questions to the best of your ability even if you think it is unworthy or annoying. When you do not know an answer (and this goes for everyone) say so. "I do not know" is better than speculating and assuming.

Girls often get asked in a lot of ways and forms for their friend's size. We all agree that it is a question that should not be asked because size is not what we should be checking out, but that is not a good reason to either hang up the phone or be less than gracious to the person requesting the information. It is understood that even if the girl is a size 2 one still does not wish to answer such a question, in which case one can answer with a witticism, or that: “She is the right size” knowing that if one refuses to answer it will be construed as a negative answer.

Friends who have lost touch since high school should specify that they have not been in touch, or have not seen each other in a long time. The growing years between high school and marriage are very formative years. A person will change tremendously during that time, therefore the way one acted then and the way one acts now could be entirely different.

A friend might be called because the person inquiring knows that these two people are friends. It does not mean one is on the friends list as a reference. Therefore if one has not heard from a friend in a long time, one should say that in a nice way, while giving positive information and reminding the caller that it is a while since there was contact.

In short, whether you are a close friend or a fair-weather friend when asked for information answer as best and as politely as you can and do not get riled at the questions you hear.

Tuesday, May 5, 2009

Being a reference

If someone calls you to ask that you be a reference for them, on the one hand, know what you are taking on, but on the other hand do not say no just because it takes a bit of effort.

You might want to discuss with the person calling you what is your impression of their child (or themselves). Or you may ask them if there is something they wish you to say, or not say.

It also pays to learn the halachos of Lashon harah for this particular case: giving information for a shidduch. You may want to go to this blog (February archive - the toungue III) and look up the article about giving information. As mentioned in the above referenced blog if you are asked something you are not sure how to answer tell the person you have to call them back and call a Rov to find out what you should say.

If you accept the responsibility of being a reference, realize that it might take time out of your schedule to properly answer the questions posed. If it is not possible for you to be available when the person calls for references, take their number and tell them you will call back or ask them to call you at a more convenient time. Do not say that you are too busy and cannot help. That is not complementary to the person who gave out your name.

If your name was given without your knowledge and you really cannot take the time to be a reference for your friend, then call your friend and ask him/her to take you off the list.

In short it is a wonderful thing you are doing by giving of your time to help someone get married, but make sure you give only facts and you know exactly what one is allowed to say and what one should not say. Answer questions to the point and not general questions like : "What can you tell me about plony ben/bas ploni."

Choosing what references to give

Keep the resume updated.

If the resume was made a year ago, make sure to review it before it is sent on. If you have not talked to a particular reference for a long time, decide if you wish to keep that reference on or change it for someone else.

Make sure you know what the reference will say about your single, or you. If you have to ask a friend to call the reference and ask about you (or your single), to find out what is said, then do it!

Please everyone, when you give a name for references speak to that person and make sure they will give references for you. There are plenty of cases when a parent will call and hear the reference say: "I can't imagine why my name was given I really do not know ... ." This is not a positive answer!

Choose some references that know your family, even if they do not know your single so well because s/he was away in yeshiva, seminary, shlichus etc. Then give adult references that know your single, maybe a shlucha/shliach they worked for, or a mashpia etc. Then give friends of your single. Have your single call his/her friends and make sure they will give the right kind of info about her.

Do not panic if no one calls your references. Maybe the person found out all they wished to know from other sources. On the other hand do not consider your references as a minor part of the shidduch process. Give enough thought to who you are giving and who would be your best advocate.