QUESTION:

Dear Rabbi Ali,

I heard you mention in one of your classes the importance of spending quality time with your spouse. My husband and I do set time aside twice a week to spend time together, however it’s always me who initiates it. This makes me feel as though my husband is not interested in going out with me. How can I either get over these feelings or maybe get him to initiate?

R’ Ali’s Response:

This is a common question. Actually, I hear this equally from men and women. Yes, men also want closeness and connection with their wives. Don’t be mistaken that women are the ones who want to cultivate a loving relationship and men could care less. This couldn’t be farther from the truth.

Your question was concerning your husband’s lack of initiative to go out and spend time together. I would like to elaborate first on the importance of quality time since it is so important. Many people feel as though quality time is a “nice thing.” I believe it’s more than just a nice thing, it’s extremely crucial for a couple to spend time together for the couple to build and maintain a healthy, loving relationship.

We all agree that we feel close to people who we speak with and meet up with often. And people that we don’t have much contact with – we don’t have such a great connection. So why would our relationship with our spouse be different in this sense? The truth is, that it isn’t.

Many people that I speak with or counsel mention that they don’t spend quality time with their spouse, sadly. They have many excuses, and the main one is that they are simply too busy. While I understand that we all get busy, this is not an excuse. I’m pretty sure everyone can find twenty minutes, three times a week to spend quality time with their spouse.

What does help a lot of people is to schedule specific times and days for quality time. Some people tell me that this feels “unnatural.” To this I say, would you rather have good quality time with your spouse that came about in an unnatural way or “organically disconnect” from each other? I believe the former makes more sense.

Before I answer your question it’s important to have in mind the main purpose of the quality time and that is, quality. What makes the time “quality”? If the time spent is light and enjoyable as opposed to pressurized and critical. This is not the time to “fix” your spouse (nor is anytime really appropriate for that). People feel connected when they’re heard, understood, and just plain enjoying time together.

Getting back to your question, how can you get your husband to initiate or to manage the uncomfortable feelings? Concerning the feeling that he is not interested in you, I can reassure you that he wants to spend time with you and enjoys it. Some people feel content with the small interactions they have throughout the day and maybe feel connected already.

As I’ve mentioned before, setting times is ideal and this would actually work to your advantage. This way no one’s initiating! The time is set already. However, if you desperately want him to initiate maybe once in a while, just tell him nicely and gently that it would mean so much to you, without blaming or accusations. Maybe he will initiate, maybe he won’t, but with this approach you will have a better chance of having him initiate.

One last thing to bear in mind – many times in an attempt to bring our spouse closer, we push them further away, unfortunately. You would like two things, to spend quality time with your husband and to have him initiate the outing. By pushing an agenda and complaining how he never initiates, you may be creating a situation, chas veshalom, where he becomes disinterested in going out altogether. This way you will lose more than you will gain. Not to say that this is what you were doing, I’m just putting it out there to be aware of this pitfall that entraps many people.

Eddie M Esses and Sari J Setton

The Sephardic Community Federation (SCF) has launched one of the most ambitious voter registration drives in the history of our community. Led by Haim Dabah and Marshall Aronow, in partnership with SCF’s executive team – Ronnie Tawil, Sari Setton, Eddie Esses, Joey Saban, Joe Mansour, and Charles Chakkalo. This unprecedented initiative is already reshaping civic engagement across our community, having registered thousands of new voters with the goal of adding many thousands more before the November mayoral election.

The campaign was launched this past August at a meeting hosted by Haim Dabah at his home in Deal, NJ. Leaders from schools, synagogues, and community institutions gathered for a powerful morning of strategy and planning. Presentations by Haim Dabah Marshall Aronow, and Ronnie Tawil set the tone for the weeks ahead, followed by a lively discussion among the assembled leadership. In addition to uniting our institutions around this mission, the meeting also raised enough money to fund the campaign’s rollout.

From that moment, the SCF team – guided daily by Haim and Marshall – set in motion a wide-ranging and highly coordinated effort:

· Rabbinical Proclamation: A landmark statement, signed by the majority of our community Rabbis, declared that registering to vote is both an obligation and a mitzvah, energizing the effort with moral clarity.

· School-Based Registration: Magen David Yeshivah, under the leadership of Gladys Haddad, mandated voter registration among its parent body in order to receive class cards. The result was extraordinary: a 99 percent registration rate in just three days. Yeshivot nationwide have since reached out, seeking to replicate this model.

· Synagogue Engagement: Congregation Shaare Zion instituted a policy requiring voter registration to reserve High Holiday seats, demonstrating the alignment of our institutions behind this effort.

· Community Registration Tables: Under the leadership of Linda Ebani, along with Rebecca Harary, volunteers have been running registration drives at summer events, synagogues, and local stores across Brooklyn, engaging our community at every level.

· Door-to-Door Canvassing: Joey Saban led a professional door-to-door campaign that has registered significant numbers of voters directly at their doorsteps.

· Direct Texting Campaign: Most recently, the group launched a major texting initiative targeting unregistered voters. In just a few days, the effort has registered hundreds, and it is rapidly expanding to registering thousands.

Together, these initiatives have already registered thousands of voters in just weeks. The goal is to register many thousands more before November, ensuring that our community’s voice is heard loud and clear in this critical mayoral election, and all future elections.

This campaign is a testament to what can be achieved when vision, leadership, and unity come together. The extraordinary dedication of Haim Dabah and Marshall Aronow, combined with the tireless efforts of the SCF team, has inspired a wave of civic engagement unlike anything our community has seen before.

With the upcoming mayoral election, we are living through uncertain times that call for decisive efforts – and community leadership is stepping up to the plate. With the continued energy and unity behind this campaign, the Sephardic Community is poised to play a significant role in shaping the future of our city and state.

By Stuart H. Ditchek, MD Board Certified Pediatrician Faculty, NYU School of Medicine

As a follow up to last month’s article (The Reality of Vaccine-Preventable Diseases), I have been asked to continue the discussion regarding the importance of childhood vaccinations and why parents should understand this complex issue. In addition, I will provide a follow up on the current Israel measles outbreak.

Unfortunately, as of the end of August, Israel saw a reported 700 cases of measles over three months resulting in the death of two toddlers to date. The majority of hospitalized seriously sick children are unimmunized. Historically, both Israel and New York have had outbreaks in similar time periods as there is so much travel between the two locations, especially for the New York Jewish community. Unfortunately, with the number of families who have sought out falsified vaccination records recently, we do not currently know how many children in our communities are unimmunized or under immunized. This makes the risk to susceptible individuals much greater.

Why Vaccine Protocols Have Changed

Understanding historical perspectives and how many of the vaccine protocols have developed is an important part of good parenting. Let’s take a few examples of how recommendations evolved as science advances over time. For example, flu vaccines are recommended now for all children over six months, whereas years back it was only recommended to vaccinate the highest risk individuals such as those with heart or respiratory disease. The answer lies in the complication rates over the past 20 plus years and how it has changed.

In 2010, the flu vaccine was added to the annual recommendations for all children. The two factors that changed the recommendations were bacterial secondary complications and the post swine flu lessons of 2009.

Years back, there was minimal bacterial resistance throughout the United States. Over time with the overuse of antibiotics, we have seen a tremendous emergence of MRSA (Methicillin Resistant Staph Aureus). This dangerous aggressive bacteria finds the most susceptible hosts and wreaks havoc on certain patients.

Flu Patients Have Gotten Sicker

The research supports the fact that as MRSA and other bacterial strains became dominant, those sick with flu were getting hospitalized at much higher rates. The majority of flu complications are the result of secondary pneumonias, many with MRSA. This type of complication often leads to hospitalization and serious complications including respiratory failure.

ICU-level care became more common for the unimmunized. Many of the sickest patients suffered terrible outcomes including deaths and amputations as a result of the severe infections. In children, the overwhelming majority of hospitalized children with flu complications are those not immunized. The fact remains that immunized children have a dramatically lower complication rate specifically for hospitalization.

While the flu vaccine is approximately 60 percent effective to prevent getting the flu, it is more than 90 percent effective in preventing hospitalizations in children. The other factor that has evolved and made the seasonal flu much more serious is the effects of the H1N1 swine flu variant.

Swine Flu

The novel swine flu variant appeared in the late spring of 2009. Existing flu vaccines were ineffective against this variant. That year, many pregnant and postpartum women were very sick and hospitalized with swine flu. Babies were being delivered by C-section in the ICUs as the mothers were too critical to risk transport to the operating room.

Why did the new variants cause such serious disease? Firstly, pregnant and postpartum women lose immunity to many infections as a result of a normal pregnancy. The other factor is related to these newer variants effects on the bone marrow causing an inability to fight infections. The current flu variants cause very significant and often unnoticed suppression of the white blood cells originating in the bone marrow. This suppression can lead to the inability to fight off the bacterial complications seen in flu, especially pneumonias.

In other words, this was not your mother’s seasonal flu that mostly affected those at highest risk. Flu vaccination is critical for all children especially the youngest ones. In my practice, flu vaccine compliance has been very good as the result of efforts to educate families. However, since the recent anti-vaccine movement has erupted, this has become more difficult.

RSV Vaccine

Let’s look at the RSV (Respiratory Syncytial Virus) vaccine, which is now a standard recommendation for all babies either after delivery or by the mother receiving it in the third trimester.

RSV is a very dangerous respiratory virus that affects tens of thousands of babies annually, often resulting in hospitalization and sometimes, unfortunately, death. This virus is benign to most healthy older children and adults (with the exception of seniors) but is very serious in newborns.

In the past two years, a recommendation came about to give babies these monoclonal antibodies to prevent complications. Those who object to vaccines would have you believe that this is a brand new vaccine and not studied. That is false. RSV vaccine is a passive antibody administration, much like the monoclonal infusions that saved so many during early COVID. There is no immune response required by the infant. The vaccine simply provides long-acting antibodies to the infection that lasts for a period of months.

This monoclonal antibody is not new. Pediatricians have been giving a product called Synagis to preemies and high risk infants since 1999. Synagis is very similar to the RSV monoclonal product (Beyfortus) except that it is a short acting antibody that requires five doses per season rather than one, as required for Beyfortus. Since the introduction of the RSV monoclonal vaccine, hospitalizations have been dramatically reduced. It is very well tolerated with minimal side effects as the baby is not required to actively mount an immune response. The antibody is given to protect the baby during RSV season in the first year of life and in the second year for higher risk babies. It is very important for parents to understand the critical nature of how this simple passive immunization with monoclonal antibody is saving lives.

Chickenpox Vaccine

One more vaccine innovation that did not exist until the early 1990s is the vaccine for Varicella (chickenpox), initially developed for use in high risk children recovering from cancer or other immunosuppressive treatments.

The recommendations changed in the early 1990s to now give this vaccine to healthy children. This is due to the complication rates from MRSA and other bacterial risks. When I was a child, chickenpox was a rite of passage with minimal bacterial secondary complications. Once antibiotic resistance and MRSA came about in the late 1980s, we started seeing children hospitalized with bacterial sepsis (blood infections), cellulitis (soft tissue infections), and serious complications.

The reason is that a typical child with Varicella has a large number (sometimes in the hundreds) of open wounds that are easy penetration points for bacteria such as MRSA. Once again, this is not your mother’s chickenpox of past years. As a young practitioner, it took me two years to adopt this recommendation as I wanted to see more data before using it broadly with my patients. It was clear that the vaccine led to dramatic hospitalization reduction and the associated complications. Is it as perfect as natural immunity? No. But the benefits far outweigh the risks. Once again, in my private practice, I have not seen a single case of chickenpox since the mid-1990s.

Mercury in Vaccines?

As you can see, understanding disease processes and solutions is critical for parents. I am often asked if vaccines contain thimerosal (ethyl mercury), a preservative. The thimerosal scare is a myth often touted by anti-vaccine activists. In my 35-year history, my practice has never used the only thimerosal containing vaccine, which is the multi-dose flu vial.

These vials are primarily used in countries where storage and shipping of single dose vaccines is difficult, such as third world countries. More importantly, ethyl mercury is excreted easily in all humans and not stored in tissues. Methyl mercury present in carnivorous fish (i.e. tuna) and present in certain environmental exposures is potentially toxic. In the book that I authored in 2001 on integrative pediatrics, Healthy Child Whole Child (Harper Collins Publishers), I advise no fish during pregnancy and limited carnivorous fish for all children and adults in general. Mercury is not an issue in childhood vaccinations in almost all medical practices.

In Conclusion

In closing, be smart and don’t let the politics of vaccination influence your decision process. We have an obligation to protect our own children and all children in our communities. When we allow those who refuse vaccinations into our schools, it puts many at risk. I have many families with children who are in the highest risk categories in schools all over Brooklyn and Manhattan. These are children recovering from cancer, immune disorders who are on immunosuppressive therapies, and others.

They must often wait until their immune systems recover from the effects of their treatments to receive boosters or get re-immunized after their immune system gets washed out by the treatments. That makes them very susceptible. The parents of those children are terrified right now as they are well aware that there are those in the community who have falsified their children’s vaccination status. That is not who we are as a community.

Please listen to your doctor and do the right thing to protect all children.

“Jeffrey and I have been raising our family and working together for over two decades. My family is Ashkenazi Hungarian and his is Egyptian. Our home is the best mix of both Ashkenaz and Sephardic customs and food. We run a home health care company that we built together.”

~~ Agnes ~~

Ellen Geller Kamaras

Please meet Agnes Shemia.

Agnes exudes positive energy, warmth, and an upbeat perspective. She is definitely a people person.

Agnes describes herself as giving, hardworking, diligent, and relentless. Agnes is both driven and is committed to her family, business, and community.

Agnes was born in Hungary and moved to New York with her parents, Susan and Leslie Gollender, at the tender age of one. Her grandparents were Holocaust survivors. Agnes speaks fluent Hungarian. She is very close with her brother, Alen, who is five years younger and lives in New Jersey.

Growing up in Mill Basin, Brooklyn, Agnes attended Shulamith Elementary school until sixth grade. She then transferred to Yeshiva of Flatbush and studied there through high school.

“I was shy as an adolescent and became less so as I got older. By the time I graduated college I was a total extrovert.”

Agnes greatly enjoyed her Judaic and Hebrew classes and preferred science to math and history. Languages came easy to her, and she was an above average student. Agnes was very social, however, and admits to chatting a lot in class.

After high school, Agnes studied at New York University and majored in speech-language pathology (SLP). Why speech? “I always loved medicine, and I thought I could be a great teacher. SLP seemed like a great combination of the two.”

Family

Agnes was introduced to her naseeb, Jeffrey Shemia, of Egyptian descent, through her high school friend, Debbie. The couple have been married for twenty-six years and combined forces to create a family and build successful home health care companies operating in New York, Florida, and Missouri.

Their children are Victor (25), Esther (22), Jacob (18), and Sophie (16). Victor attended NYU Stern School of business and is working in the family health care business. Esther is studying nursing at NYU and is married to Samuel Krost, who is like a son to the Shemias. Jacob is starting his sophomore year at NYU and Sophie is a junior at Ramaz High School.

Agnes and Jeffrey raised their children in Brooklyn and spent summers in Deal. Their office is in Brooklyn. As they started their family, the Shemias moved to Mill Basin to be close to Agnes’ parents. “My career would not have flourished if not for my parents. They helped us with our kids tremendously.”

With their youngest in school in Manhattan, Agnes and Jeffrey are planning a move from Brooklyn to the Upper East Side.

Their Journey

As a newlywed, Agnes completed her master’s degree in SLP at Lehman College. She has always preferred working with adults. Her patients were primarily stroke victims or had traumatic brain injuries.

It was Jeffrey’s idea and dream to build a home health care company. An avid newspaper reader, he recognized in his early twenties that the aging baby boomers would need and desire home health care. The U.S. Department of Health and Human Services cited that by 2050 those over age 85 are projected to more than triple, and an estimated 70 percent of older adults reaching age 65 are expected to require, in their lifetime, some type of long-term care assistance, such as help with bathing, dressing, meal preparation, medication management, housekeeping, and transportation.

Jeffrey worked in Agnes’ father diamond business and Agnes practiced SLP at outpatient rehabilitation centers. They worked hard to build up savings to realize their dream. A few short years after graduation, Agnes and Jeffrey built their home health care business one patient at a time.

After many failed and challenging attempts, the Shemias were licensed by the NYS Department of Health. They opened their first home health care business, HCS Home Care, in 2004, providing non-skilled services. In 2017, they expanded their scope and purchased Girling, which includes a range of skilled services, nursing, SLP, physical therapy and occupational therapy.

Approximately a year ago, HCS-Girling entered into a strategic partnership with Pinnacle, one of the largest private Medicare certified providers of skilled home health and extended care services in Florida.

Passions

On a personal level, Agnes is most proud of her children and family.

Professionally, she is thrilled with the business she and Jeffrey created. Agnes loves the purposeful work that she does.

She is impassioned about health care and truly enjoys helping people.

“Unfortunately, there will always be a need for home health care. Fortunately, with the advances in technology, we have been able to take care of so many patients, their caregivers, and families.”

Agnes’s biggest challenge is finding the right people to take care of the patients. She is always looking for new opportunities and new creative and smart talent.

During the pandemic the Shemias went to their office daily. If their staff was required to work and be there for their clients, then they were there, too.

Agnes explained how HCS-Girling is different than other agencies – it’s about their adherence to compliance with government regulations and also her accessibility. “I can be reached on the phone and help a family find the right caregiver. I genuinely care. I am aware and appreciative that my secret to success is Hashem.”

Balance

“I am obsessed with my children. I don’t want to miss out on being a mom, a wife, a daughter, a sister, a hostess, and a community member. I do what needs to get done. I love to cook and entertain. Chicken soup for Shabbat and cholent parties are a must. Juggling business and family is challenging but greatly rewarding.”

Agnes is grateful that she and Jeffrey have very similar values, and they are on the same page regarding parenting. “We work a lot, talk shop a lot, and our kids grew up in the business. Both my daughters want to have careers.”

The Shemias appeared on a Propel panel called Couples Who Work. Watching the interview, one could see the love and effort they both gave and continue to contribute to their children and the business.

Agnes is happy that she was able to practice SLP for several years and has grown in her time management skills, organization skills, and as a clinical director and administrator of HCS-Girling. “I don’t work less but I work with more intention.”

Jeffrey is proud of how he and Agnes partner on both fronts, at work and at home, and he confesses that achieving work-life balance is not easy and requires a lot of effort.

Community is essential to Agnes. She is involved with SBH, Propel, various mikvehs, and helping Chabad houses all over the world. She does not say no when organizations reach out to her.

Agnes acknowledged that she is not so good at relaxing, but she does enjoy cooking and she loves music.

Tips for Young Adults

Don’t give up and don’t take yourself too seriously. Do what you love, and it won’t feel like work. Stay humble especially when you are successful – it’s not only because of you.

You can connect with Agnes at Ashemia@hcshomecare.com. Please check out her Instagram pages @HCS Home Care, @Girling Healthcare, @Extended Home Care and @Pinnacle Home Care.

Ellen Geller Kamaras, CPA/MBA, is an International Coach Federation (ICF) Associate Certified Coach. Her coaching specialties include life, career, and dating coaching. Ellen can be contacted at ellen@lifecoachellen.com.

In the heart of Seattle, Washington, a vibrant legacy endures with the Sephardic Bikur Holim Congregation. Established in 1914 by Levantine Jews from western Turkey, it continues to this day.

The incredible story of Sephardic Bikur Holim began in Medieval Spain. Then, during the Golden Age of Spanish Jewry, it all came to a tragic close with the Edict of Expulsion in 1492, issued by Ferdinand and Isabella. The Jews were forced to flee their homeland, and the refugees found a welcoming sanctuary in the Ottoman Empire. The Sultan, sensing an opportunity, was eager to take advantage of the Spaniard’s misjudgment. He opened his ports and cities to the refugees. They settled into their new homes and flourished there while keeping to their customs. As they settled across the Ottoman Empire, they not only survived, but thrived, while preserving a legacy that spans centuries, and through it all, they remained steadfast to their heritage.

After World War I, these Jews came to Seattle looking for a better life as well as to escape the crumbling Ottoman Empire. Our ancestors brought with them a treasure trove of culture, including their own unique language (Ladino), cherished customs, distinct minhagim, Turkish foods, and beautiful music (Romanzas), along with a deep well of religious knowledge.

Today, the Sephardic Bikur Holim community continues to honor its distinct practices rooted in ancient traditions. This connection to a shared past is not a relic but a living, vibrant force, expressed through unique liturgical practices (hazzanut), a love of family, and a profound respect for the Torah.

Our congregation is seeking a new spiritual leader to guide its next chapter. Over the past 100 years there have only been four Rabbinic leaders.

If you, or someone you know, are interested in making a big impact on a close-knit Sephardic community, this is an opportunity to make a real difference in a beautiful city.

To find out more about the community and our congregation, we invite you to visit our website at www.SBHSEATTLE.ORG. Here you can find out more details about the position, as well as the warm and friendly Seattle Sephardic community!