Food

Unhappy cafe

It was clear from the moment we entered that this was not a happy place. It was our oldest son’s 20th birthday and we decided to celebrate over food. We’d heard that Roza, which has branches in town and on Emek Refaim in Jerusalem, had a creative menu and reasonable prices.

We made a reservation for 6:15 PM and arrived slightly late. The greeter at the door scowled at us, didn’t even look at the reservation book, and pointed to several tables that would fit a party of four. As we skimmed the menu, we noticed that none of the other wait staff were smiling. There was a general feeling of malaise at best, or more likely passive aggressive disquiet.

When Gal, our waiter arrived, my wife made a point of acting chipper. Gal seemed to brighten at her energy. She then proceeded to ask if the establishment has a tav chevrati. The tav is a sort of parallel to kosher certification. Rather than referring to the food, it is given based on whether the employees are treated well, given favorable work conditions and a sufficient salary.

Gal had never heard of the tav chevrati. When my wife Jody asked if the restaurant has terms that might grant it such a certificate, Gal was quick to answer “absolutely not.”

Which is a shame, because the food was quite good. I had a fajita with stir fried veggies on a sizzling platter, our son had a steak sandwich so stuffed that it was hard to figure out how to fit it in his mouth without using a knife and fork. We also had an awesome starter of a lamb kebab foccacia.

We have friends who won’t eat at restaurants without the tav chevrati. I’ve already boycotted at least one, despite the café’s truly excellent crushed ice lemonade with fresh mint.

Jody thought about telling the manager that his or her employees were not happy, but we were in a hurry at the end of our meal and the thought slipped her mind. In any case, it seems like a case of preaching to the wrong choir. But maybe if enough people voice their concerns, conditions will improve.

Try it for yourself – order a meal (that part will be good at least) and if the wait staff are grumpy on your visit, tell the manager. We’ll go back and do the same.

Consider it your own little tent protest for social justice.

Does that pill cause side effects? Treato will tell you

Israeli website aggregates and analyzes user-generated data to revolutionize the way patients, physicians and drug companies share info about medications.

Pills

Photo by Abed Rahim Khatib/Flash90
Treato allows patients to understand the side effects of every medication.

Have you just been prescribed a new medication and want to know its possible side effects? Are you already taking a drug whose side effects aren’t listed on the package insert? Most likely, your first step is to Google it. But the unstructured results can be overwhelming and hard to make sense of.

That was exactly the problem confronting Gideon Mantel, the CEO and co-founder of First Life Research. His 17-year-old daughter had suffered a basketball injury and was facing knee surgery, medication or both. Mantel searched the web to learn as much as he could in order to ask the right questions of his daughter’s doctors. He spent days combing through posts on patient blogs and online bulletin boards.

And that led to Mantel’s light-bulb moment. The former CEO of Israeli high-tech heavyweight Commtouch was determined to create a service that would aggregate all that patient information in one place, categorized in an easy-to-understand format.

Four years in the making, with $5.5 million in venture capital financing, Treato was launched at the end of September at the Health 2.0 conference in San Francisco. First Life Research is betting that Treato will revolutionize the way patients, physicians, health maintenance organizations (HMOs) and pharmaceutical companies integrate user-generated data into their information processing.

In fact, Treato’s revenue is expected to come from partnerships with pharma, HMOs and drug-related research groups willing to pay for the data. First Life is in negotiations with half a dozen big players, with deals possible by the end of the year.

Organizing billions of posts

Sifting through roughly 10 billion patient discussions posted online — a number that grows by nearly 50 percent each year — and putting them into some sort of logical structure was Treato’s challenge.

To do so, the company had to develop its own natural language processing, a tricky task that took a few years. Someone writing in Texas may not use the same expressions as a patient in India to describe the same side effects, explains Haggai Levy, head of marketing communications.

“There are different writing styles, slang and misspellings,” he points out.

“If someone says they feel like their ‘head is going to explode,’ we have to understand that this is referring to a headache,” adds Michal Tamir, the company’s marketing and business development manager. Making sense of such similes in several billion messages requires a “machine,” as Levy puts it.

Michal Tamir

Michal Tamir, marketing and business development manager of Treato.

Once the data is categorized, it’s possible to analyze it and present significant statistics. An asthma medication may have some 700 reported side effects, but which are the most prevalent? And which side effects are most common when switching from one drug to another? Treato aims to conquer all of these tasks.

You can also search for medical conditions. The Treato site covers 13,000 conditions and 11,000 medications. Of the 10 billion patient discussions, Treato indexes just over 800 million of them from 23 million patients.

Tamir adds that clinical trials only look at one drug at a time rather than side effects that may occur when two medications are taken at once, something that Treato’s software can compare and correlate.

Drug companies like it, too

The result is a free service that is valuable to patients, but equally in demand by pharmaceutical companies.

“The drug companies know which side effects occur from the clinical trials,” Levy tells ISRAEL21c. “But these studies can be very small. As a result, most side effects are unknown when the medication hits the shelves. It’s not like Merck or Pfizer are trying to hide anything, that there’s some conspiracy going on. They are trying to do their best, but their tests are necessarily limited.”

Levy gives an example regarding the popular asthma drug Singulair. “A patient went to see his doctor complaining about mood swings and suicidal thoughts. These were not known side effects for Singulair. The physician had access to our database, plugged in the medicine and saw that, even though those side effects were rare, some people were suffering from it and blogging about it. The physician connected the dots, switched the drug, and the side effects went away.”

While some physicians criticize the veracity of user-generated online medical content, Tamir claims that some 60% of them “are going to the web seeking health information from these types of sources.”

“At the end of the day, the physicians may have their egos, but they also want to give better service,” Levy adds. “Our advantage is that we can transform random anecdotes into patterns resulting in known phenomena.”

Treato just launched a co-branded partnership with Healthline, a medical information site that previously had no user-generated content, bringing Treato even greater exposure. First Life received a grant from BIRD (Israel-US Binational Industrial Research and Development) Foundation for this project.

First Life is backed by Reed Elsiver Ventures, the VC arm of the largest US medical publisher. All initial staffing for the company – which now numbers 27 in Yehud – came by recommendation from advisory board chairman Yuval Shamir, a professor of medical informatics research at Ben-Gurion University in Beersheva. Founder Mantel is joined by Jacob Sabo (the two met at the gym) and Dr. Itzhik Lichtenfeld, who built the risk management operations at the Israeli HMO Maccabi.

The site is bringing in about 600 queries per day. “We are all patients at some point in our lives,” says Levy. “So you want to tell your friends about it.”

Religion

Rabbi condemns Steve Jobs as consumerist Moses

Moses (er...Steve Jobs) introducing the iPad

Late Apple founder Steve Jobs has often been likened to a hi-tech prophet, sensing consumer need before the public had any idea that they desperately desired a portable music player or a tablet computer. Now, Britain’s Chief Rabbi Lord Jonathan Sacks has accused Jobs of playing Moses for the modern day, “coming down the mountain with two tablets, iPad 1 and iPad 2,” and laying down the foundations for a “consumer society.”

The result, Sacks says, is not positive this time. “We have a culture of iPod, iPhone, iTunes. It’s all i, i, i, nowadays. (But) when you’re an individualist, egocentric culture and you only care about ‘i’, you don’t do terribly well.”

Now, Israel is certainly as i-Crazy as anywhere else in the world. I may be even more so. As a Mac-addict since nearly the beginning (I bought my first boxy Mac SE in 1998) and as part of a family that owns two iPhones, an iPod Touch, three iPods in various states of disrepair, and a growing brood of Macintosh computers (we only have one working Windows machine left), I don’t take particularly kindly to Sachs telling me my buying practices constitute values that “aren’t ones you can live by for terribly long,” and that western society has built “the most efficient mechanism ever devised for the creation and distribution of unhappiness.”

Thanks, Jonathan, for bumming out my day, not to mention disrespecting the genius of Steve Jobs who undoubtedly had many more similarly debased tricks up his digital sleeve before his painfully premature passing.

Now to be fair, Sachs isn’t entirely off base. I fully agree that an overly consumer-focused society goes too far into making one pine away for what you don’t have, rather than being grateful for what you do. This is not a trivial problem by any means, and it’s certainly been an important subtext to both the recent Occupy Wall Street protests in the U.S. and our own social justice demonstrations this summer.

And Sachs solution – “the world of faith, which the Jews call the world of Shabbat, where you can’t shop and you can’t spend and so you spend your time with things that matter, with family” – is right on, whether you’re religious or not. In our house, when the Sabbath comes, we urge our family to do their best to unplug; to turn off the electronic devices, for at least those 25 hours a week.

We’re not always successful, but Sachs has got that one right, and it’s been a critical factor to our family’s cohesiveness. But that was no reason to go and dis Steve. And no matter what you say, Lord Sachs, I’m still buying that iPhone 4S, whenever Israel actually lets it into the country that is (see my previous post here).

One more point: Rabbi Sacks’ office has subsequently tried to tone down their boss’s comments, saying that, “The chief rabbi meant no criticism of either Steve Jobs personally or the contribution Apple has made to the development of technology in the 21st century.” He was simply “pointing out the potential dangers of consumerism when taken too far.”

And, the statement added, the Rabbi “uses an iPhone and an iPad on a daily basis.”

Education

Riding on the wheels of love

By Steve Zerobnick, associate director, Keshet

The excitement was electric as 700 cyclists climbed the steep ascent from Ein Kerem to Jerusalem last week. We were part of the annual “Wheels of Love” bike ride, the largest fundraising sporting event in Israel, whose purpose is to raise much-needed funds for Alyn Hospital, one of the world’s leading rehabilitative facilities for youth.

Alyn riders

The ride is proof-positive of the power of the individual. In September of 2000, eight riders and I made our way from Jerusalem to Eilat. We were due to take part in a ride to support a hospital in England which held an annual ride in Israel. Because of the outbreak of the intifada, however, the British hospital cancelled their ride, leaving us Israeli riders stranded. We were given two choices: Ride with the British hospital’s rescheduled ride in Spain, or cancel our participation. Fortunately, we thought of a third option – riding for Alyn Hospital.

As one of the would-be riders I offered to use my experience in running Israel tours for over 15 years to organize our own ride. The other riders accepted my proposal and the rest is history. That year our small group raised over $65,000 for the hospital and founded a committee which started the second “annual ride”. Since that modest beginning the ride has raised over $20 million, benefiting children who are the victims of terror attacks, car or other accidents, congenital defects and more.

This year two young men, one age 14 ½ and one age 17, both former patients at Alyn, rode with us as their way of giving back to the hospital. Keshet CEO Yitzhak Sokoloff and I were proud to be a part of this.

FOMO at the Dead Sea

FOMO or not, the kids had a great time at the Dead Sea

When I was ten, my parents planned a trip for the family to Disneyland. But a few days before we were set to leave, my father got sick – it was a cold or a flu, nothing serious, but still, the trip was cancelled. I was devastated and, since then, I have tried to never miss out on any kind of experience, big or small. Understandably, this creates a lot of anxiety – I mean, which exciting activity should I choose? What if I choose the wrong one? And if I choose not to go at all, will I be filled with regret?

It turns out there’s a name for this – it’s called “Fear of Missing Out” (or FOMO for short).

Now, citing my missed Disneyland experience is a bit flip – by itself it wouldn’t qualify as the sole cause of my FOMO (for that, I’d need a regular series of dashed expectations that built up over my childhood). But today, the FOMO persists and lately, it’s been causing more distress than the actual missing out.

FOMO was in full bloom this past weekend. Our community was having a Shabbaton at the Ein Gedi Youth Hostel. On the way, we wanted to stop at the Dead Sea. The kids were excited to lather up with Dead Sea mud; I had heard from David Brinn in a post on Israelity about a nature reserve at Einot Tzukim that was supposed to be beautiful. The site also has a number of crystal clear spring-fed swimming pools and mud to boot (or so I thought).

We got a late start leaving Jerusalem. When we called Einot Tzukim, we were told that you can only get into the nature reserve part of the site on a guided tour. The last tour left at noon. We were passing Ma’aleh Adumim and had only 20 minutes to get there. I floored the accelerator and we arrived, miraculously at the gate at exactly 12:00 PM.

I jumped out of the car and cried, “let’s go.” But the kids didn’t want to hike and I hadn’t really considered their needs (mud, of which there turned out to be none) – my FOMO was so much in overdrive. I threw our daughter Merav the car keys and said, “The pools are that way. Imma and I will be back in an hour.” She looked perplexed and not a little bit cross.

As we toured the marshlands (gorgeous, by the way and highly recommended), I kept thinking about how I’d treated the kids and didn’t really enjoy myself. I vowed to make it up.

“Let’s go to the mud!” I announced.

And off we went again, racing towards Mineral Beach (only a few minutes from Einot Tzukim). But it was getting late and Shabbat was coming up quickly. My wife Jody was now the one who was upset. “We’ll only have 45 minutes. It’s not worth the NIS 220 to get into the beach.”

But FOMO raised its ugly head again. And so into the beach it was. The kids were delighted. Me – I couldn’t enjoy myself because, this time, I was disappointing my wife.

I had checked off both experience boxes in order to not succumb to FOMO and yet, I was desperately unhappy. This double whammy, driven home by the negative effect I’d had on the people I love the most, was the proverbial straw that perhaps, finally, would serve to break the FOMO camel’s back (a fitting cliché given our travels through the dromedarian Judean desert). My hope and aim is that, the next time I feel the FOMO rising like some unwelcome bitter bile, I’ll be able to draw on this weekend’s painful memory to keep it at bay.

Or maybe I should keep in mind one person who has it even worse. A friend at the Shabbaton shared with me that, whenever he’s at a buffet meal, he suffers from FOMOFF: “Fear of Missing Out on Free Food.”

Fortunately for him, the limp meat and cold schnitzel served at the Ein Gedi Youth Hostel was a fitting antidote.