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Women's Bodies, Women's Health

Lorraine Rothman (1932-9/25/07): Pioneer of Guerilla Gynecology*

fhlrothman1.jpg 

Lorraine Rothman, a second-wave pioneer of the feminist self-care and self-help movement, died yesterday at the age of 75 at her home in California.  She had been diagnosed with cancer only a week prior. 

Rothman, together with her colleague, Carol Downer, pioneered the concept and practice of guerilla gynecology (thanks, Sis, love that term!).  In the early 70s, Downer, having learned how easy it was to look at her own cervix with a speculum and flashlight, began to teach other women in small consciousness-raising groups how to look at their own cervices in order to monitor their own cervical health and well-being.   Lorraine Rothman moved on to invent the “Del-Em” kit using a Mason jar she had in her kitchen and aquarium tubing.  This device allowed women to perform their own menstrual extractions (early abortions) safely and privately.  Rothman and Downer traveled across the country teaching women how to take control of these and other facets of their own reproductive health care.  After Roe v. Wade, Rothman and Downer created the first Feminist Women’s Health Center, which employed only women.  Sister clinics soon followed in other parts of California, as well as Oregon, Iowa, Tallahassee, Atlanta…and Yakima.    In 1975 Rothman’s self-help clinic concept was the subject of the books A New View of A Woman’s Body, How To Stay Out of the Gynecologist’s Office and Woman-Centered Pregnancy and Birth.

Rothman, Downer and women who staffed and worked in the women’s clinics empowered a generation of women not only to take charge of their own reproductive and gynecological health but to steadfastly, and always, question and challenge the authority of patriarchal medicine over women’s lives and bodies.    Their research was committed, woman-centered and cutting edge.  Over 20 years ago, for example, Rothman began researching the hormones used in birth control pills and hormone replacement therapy.  In her book Menopause Myths and Facts:  What Every Woman Should Know About Hormone Replacement Therapy,  she challenged the prevailing theories and practices of patriarchal medicine in ways exemplified by this excerpt:

Myth 14    Most of the estrogen replacement hormones are natural hormones; those that are synthetic act as natural hormones.  

Fact  Estrogen replacement hormones are not natural to women’s bodies. So-called natural hormones are not part of the body’s process of making hormones and have not had long-term large-scale studies to determine safety. 

All hormone drugs are synthetic chemicals that are manufactured in laboratories; even the ones derived from plants have been chemically altered in laboratories. The closest to “natural,” the most popularly prescribed and longest on the market – Premarin – is reconstituted from PREgnant Mares’ UrINe (PRE+MAR+IN). Once the mare’s urine is altered in the lab, Premarin is not even natural to a horse.

Drug companies deliberately make their synthetic hormones NOT identical to human hormones so that they can patent these products and make them financially profitable.

Our endocrine glands respond to very subtle stimuli and the amount of hormone secreted by any gland can vary widely throughout the day. Finding a dosage of synthetic hormones that feels comfortable in your body is still a crude way of trying to mimic what our bodies will do if left alone.

Further, the amount of estrogen secreted by our ovaries during a normal menstrual cycle is measured in millionths and billionths of a gram – a phantom, a wisp of mist suffusing our body. Yet this minute amount has profound effects in our bodies.

Under the category of “natural” are isolated substances derived from plants, such as soy and Mexican wild yams, none of which contain any human hormones. When these molecules are altered in the laboratory to match the structure of human hormones, they are marketed as “bio-identical” or “natural” hormones. Even though these engineered molecules are identical to our own progesterone and estrogen, they can never match what our body’s timing, quantity, or natural processes require.

Unless these new molecules can be patented it is extremely unlikely that long-term studies of large numbers of women will be done to determine the effects and safety of “natural” hormones.

Rothman’s, Downer’s and other feminist women’s voices on the subject of synthetic hormones prescribed to women were ignored for years by patriarchal medicine.  Recently, of course, hormone replacement therapy was found to be risky and dangerous.  As has happened so many times, the claims of feminists — woman-centered women — like Rothman proved true.  

In a blog post written before Lorraine Rothman died, Jewesses with Attitude wrote of her:

It is sad and ironic, then, that she is now fatally ill because of the failure of her own health care.  She is dying of advanced, metastasized bladder cancer, which was not detected by the doctors she saw through her HMO over the past two years of her pelvic pain. She did not see a urologist, because her HMO did not offer the option of seeing a female doctor. A physician’s assistant at a women’s health center finally detected that she had a serious problem, but while Rothman waited for an appointment with a uro-gynecologist through her HMO, her pain became unbearable and a visit to the emergency room diagnosed her advanced cancer.

Her story proves that we still have a long way to go to create a health care system that is responsive and accessible to all patients, providing services that meet their needs and earn their trust. With feminist health care centers like those Rothman helped create now on the wane, many women like her (and others, such as transfolk) with reason to distrust the medical establishment, are falling through the gaping health care cracks. Rothman may have been utopian in thinking that viewing the cervix with a group of women friends could change the world, but we would do well to ask ourselves: where is empowerment and self-determination in health care today?

It is a source of endless frustration to me that despite the fine and selfless work of feminist women in decades past, in these days so many women, even feminists, continue to subject their bodies, minds, and lives to a medical and pharmacological establishment which has proven time and time again that it does not have the interests of girls and women at heart.  It is wrong that this HMO did not offer Rothman the option of seeing female medical practitioners.  It is devastating that she wasn’t able to obtain the care she needed after all her many years of service to women and to the medical establishment as well.

I can only hope that hearing of Lorraine Rothman’s work, perhaps for the first time, might inspire feminist women and all women to investigate her work and the work of her feminist colleagues so that the lives and bodies of girls and women might be spared the indignities of a medical establishment which rarely treats them well. 

Thanks to Sis who forwarded along the e-mails and other information from Barbara Seaman, Barbara Love, Carol Downer, and other feminist women, who, like Lorraine Rothman was, are giants.

*Check out the book Guerilla Gynecology, written by this cool woman.

Heart

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Discussion

26 thoughts on “Lorraine Rothman (1932-9/25/07): Pioneer of Guerilla Gynecology*

  1. I would love to know what she thought of the Gardasil ‘experiment’.

    Thanks for this Heart. This is one area that needs much, much more discussion among radical feminists. We have a generation who have been soaked in misogynistic thinking about women’s bodies. We owe it to our foremothers to keep their initiative thriving.

    BB: this was for you.

    Posted by Sis | September 26, 2007, 7:30 pm
  2. My efforts, I should say, much less work than what Heart has done, were done with BB in mind.

    And Heather.

    And all the young women so radical and fine. Carry it on sisters and daughters. Carry it on.

    Posted by Sis | September 26, 2007, 7:39 pm
  3. As someone who’s worked for blah blah years in western patriarchal medicine including exclusively women’s health, I just love hearing about women such as this.

    Yeah Sis, I would also like to know what she thought about the Gardasil “experiment” and of course “Female Sexual Arousal Disorder” where Robert Wilson’s book started this ball rolling back in 1966 with his book “Feminine Forever” where he effectively persuaded the world that the menopause was in fact a “disease” and not a normal female stage of life, In fact the cover boasted. “Every woman no matter what her age can live a full-sexed life for her entire life” Sorry I shit you not!

    Posted by sparklematrix | September 26, 2007, 7:50 pm
  4. I know three women past 60 who take HRT because their husbands demand penetrative sex; one has had mastectomy for breast cancer. Here’s the punch line (yah I mean that). The husbands are all physicians.

    Posted by Sis | September 26, 2007, 8:15 pm
  5. There is a direct link to HRT and ovarian cancer:

    http://www.medscape.com/viewarticle/555597

    Thank the goddess for women like Lorraine Rothman who were prepared to stand against the male medical establishment and their sadistic interference in women’s bodies.

    Posted by delphyne | September 26, 2007, 9:31 pm
  6. I know this might be a terribly ignorant question, but as a young woman whose mother doesn’t discuss this very much, how do HRTs effect sex? Figured this was a safe place to ask and get reliable answers :) Thanks ladies.

    Posted by b | September 26, 2007, 10:14 pm
  7. b: I found a good site that talks about menopause and answers your question: http://www.fwhc.org/menopause/meno.htm

    About half-way down it talks about vaginal changes.

    Posted by psyck | September 26, 2007, 11:47 pm
  8. This comment doesn’t ring true to me.

    “6 b

    I know this might be a terribly ignorant question, but as a young woman whose mother doesn’t discuss this very much, how do HRTs effect sex? Figured this was a safe place to ask and get reliable answers :) Thanks ladies. “

    Posted by Sis | September 27, 2007, 12:03 am
  9. Yeah, I had that same question, Sis. But psyck did good in referring to that link. ;)

    Posted by womensspace | September 27, 2007, 12:04 am
  10. Had very helpful dinner discussion with my cancer scientist roommate who is nothing but helpful with my random biology/medical questions. Thanks for the link psyck! This was one educational evening. Heart, thank you for an informative, thought-provoking post – timely in all sorts of ways.

    Posted by b | September 27, 2007, 12:38 am
  11. The site which psych gave is from the organization that grew out of Lorraine’s work, and includes information on how to do a self-gyne exam. I think pretty much everything here is good, except for their reference of Our Bodies Ourselves, but at the time this list was made, perhaps OBO wasn’t shilling porn. See Rich’s article on Adonis Mirror website.

    http://www.fwhc.org/health/index.htm

    Self Cervical Exam with your own speculum

    Pap Smears – find out about detecting cervical cancer early!

    The women’s Self Help Movement celebrates 25 years
    “Infections and Insurrection” – the great yogurt conspiracy to treat yeast.

    Natural yeast treatments

    Moontime: What Really Happens During Our 28 Day
    Menstrual Cycle? A complete explanation of the hormonal changes women experience each month.

    Fertility Awareness – Learning the signals from your body about what is happening with your hormones and when you are most likely to become pregnant.

    Spectacular Specula – an activist dyke discusses self-care, queer reproductive rights, and her os.

    Posted by Sis | September 27, 2007, 2:55 pm
  12. Such a loss, especially right now when feminist women’s heaqlth centers have dwindled down so, so low (last I checked, we had ten in the states).

    FYI, the Yakima location of the Feminist Women’s Health Center recently sent out a notice looking for a manager for that particular clinic.

    If I had the full creds, I’d be on it in a heartbeat, but for anyone who does and is nearby, I’d encourage you to take a look. I’ve spent some time with the women from this clinic system before, and it’s a tremendous community.

    Posted by Heather | September 27, 2007, 4:27 pm
  13. (And Sis, thanks. As ever.:))

    Posted by Heather | September 27, 2007, 4:27 pm
  14. Thanks for that link, psych. My own mother had an early hysterectomy after uterine cancer (which coincided with my birth) and has never been comfortable discussing anything to do with her illness and the resulting problems with me. As such, it’s only been in the past year as my eldest sister has gone through menopause that I’ve had a female relative discuss even the basics with me.

    I’ve been trying to do a bit of research to understand what she’s going through better, but there is just so much contradictory information for those who don’t have much of a starting point.

    Posted by hexy | September 30, 2007, 1:26 pm
  15. Here’s another link or three Hexy. The first is what every woman should know, because although you may not be now counseled so, every woman is eventually counseled to have a hysterectomy. Just a question of time.

    And unless your mother had a lab test which said outright, frank uterine (now called endometrial) cancer, I would say she was hysterectomized, as most women are, unnecessarily and on the basis of a blip on a test. Hysterectomized as “prevention”. That is, prevention of the gyne not making it to the Bahamas this year.

    Most health care insurance pays more for the hysterectomy, a relatively unskilled quick procedure, than they do for myomectomy (fibroid removal), or D&C and biopsies, which require much more time and skill. Guess which the gyne prefers to do. Most gynes most times, never tell women there is an option; they don’t want to do it, it doesn’t pay enough, they don’t want to do it they don’t have the skill and will be damned if they refer you to a gyne who does, thereby losing $$, they don’t want to do it because why the hell should they also then pass up the opportunity to have you on hormones the rest of your life, and all the wonderful cancer sugeries they’ll miss out on with you taking carcinogenic drugs? Hmm?

    HERS Foundation.

    http://www.hersfoundation.org/

    Myomectomy

    http://www.parkermd.com/

    Posted by Sis | September 30, 2007, 6:11 pm
  16. This is why I love Sis.

    One reason.

    xxxooo

    Posted by womensspace | September 30, 2007, 6:17 pm
  17. Ooooh. Bluuuuush.

    More for anyone who is like Hexy:

    http://hiu.nahu.org/article.asp?article=1642

    12-Minute Video to Save Health Insurance Providers More than $17 Billon Each Year
    by Rick Schweikert
    September 2007

    Rick Schweikert can be reached at 610-667-7757.

    There is little disagreement that 90% of all surgeries to remove the female sex organs are elective—which is to say that hysterectomy is perceived to be a woman’s choice. In fact, only about 2% of hysterectomies are lifesaving, although they are generally covered by most health insurance policies. Hysterectomy and oophorectomy are most commonly performed for benign fibroids and ovarian cysts, not cancer. Indeed, a statistically insignificant number of men have had their sex organs removed, even though the rate of cancer in the male and female organs is nearly identical.

    The number of hysterectomies reported to the Centers for Disease Control (CDC) has remained steady. On average, more than 620,000 hysterectomies were reported to have been performed each year in the last decade. The CDC reports that the sex organs are removed from one out of every three women before she reaches the age of 60.

    Health insurance providers and doctors are well aware that the number of hysterectomies reported is shy of reality. The National Hospital Discharge Survey (from which the CDC derives its statistics) includes in-patient stays of one to 30 days and participation is not compulsory. Nor does it include statistics from federally funded hospitals, military hospitals, or hospitals located on Indian reservations. Finally, and most importantly, nor does it include the quickly growing number of outpatient hysterectomies where the hospital stay is less than 24 hours.

    In an article published in the July 2007 Obstetrical & Gynecological Survey titled A Prospective Observational Study of the Safety and Acceptability of Vaginal Hysterectomy Performed in a 24-Hour Day Case Surgery Setting, R. Penketh et al write, “Opening of an ambulatory care unit provided an opportunity to evaluate vaginal hysterectomy when performed in a 24-hour day case surgery setting — more than 90% of women were discharged home within 24 hours of surgery.” Therefore, the commonly quoted figure for the number of American women alive today without their reproductive sex organs is grossly understated at 22 million.

    The uterus is a hormone-responsive reproductive sex organ that provides structural support to the bladder and the bowel. The consequences of severing the ligaments, nerves, and blood supply attached to the uterus are profound and predictable. The sequelae of problems that women experience after hysterectomy further tax our limited health care dollars. Physical damage, functional loss and endocrine abnormalities are inescapable and irrevocable consequences of hysterectomy.

    The ovaries are biologically-active glands that have systemic and regulatory functions throughout a woman’s life. About 75% of the women who are hysterectomized in this country are also castrated at the time of the surgery. A woman’s ovaries are her gonads. Removal of the ovaries is castration, and the aftereffects are the same for women as male castration is for men. Furthermore, because of damage to the blood supply to the ovaries, there is a loss of ovarian function in 35 to 40% of the women whose ovaries are not removed during hysterectomy. This too results in a loss of ovarian function, which is the same as castration.

    Women are told that they do not need their ovaries because they are a potential site for cancer and their ovaries will stop functioning at menopause. Both of these claims are false. The incidence of ovarian cancer in the U.S. is only about .01%, and the ovaries continue to produce hormones a woman’s entire lifetime the same as the testicles continue to produce hormones a man’s entire lifetime. Ovarian function cannot be artificially replicated, and the lifetime of drugs that many women take after oophorectomy expose them to possible serious adverse effects, including stroke and cancer.

    No one can predict which women will experience the least or the most serious effects of removal of the female sex organs. The most consistent problems women report after hysterectomy are a loss of sexual feeling, a loss of vitality, joint pain, profound fatigue, and personality change. There is a three times greater incidence of heart disease when the uterus is removed and a seven times greater incidence of heart disease when the ovaries are removed. Hysterectomized women commonly report to the HERS Foundation that they visit 25 doctors or more in the first year after surgery, seeking surgical and pharmacological solutions to irreparable damage. An estimate of the true cost of hysterectomy throughout a woman’s lifetime (including lost wages and insurance for the 50% who are unable to maintain their previous level of employment) is not available.

    It is commonly believed that this is a woman’s issue only, because hysterectomy can only be performed on women. It is true that hysterectomy is in fact an urgent women’s health issue first and foremost for each woman who is confronted with it. But hysterectomy profoundly impacts a woman’s relationships with her partner, her children, her family, her friends and her community. Ultimately, hysterectomy is a humanitarian issue.

    The number of hysterectomies and oophorectomies performed in the U.S. continues to rise because of the growing number of unreported hysterectomies, while the incidence of surgery to remove the male sex organs remains statistically insignificant. There are numerous factors that explain why this is so. Chief among them is the fact that the male organs are visible. The female reproductive sex organs are internal. Their functions are not visible. Consequently, what is often referred to as the most over-utilized and unwarranted surgery in the U.S. remains the most commonly performed non-obstetric surgery, at a cost to health insurance providers far exceeding $17B/year.

    A new 12-minute educational video from the HERS Foundation makes the female organs and their functions visible. “Female Anatomy: the Functions of the Female Organs” provides an essential component of the educational process known as informed consent, which is necessary for women to understand the physical consequences of hysterectomy and oophorectomy. The video is now available to the general public and can be viewed at http://www.hersfoundation.com/anatomy.

    The HERS Foundation is an independent, non-profit women’s health education organization dedicated to educating the public about the alternatives to and consequences of hysterectomy and female castration. Throughout the last 25 years HERS has counseled more than 850,000 women and has provided information to millions more worldwide. In an ongoing HERS survey begun in 1991, 99.7% of women reported that they were not informed of the functions of the female organs or the consequences of their removal and said they would not have proceeded with the surgery had this information been provided to them. No woman can be said to have chosen a surgery to remove her female organs unless she is first informed of the functions of those organs and the consequences of their removal.

    Because it is a critical component of the educational process of informed consent, failure to provide the information contained in this 12-minute video prior to asking a woman to
    sign a consent form for hysterectomy or oophorectomy constitutes a lack of informed consent, which is a breach of duty that invalidates consent. “Female Anatomy: the Functions of the Female Organs” fills that information gap. It is a simple, cost-effective cure for a complex problem. Doctors everywhere are urged to make it available to every woman to whom they recommend the removal of the uterus or ovaries.

    Women live fuller, healthier lives with their sex organs intact throughout their entire lifetimes. Requiring doctors to distribute HERS’ 12 minute video would result in vast and immediate cost savings to help curb rising health care costs.

    ##

    A woman who has been hysterectomized and castrated:

    http://beingempowhered.blogspot.com/

    My experience, told briefly on another blog:

    http://jwablog.jwa.org/node/162

    Posted by Sis | September 30, 2007, 6:37 pm
  18. This is off topic a little, but my mother wanted a hysterectomy so bad. After seven children, she seemed in my opinion to feel entitled to have one. No doctor would give her one because she was/is healthy. Her last child was born in 1968, maybe 1969, and I suspect her menopause started in her late 40’s maybe early 50’s. Now that she is 72 (I think), she is still intact. In her case, actually in ours, it was very cruel not to give her a hysterectomy because she was tormented by not having one. Not because of physical pain but simply because she was through with having children and felt her period should cease and show her misery about it to us. Of course, this is all my conjecture; I have never really had a conversation with her about anything because she is unfortunately, unbearable to talk to about anything I consider significant (always has been nothing to do with her current age).

    Fast forward to now, I discovered my friend who recently visited me (I had not seen her in ten years but kept in touch by phone once or twice a year) and who is my age (44) has had a hysterectomy a few years ago. Apparently, she too felt like she was entitled to a hysterectomy because she was not going to have children anymore and could not bother with having a period. I asked her if anything was diagnosed that warranted the hysterectomy and she told me how she told her doctor that he/she had better find a suitable diagnosis.

    I totally missed this boat, this connection, this no more children means no more having a period, because I am sure having a period every 28 days and do not foresee anymore children. Actually, even though I do not like having a period, I think when it is gone I may really feel old, and not because of appearance but because it will make me feel like my time is ending. Nevertheless, I am sure there is some kind of conditioned misogyny at the root of this thinking, mine and the women who desire hysterectomies.

    Posted by E. K. "Kitty" Glendower | September 30, 2007, 8:42 pm
  19. You know, one of my very favorite stories I have ever heard about a woman being pushed to have a hysterectomy as a first, rather than very last, resort was this:

    My acupuncturist in Minneapolis (she’s now in Portland and as the best doctor I have ever had, if anyone in Portland wants an amazing female doc who works with chinese medicine) is natively Yugoslavian, and her mother was also an acupuncturist.

    I forget what exactly her mother’s condition was, but a male doctor she saw in the states here, when she was in her late forties, was very quick to suggest she have a hysterectomy. he even went so far as to use the language “Let’s just cut it out.”

    She didn’t care for this idea, especially when nothing else had even been explored, and he asked her if, given her age, she was done having children. She said she was. He replied that there was then no reason not to cut her uterus out. (eyeroll)

    She, very calmly, asked him if HE was done having children yet himself. He said that he was. So, she looked at his crotch, gestured to his testicles and said, “Well, let’s just cut those off then, eh?”
    :)

    (As I understand it, duh, she didn’t go back to that doc. She’s also doing just fine, uterus and all.)

    And yeah, per usual, you’re the bomb, Sis. But you already know I think so. :)

    Posted by Heather | September 30, 2007, 9:15 pm
  20. Oh sorry Kitty, but yes; you will look old. Fast, without your uterus, which when it goes eventually takes your ovaries with it. Gone. All your estrogen and progesterone which keeps you young, gone. Read the HERS site. No chemical developed hormone can replace what your ovaries make: cardiovascular disease, osteoporosis, cognitive decline, teeth skin and hair become that of an old woman. Your vagina will begin to atrophy, the internal pelvic organs will sag without the uterus to keep them where they belong. It’s not pretty. No matter how bad one’s cramps, they will not be as devastating as what losing your uterus and ovaries will be. In a year or so, you will have aged 15-20 years, in every way, physiologically and in how you look.

    Posted by Sis | October 1, 2007, 12:32 am
  21. Good thing, no surgeon is coming anywhere near my body then. Wink. I will deal with the periods. I don’t see what the big deal with having periods is anyway.

    Posted by E. K. "Kitty" Glendower | October 1, 2007, 2:01 am
  22. Hi Sis,

    With my mother’s particular situation the hysterectomy was certainly necessary. She had tumours cut from her uterus while I was still in there, and flatly refused to terminate the pregnancy in favour of keeping her reproductive organs intact. She had the hysterectomy as soon as she’d delivered me, by which stage the cancer was quite developed, and spent the next couple of years being treated to make sure it didn’t pop up elsewhere.

    I’m quite sure the circumstances are different for other women who are not necessarily in such need of the procedure.

    Posted by hexy | October 1, 2007, 2:37 am
  23. Thank you for the extra links, btw! I’ll read through them.

    Posted by hexy | October 1, 2007, 2:38 am
  24. Cancer is a good reason for a hysterectomy. Fibroids? No. Bleeding? No. Birth control? No! And hysterectomy as prevention of possible further cancer in BCRA gene positive women? No there too. The uterus is not particularly involved in that type of cancer. Some women with the BCRA gene are electing not to have profalactive hysterectomies or mastectomies. It’s not proving out.

    Posted by Sis | October 1, 2007, 7:55 am
  25. prophylactic

    Posted by Sis | October 1, 2007, 7:58 am
  26. Rothman thought the abortion clinic’s device was clumsy and had a potentially fatal flaw: It lacked a mechanism to keep air from being accidentally pumped back into the uterus. She spent the next week redesigning the device with parts she found in supermarkets, hardware stores, aquarium shops and her husband’s biology lab.

    When she brought her version of it to the next clinic meeting, Downer was enthusiastic. It was relatively easy for women to use on one another, and it had a two-way bypass valve to prevent air from being injected into the uterus.

    Because abortion was still illegal (Roe vs. Wade, the U.S. Supreme court case that legalized it, was not decided until 1973), menstrual extraction was not touted as a method for ending a pregnancy but for regulating menstrual flow. Nonetheless, the implications were not lost on Downer and Rothman, who saw themselves as revolutionaries.

    “The idea of women being able to control their own birthrate is fundamental. It goes right to the heart of women’s political situation,” Downer said this week. “We both wanted to turn the whole thing upside down. We wanted to make women equal with men.”

    How radical is that? How much better for our bodies, if we indeed do menstruate too much more than our foremothers did? How much easier, simpler and better for our health than taking toxic, carcinogenic chemicals for the majority of our reproductive years?

    From Lorraine Rothman’s obituary in the LATimes, today.

    http://www.latimes.com/news/obituaries/la-me-rothman3oct03,

    1,5981288.story?ctrack=1&cset=true

    Posted by Sis | October 3, 2007, 6:19 pm

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