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Dec. 19—Noon Weiss said she didn't see any signs that her life partner, Dr. Jonathan Shenkin, was experiencing a mental health crisis, but she sensed something was terribly wrong when she got a call from his pediatric dental practice in Augusta.
"Have you heard from Jonathan?" one of Shenkin's employees said to her, Weiss recalled, on that day, Aug. 23. "He never came back from lunch, and there's an envelope with your name on it in his office."
Weiss said she knew that Shenkin had become upset that the Maine Dental Association removed him from its board the night before, during a special emergency online meeting. She said prior to the meeting, he was unaware that the purpose of the meeting was to consider his removal. The dental association had become embroiled in vaccine politics after it expressed support for the Mills administration's vaccine mandate for health care workers. The removal was for four years, with the potential to be reinstated afterward.
"Jonathan's work reputation was very important to him. His identity was very important to him," Weiss said. "They stripped him of his dignity."
Weiss — a psychiatric nurse practitioner — said she didn't realize the extent of how distraught he had become over the dispute with the board, and had not seen any previous signs of mental illness. The two had been romantic partners for three and a half years, and had purchased a house together in North Yarmouth, where they lived with her two boys.
After getting the call from Shenkin's dental practice, Weiss said she had the office worker open the note and read it to her. Shenkin wrote that he was sorry, but he couldn't live with the damage to his reputation and professional life. "I thought I was doing the right thing," the note said.
She called 911, and police found Shenkin, 50, in his vehicle in the parking lot at the Augusta Civic Center near his practice.
He had killed himself.
Shenkin had long advocated for public policy improvements to dentistry in Maine, including insurance reforms and pushing for an adult dental Medicaid benefit.
After lobbying for many years for adults with Medicaid to have dental services, the Maine Legislature and the Mills administration approved the dental benefit this year, expanding access for about 70,000 more people. Shenkin had also previously been a vice president for the American Dental Association, and had been quoted in many major media organizations about how public policy could improve dental care.
"He was amazing. He was a trailblazer. He saw around corners and pushed for change when he saw there was an unmet need," said his brother, Todd Shenkin, of Bergen County, New Jersey.
Shenkin had been a member of the state's dental association for many years when the issue of whether to support a vaccine mandate for health care workers came up this summer.
The MDA board voted in June to support the Mills administration's health care mandate, with a motion made by Shenkin. Weiss said he told her that he agreed with the state's efforts to have safe workplaces with vaccinated health care employees, including dental practices. A news release sent out Aug. 12 by the governor's office quoted Dr. Heather Keeling, MDA board president, as being in full support of the mandate.
"The Maine Dental Association and its members have been proactive about COVID-19 vaccinations and keeping their practices as safe as possible for patients," Keeling said in a statement. "That will continue with the governor's new requirement, which we fully support."
But Weiss said Shenkin had told her that after the MDA supported the mandate, some dental practices complained to the MDA that the mandate would cause them to lose employees who didn't want to be vaccinated.
By August, the controversy made its way to the Maine Dental Association board, which held an emergency meeting on Aug. 22. Weiss said Shenkin told her he was blindsided, and had no idea the meeting's purpose was to decide whether he should be ousted.
"I think they panicked, and he was a perfect scapegoat. I think there was fear behind this," Weiss said.
Shenkin's ouster was related to communications he had with the Maine Center for Disease Control and Prevention about the vaccine mandate. Shenkin, in an email, told Dr. Nirav Shah, Maine CDC director, that the Maine Dental Association had approved a policy in June supportive of the vaccine mandate, and referred further questions to MDA leadership.
A dentist who was present during the Zoom meeting where Shenkin was removed — and who did not wish to be identified for fear of professional reprisal — said the proceeding was like a "witch hunt" and that Shenkin did not do anything wrong by relaying messages about the MDA's position to Dr. Shah. The individual said the meeting was run by board member Dr. Brad Rand, who made the motion to remove Shenkin. Rand did not respond to requests for comment.
An email from Shenkin to his attorney — shared with the Portland Press Herald/Maine Sunday Telegram by Weiss — recounted his communications with the Maine CDC.
"I emailed Dr. Shah and mentioned the MDA now had policy supporting (the vaccine mandate)," Shenkin wrote. "He thanked me and I referred him to our Executive Director. I did not say I was an officer or even a board member in my communications."
The dentist who was present at the board meeting that removed Shenkin said, "I don't think he said anything different than what I would have said to Dr. Shah." There were two calls for votes to oust Shenkin, a motion that would require a two-thirds majority. The first vote failed 7-3 with three abstentions and after more discussion, the second vote succeeded 11-2, the individual said.
Weiss said Shenkin did not hold an inflexible position about the vaccine mandate. He wanted to give dental practices sufficient time to comply so as not to suffer from workforce shortages. The Mills administration delayed enforcement of its vaccine mandate to late October to give health care providers time to comply and, if needed, find replacement workers.
"He just wanted people to be safe, the patients to be safe and the staff to be safe," Weiss said.
An email from the MDA board of directors on Aug. 23 sent to its members stated that an "unauthorized member" had communicated with Dr. Shah.
"This communication occurred without the board's knowledge, and further was a misrepresentation of the board's intent," according to the email. "The board's press statement following the governor's announcement was drafted just prior to the announcement and was based on the assumption that ALL health care workers were included. Further, we were unaware that no exemptions other than medical would be permitted."
Publicly, the MDA did not issue a news release backing away from its statement of full support of the mandate. But this fall MDA officials testified in favor of being removed from the mandate in submitted remarks to the Maine Department of Health and Human Services, which was finalizing the rules of how the mandate would be implemented.
The mandate went into full effect in late October, but in early November, the state decided to exempt dentists and dental workers from the requirement. Part of the reason cited by the state was technical: dentists are covered under rules that don't apply to other health care workers and are set by the State Board of Dental Practice.
Kathy Ridley, MDA interim executive director, declined to answer questions about the dispute between the board and Shenkin.
"Dr. Shenkin's death was a tragic loss for his family, his patients, the community he served and our association," Ridley said in a statement to the Portland Press Herald/Maine Sunday Telegram. "He was an active and valued member whose career and leadership will leave a tremendous legacy. We continue to remind people of his lifelong achievements and the countless efforts he took to improve pediatric oral health in the state of Maine."
Weiss said she believes the board's action to remove him from the dental board triggered Shenkin. She shared the note he left her:
"Noon — I am so sorry that it has come to this. I had no expectation that my actions would destroy me professionally," Shenkin's note said. "I thought I was doing the right thing. I feel awful thinking about how this will impact you and the boys. I love you all. I know some would say this is selfish, but I can't go on living my life with what I have created. I am responsible. There is no turning back. My practice will be ruined, my reputation tarnished, everything I had worked for since I was a struggling kid."
SUICIDE AND MENTAL HEALTH
Maine's suicide rate is 12th-highest in the country, at 19.8 per 100,000 residents, compared with the national average of 14.5 per 100,000. Most of the states with the highest suicide rates are rural states like Wyoming, Montana, Alaska and New Mexico.
The reasons behind a suicide are myriad and simple explanations are insufficient, said Greg Marley, director of suicide prevention for the National Alliance on Mental Illness, Maine.
"People looking for reasons often grab onto easy answers," Marley said. "This is a complex mental health issue."
Marley said an event can trigger a suicide, but usually there are warning signs, such as changes in behavior, that manifest long before the suicide. He said suicide is preventable and connecting people to help is shown to work in most cases.
"For most people, suicidal ideation is short term and it passes, so prevention works," Marley said. "If you suspect suicidal ideation, step closer, talk to them. If you can, break through the isolation and get them help."
Shenkin grew up in the Westchester County, New York. His brother said he was inspired to be a dentist after having TMJ — a dysfunction of the jaw — as a child and needing advanced treatment.
Todd Shenkin said his brother remembered being a difficult patient for dentists, which inspired him to go into pediatric dentistry, graduating from Columbia University in New York.
"He wanted kids to feel comfortable at the dentist's office," Shenkin said. "And he wanted to have a broader impact on society."
Although he had no children of his own, Shenkin was a "doting uncle" to his two nieces, his brother said, and like a stepdad to Weiss' sons.
"After I started having kids, I used to ask Jonathan when was he going to have kids so that I could become an uncle. His stock response was 'Sorry, but I see enough kids at work.' However, underneath all that bluster, he was really a kid at heart and knew how to have fun. "
A "foodie" who loved to travel, Weiss said Shenkin believed he could change the world, and did so. Helping children at a pediatric practice, and accepting Medicaid patients, many of whom have difficulty accessing care, was not enough for him, she said.
"He couldn't sit still — he was a restless soul. He was unable to sit back and watch injustices," Weiss said. "He had his hands in everything. When he sees something he wants to change, he goes all in. He's fully dedicated."
Besides helping extend dental benefits to adults with Medicaid, Shenkin also championed the elimination of waiting periods for children whose families get new dental insurance, with that measure becoming law in 2019. Most recently, an insurance reform bill proposed by Shenkin failed this year, but is expected to be taken up in 2022.
"His legacy is still there," Todd Shenkin said. "He was brilliant. My brother was a force for good in the world. When he died, a light went out."