WASHINGTON (JTA) — Miriam Adelson, best known for being married to one of the world’s richest men and perhaps the leading benefactor of the Republican Party, Sheldon Adelson, was named as a Presidential Medal of Freedom winner.

The White House announcement on Saturday spurred much liberal outrage: Miriam Adelson “has done nothing for her country besides being the wife of a Trump-friendly megadonor,” Paul Krugman, The New York Times columnist and Nobel laureate in economics, fumed on Twitter. “Of course it’s ludicrous, and an insult to people who received the medal for genuine service.”

Indeed, the Adelsons boosted Donald Trump’s presidential campaign in its final months with a much-needed infusion of $30 million. They also spent a stunning $100 million on Republicans in the midterm elections — the couple spent election night at the White House watching the returns with Trump.

It’s also true that Trump has paid dividends to Sheldon Adelson’s hard-right pro-Israel ideology, moving the U.S. Embassy to Jerusalem, and perhaps to his business: Trump reportedly lobbied Japanese Prime Minister Shinzo Abe to help open an Adelson casino in Japan.

But using the Medal of Freedom to reward political backers is not exactly new. Oprah Winfrey, who helped make Barack Obama a star in 2008 and was deeply involved in that campaign, was chosen in 2013. George Tenet, the CIA director who gave President George W. Bush’s Iraq War a much needed (and it turns out misguided) seal of approval, was a recipient in 2004.

And like Winfrey, the Adelsons have a record of philanthropic giving independent of any political agenda: in the Adelsons’ case, funding medical research. That’s the main citation in the White House announcement.

“Miriam Adelson is a committed doctor, philanthropist, and humanitarian,” it says. “She has practiced internal and emergency medicine, studied and specialized in the disease of narcotic addiction, and founded two research centers committed to fighting substance abuse. With her husband, Sheldon, she also established the Adelson Medical Research Foundation, which supports research to prevent, reduce, or eliminate disabling and life-threatening illness.”

Devex, an aid and development fund tracker, says that the Sheldon G. Adelson Medical Research Foundation has dispensed $67 million.

The couple is also well known — perhaps better known — for their Jewish and pro-Israel funding. Sheldon Adelson is the preeminent funder of Birthright Israel, the program that flies young Jews to Israel for free. He also gives to Holocaust remembrance and the Israeli American Council.

Here are five things to know about Miriam Adelson:

She’s hands on at her methadone clinics.

Adelson, 73, who grew up in the Israeli city of Haifa, earned her medical degree from Tel Aviv University’s Sackler Medical School. She later attended Rockefeller University in New York on an exchange program, focusing on treating drug addiction, which became her specialty.

Adelson routinely drops in at her treatment clinic hard by a nondescript strip mall in Las Vegas. She launched the clinic in 2000, seven years after opening one in Tel Aviv — which she also visits when the couple is in Israel. She will don a white coat and personally treat patients.

She couples treatment with research through Rockefeller University, where she worked in the late 1980s and is a board member. Her mentor there was Mary Jane Kreek, who developed methadone as a treatment for heroin addiction.

“From the beginning, the clinic was doing treatment and research,” Adelson told JTA in a 2016 interview at her Las Vegas clinic. “I can add more to the knowledge of addiction and we can save lives.”

Adelson’s research has explored whether there is a genetic component to addiction, not just to drugs but to behavior, like gambling and the internet.

She liked Ted Cruz.

By all accounts, the Adelsons are close partners in both philanthropy and politics. (They married in 1991 following her divorce from fellow physician Ariel Ochshorn.)

However, the couple had a friendly and sometimes public disagreement over which of the more establishment Republican presidential candidates they preferred in the 2016 campaign. Sheldon Adelson was leaning toward Sen. Marco Rubio of Florida, while Miriam Adelson preferred Sen. Ted Cruz of Texas. Before they settled on Trump, however, Miriam appeared to be winning the argument — they maxed out in individual donations to Cruz’s campaign.

The Adelsons didn’t quite crown Trump the nominee — Trump, in fact, clashed with Sheldon Adelson for a period. But Sheldon Adelson consolidated Trump’s front-runner status with a May 2016 appeal to his fellow Jewish Republicans to back the presumptive nominee and make it easier for Trump to defeat Hillary Clinton, the Democratic presidential nominee.

She modeled a Las Vegas Jewish school on her Israeli high school.

In describing the Adelson Educational Campus, a Jewish day school in Las Vegas, Adelson explains how her education at the famed Hebrew Reali School in Haifa helped shape its educational vision.

There are no morning prayers on the campus, just as there are no prayers in Israel’s secular school system.

“We don’t force the kids to pray, we don’t force them to wear a yarmulke,” she said. Instead, the students sing “Hatikvah,” Israel’s national anthem. “Be proud of what we are” was her philosophy in the school, she told JTA.

In the upper classes, students are expected to have a major, just as Adelson majored in biology when she was a student at Reali decades ago.

She also insists on mandatory drug tests for everyone — students and staff.

“I don’t want a situation where one of the people on our campus is selling drugs,” Adelson told JTA. “I wanted to show the kids we are all being tested in order to find one or two that would never come forward in the early stage. We want to find them, to help them. It’s like a cancer, addiction. It’s much easier to treat it in earlier stages.”

She wants American Jews to be more like Israelis.

Injecting Israeli Jewish sensibilities into the American Jewish body politic is what drives a lot of what the Adelsons fund, including Birthright, the Las Vegas school and the Israeli American Council.

Much media coverage of the IAC focuses on how Sheldon Adelson wants it to supplement — perhaps even replace — the American Israel Public Affairs Committee as the preeminent pro-Israel voice in the United States. Sheldon Adelson’s politics tack well to the right of AIPAC’s, and so do those of the IAC.

But attend an IAC conference, and the biggest takeaway one gets is that its agenda is overwhelmingly about making Israelis feel more at home in an American Jewish community that does not always share Israeli sensibilities. Israelis prefer to coalesce around food and culture, American Jews around the synagogue.

Those “how do we integrate?” side sessions bear Miriam Adelson’s imprint, and she often engages in them, in Hebrew and in English.

Adelson told JTA that American Jews could learn a lot from Israelis, especially in how to be pro-Israel.

“The Israeli Americans can help Israel,” she said. “The Jews, as we know from all the history, have many enemies, suffering a lot of hatred, sometimes within our own people. I think the Israeli Americans, the majority of them, love Israel, respect their homeland, many of them served in the Israeli army. Altogether if we are united we can be a major force to help Israel.”

She loves scouting.

Adelson, a member of the Tzofim, the Israeli scouting organization in her youth, is on the board of its American branch and has dedicated resources to expanding its reach not just to the children of Israeli Americans, but to American Jewish kids.

“If you talk about the Israeli community, you should talk about the Israeli scouts,” she told JTA. “This is really causing attachment between the Israelis” in America and those in Israel.

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