Yiddishkeit teaches us that whatever happens to us is for the good. “Gam zu letova, even this is for the good,” especially when no matter how you look at it, no matter how creatively you try to spin it, it’s not. Often it is a supreme test of one’s emunah to see the positive, to really feel it’s ultimately to our benefit.
Where am I going with this?
In my last column, I advised people to get timely medical tests, like mammograms and colonoscopies. I also suggested that if something felt or seemed different, it should be checked out.
I try to practice what I preach, so last July, when I felt a sharp, but brief pain in my lower left rib after sneezing, I decided to have it investigated. After all, in my lifetime, I must have sneezed a thousands times, but never ever felt any pain from doing so.
There is a Yiddish saying, one “avera shlept an anderer” – one “sin” leads to another. An X-ray of my ribs led to a chest CT and whole body bone scan. The very next morning, on Tisha b’Av, my doctor called. It seemed I had “intense abnormal activity in two ribs, corresponding to osteolytic metastases.” I had bone lesions – “holes” in the bones, caused by what I call “cancer termites.”
I faced the possibility that an undetected cancer had jumped to my bones. My mourning the destruction of the Beit HaMikdash was quickly supplanted by mourning the possible destruction of me.
I often have a one-way dialogue with Hashem, thanking Him for the good, but expressing puzzlement over the bad and even perplexed rage over the ugly – like the Holocaust and dying children, or innocent young lives snuffed out by terrorists or car crashes or illness.
“Seriously, Hashem, noch a mul?! Cancer again, for the third time – didn’t I pay my dues already?”
Various tests and scans and blood work ruled out common cancers like liver, ovarian, stomach, lung and kidney. And the typical blood tests did not show any blood cancers. Hoping this was a second recurrence of my previous thyroid cancer, I reached out to my thyroid doctor who sent me for a bone biopsy. Those results led to a referral to hematology, and a bone marrow biopsy of my hip.
The biopsy confirmed that I had Multiple Myeloma (MM), a cancer of the plasma cells, the white cells in the bone marrow that fight off infection.
Never heard of multiple myeloma? Most people haven’t. It’s relatively rare. I had ruled out this challenging cancer – treatable, but not yet curable – because my blood work was normal.
Nobody would guess from looking at me this past year that I had undergone months of oral and injected chemo (in my stomach fat, no shortage of that); steroids that bloated me; a one time high dose of IV chemo that targeted my cancerous marrow but also obliterated my normal white and red cells and platelets (also produced in the bone marrow) and transplantation of my own bone marrow stem cells that had been removed a few weeks earlier and frozen. This process resurrected my wiped out immune system, red cells, and platelets. (Red cells give you energy and platelets clot your blood so you don’t bleed nonstop from cuts, abrasions, etc.)
For months I attended classes and lectures, went to shul, had lunch with friends and did most of what I would normally do. A sheitel hid my hair loss and “being on a diet” hid my serious lack of appetite.
Why then go public about an illness that still carries a stigma; why come out of the “cancer closet” and arguably be viewed with pity or possibly avoidance, as if I was contagious, or was an uncomfortable reminder of human vulnerability?
As I mentioned at the beginning of the column, it all boils down to emunah.
Sometimes, people are fortunate to see a good outcome from a bad situation very quickly. You miss the plane you desperately needed to catch and that plane crashes.
Sometimes it may take years to see a benefit from an undesired reality. You lost a job due to downsizing, couldn’t get hired elsewhere, and in desperation turned a talent into a business – and became very successful.
Sadly, in many cases, “gam zu letova” will only be revealed in the Next World. In this world we can’t always make sense of or see any positive aspect to the many horrific tragedies that afflict families and communities.
But I believe there is a fourth component to emunah, a belief that what is undisputedly a bad thing can evolve into a greater good – but it’s up to the individual, family or community to take the bitter lemon handed to them and transform it into lemonade. Hashem wants us to use our hishtadlut and convert a misfortune into a benefit.
In my previous column, I mentioned the Kleins, who lost a daughter to a drug overdose and went public about it and helped sponsor a MASK symposium in order to educate the community, potentially save lives and spare other families the anguish they were experiencing.
Perhaps people are given “unfair” challenges so that they could transform their hardships into tikun olam. Perhaps, on that Tisha B’av a year ago, when I asked Hashem, “Why?” the answer was up to me to create.
I could hide my illness, or I could remove a potential stumbling block from the path of the blind (the unaware) by using my column as a tool to educate about a sneaky disease whose symptoms are often overlooked until major damage is done.
The median age of a MM patient is 65. The most common symptoms are fatigue caused by anemia, the result of the rapidly multiplying cancer cells overwhelming energy-giving red blood cells, and chronic bone pain and destruction due to the cancer in the bone marrow.
Does not fatigue and body aches describe almost everybody middle aged and older (and younger)? Don’t we all complain about being tired or having aches and pains somewhere?
Because Multiple Myeloma is relatively rare it isn’t typically on the “reason why” menu. Many, including doctors, rightfully explain away aches and fatigue to age and “overdoing it.” Work, household chores, getting ready for Yom Tov, traveling, lifting babies out of cribs or swings, too much weight lifting at the gym, sitting at a desk all day, interrupted sleep, a pulled muscle, arthritis – are among the legitimate reasons we can come up with.
Tom Brokaw, the renowned NBC broadcast journalist, was diagnosed with MM at age 73 and wrote a book about it: A Lucky Life Interrupted. In it he writes about persistent and at times excruciating lower back pain, which he attributed to an active lifestyle. Two orthopedists both concluded that he had lower-back thinning of a disc, some arthritis and “the inescapable consequences of age.” His pain was due to compression fractures caused by the cancer.
When I ask fellow patients how they were diagnosed, many say they fell and broke a bone. I think in some cases, a weakened bone cracked first, causing the fall. Many required surgery and had rods and plates put into their backs. One man told me he was just days away from becoming paralyzed. He had had severe neck pain.
Another patient was finally diagnosed after he had recurring infections, likely due to the malignant, dysfunctional plasma cells that impaired his immune system.
I want to emphasize that Multiple Myeloma is quite rare. Do not jump to an unfounded conclusion just because you’re feeling tired or achy.
But I do suggest that if it’s chronic, ask your doctor to test for it for your mutual peace of mind.