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In my previous three columns (1-7, 1-21 & 2-04-2011) I wrote about my experience with thyroid cancer – a disease that I actually had twice, almost nine years apart. I was very lucky that this is a very curable carcinoma, and even more fortunate that I never felt any real discomfort or pain from the two surgeries and radioactive iodine treatments I underwent. Even when I was very hypothyroid – a prerequisite for the radioactive iodine to have the maximum affect on any cancer cells that were not removed by the surgery – I still felt fine. Common symptoms of hypothyroidism are sluggishness, depression, loss of appetite, weight gain (that’s me on a good day), fatigue, joint and muscle pain, headaches, dry skin, brittle nails and hair and memory loss. (If an elderly family member is getting forgetful or seems to be thinking more slowly, please have his/her thyroid checked to determine if hypothyroidism is a possible cause, before assuming it is Alzheimer’s or dementia. Hyperthyroidism means that not enough thyroid hormone is being produced, a condition that often is quickly remedied by medication).

If indeed I had any of these symptoms, they were not severe enough to get my attention.

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While physically I had a relatively easy time of it, emotionally, I was on a dizzying merry-go-round. I was terrified – especially while waiting to hear test results; elated when the news was good; numb – not wanting to think of what lay ahead; angry; grateful that I felt well; optimistic; pessimistic; proud that I was given this test; ashamed that I was given this test – sometimes all at the same time.

However, there was one very strong emotion that I didn’t at all anticipate, one that would sink its barbed teeth into my psyche: Guilt. Guilt because I didn’t “suffer” enough – that not only did I survive, but I did so with out paying “my dues.”

I know these feelings are not unique – there is even a medical term for this emotional reaction, called “survivor’s guilt.” Often, a person can’t help feel some measure of guilt for having gotten through a life-threatening trauma when others did not.

When I was dealing with my first bout of thyroid cancer almost 18 years ago, two of my friends were being ravaged by other, more vicious and debilitating malignancies. Their ability to function, to live, was slowly and insidiously being whittled away and destroyed. Both were ultimately niftar at relatively young ages.

I would often wonder why I was spared. We all had children who were dependant on us; we all had “unfinished businesss.” From where I stood, I certainly wasn’t better than them, nor more deserving to live. Why did they suffer and lose the battle they had fought with such mesirat nefesh and bitachon, while my fight was, in comparison, a non-event?

You definitely feel great pride, and of course, joy when you are given a clean bill of health after facing a potentially lethal event – whether you survive an illness, a car accident, a fire or an act of violence that others succumbed to. You walk around feeling like you’re special, even superior. You’re a survivor! I too from time to time had “gloat” moments. Yet, I also felt very confused as to why I was chosen to live, when others weren’t.

I know this question has haunted many survivors of the Holocaust – and because of my own experience, I gained much insight into the mindset of this community which my parents, a”h were also a part of. I came to understand that there is a driving need for survivors of any calamity to justify their survival, to validate their continued existence, and ultimately, assuage the unforgiving guilt that gnaws on their souls. They are driven to excel, to make a difference, to do something amazing – or to produce children who will.

Collectively, there was relentless pressure on children of Holocaust survivor parents to be the best academically and/or socially. Excellence wasn’t good enough. You had to get the highest mark in your math test; you had to be the most popular kid in your class. For many of the children who understandably fell short of these often-unrealistic goals, praise was sparse and compliments were few.

But because I too am a survivor, I now understand what fueled this hunger for super achievement. Holocaust survivors were wracked with guilt for being able to walk in the fresh air; to eat and drink and partake in whatever pleasures life has to offer. Many of their family members were murdered in their youth; they never reached the milestones that were their birthright – growing up; getting married; having children; growing old. I remember my mother, who was very beautiful and very sharp (everyone who met her walked away with this opinion) lamenting to me that her brother and sisters were so much better looking and smarter than her, and were more deserving than she of surviving. They perished in their twenties. She was her family’s only survivor.

She, and I imagine the typical survivor, subconsciously could not forgive themselves for living while their siblings, children, nieces, nephews, parents, etc. were prematurely and unnaturally dead. For them, the only way to mitigate the grinding guilt was to either achieve greatness on their own or raise amazing children. Thus they could rationalize and excuse the fact that they lived when the others didn’t. They could silently shout out to themselves, “I survived so I could give birth to my son, the brilliant, life-saving neurosurgeon.” This was their ticket to a guilt-free existence.

I’m not so hard on myself. I don’t need to win, for example, the Nobel Prize in Literature, to make sense of why I am still here, why I was given a “mild” cancer as opposed to a “vicious” one. My job, my purpose, my task is to be b’simcha. Like laughter, I hear it’s contagious!

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