“You look like you need a l’chaim,” the yeshiva bocher said to me, extending a plastic cup in one hand and elevating a bottle of vodka in the other.

“No, I can’t, it’s OK,” I replied, but he was insistent.

“I know a little about people and I can tell that you, my friend, are really in need of a shot,” he continued. He started to pour.

“You’re being very kind,” I demurred, although at this point I was starting to get annoyed. “But I’m just not allowed.”

He looked at me puzzled and I could tell he’d had a few drinks of his own already.

“But … it’s Shabbos!” he sputtered, then slumped onto the couch dejected before being distracted by the eye-popping scenery all around the two of us. We were at the 12th floor rooftop pool of the Ritz-Carlton Hotel in Herzliya. His black and white Shabbat garb was no match for the ever-changing color parade of half-naked men and women in their swimsuit finest.

I could have told my interlocutor why I was turning down his offer – that alcohol and chemotherapy don’t mix so well for me – but that would have gone against the aim of this weekend. My wife Jody and I had slipped into the Ritz-Carlton “cancer incognito.” We did it with the help of the wonderful Refanah organization.

Refanah is an Israeli non-profit that provides much needed “healing holidays” to people suffering from cancer. Refanah founder and executive director Robyn Shames has convinced dozens of hotel, B&B and guesthouse owners around Israel to donate sleeping accommodations based on the property’s availability.

Refanah’s pitch to proprietors is that they already don’t run at full occupancy year-round, especially during the week. So donating a room for a night only really costs them the cleaning afterward.

According to the Israel Central Bureau of Statistics, there are 6,500 B&B rooms in Israel with an average occupancy rate of 50 percent on weekends and just 25-30 percent during the week. There are another 50,000 hotel rooms with an average occupancy of 55 percent.

Shames came up with the idea for Refanah in 2014 after a relative, who had survived cancer, told Shames about Cottage Dreams, a similar program in Ontario, Canada.

Shames had already been doing important work as the executive director of ICAR, the International Coalition for Agunah Rights, fighting to “unchain” women whose recalcitrant husbands were refusing to provide them with a get, a divorce decree according to Jewish Law. After 11 years at ICAR, she was looking for a change. But it had to be one where she could continue doing good in the world.

The name Refanah comes from the Bible. Moses asks God to cure his sister Miriam of leprosy by praying “El na refana la.” It means, quite literally, “God please heal her.”

Shames started her Refanah by randomly contacting some 100 Israeli B&B owners to gauge interest. She figured maybe 10 percent would say yes; almost half agreed immediately.

“People are very excited about having this opportunity to do something nice,” Shames says.

In our case, the room at the exclusive Ritz-Carlton Hotel, overlooking the picturesque Herzilya Marina with its hundreds of yachts and sailboats, was owned by an individual who vacations in Israel the summers. The hotel generously added breakfast to round out the weekend.

People with cancer can browse the Refanah website to view properties and read details about availability. Refanah collects a modest NIS 100 fee when you make the reservation, “thus enabling every cancer patient to help others by participating in their circle of giving,” Shames says.

Both people undergoing cancer treatment and those who have finished treatment in the past year are eligible.

There are Refanah properties all over the country – on kibbutzim; smack dab on the beach; in the centers of Jerusalem, Tel Aviv and Eilat; in a stark caravan overlooking the Sea of Galilee; and even on an alpaca farm outside of Mitzpeh Ramon.

Refanah is great for people with cancer, but it’s good for property owners, too: a free night generates positive publicity that can lead to referrals and future business.

Despite the number of properties working with Refanah, the demand is constantly growing: about 28,000 people are diagnosed with cancer each year in Israel.

Refanah has now provided free vacations for nearly 2,000 cancer patients and their families.

For Jody and me, it was not just the break from routine in a pampering seaside hotel that was so invigorating. It was also the anonymity: no one knew how we got there or why. Maybe there was something small written on our reservation form, but to everyone else, we were just two ordinary guests.

For someone like me who’s been so public about his cancer experience, going incognito was as refreshing as that rooftop pool (which my doctor told me I was not allowed into because, you know, germs).

It’s not so surprising, then, that I chose not to tell my new yeshiva buddy the reason I was so resistant to his vodka volunteerism. Nor could he have surmised on his own my status – my hair hasn’t fallen out from the chemo (although my hairdresser says it’s thinned a little) and I’ve actually gained weight (treatment makes me crave carbs).

But someday – hopefully soon – I might just take him up on his Shabbos shots offer. L’chaim right back at ya.

I first got healed by Refanah at The Jerusalem Post.

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My daughter Merav is a proud Zionist. But even Zionists get scared sometimes. And living for the past two years in the Gaza border community of Sderot, where she’s studying at Sapir College, there’s been a lot to be frightened of.

In a heartbreaking post that’s been circulating on social media, Merav described the weekend of July 15, when 150 missiles were fired from Gaza. One landed just a block away from her apartment. After the hundreds of incendiary kites and balloons that have turned the air outside Merav’s idyllic student dorm room into a smoky hell, that was the straw that broke this Zionist camel’s back.

“We grabbed our backpacks and started stuffing them with whatever was near, threw them in the car and hit the gas, driving 140 km an hour through the eerily empty streets of Sderot, as though we were being chased,” Merav starts her piece. “I didn’t breathe normally until we passed Bror Hayil, a kibbutz outside the immediate radius of the current missile attacks.”

It’s not like Merav and her husband Gabe didn’t know what they were getting themselves into when they moved to Sderot. After four years of mostly calm following the conclusion of Operation Protective Edge, they knew that violence could return to the region. But they found the laid back lifestyle of Israel’s south enticing.

They’re not alone.

The Israeli communities adjacent to Gaza have been booming. Hundreds of families have moved to the region’s cities and kibbutzim since 2014.

Some come for idealistic reasons: to fortify the vulnerable border. Others cite the natural beauty (although the fire kites have blackened that), affordability compared with Jerusalem or Tel Aviv and the child-friendly atmosphere. One new resident interviewed says that, despite the violence, he feels his kids “are safer here than in the big city.”

In the last year alone, eight new homes have been built on Kibbutz Nahal Oz and another 12 houses are being planned – “no small feat for a community overlooking Gaza,” reports journalist Amir Tibon.

The same pioneering spirit pervades the student body at Sapir. Merav and Gabe live in a college community called Ayalim, part of a national organization that recruits young people to move to student villages across Israel’s periphery. Ayalim’s 22 campuses provide low-cost accommodation and scholarships in exchange for community service.

In Merav’s first year, she volunteered with Holocaust survivors. Last year, she mentored a teenage girl.

Ayalim (and Sapir as a whole) remind me of my own college days in the U.S. – there’s a real small-town campus environment, unlike Israel’s bigger universities which have a high percentage of commuters. The students make Shabbat dinner together and run a local pub. There’s a fantastic humus place nearby (owned and operated by Ayalim graduates).

The city regularly invites top Israeli musicians to perform; most recently Sderot hosted its first Blues Festival.

If I were going to college in Israel, I’d want it to be in Sderot.

All that changed when the Hamas-fueled demonstrations broke out along the border and rockets returned to the skies.

A study which appeared in the Journal of Adolescent Health a few years ago found that half of middle schoolers in Sderot suffer from post-traumatic stress disorder. Others put the number at closer to 80 percent.

When Merav asked the teen whom she mentored last year how she’s been coping with the situation, the young girl simply shrugged, her anxiety cloaked in denial.

“It’s no biggie for me,” she told Merav. “It’s definitely better then when we lived in Ashkelon and didn’t have a safe room in the house and had to go sleep in the stairwell.”

Merav wishes in some ways she could be more like her student.

“When people ask me how it’s going living where we live, I so badly want to say ‘you know, its life. We handle it, we’re Zionists and we are brave!’ But I don’t. I feel sad and scared.”

When the explosions intensified, Merav says she felt every one of them – on both sides of the border. “It was like our house was lifting off the ground,” she writes of the night before she and Gabe made their decision to leave for Jerusalem.

You might think at this point we’d be advising Merav to get out. There are other colleges in Israel. Does she have to be such a Zionist?

Merav is having none of it.

“I’ve never been one to quit anything,” she states. Describing her fellow students – as well as herself – she adds, “We are the reason our country still thrives, because we don’t leave, no matter how scared we are. Because we know how to weigh the enormous benefits of life in the periphery against the equally enormous challenges.”

How does she do it? I don’t know if I could.

Merav says she closes her eyes and imagines “the hot summer afternoons, the DJ jamming in the main square of the campus, the popsicles that the student union passes around. I remember the first Sderot marathon a few months ago where the entire city – including me – came out and ran alongside the fear.”

School is on break until the fall. Maybe this time, a cease fire will hold. In the meantime, Merav writes how she no longer takes things for granted.

“Every day with no siren is a gift.”

That’s not a lesson I’d wish anyone would have to go to college to learn. But I’m so proud that my daughter has learned it anyway.

I first wrote about Merav’s life in Sderot in The Jerusalem Post.

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Cancer as a chronic illness

by Brian on August 19, 2018

in Cancer,Health

Cancer isn’t what it used to be. Increasingly, researchers are no longer searching for a cure but for ways to manage this once dreaded disease over a lifetime.

Indeed, with new treatments showing such great promise (Gilead’s stunning $12 billion acquisition of Kite Pharma, which commercialized an Israeli-developed immunotherapy treatment called CAR-T, being perhaps the most dramatic), more and more cancers are becoming essentially “chronic conditions” – incurable but treatable, akin to diabetes, heart disease or even HIV, which used to be a killer but is now surprisingly survivable with the proper chemical cocktail.

“With regards to a cure,” Dr. Lisa Coussens of Oregon Health and Sciences University told the American Association for Cancer Research’s annual conference in April, “it’s really not a realistic goal.”

Coussen’s prescription: “Live with disease and live your life well with that disease. It’s a major shift, but a tremendous goal.”

Not every cancer is a candidate for this new status, of course, but mine is. The black humor among fellow patients is that “you won’t die from the lymphoma; you’ll die with it.

Another well-worn line that’s meant to evoke a wry smile (I’ve even heard it from my doctors): “If you had to get cancer, this is a good one to get.”

Chronic cancers ebb and flow, although rarely without treatment, which often involves chemotherapy and other meds that are a whole lot tougher on the body than, say, a simple course of antibiotics for a recurring head cold. The upshot, though, is that people are surviving – and even thriving – for decades with the Big C.

Cancer’s new chronic status throws into disarray much of standard language that’s evolved around the disease. You are supposed to “fight” cancer until you “beat” it. But chronic cancer never goes away. It may slip into remission for a while – sometimes years – but it’s always there, lurking in the background.

You find yourself worriedly scanning your body for signs that something’s off. Is that a lump? Did I work out too hard today or am I just cancer-fatigued? When’s my next PET CT?

You calm yourself by intoning, “it’s no different than any chronic disease,” but it’s still, you know, cancer and that carries a stigma, even today.

A colleague who I’ve never spent time with socially offered to come visit. It took me a while to figure out what he probably thought: it’s cancer, he’s going to die.

People with chronic cancer and other conditions can be wracked with guilt. The website The Mighty.com compiled a list.

“I feel guilty whenever I feel like I’m enjoying myself,” wrote one person. “Like, ‘you’re chronically ill so you can’t be allowed to have good days or else people will assume you’re better.’”

“I dread going to the doctor,” said another. “I hope I have enough symptoms to have them believe me and take me seriously. But I don’t want enough symptoms and hurt going on to warrant a crash.”

Part of the confusion is that with the classic stereotype of cancer there’s an “expiry” date. “You’ve got six months to live. Make every moment you’ve got left count.”

But with chronic cancer, there’s no unexpected early ending to prod such personal transformation. So, do you just continue with what you were doing before, punctuated by trips to the local hospital daycare ward for the occasional IV?

My wife Jody has remarked that I’ve been operating at 99 percent, even during chemo, barely braking and keeping up with my routine.

But make no mistake about it, I amsick. In remission, not in remission, from the day of my diagnosis forward, I will always have chronic cancer. It’s become part of my identity and the number of good days I’ll have over the long term is definitely less than it was BC (before cancer).

Mindi Boston writes on The Mighty about how her own chronic illness “may not define me, but it defines how I have to live.”

And yet, therein lies the “blessing” of chronic cancer. (Not that I would ever wish such a “blessing” on anyone – let alone myself.) But knowing – not just as a cognitive exercise but deep in your kishkes through lived experience – that health is not a given can help you appreciate the good (when it comes) that much more.

Stacey Kramer survived a brain tumor. She described it in a TED Talk as a “gift” that will have you feeling “loved and appreciated like never before … challenged, inspired, motivated and humbled.”

Psychologists at the University of North Carolina at Charlotte coined a term: PTG for “post-traumatic growth.”

I’ve had my own moments of PTG.

The night before my fifth round of chemo, Jody and I went out to eat in Jerusalem’s Mahane Yehuda market. We chose the popular Pasta Basta, which always has a long line of eager young noodle nuts. I put together an odd mix: cheese and sweet potato ravioli swimming in a coconut curry sauce.

I was blown away by how incredible that evening was. Everything about it – the flavors in my dish, the parade of people, the sounds of the shuk – was heightened.

I knew as I was experiencing it that the hour was fleeting. The next day, I was subsumed again by the familiar aches and pains. But I could still savor how I’d maximized the moment.

I find myself returning regularly to that accident of attitude as I navigate the strange new world of chronic cancer.

I originally described cancer as a chronic illness at The Jerusalem Post.

Image by Bkalim [CC BY-SA 3.0 (https://creativecommons.org/licenses/by-sa/3.0)], from Wikimedia Commons

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If I were making aliyah today, I’m not sure I would go through with it. If a potential immigrant asked my advice about moving here, I’m not sure what I’d say anymore.

Those were my first reactions after the Knesset enacted a double whammy of legislation earlier this month – the unnecessary Nation-State bill, which codifies language describing Israel as a Jewish State but has little practical effect other than making the 20 percent of Israelis who are not Jewish feel unwelcome, and changes to a law enabling state funding for surrogacy that leaves out single fathers and by extension men in same-sex relationships.

Those two laws were followed by the early morning detainment of a rabbi affiliated with the Conservative movement for the crime of conducting a marriage between two Jews whom the rabbinate claimed “are not eligible to be married.”

The attorney general quickly stepped in on the latter, freeing Rabbi Dov Haiyun from additional questioning by police. But taken as a whole, these three actions lead me to wondering: What has happened to us? Where did the shining words of Israel’s Declaration of Independence – which promised to “ensure complete equality of social and political rights to all its inhabitants irrespective of religion, race or sex” – go?

The problem, as so often happens, is inertia. None of the actions in the Knesset or at the Haifa police station, however upsetting, affect the majority of Israelis on a day-to-day basis. On the contrary, life in general just keeps getting better and easier.

Sure, there is the constant threat of another war, but that hasn’t changed since the founding of the state. On the street, however, the differences between now and when I made aliyah 24 years ago can sometimes seem miraculous.

Some of the improvements are the result of actual good governance. Smoking has been banned nearly everywhere, we’re nearing the last bank or insurance company that still requires sending forms in by fax and if you get caught with pot (without a medical license), it’s a fine not a felony.

Jews and Arabs are integrating more than ever before, as well. As Matti Friedman pointed out in a 2017 article, nearly half of the Arab workers in Jerusalem are now employed in Jewish areas, and the number is rising. So is the percent of Palestinian students enrolled at Israeli universities. “Palestinians and Israelis might not like each other, but their fates are becoming more tightly entwined, and everyone has more to lose if things fall apart,” Friedman writes.

The cost of living in Israel remains high compared to other developed economies but, writes David Rosenberg, “real wages have risen 12 percent in the last five years, unemployment is at record lows [and] inequality and poverty have been falling.”

Then of course there’s technology. Social media may have mangled what’s left of our already email-challenged attention spans, but there’s no arguing it’s made the world a smaller, more connected place. (I’m on the side that says that’s a good thing.)

And the tech business is booming – so much so that the Startup Nation is having trouble recruiting engineers locally. A program called BETA (“Be in Tel Aviv”) offers a $20,000 relocation bonus, a yearly round-trip flight home and a Hebrew tutor among other perks.

It’s in the tech space where we can find one possible solution to the disconnect between an Israel getting better and a Knesset pushing a political agenda designed to engender the opposite.

We’ve seen it in action twice in recent weeks.

When ultra-Orthodox men refused to sit next to women on a recent El Al flight, Barak Eilam, the CEO of Ra’anana-based software giant NICE, declared that his firm would boycott El Al until the airline changed its policies. “At NICE, we don’t do business with companies that discriminate against race, gender or religion,” Eliam wrote.

Within days, El Al CEO Gonen Usishkin announced that passengers not taking their assigned seats would be deplaned immediately.

When the surrogacy law was passed, it was tech firms again who took the lead. Scores of companies gave employees who wished to join the protests permission to take the day off with pay.

“We stand with all of our employees seeking equality under the law,” Apple said in a statement.  “No one should be denied one of the most basic human rights … for being who they are” was how IBM’s statement read. CRM giant Salesforce said it “will support our employees who campaign for change to this law.”

Those same statements could have been made just as easily about the Nation-State law.

In the summer of 2011, tens of thousands of Israelis pitched tents along Tel Aviv’s Rothschild Boulevard to protest rising consumer costs. Some prices came down but mostly life went back to the status quo.

When Startup Nation gets involved, though, the possibility of real pain to the bottom line is greater, as El Al experienced. More of that could finally get the government spooked.

I’m not so starry-eyed to believe an activist Startup Nation will turn the tide alone – change still runs through the Knesset – but it’s a new approach and it takes courage for a sector that doesn’t usually get involved in politics.

In July, tech firms proved it’s possible. If the influence of tech was limited in the past to silicon and software, moving forward, it may be able to move the needle on injustice and enmity.

What would I say to someone making aliyah today? Come! Get involved. Protest. (And take the $20,000 relocation bonus.)

I first pondered whether the Startup Nation could save Israel from itself at The Jerusalem Post.

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Playing the cancer card

by Brian on July 23, 2018

in Cancer,Reviews

All I wanted was a “free pass” – the ability to say, “No I don’t feel up to walking the dog, can you?” or the option to tell a client, “I’m going to need an extension on the deadline because, you know, cancer.”

But, other than days when I really am so out of it I can’t hold a coherent conversation, I haven’t been able to play the “cancer card.”

It’s not that I’ve been doing so well. Behind the “inspiring” pictures I post to Facebook, smiling in my hospital bed or out for a stroll in nature, there’s been some genuine misery: fatigue, nausea, vertigo and various aches and pains. (So far, a healthy dose of medical cannabis and judicious “elbow bumping” seem to have kept me out of the ER.)

It was during one of those bad days that I became particularly discouraged.

“Maybe I could take a few months ‘sabbatical’ from work,” I suggested to my wife, Jody. “I could watch TV all day, catch up on my shows.”

“That’s not the cancer talking,” said my therapist, when I laid out my proposal. “That sounds more like depression. And you don’t want to go down that rabbit hole.”

My therapist was referring to my tendency to spiral in the face of bad news; to pile on the negativity until it becomes an obsession that isn’t good for anyone. “Checking out” could cause some serious psycho-social damage, she implied.

“But this time it’s different,” I countered, not ready to give in without putting up a fight for passivity. “It’s not like in the past when my boss was on my case or I had a tiff with Jody. This time, I’m really sick. I think a free pass could do me good, give me time to heal.”

But my therapist just shook her head. “You’ve built up all these structures that are a major part of your identity,” she said. “As a husband, a father, an employee, a dog walker, a friend, someone who exercises and eats well and hikes the Himalayas. Take those away and your self-image becomes limited to that of a ‘sick person.’ I don’t think that’s really what you want.”

That advice is consistent with the popular concept that maintaining a positive attitude can play a critical role in alleviating illness. The idea took off big time in the 1980s with Louise Hay’s massive best-seller “You Can Heal Your Life,” in which the author documents how through positive affirmations and visualizations she cured herself of cancer.

Hay’s approach resonates beyond rehabilitation. “For many years there have been those who were convinced that people with certain personality types were more likely to get cancer,” the American Cancer Society website recalls. “The common thought was that neurotic people and introverts were at the highest risk of cancer.”

That line of thinking has been since debunked – significantly through a 30-year study following 60,000 people published in 2010. But the belief in a mind-body-healing connection continues.

Is it backed up by science, though?

A study published last week in the journal Nature Communications conducted at the Technion – Israel Institute of Technology suggests the answer may be yes. The researchers found that increasing the level of dopamine in the brains of tumor-bearing mice – thus boosting their positive emotions – reduced the size of their growths.

Whether or not the science holds up with humans, it misses the point, implies Barbara Ehrenreich in her book “Bright-Sided: How Positive Thinking is Undermining America.”

When Ehrenreich was diagnosed with cancer herself, she ran into an almost unrelenting requirement to stay positive.

“Cancer was the best thing that ever happened to me,” she quotes Lance Armstrong as saying.

“Cancer is your passport to the life you were truly meant to live,” quips Anne McNerney in the book “The Gift of Cancer.”

“Cancer had everything to do with how good the good parts of my life were,” writes NBC News correspondent Betty Rollin.

Ehrenreich disagrees.

“Rather than providing emotional sustenance, the sugar-coating of cancer can exact a dreadful cost,” she writes. “It requires the denial of understandable feelings of anger and fear, all of which must be buried under a cosmetic layer of cheer.”

And, if positive thinking fails and the cancer spreads or eludes treatment, “the patient can only blame herself: she is not being positive enough,” Ehrenreich adds.

It’s not just for cancer, either. “If your business fails or your job is eliminated, it must be because you didn’t try hard enough, didn’t believe firmly enough in the inevitability of your success,” Ehrenreich rails.

The members of a Facebook group for people with follicular lymphoma (my cancer) are on the same page.

“We need the opportunity to experience and express a full range of emotions without guilt and having to always be positive for others,” wrote one.

“My husband was Mr. Positivity with his cancer. I am an Eeyore by nature – gloom and doom and grump. He died. I didn’t. So go figure,” posted another.

“Show up, take the drugs,” wrote a third. “That’s what takes care of the disease. But a good attitude makes it easier to show up.”

That last line most aptly describes why I’ve been unwilling to claim my free pass.

Cancer isn’t easy. It isn’t necessarily transformative. But continuing to show up, rain or shine, gain or pain, with a tired but true smile on my face, is without question better for me and, just as important, it’s better for my friends, family and coworkers when I present with some semblance of a recognizable self-identity.

I don’t get to play the cancer card. The truth is, I don’t want to anymore. That justmight be the most positive outcome of this unexpected journey.

I originally (didn’t) play the cancer card at The Jerusalem Post.

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Pay mindfulness forward

July 9, 2018

“I’m afraid,” I told my doctor, “that I’ll get to remission from the cancer but still be suffering from chronic pain. How do I cope with that?”

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The death of rational Judaism

June 25, 2018

Nearly all Jews today are “rational” in that we know which thoughts and behaviors to assign to the religious domain and which remain beyond it. But can that kind of Judaism survive?

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Famous germaphobes

June 10, 2018

I recently joined some dubious company. Among my companions are Michael Jackson, Howard Hughes and Donald Trump. We all suffer from mysophobia.

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About that Baka boom

May 28, 2018

I was in the shower when it happened: a boom louder than any I’ve heard since the suicide bomb at Café Hillel on Emek Refaim Street in 2003.

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Finding the groove at Jacob’s Ladder

May 14, 2018

A pre-show “review” from last week’s Jacob’s Ladder indie, folk, country, blues and bluegrass festival at the Sea of Galilee.

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