Many years ago, when we were still living in the U.S., I had a Reform rabbi friend who said something I found shocking at the time. He declared defiantly that he would never daven (Yiddish for “pray”) in a synagogue with a mechitzah – a divider separating men and women.

Mechitzah at synagogue in Afula, Israel

Back then, my wife, Jody, and I were members of a Modern Orthodox shul and I just didn’t understand my friend. He wouldn’t go into such a synagogue even for a simcha? A brit milah or a baby naming?

Then, a few weeks ago, we were invited to an Orthodox synagogue for a Shabbat Chatan, where a groom is called up to the Torah on the week before or after his wedding.

That’s when I realized that I, too, felt awkward in synagogues where men and women can’t sit together. 

This has been going on for a while. As I began to move away from observance over the last decade, eschewing the mechitzah minyans of my younger, frumer days felt more like an act of rebellion (“why can’t I sit with my wife and daughter?”) or perhaps a way of virtue signaling my new, unorthodox status, rather than some overarching anti-mechitzah ideology.

Charles King’s recently published book Gods of the Upper Air: How a Circle of Renegade Anthropologists Reinvented Race, Sex and Gender in the 20th Century helped me understand that my discomfort might involve something deeper.

King, a professor at Georgetown University, has written the fascinating story of German-born Jewish anthropologist Franz Boas and his social science colleagues, whose pioneering work in the early 20th century challenged – and eventually upended – long-held notions of gender, race and class.

Interviewed on the NPR program Fresh Air, King explained that, 100 years ago, most Westerners believed there were clear divisions between people based on their sex, color or social standing. 

Race, for example, was considered “inheritable and biological,” King said, while “people came in natural gender categories [that] would be the same across all societies and for all time.” 

As a result, everyone had their prescribed roles. Men, it was widely understood at the time, had a built-in genetic right to leadership – after all, they had been the hunter-gatherers, so of course they would also dominate in the modern world as CEOs, soldiers and synagogue heads. 

Boas and his followers were among the first to break down such conceptions.

Anthropologist Ruth Benedict wrote in the 1930s, for example, about how among a number of plains tribal groups in the U.S., gender identities included an intersex category “where a person could have some of the outward biological features of one sex but occupy a social role that was on the opposite side.”

That was radical: It simply hadn’t occurred to people at the time, “that the reality you were observing in the world was a product of circumstance, culture and history, not of something that was innate,” King said.

Feminist writers from Simone de Beauvoir to Andrea Dworkin expanded on the work of Boas and his associates. Today, the idea that gender and racial roles are not fixed by biology has become mainstream in liberal Western thought. 

The message seems to have gotten stuck when it comes to Orthodox Judaism, however.

When I first spent time in Israeli yeshivot in the 1980s, I remember hearing the mantra that men and women are “separate but equal” and, as a result, women are not obligated to fulfill certain commandments, nor are they permitted to lead particular prayers or ceremonies, because they had “more holiness than men.” 

I found that disingenuous at the time, but I looked the other way. An Orthodox lifestyle offered enough benefits for me to dissociate from the misogyny lurking at its core. Perhaps, I hoped, Orthodoxy’s attitude would go away over time.

It hasn’t.

Just this summer, Rabbi Shlomo Aviner, one of the leading figures of the religious Zionist community’s hard-line wing, when asked whether Ayelet Shaked could head the block of right-wing parties, declared, “The complicated whirlwind of politics is not for women.” Is a woman allowed to be in the Knesset? he asked provocatively. “Of course not.”

Aviner is clearly mistaken: there are Orthodox women in Israel’s parliament. Moreover, the progressive side of Orthodoxy now ordains female rabbis, even if they’re not always called that. 

But, to date, I’ve never seen an Orthodox synagogue with no separation of men and women whatsoever. The mechitzah may be low, it may be sheer or even made of glass, but it’s still there. 

And for me, that mechitzah is like a high-voltage wire or a radio antenna, a visceral symbol broadcasting that congregants who accept its presence still subscribe to an outdated belief that different roles for men and women are immutable and eternal, whether that’s based on our hunter-gatherer DNA or God’s word as transmitted by Jewish Law.

I’m not trying to be proscriptive here. As Shoshanna Keats-Jaskoll, founder of the Chochmat Nashim organization of religious women fighting extremism, told me, “I can respect the need for separate seating as a way to focus and not be distracted.” The problem, she says, is that what starts with the mechitzah “becomes highly unequal, fast,” going far beyond the choreography of prayer. 

A better approach – for me, at least? Mechitzah-less, egalitarian synagogues. One that I particularly respect is Jerusalem’s Zion congregation. While it makes no pretense to being Orthodox, Zion’s slogan resonates deeply. It reads simply: “come as you are.” 

That’s a kind of Judaism ready for the next 100 years.

I first wrote about my problems with mechitzah minions at The Jerusalem Post.

Photo credit: Wikimedia Commons (Deror_avi)

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Running simulations

by Brian on October 26, 2019

in Cancer,Health,Science

As I sat in my doctor’s office, I was prepared. I had assembled a thick folder with all the latest research on my chronic cancer – the pros and cons of continuing immunotherapy along with newly released data that pushed the average duration of remission for follicular lymphoma to an encouraging 10.5 years. 

Moreover, I had run countless simulations in my mind, imagining every which way the conversation could go: my doctor agreeing with my assessment, my doctor pushing back, my doctor sharing bad news.

The bad news simulation stemmed mainly from the first item on the agenda for our appointment: the results from my latest PET CT – the same one that had been the source of such “scanxiety” over the previous weeks.

I tried with all my might to imagine how my doctor would give the all-clear, but I found myself gravitating again and again to the flip side: how she would gradually ease into the presentation of a negative outcome.

“The results were a bit surprising,” I imagined she would begin. Or, “The treatment doesn’t seem to have worked as well as we’d hoped.”

I envisioned my reaction, as well. In some versions, I would receive the news stoically and ask smart follow-up questions. In others, I would slump into my chair, holding my wife Jody’s hand. 

In some simulations I would cry.

Dwelling on these worst-case scenarios was crazy making. But spinning simulations is also essential to being human, says Prof. Moshe Bar, head of the Gonda Multidisciplinary Brain Research Center at Bar-Ilan University. It has to do with the true purpose of memory.

Prof. Moshe Bar of Bar-Ilan University

“Before I studied it, I thought of memory as a big photo album, one that you pull out to reminisce on your kids’ bar mitzvahs or a trip to Europe,” Bar told me during a recent interview I conducted for The Jerusalem Report.

The main function of memory, however, “is to help the brain predict, to prepare for upcoming events and encounters,” Bar explains. “In order to anticipate, you have to lean back on memory. Every decision – and we make hundreds or thousands of decisions a day – involves some kind of foresight, some kind of simulation about the future.”

Those can be simple ones, like what to order for lunch (by remembering what you’ve enjoyed in the past). 

They can be strategic ones, like anticipating an offer and counteroffer (by calling up past negotiations). 

And they can be defensive, like preparing to receive bad news.

Memory, in this way, is more a survival tool than an entertainment platform, Bar says.

Brain researchers like Bar refer to two types of memory: “semantic memory,” which you use to describe something generic – such as a typical “breakfast” consisting of scrambled eggs and toast – and “episodic memory,” where you recall the specific breakfast you had yesterday morning. 

Episodic memory is key to generating detailed and potentially accurate simulations. It’s “the scaffolding [needed] to mentally time travel,” explains Kim Mercuri, a clinical psychologist at Australian Catholic University. “In order to go forward, you need to go back.”

Episodic memory is your identity. Bar adds, “It’s your own history, your own desires, your own fears.”

While running simulations can trip you up if they transform into obsessions, most of the time they are quite helpful. 

“What would you do if upon landing [at the airport] you discover that the airline has lost your luggage and you are scheduled to give a talk in two hours,” Bar ponders. “It has not happened, but if it does, you will be ready. If you ran this simulation in your mind early enough, you might have packed extra clothes and other essentials for your talk in your carry-on.”

Negative simulations can give us the courage to move forward with something difficult. When I was first diagnosed with cancer, I steeled myself emotionally for the chemo to come by simulating in my mind how my family would feel if I were gone – my children without their father, my wife without her husband. 

But a simulation can only go so far, especially when the news comes out of the blue. When my doctor started the conversation by stating exactly what I’d foreseen – “the results were a bit surprising” – I was ready, but it still didn’t blunt the shock.

As we huddled in front of her computer, she pulled up the images from my PET CT showing a new tumor on a lymph node near my pelvis and two smaller ones in my chest.

“How could this happen?” I sputtered. After all, I was still in the midst of “maintenance” immunotherapy and my previous PET CT had shown no evidence of disease. I had sailed through most of the treatment with so few direct side effects, that – a persistent but expected low white blood count notwithstanding – I was convinced I’d be one of the 10-year-in-remission patients.

My doctor shook her head empathetically. “There are statistics,” she said, “and then there’s Brian.”

She tried to reassure me. “You’re not dying,” she stressed several times. “There are more treatments we haven’t tried yet that could result in a durable remission,” although many are harsher than the chemo I’d already endured and that had apparently failed. There are clinical trials, too. 

She ordered a new biopsy to figure out what we’re dealing with.

I took it all in, but for the most part, just sat there quietly, without words, my mind stuck on stun. 

For the moment, I was all out of simulations.

I first wrote about running simulations in The Jerusalem Post.

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Last week marked our “aliyah-versary.” Twenty-five years ago, on October 10, 1994, my wife, Jody, and our two young children immigrated to Jerusalem from Berkeley, Calif. A third child – our only Sabra – was born a few years later.

The Blum family in the sukka, 2019

So, on this, the silver anniversary of our Israeli citizenship, I present 25 reasons to make aliyah (not in any particular order). 

1. Bilingual children. For every moment that I’m frustrated I can’t speak Hebrew decently, I am so proud of my children for being completely comfortable in both languages. Even if it’s difficult for me, I appreciate the unprecedented renaissance of our ancient tongue. 

2. National health insurance. Whenever I hear a story of a friend in the U.S. having to fork out a huge co-pay or being denied coverage for a critical cancer treatment, I am grateful for the universal healthcare we have here. I’ve never been turned down for a medication and I don’t stress about $15,000 deductibles. 

3. Properly spiced food. We took a luxury cruise out of Miami earlier this year. The food was plentiful and prepared beautifully. But it was always missing something. Israeli food – whether it’s local or an Israeli fusion spin on an international delicacy – is always a well-spiced delight for the palette. Also: falafel.

4. Tel Aviv as the vegan capital of the world. In a Jewish world where the rabbinate’s kashrut department has become irredeemably corrupt, vegan is the new kosher. 

5. The Startup Nation. Israel’s bustling high-tech scene always gives me plenty to write about. Plus making aliyah no longer entails career suicide.

6. Dress code. Admittedly, no one in Silicon Valley wears ties anymore, either. But I love not having to dress up to go to work or a wedding. 

7. Medical breakthroughs. CAR-T was invented here. It’s saving lives for people with blood cancers. Maybe someday it will save mine.

8. Mandatory army service. After nearly three years in the IDF, our young people enter college older and having shouldered incredible responsibility compared with their peers elsewhere. The army is also Israel’s ultimate melting pot.

9. Proximity to cool travel destinations. We’re just a few hours from nearly everywhere in Europe, on the same time zone as Africa and there are direct flights to all over Asia. Ben-Gurion Airport is manageable, efficient and attractive. And you don’t have to take your shoes off or dump your water at security. 

10. The cost of education. $3,000 – that’s all it costs for a year of school at a top university. Public elementary and high school are also so much less expensive than Diaspora Jewish day schools. 

11. Israeli television. Netflix just can’t get enough: Fauda, Shtisel, False Flag, Prisoners of War. Move to Israel and you can watch them here first. 

12. Religious pluralism. Yes, despite the Orthodox monopoly, post-denominational congregations across the country are reinventing pluralistic prayer, with rock and roll piyyutim moving onto the bima.

13. Datlashim. When you leave religion, it’s a statement of status, a shift still within the national-traditional spectrum, rather than a pejorative like “Off the Derech.” 

14. The weather. There’s nothing quite as lovely as walking in short sleeves on a temperate summer night in Jerusalem. And when much of the world is buried in snow, Tel Aviv is still warm in the winter. 

15. A kid-centric country. Our children walk to school, take public transportation, go camping alone at age 15 and hang out until the wee hours of the night without fear of kidnapping. Strangers care about your kids (sometimes too much). 

16. The calendar. The national and Jewish holidays are one and the same. Shabbat is (mostly) a day off. You don’t have to burn all your vacation days for the Jewish holidays. And keeping two Passover Seders – forget about it.

17. The Israel Trail. One-thousand kilometers winding through deserts, forests and cities. Hiking is a national pastime shared by young and old.

18. Jacob’s Ladder. This musical weekend at the Sea of Galilee has been a huge part of much of our aliyah. It lives up to its reputation as Israel’s friendliest festival. 

19. The Yuri Shtern Holistic Center and Refanah Healing Holidays. If you have to get cancer, these two organizations can make a huge difference, with discounted massages and free vacation nights in Israeli hotels. 

20. Being part of something greater than ourselves. Israel as a national project began before we were born and will end (hopefully) long after we’re gone. That gives intrinsic meaning to life here. 

21. Pardes. Pluralistic, egalitarian Torah learning in Jerusalem. It’s where Jody and I met.

22. History. Every time you pick up a rock, you might discover a new archaeological site. We don’t go to the Western Wall much these days, but we’re glad it’s still there after 2,000 years.

23. Israeli music. Attending a concert in Israel, where everyone knows and loudly sings along to the lyrics in Hebrew, is an unmitigated blast. Bands like Kaveret and Gazoz stand up to the best of 60s and 70s Brit pop.

24. Gun control. It’s remarkably difficult to get a gun license and mass shootings at schools are virtually unheard of. 

25. Friends and community. This is a hard one to quantify, but we have undoubtedly made the best friends of our lives in Israel and found supportive Jewish communities of interest. I don’t know if that would have happened everywhere. 

Bottom line: after 25 years, this is home. 

I first posted my list of 25 reasons to live in Israel at The Jerusalem Post.

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Scanxiety

by Brian on October 2, 2019

in Cancer,Mindfulness

I’ve got scanxiety and it’s hitting me hard.

Scanxiety is what happens when you’ve just done a major radiological test – a scan – and you’re waiting for results. In the case at hand, it was my latest PET CT to check if my chronic cancer is still in remission. Worry about the opposite result is what leads to scanxiety.

A PET CT is an overwhelming experience. It seems almost designed to trigger fear. It’s not just the machine, which takes up an entire room (you lie on a moving platform which glides you in and out of the whirring mechanism – it could be fun if the stakes weren’t so high). 

There’s also the fact that, in order to do the scan, you have to be injected with a radioactive dye. A special bathroom nearby is designated solely for radioactive pee. 

After the dye is in, you’re instructed to sip two full cups of flavored sugar water over the course of 50 minutes. Cancerous tumors, it seems, gobble up the nearest available sugar, which when combined with the radioactive contrast, rushes to any tumors, which subsequently light up under the machine’s watchful eye.

Fear of recurrence is the ugly elephant that refuses to budge from the living room of the anxious mind. While this is a classic hallmark of living with a chronic cancer like mine, it’s relevant to cancers that can be “cured” but where you can never quite let down your mental guard because there’s always a chance, however statistically rare, that it could come back.

Indeed, the American Cancer Society found that a year after being diagnosed, around 2/3 of the people they studied said they were concerned about their disease returning. 

That a fear of recurrence is so prevalent shouldn’t be surprising: negative “what if” thoughts appear to be an integral part of the human experience – as unavoidable as the common cold. 

“Half the world is on the low positive affective spectrum,” explains Dr. Martin Seligman, former president of the American Psychological Association and the “father” of the positive psychology movement. 

Pessimism, in fact, may have been selected during human evolution. “The mentality that said, ‘it’s a beautiful day in San Diego today, I bet it’ll be beautiful tomorrow’ got crushed during the Ice Age,” Seligman explains in his new book The Hope Circuit. So-called “bad weather animals, who were always thinking about the bad stuff that could occur” were more likely to survive.

In that backhanded way, fear of recurrence brings its own advantages when it comes to something like chronic cancer. It can lead one to be more vigilant, not missing or postponing that annual test, and being mindful of changes to the body that should prompt immediate medical attention. 

What makes less sense: getting stuck in worry and obsessive rumination. Which is where I am with my post-CT scanxiety.

How do you fight a way of thinking that is hard-wired into humanity since the days when we were painting pictures of wooly mammoths on cave walls? 

The Mayo Clinic has a few tips to reduce fear of recurrence.

“You know more now.” Think about how much you didn’t understand when you were first diagnosed, the Mayo Clinic suggests, and compare it to now. That’s certainly been my experience: I’ve been forced by dint of necessity to become an expert in treatment options. When a relapse eventually comes, I won’t be going in as blind as the first time.

“You’ve built relationships.” I have a doctor, I know my way around the hospital, we’ve worked the HMO-approval bureaucracy. 

“You’ve done this before.” Yeah, it’s no fun to head back into a period of prolonged fatigue, nausea and pain, and I won’t pretend it was “easy” the first time. But, like running a marathon or climbing a mountain, the end seems closer when you’re no longer a newbie. 

If this sounds like yet another reminder of the value of mindfulness, Seligman says that’s not necessarily the goal. 

“What distinguishes human beings from all other animals is that we’re creatures of the future,” Seligman says. Indeed, so much of our mental life is concerned with what’s to come, “the notion that we should live more and more in the moment denies what, evolutionarily, we’re really good at.”

I’m not sure that trading in mindfulness to focus on the future is the right call. But either way, there is something to be gained from perceiving reality with eyes wide open: you can help others.

A few months ago, a good friend of mine WhatsApp’d me. 

“Can you talk? Like, right now?” he wrote. 

I picked up the phone. It turns out my friend had just been diagnosed with the same cancer as me and he was panicking. He’d been reading my columns and wanted advice. 

I had plenty to give. 

“You won’t die from this, you’ll most likely die with it,” I told him, parroting one of the repeated lines that has been at once helpful and profoundly frustrating when stated by doctors and other lymphoma patients. 

But it was the first time he was hearing that aphorism, and he found it comforting. The Mayo Clinic was right: I know more now. I’ve been through this before.

I don’t expect to ever rid myself entirely of scanxiety – nor do I want to. Still, it’s nice to know that this understandable and evolutionarily-justified fear can be channeled into something productive – if not for me, then for those I care about.

I first shared my fear of scans on The Jerusalem Post.

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I hadn’t seen Miriam in months, but she’s been following my cancer and health columns here and online. My wife, Jody, and I bumped into her at a lecture a few weeks ago.

She spotted Jody in the crowd first. “How’s it going?” she said, casually, before turning to me. I saw the corners of her mouth drop a bit and her brow furrow as she sought the right words. 

“How ARE you?” she said, after an awkward beat, putting the emphasis on the second word, which was drawn out in a way meant to signal compassion.

If Miriam wasn’t entirely comfortable with what to say, the truth is, neither was I. These days, how to respond is not as clear-cut as it was a year and a half ago when I was first grappling with my diagnosis and had a practiced, if pat answer.

Back then, I was “the cancer guy.” That was my public persona and I embraced the opportunity to educate, to console, perchance to inspire. But today I’m not sure I’m still looking for such notoriety. 

“You know, when you open up about this in the newspaper, that’s going to become part of your identity forever,” Jody said to me when I was first deciding whether to write about my health. “Are you sure that’s what you want?”

“What other option do I have?” I responded, convincing myself that taking the plunge was inevitable. “My life online is already an open book. My religious beliefs, my political convictions, even our love life.”

As much as I might feel the urge to bury the past year and a half and move on, posting pictures of mountain hikes not Hadassah Hospital waiting rooms, that’s not really honest either. Mine is a chronic cancer which, like so many other protracted pains and illnesses, has no cure and is guaranteed to return, whether that’s in 6 months, 5 years or longer.

So yeah, I’m still the cancer guy, whether I like it or not. As a result, when someone like Miriam asks me how I am, the answer is complex. 

Do I launch into a novel-length narrative of my latest aches and pains? Should I revert back to the succinct “fine, thank you” quickie of my pre-cancer days? That wouldn’t be untrue – right now, at this moment, I am mostly fine. What I’ll be in another month, I can’t know.

When I was in the thick of my first round of treatment, I had what seemed like an authentic rejoinder: “I’m up and down, depending on the hour. This is a [fill in the blank] hour.” 

Is that still an appropriate response?

This is not a question I have to grapple with alone. Chronic illness and pain affect nearly 50 percent of the U.S. population, each of whom must decide how to answer their own “how ARE you?” questions while living with an often-invisible illness where symptoms are not obvious to the casual observer. By 2025, a projected 164 million Americans will be chronically ill. 

“One of the punitive effects of pain is that it is unsharable,” writes Karen Duffy in her book Backbone: Living with Chronic Pain Without Turning into One. “Pain is subjective. It is unknowable unless you are afflicted with it.” 

When you live with chronic illness, chronic pain or chronic cancer, you have to get comfortable with being uncomfortable.

Joy Selak and Steven Oberman write in their book You Don’t Look Sick! Living Well with Chronic Invisible Illness that there are five stages of this kind of disease: 1) getting sick, 2) being sick, 3) grief (for the loss of the person you once were), 4) acceptance (of who you are today) and 5) living well with the illness.

I breezed through steps 1 and 2, I’m actively dealing with step 3, but I seem to have gotten stuck on step 4 – acceptance. 

Ilana Jacqueline has some wise words on that topic in her book Surviving and Thriving with an Invisible Chronic Illness

“Acceptance isn’t about making you weak from the battle of fighting your disease,” she writes. “It’s about building a smart and capable foundation from which a relapse can’t knock you down.”

“Accepting being ill with an invisible chronic illness means knowing yourself, knowing when to rest and when to work, when to play and when to watch, when to exert energy and when to conserve it,” add Paul Donoghue and Mary Siegel in Sick and Tired of Being Sick and Tired.

To that I’d add knowing how to respond.

When I was first diagnosed, I wrote an article in which I quoted Letty Cottin Pogrebin. The founder of Ms. Magazine described in her book How to be a Friend to a Friend Who’s Sick why the “how are you question” becomes a loaded one for someone who’s ill, as they now have to “decide on the spot, questioner by questioner, friend by friend, situation by situation, how candidly to respond.”

Over the course of the last year and a half, I’ve replied in different ways at different points in my treatment. Yet, the question remains: How do I want to be addressed now?

Here’s my new bottom line: Just ask me “How are you?” No added emphasis, no furrowed brow. I don’t want you to forget what I’ve been through – if I know you know my backstory, I may choose to give you a little extra detail. Or I may just politely demure. 

If you’re listening carefully, that can be just as telling.

I first wrote about what to say 18 months later in The Jerusalem Post.

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New kosher restaurants make dining out on Shabbat a mitzvah

September 1, 2019

A few weekends ago, my wife, Jody, and I ate out in a kosher restaurant open on Shabbat. In Jerusalem of all places.

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Bubbles of happiness

August 18, 2019

This week’s column is about how to find happiness when our bodies conspire to push us in the opposite direction. Hint: it’s all about the bubbles.

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Datlashim: can there be a second generation?

August 4, 2019

Last year, I wrote a column that asked the question: “how do datlashim – the Hebrew acronym for formerly religious Jews – want to raise their children?” The main response I received during the course of my research: “to be just like them”– that is, to also be datlashim. This poses a dilemma, as to […]

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Flunking out of blood school

July 21, 2019

I flunked out of blood school last week. I wasn’t expelled exactly, but my scores dropped significantly enough that I was put on probation.

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Sex and religion come together in new podcast

July 7, 2019

Sex and religion are two of my favorite topics. So when I heard about this new podcast, I knew I’d have to write about it. A review.

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