Pay mindfulness forward

by Brian on July 9, 2018

in Cancer,Mindfulness

“You’re going to feel so much better in a week.”

I don’t know if it was a pep talk or my doctor’s analysis of my cancer, but those words of encouragement, uttered two days before my treatment for follicular lymphoma was to start a few months back, buoyed me through the initial fears and side effects of starting a 2-year process of chemo and immunotherapy.

It also set my expectations high – really high. So when I came back to Hadassah Medical Center for my second treatment a week later, it was hard to hide my disappointment.

“How do you feel?” my doctor asked with her usual cheer.

“In general, I’m tolerating the meds well,” I responded, which was true. I hadn’t wound up in the emergency room with a high fever or an infection. I’d had no allergic reaction while receiving the IV itself, which is another common concern.

Yes, I ached all over and felt fatigued much of the time. “But those are manageable,” I said, reassuring myself as well as my doctor. “It’s the stomach aches that are the worst. And that’s got me worried.”

Worried, because it was abdominal pain that sent me for that first ultrasound (the one that caught the cancer early) and now there seemed a distinct possibility that the pain might not go away with the cancer treatment; that the knife stabs to my stomach that I was experiencing daily might be caused by something entirely unrelated to my cancer.

“I’m afraid,” I told my doctor, “that this is going to be how I’ll feel for the rest of my life. That I’ll get to remission from the cancer but still be suffering from chronic pain.”

“Let’s not worry so much about a year from now,” she said. “How about we try to just get through the next week?”

Anxiety about the future has been one of my emotional bogeymen for as long as I remember.

It comes from an understandable place – it’s what makes us human. After all, human beings are the only animals that can even imagine a tomorrow. We play out in our minds multiple possible responses to everything. That allows us to think strategically; to be three steps ahead in a negotiation.

But when it fuses with worry, “future thinking” is decidedly less helpful.

I’d already begun to deal with this even before my cancer diagnosis.

I set out on a speaking tour of the U.S. at the end of 2017 to promote my new book. Yet every time I started my spiel, my stomach would flare up.

When I returned from the trip, I met with my therapist who suggested I try a variation of “pay it forward.”

“Can you derive any enjoyment at all from these talks?” she asked.

“Well, when the pain has subsided and I reflect back, I feel pleased about the job I did and the way the audience reacted,” I replied.

“So, can you bring some of that good feeling you know you’re going to get in the future into the moments when you’re actually talking?” she continued. “Even if you’re physically uncomfortable?”

“That’s not very mindful!” I chided her. I’d long ago internalized the meditation mantra that you should always strive to focus on the present and the feelings you’re having right now.

“I’m just suggesting a way to give those ‘future feelings’ more prominence in the current moment,” my therapist said. A kind of an “anti-mindfulness mindfulness.”

The concept was not unfamiliar to me. When we used to camp at the Jacob’s Ladder music festival (before we started renting a room with a proper bed), I would never get more than 3-4 hours of sleep. The tent was too cold. Then it was too hot. There was too much noise from the kids next door.

I’d walk around the grounds for the next two days in a daze.

But there’s so much more going on at the show: all the music, connecting with old friends, the late night jams by the Sea of Galilee.

How much of my overall experience was not feeling well? Ten percent? Why should I let just one element, already in the minority, define the entire weekend?

Here’s another way of looking at it: What’s the cost-benefit analysis on the weekend as a whole? Does the discomfort outweigh the positives? Would it be a reasonable decision to skip out on the festival entirely just to avoid the possibility of not sleeping? Of course not.

“The things we generally value most in life bring with them a whole range of feelings, both pleasant and unpleasant,” writes Russ Harris in The Happiness Trap, a primer on ACT – Acceptance Commitment Therapy. He gives the example of an intimate relationship, which comprises desirable feelings like love and joy, but is also hard work with inevitable ups and downs and emotional pain.

To be sure, it’s not always possible to willpower your way past pain, especially when it’s chronic. But I’ve already found this technique helpful as I settle into my new normal.

Maybe I won’t feel better in a week, I told myself. Maybe it will take a month. Or a year. Or it won’t happen at all. My job is to accept whatever reality is mine (including the pain), while at the same time committing to embrace the bigger blessings in my life – those that are happening right now and those that I can imagine enjoying in the (hopefully very near) future.

I first paid mindfulness forward at The Jerusalem Post.

Photo of Hadassah Medical Center via Wikimedia Commons, taken by David Shankbone

{ 0 comments }

The Babylonian Talmud tells the story of the great rabbinic leader Rebbe who in the third century CE developed a malignant gastro-intestinal disorder. His followers set up a non-stop prayer vigil in the courtyard of his house. The idea: as long as they continued to pray, he would live.

His maid, however, felt that Rebbe would be better off ending his misery and smashed a large ceramic jar nearby. The loud noise startled the petitioners and broke their concentration. At that very moment, the Talmud relates, Rebbe died.

Jewish educator Dr. Elliott Malamet presented that story to illustrate a point in a provocative new talk he’s dubbed “Faith, Interrupted.” His lecture delves into the changing nature of belief and the rise of “rational” Judaism.

Malamet first needed to explain just how much the world has transformed since the advent of a scientific worldview – even amongst the religious. If, in a pre-modern age, the ancients ascribed cause and effect for inexplicable events to invisible deities and demons, today we know where to draw the line.

Malamet compared the prayer vigil at Rebbe’s house with a modern equivalent: life support technology. “Aren’t the two essentially the same?” Malamet once asked a class, only somewhat rhetorically. “You pull the plug and the person dies. You stop praying and the person dies.”

“Come on, Professor,” one of the students, who identified as Orthodox, responded. “The life support system, that’s science. But prayer, we all know that’s not how it really works.”

“The fate of our times is characterized by rationalization and by the ‘disenchantment’ of the world,” wrote the German sociologist Max Weber in 1918, one of 35 citations Malamet brought to his talk. By “disenchantment,” Weber was referring to the belief that “there are no mysterious incalculable forces that come into play, but rather that one can, in principle, master all things by calculation.”

In that respect, nearly all Jews today are “rational,” Malamet explained, in that we can clearly contextualize the limits of religious phenomenon. Rational Jews intuit which thoughts and behaviors to assign to the religious domain, and which remain beyond it.

Contrast that with the pre-modern “irrational” era of Rebbe, where God controlled everything, disease was an inexorable riddle and miracles were everyday occurrences.

We take the steady drift away from our irrational prehistory as a given. But it prompts a tougher question with a less certain answer: is the rational approach to Judaism we have today sustainable over the long-term?

That is, can a Judaism that cohabitates with the modern world continue to propagate well into the 21stcentury? Or has the breakdown of a once shared, if simplistic, understanding of how the universe works irreparably wrecked the system?

In 2011, Moment magazine asked a group of prominent Jewish leaders this question: “Can there be Judaism without belief in God?” While that takes the discussion of rational Judaism to a supernatural extreme, one rabbi’s response was nevertheless telling.

Rabbi David Wolpe is a leader in the Conservative movement. He says yes, there can be a Judaism with a less proscribed attitude towards the divine. But it will continue only “briefly, as it cannot reproduce itself … It can last a generation or two but will disappear without the roots that gave it nourishment. I don’t believe that people will continue to light Shabbat candles because it’s a cultural practice.”

Transmitting such a Judaism, Wolpe concludes, “will be an insurmountable challenge.”

That’s a pretty bleak prediction. But could Wolpe be right?

Rabbi Nachman, founder of the Breslow Hassidic movement, tackled a related problem some 200 years ago. If God was everywhere, as Jewish mysticism proclaimed, he pondered, how could there be room in the universe for human beings?

Unable to resolve the paradox, Nachman wrote in his seminal Likutei Moharan that one must “cast aside all rational processes and serve God simply.” Mental understanding, he added, “is not essential.”

Even if Rabbi Nachman could not have anticipated the challenges of the scientific age, his conclusion was clear: only an approach to Judaism that deemphasizes thinking can persevere.

Two opinions, however respected their authors may be, do not foretell an immutable future, of course. But still: is it possible that, in another 50 or 100 years, just the irrationalists will be left standing?

Then I remembered where I live. While there’s no shortage of irrational Jews here in the Holy Land, Israel is flourishing as a bastion of rational Judaism. That’s in large part because we’re not just another denomination but a full-fledged nation and as such we don’t have to pay liturgical lip service to our irrational roots. When Jews light Shabbat candles in Israel, it can be part of our national traditions, not only as an expression of religious doctrine.

We may not exactly be secular, and the separation of church and state is hardly even a concept here. But we are at our core rational, and our identity as Israelis does not require that we revert to irrationality in order to survive.

Yes, Israel is still a work-in-progress. I’m not sure anyone would be entirely satisfied if, say, the recent holiday of Shavuot was reduced to cheesecake and water balloon fights.

But Israel can serve as the proverbial light unto the nations – in this case for the Jews. What we’ve built here, as unlikely as that seems these days given the ever-growing rift with our Diaspora brethren, can actually be an inspiration – or at least the starting point in a longer conversation – for Jews everywhere looking to strengthen a rational, enduring approach to tradition.

I first looked at rational vs. irrational Judaism in The Jerusalem Post.

{ 0 comments }

Famous germaphobes

by Brian on June 10, 2018

in Cancer,Science

I recently joined some dubious celebrity company. Among my companions are Michael Jackson, Howard Hughes, Cameron Diaz and Donald Trump.

What do we have in common? We all suffer from mysophobia. That’s an irrational fear of germs.

Donald Trump, for example, is so germophobic that Newsweek reported last year that he “needs to drink through a straw because he wants to avoid contamination” and that he washes his hands “as much as possible.”

Michael Jackson famously wore surgical masks and gloves in public. Howard Hughes would lock himself in his “germ-free” hotel room for months at a time.

My mysophobia is less obsessive, more practical and hopefully quite temporary. Blame it on the cancer.

When I started chemotherapy a few months ago, I asked my doctor whether I could go out in public. The concern is that chemo wrecks your immune system. So if you catch a common cold or a stomach bug, rather than simply stay in bed to recuperate, you could wind up in the emergency room getting pumped full of antibiotics.

“Try to avoid enclosed places with a lot of people,” my doctor advised. “And don’t shake hands. That’s the most common way to pick up a bacteria or virus.”

“Sure, I can do that,” I replied confidently. But the reality was a lot easier said than done.

In particular, I now had to figure out a whole new way to greet people, along with a litany of clever excuses when someone extends a hand.

I could have just blurted out, “I’m not shaking hands because I have cancer.” But that’s not always a discussion I’m ready to have, especially with strangers.

My more discreet response: “I’m not feeling well, so I’m not shaking hands right now.” First of all, it’s true. And it makes me seem like I’m more concerned about the health of the other person.

To wit: a few weeks ago, my wife Jody and I were invited to a Shabbat dinner at the home of some new friends. We didn’t know any of the other people there, which meant I’d have plenty of opportunity to practice my new line.

“That’s very considerate of you,” said Mark, one of the guests, as I kept my hands firmly at my side.

But when it turned out we were seated next to each other at the dinner table, Mark started to squirm. He moved his chair slightly away from me. “Just how, you know, contagious are you?” he asked hesitantly.

“Oh, I’m not contagious,” I admitted. “I’m worried about getting sick from you!” I then explained about the chemotherapy and I saw his expression morph from apprehension about his own health to compassion for the cancer guy.

With friends who know what I’m going through, I’ve developed a special kind of greeting: the “elbow-bump.” Rather than extend a palm, I jut out my right elbow. We do a little dance and have a laugh, which gives me the chance to explain what it means to have a neutrophil count of only 1.4.

“If you do shake someone’s hand, just avoid touching your face afterward,” my doctor said.

I’d have to be a pretty flexible yogi to bring my elbow all the way to my mouth.

There have been a few times where I had no choice but to shake hands. Once, I was interviewed by a Swedish journalist who covers electric cars about my book. We were at an Aroma cafe. I decided up front that cancer didn’t need to be part of that conversation.

“Excuse me for a moment, I need to use the toilet before we start our chat,” I said. I then quickly washed my hands. I figured his Scandinavian politeness wouldn’t begrudge me that favor.

Not that restrooms are the cleanest places. The website TravelMath tested the surfaces in an average hotel room to find out which were the “germiest.” The bathroom counter topped the list with 1,288,817 CFUs (that’s “colony-forming units”) per square inch.

Running a close second: the TV remote control. Interestingly, 3-star hotels came in considerably less germy than 5-star properties.

Being a germaphobe can be crazy-making. Once, I had an appointment in downtown Jerusalem. Normally, I’d drive, but Jody needed the car that day. I planned to take a taxi. Just as I got to the main street, though, an Egged bus that would take me right where I needed to go arrived.

It wouldn’t take much longer on the bus, I thought to myself. And it would cost so much less than a cab. I hopped on.

Immediately I realized I’d made a mistake. As I scanned the vehicle packed with people, windows closed, I imagined myself aboard a rolling petri dish of bacteria all gunning for my white blood cell-deficient system. If I could just get to a seat and keep my hands to myself…

The bus lurched forward and I had no choice but to grab one of the bug-infested poles. I sat down, defeated and anticipating my coming hospital stay.

When it was time to press the button for my stop, I tried valiantly to use my elbow. A teenager who was standing nearby regarded me quizzically, made what I imagine were some cursory conclusions before kindly using her gloriously non-immuno-compromised finger to do what had so terrified this unintended mysophobe.

I washed my hands like Donald Trump when I got home. The ER, thankfully, hasn’t seen me yet.

I first revealed my mysophobia at The Jerusalem Post.

{ 0 comments }

I was in the shower when it happened: a boom louder and stronger than any I’ve heard since the suicide bomb at Café Hillel on Emek Refaim Street in 2003. I shut off the water immediately and got dressed as quickly as I could. I raced up to the terrace of our top floor apartment and surveyed the drama unfolding below.

There was a full-size firetruck parked in front of our building in Jerusalem’s Baka neighborhood. Next to it were several ambulances. Even more unnerving, there were men and women running down the main street pushing empty stretchers. Aid workers were speaking heatedly, loud enough to be heard from my observation perch four floors above.

At this point, I had no idea what was going on, but I could use my imagination. It had to be a bomb – but why would an attacker target my building in a quiet suburb at 1:15 in the afternoon when most everyone was at work?

Perhaps it was a knife attack – that had happened in Baka 28 years ago. Three people were killed by an assailant running wild through the neighborhood’s narrow streets.

I pulled out my phone and began searching for news. Eventually the story became clear. It turned out not to be terror at all but a gas explosion in one of the four other buildings of our apartment complex.

By now, the media had picked up the story. Journalists, video crews, neighbors and random rubberneckers were crowding around the hollowed out shell of the units directly above the blast that had rippled through our shared underground parking lot.

Speculation ran wild, online and off. Search teams had been dispatched to rescue those “trapped under the rubble and to evacuate civilians,” Kol HaIr reported breathlessly. Some residents had been rushed to the emergency room. The building might be in danger of imminent collapse.

Over the next days, the entire structure was cordoned off by fences and police tape. Guards were stationed to prevent curious onlookers from getting too close and to keep looters away.

The police conducted their investigation and referred the case to the state prosecutor’s office, which is where it’s stayed, shrouded in mystery until today when, some four months later, none of the residents – not those directly affected nor their neighbors – knows the whole story, only that a worker involved in a renovation had used a blow torch to connect a gas line that was supposed to be turned off, but wasn’t. The worker died in the explosion.

When calamity strikes, an understandable response is: could that have happened to us? And if so, what do we need to do to be fully prepared?

One of the most talked about conclusions has not been how to legislate better safety standards (that’s important of course but mostly out of the hands of us homeowners). Rather, it’s something far more prosaic.

Insurance.

Residents of the eight apartments that have been evacuated now need to rebuild. But how are they going to pay for that? Barring a judgment identifying a negligent party and, assuming said party has enough coverage for the NIS 12 million estimated cost, it’s each homeowner’s structural insurance that will need to kick in.

It turns out that many of the residents don’t have anywhere near enough.

That’s because when you take out a mortgage in Israel, you’re not required to purchase a specific amount of structural insurance. So most people take the minimum. After all, you’ve just bought a new apartment – what could possibly happen?

We checked our policy and we were in the same boat: Our insurance was sufficient to fix significant damage – say if a major water pipe burst or a fire broke out – but if the entire apartment needed to be rebuilt, there’d be no way.

The smartest solution is to up your coverage before disaster hits. If you can afford it, though, there’s an even more intriguing option: “walk-away insurance.” That’s where, if rebuilding isn’t in the cards after a predetermined number of months, the insurance company will pay out the market value in cash and take ownership of your mangled apartment so you can buy a new place of similar size in a comparable location.

Insurance may not sound like a hot topic, but it’s far from irrelevant. Yes, gas explosions are relatively rare. There was a big one in Gilo in 2014 that killed three and injured 11, and another blast in Netanya in 2011 that left four dead and 90 wounded.

Rather, it’s a different type of disaster we need to be prepared for these days: the very real threat of war, with the increasingly imminent possibility that a missile from Syria, Lebanon, Iran or Gaza could hit our apartment.

My wife Jody and I poured through policies with our insurance agent. In the end, we expanded our structural insurance to cover every contingency – at least until the end of the year, at which time we’ll reevaluate.

Was it fear driving us? Sure. But that doesn’t make it illogical. We felt we were making a proactive choice given the neighborhood we live in (and by that I don’t just mean Baka).

The gas leak was a tragedy for the worker who died and an ongoing nightmare for the residents affected. The best response for the rest of us is to transform anxiety into a learning opportunity and to take practical action – even if (hopefully) all it does is enrich the insurance companies and we’ll never need to walk away.

I first made the connection between the Baka boom and insurance at The Jerusalem Post.

{ 0 comments }

I’m looking out at the sprawling Peace Wood stage, a generous grassy lawn, dotted by august Eucalyptus trees, that slopes down towards a well-equipped performance platform. Much of the plot is covered by large cloth tarps that provide shade from the mid-May sun and can swing wildly when the wind kicks in.

The stage itself is flanked by a towering speaker system with enough intensity to get a crowd of 3,000 on its feet dancing while still respecting the aural sensitivities of the older generation.

It’s Jacob’s Ladder 2018 and, as you read this, the merriment at Kibbutz Nof Ginosar on the Sea of Galilee is well underway. The annual indie, folk, country, blues and bluegrass festival has been a home away from home for many of the tens of thousands of Anglos (and an increasing number of Israelis) who have pitched a tent here over the past 42 years.

My family and I are relatively newbies, coming to Jacob’s Ladder only for the last decade or so. While our kids still sleep under the stars, my wife and I gave up camping for the luxuries of a simple rented room on the kibbutz with a spartan bed, a shower with passable water pressure and a functional air conditioner.

When we arrive, we have our Jacob’s Ladder rituals. First, we find a spot at the Peace Wood space to lay out our mat and plant our low rise folding chairs. It’s not a simple decision. Are we fully under the tarp? Which way is the sun moving? Would it be better to be further back with a clear view or close up but with that tree in the way?

Fortunately, once everything’s in place, Jacob’s Ladder’s reputation as Israel’s “friendliest music festival” is confirmed with this unwritten but critical rule: You can leave your stuff out all day and all night and no one will steal or move it. If someone does sit in your seat, you can nicely ask and they’ll vacate without a fight.

Next, it’s off to get our Jacob’s Ladder t-shirts, exchange cash for “scrip” (the Jacob’s Ladder funny money with which we pay for schnitzel from the food court and vegan chai from the tea shop) and a quick visit to the Kinneret to check how far the shore has receded.

The Peace Wood stage is just one of four set up to accommodate all the acts at Jacob’s Ladder (there are 37 this year). The eponymously-named Lawn Stage is the most laid back. The Hermon Hall inside the kibbutz hotel building is the most chill (in that it’s usually frigid from the powerful a/c). And the Balcony Stage is where overseas guests, Italy’s “Ukus in Fabula,” will be leading a ukulele workshop.

For much of the past decade, the festival’s main act has been the Abrams, a country-pop Canadian boy band that exudes evangelical love for the Holy Land. This year, the Abrams are elsewhere, replaced by home-grown Tarante Groove Machine who promise an hour of energetic world music – a very different vibe that will undoubtedly go down well with the legions of dancing teens who have created their own Jacob’s Ladder “mosh pit.”

I asked Yehudit Vinegrad, who produces Jacob’s Ladder with her husband Menachem, if choosing Tarante to headline this year was a nod to the next generation of festival goers. “Definitely,” she said. “Though we want the 71-year-olds to dance, too. Our aim is to cater to all ages.”

And to an ever widening demographic.

“The festival originally attracted mainly the English-speaking immigrants who came in the 1960s and 1970s,” Vinegrad told me. “In order to carry on the festival, we need to sell enough tickets, so we do our best to attract Hebrew speakers too.”

Another change: a special Thursday through Friday afternoon-only ticket for the growing number of religious attendees.

My musical tastes tend more to indie than Irish fiddling. As a result, I’m most looking forward to two young bands. One is the six-piece Forest, who mix up psychedelic klezmer, progressive rock, chanting, shamanism, storytelling and prayer.

The other is Kim in the Sun, a new configuration for Mika Sade who I praised as one of the breakout artists from Jacob Ladder 2017. Vinegrad was impressed enough with Sade and her Minnie Riperton-esque trills to move her to the Peace Wood stage this year. “Mika Sade is unique, original and overflowing with talent and surprises,” Vinegrad said.

Vinegrad also suggested I don’t miss the Ukrainian band, Spiritual Seasons, who focus on North European folk music; Itamar Haluts, with his infectious power pop originals; English folk music devotees The Fine Marten; and Richie and Bel, who came to Vinegrad’s attention after the lead singer “bought a ticket last year and stood on one of the main pathways and played. Lots of people stopped to listen to her.”

When the last band winds up the final notes of the traditional Jacob’s Ladder closer “Good Night Irene” Saturday afternoon, a group of stragglers who can’t get enough will head down to the Sea of Galilee where, gingerly anchoring the legs of our white plastic chairs in the rocks and gently lapping waves, we’ll hold one last jam, piloting the virtual Chevy to the levee along the City of New Orleans and already dreaming of 2019.

I “previewed” this year’s Jacob’s Ladder originally at The Jerusalem Post.

{ 0 comments }

Please don’t pray for me – here’s what you can do instead

May 7, 2018

“But you’re so healthy. You work out, you’re always hiking, you don’t smoke. And your wife’s a vegan. How could this have happened?”

Read the full article →

What getting chemotherapy’s really like

April 22, 2018

I’ve long harbored a grim curiosity about chemotherapy. Does it hurt? Do you feel like vomiting the whole time? Here’s my personal experience.

Read the full article →

What datlashim want: “children just like us”

April 1, 2018

Will your datlashi children be driving to and from your Seder this year? Rabbi Shlomo Riskin says that’s OK – even into and out of Efrat.

Read the full article →

The TV club

March 20, 2018

A TV club is like a book club only less solitary. Our club is a mini-family for our group of immigrants. What should we watch next?

Read the full article →

Fateful decisions, cancer and faith

March 6, 2018

How do you make a decision with imperfect information? That was the question in front of me as I had to decide between cancer treatments.

Read the full article →