Treatment Plan
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I was perfectly healthy, with no risk factors for the disease. No one in my family was sick. And I was a good person!
Fifteen minutes before Shabbos in Eretz Yisrael I got a call from my brother Danny.
“I’m in Las Vegas” he said in a thick voice. “I just overdosed. They’re taking me to the hospital.”
I have a large family and I run a busy company but the minute Shabbos was over I dropped everything and dashed to the airport where I boarded a flight to the US taking literally the last seat on the plane. I spent the next two weeks at Danny’s bedside in the hospital after which I arranged for him to enter a top rehab center whose cost I paid from my own pocket.
When I spoke to my father he was overwhelmed with gratitude. “How can I thank you for what you did for Danny?” he said his eyes brimming with tears. “You saved his life.”
“What do you mean?” I responded. “He’s my brother! How could I not do it for him?”
That was my attitude to doing chesed in general. Every Jew is my brother — how could I not help him?
Having grown up poor and been blessed with success in business I always saw it as my duty and privilege to use my G-d-given gifts to help others. I’m not the type of person who seeks recognition — you won’t see my name on any plaques or dedications — but I’ve always felt tremendous inner satisfaction from doing people favors small or large and from quietly slipping money to those in need.
I tried to take good care of myself as well. I ate healthy went for regular medical checkups and did plenty of exercise playing tennis several times a week and working out with a personal trainer twice a week. From the time I got married I paid for private health insurance that would cover the best medical treatment for me and my family anywhere in the world.
I thought I was doing everything right. I was raising a large family in Eretz Yisrael maintaining a daily learning seder and doing plenty of chesed. I felt genuinely grateful to Hashem for putting me in the position of benefactor and while I didn’t feel smug about my munificence I did feel like a good Jew.
When I was 42 I began experiencing shortness of breath during intensive tennis rallies. Having played the game for years I couldn’t understand why this was happening. I went to see my family doctor who sent me to a pulmonologist who sent me for a chest X-ray an EKG and a stress test all of which came back normal.
My last stop was at the office of an ear nose and throat specialist. “Ah you have reflux ” the doctor said. “That can sometimes cause shortness of breath.”
Happy to have finally figured out what the issue was I began taking a prescription antacid. “You might not notice any change for at least a month ” the doctor cautioned.
Several months passed and I still felt short of breath during tennis. But I got used to it.
One Shabbos morning I awoke in a fit of coughing during which I coughed up some blood. Concerned I went to see the doctor Sunday morning. My regular doctor was out of town so I saw a doctor I had never seen before. He sent me for another X-ray and immediately after he received the results he called me and told me to go for a CT scan right away.
Following that CT scan I was diagnosed with stage three lung cancer — “a smoker’s tumor ” as the doctors put it. I have never smoked a cigarette in my life.
Lung cancer is one of the deadliest forms of cancer. It typically has no symptoms in its early stages and by the time it’s detected it’s usually too late. Survival rates of stage three lung cancer are dismal.
The doctors were pessimistic about my chances of being cured. “Your tumor is located near major arteries so we can’t operate on it or do radiation ” they said. “And we don’t think chemo can get rid of it.”
Shock isn’t the word to describe my reaction to the diagnosis. How could this happen to me? I was perfectly healthy with no risk factors for the disease. No one in my family was sick. And I was a good person!
Several years earlier, I had called up my insurance agent and complained that the premiums I was paying on my family’s private medical insurance were exceptionally high. “Yossi,” he had said, “I hope you never need the insurance, but if you do, it will come in handy.”
When I received my devastating diagnosis, I thought to myself that the premiums I had paid all the years had been worthwhile, after all. As it happened, however, the doctors recommended for me by Israel’s top medical askanim all worked through the public healthcare system. I considered undergoing treatment in America, but when I sent my medical file to New York’s Sloan Kettering Cancer Center for review, their conclusions and recommendations echoed those of the Israeli doctors. So flying across the world for treatment was pointless.
Going through the public system meant that I got no preferential treatment, however. I had to wait to see the doctors, and then wait again to receive test results and hear what the doctors advised.
After my initial diagnosis, the doctors had told me that they would devise a treatment plan. They warned me, however, that I had a very rare case and they weren’t sure how to go about treating it. “We’ll discuss it and get back to you,” they said.
I waited to hear back from them. One day. Two days. Three days. A week. The waiting was excruciating. Several times a day, I would break down in tears, unable to wrap my mind around what was happening. And still I had to wait.
One day, I called up a medical askan and asked in frustration, “If I have private insurance, why can’t I just pay these doctors privately and get better service?”
“These doctors don’t work privately,” came the answer. “In this situation, money can’t help.”
“So what can I do to move things along faster?”
“Yossi,” he said, “if you want to get through this, you’re going to have to learn to be like everyone else in this world. Get on line and wait.”
For the first time in my adult life I felt utterly helpless and powerless. I, head of a flourishing company, boss of myriad employees, patron of the needy, was a nobody.
The doctors, with their worried frowns and grim statistics, weren’t offering much hope. The medical-referral askanim had no ideas. Only Hashem could help me. It was time to get off my high horse and open a Tehillim.
I had always known that Hashem was in charge. I had seen myself as His loyal shaliach, the one charged with the responsibility and privilege of helping others in need, using the resources He had granted me.
But me? I was okay. I didn’t need help. I was the strong one.
Not anymore.
What did Hashem want from me? As I waited to receive the treatment plan, I pondered the question endlessly. Wasn’t I a shining example of what a frum Yid is supposed to be? I learned Torah. I was a devoted husband and father. I sent my kids to yeshivos and Bais Yaakovs. I was the go-to guy for the local tzedakah fund, whose director would approach me any time someone in the community fell onto hard times.
I tried to be there for my own family, too, in any way possible. After every Shabbos meal, I would clear the table, put away the food, and wash the dishes. When the cleaning lady didn’t show up, I was the one who mopped the floor. When it rained, I drove my kids to school and picked them up, because I didn’t want them to get wet while they waited outside for the school bus.
Oh, sure, I had things to improve. Every Elul, I made my kabbalos for the coming year. One year, my kabbalah was to try to daven every Minchah with a minyan. But when you’re running a busy company, sometimes you have to work late, or you have a bunch of meetings in a row, or you have to travel, and you suddenly find yourself with no minyan on the horizon, only a rapidly setting sun. So that kabbalah petered out shortly after Yom Kippur, going the way of my kabbalos of previous years, such as bentshing slowly, or learning something right before I went to sleep.
Like most people, I experienced the requisite guilt every year come Selichos time, knowing that my kabbalos of the previous year hadn’t lasted and my kabbalos for the upcoming year were equally unlikely to last. But life was busy enough to distract me and fill my mind with pressing matters that overrode my “New Year’s resolutions.” The twinges of guilt I felt here and there over these forgotten kabbalos were more than overshadowed by the noble feelings I experienced when giving tzedakah, helping others, and in general living a Torah life.
From my new, worm’s-eye vantage point, where I viewed myself as utterly dependent on Hashem’s mercy, those noble feelings seemed pathetic indeed. I was just going about my life doing what came easily, without putting in the effort to challenge myself to change in a meaningful way. What I had considered being a good Jew was just — complacency.
Now that the illusion of my omnipotence and invincibility had been stripped away, I saw how distracted I was from my obligations vis-à-vis HaKadosh Baruch Hu. I would wake up, wash my hands in a daze, charge through davening, mumble brachos and then forget if I said them. My avodas Hashem was, for the most part, on autopilot, with very little engagement of either head or heart.
Yet if I bought something at the grocery, I’d make sure to check if the cashier had given me the right change. Or if I was talking to a potential client, I’d be fully present and aware of every nuance of my behavior. So what excuse did I have for my lackadaisical attitude to avodas Hashem?
Apparently, Hashem had wanted to wake me from the slumber of complacency and make me realize how dependent I was on Him. It’s not enough to do good, I suddenly realized. You have to do better. And then better yet.
While waiting to hear back from the doctors, I made a list of about a dozen areas in which I needed to improve. Say Asher Yatzar with kavanah. Always say a brachah achronah. Don’t ever get up from the table till after bentshing. Say Krias Shema al Hamittah from a siddur. Come on time to minyan and leave only when davening is over. Daven every tefillah with a minyan — and not at the last minute. And the list continued.
People had recommended all sorts of segulos for recovery, but I had a long way to go just in basic halachah before I could even consider these nice extras. I had learned Mishnah Berurah and Kitzur Shulchan Aruch enough times to know that there were hundreds of halachic details of everyday living that I wasn’t so careful about. All the years, I had consoled myself, whether consciously or subconsciously, that I was hardly alone in this regard. But when your life is hanging in the balance, the knowledge that everyone else is similarly remiss in their halachic obligations is scant comfort.
Once I started paying attention to how far I had to go in fulfilling the fundamental obligations of a frum Jew, I noticed something astounding. At a regular weekday Shacharis, there were about 100 people davening in my shul. By the time the minyan reached Ein K’Eilokeinu, there were only 12 people left! The other 88 or so had slipped out sometime after Shemoneh Esreh.
Viewed through the eyes of someone who realized how badly he needed Hashem’s mercy, this was incomprehensible. If I had an important business meeting, would I slip out when things were wrapping up? Would I come a few minutes late, as I often did to shul? Would I mumble my way through the meeting, so that neither I nor the person I was meeting with had any idea what I was saying?
Yet all my life, I, too, had treated davening as some kind of highway toll to pay and get past! No wonder Hashem had seen fit to disregard my hastily rattled prayers for health, for life, for tranquility. In His kindness, He had stopped me from bumbling through life by placing a life-threatening tumor in my path.
Perhaps the point of this illness wasn’t just to get me to daven to be healed, but also to get me to understand that I was purely a beneficiary of Hashem, not a benefactor. Whether I was healthy or sick, prosperous or poor, serene or harried, I didn’t call the shots.
In addition to transforming the way I viewed my bein adam l’Makom responsibilities, this realization completely altered the way I viewed bein adam l’chaveiro as well. When you do chesed from a place of magnanimity, you see yourself as the lucky giver and the recipient as the unfortunate taker. But when you see yourself as a pauper knocking at Hashem’s door, the help you extend to others is from a place of humility, because you understand that all that separates you from your recipient is the deposit Hashem entrusted you with. I wasn’t the successful businessman who generously supported his family and community — I was just another needy human being charged with the responsibility of distributing certain resources.
From here on, any chesed I would do would be with the humble understanding of what it’s like to be in the shoes of a helpless recipient.
It took a full month for the doctors to get back to me with their treatment plan. By then, I already had my own treatment plan. And mine was the real one.
At the time of my diagnosis, I had undergone extensive testing to determine which form of chemotherapy would be most effective for my particular tumor. The results had come back inconclusive, however, so the doctors’ treatment plan involved a standard, nonspecialized chemo regimen. To their amazement, after only four weeks of this chemo, the tumor had shrunk 30 percent. Not only did it shrink, it actually moved away from the major arteries it was threatening, enabling the doctors to operate.
Three months ago, I underwent surgery to remove the tumor, after which I had to continue chemotherapy to destroy any remaining malignant cells. I’m still receiving weekly chemo, but the doctors, those incurable pessimists, tell me I’m on my way to remission. They would never use the word “miracle,” but they do admit they never thought they’d see such good results. That was without any private doctors and without any specialized chemotherapy.
Today, my davening is entirely different from what it was before I was diagnosed. I see now with stunning clarity that the only thing that can change a person’s situation is tefillah, and that there’s no greater segulah than simply talking to Hashem and requesting His help.
Although I’ve improved my avodas Hashem considerably, and I’m continuing to pinpoint additional areas that need improvement, I’m not doing that in order to save myself; I’m doing it to be closer to Hashem. With each small halachic detail I pay more attention to, I become more aware of Hashem’s constant presence and involvement in my life. None of these things require a tremendous time investment, but they do require a level of awareness.
I reached that awareness through lung cancer. I hope others can do so without it.
(Originally featured in Mishpacha Issue 687)
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