October 5, 2000
Too Much a Mirror
An encounter with the doctor behind "Gideon's Crossing" turns into a life-saving friendship
"Try to be one of those people on whom nothing is lost!" Henry James' advice to the beginning writer, expressed so exuberantly in his 1884 essay "The Art of Fiction," is a credo worth adopting for any sentient person. Notice everything, make the most of every experience, and, one might add, be thankful for even the smallest gifts of daily life. The Jewish tradition, by establishing a set of specific blessings upon everything from bread and wine to viewing a rainbow and emerging from the commode, mandates such an attentive, appreciative way of life. In so doing, it imparts sanctity to the mundane.
To be frank, I am a selectively observant Jew and do not habitually murmur the ritualized blessing every time I wash my hands or eat a peach. But I can assure you that I strive each day to abide by the wise words of Henry James and the ancient rabbis whose spirit he echoed. And if you ask any other cancer survivor, chances are you will hear something similar. Ten years of grappling with lymphoma and leukemia have made me, to put it mildly, a different person. A better one, I hope. In any case, a person who takes nothing for granted.
Jerry Groopman knows well of what I speak, both generally and in my particular case. We were introduced by a mutual friend about 25 years ago, when I was a cub writer at Time magazine and he was a med student at Columbia. Our friend, a soulful woman from a Mayflower family, said to me one day: "You have to meet my friend Jerry. You're both very tall - and very Jewish." Truer and more portentous words were never spoken. The Jews call such a matchmaking beshert (destined).
Within a few years, Jerry and I were both living in Los Angeles. He was a hematology-oncology fellow at UCLA; I had morphed from journalist to screenwriter. It was I, it can now be told, who introduced him to sushi, someplace in Santa Monica. As we awaited our order, he regaled my girlfriend and me with a textbook litany of parasitic diseases traceable to raw fish. I encouraged him to lighten up and enjoy his meal, which he bravely did, with memorable gusto, and we have been fressing tuna roll together ever since. At the bris of his son Steven in the fall of 1982, I was privileged to serve as anesthesiologist, in other words, the guy who sticks the gauze soaked in wine in the screaming kid's mouth. The honor was amplified by the fact that I was the only friend in attendance who was not a medical doctor.
Then Jerry and I both headed east to fulfill our Jewish destinies, he to become a Harvard professor of medicine who wrote on the side - Maimonides also had a solid day job, as court physician to the Egyptian caliph - and I to marry a native of Sacramento who had made aliyah and refused to move back to America. My leap from Hollywood to Jerusalem - the antipodes of modern Jewish dreaming - was rendered more adventurous than anticipated by the outbreak, two years after my arrival, of the Gulf War. Night after night, in that eerie winter of 1991, I sat with my pregnant wife and my parents, wearing gas masks like a family of aardvarks, the windows sealed with plastic sheeting, our toddler Dani caged in an army-issue plastic incubator, as Saddam Hussein's Scud missiles wobbled overhead en route to Tel Aviv. The first sign of illness was that I found it harder than did the others to breathe through the mask. The doctors initially thought I had bronchitis. An X-ray showed a large mass in my chest. I immediately called Jerry. The next day, Roberta, Dani and I were on a plane to Boston.
For a week we stayed at Jerry and Pam's, keeping our voices down around his young sons as we discussed the ominous findings that came back daily from the hospital lab. Non-Hodgkins lymphoma. T-cell, an aggressive strain. B-symptoms, fever and night sweats, were in evidence, indicating an advanced stage. In the midst of these depressing revelations, we got a phone call from Jerusalem. Roberta's amniocentesis results were in. Our new baby, due in July, was a girl. Roberta and I held one another tight, spinning in a maelstrom of wildly mixed emotion, and decided in an instant: we would name her Rafaela, which means "healed by God."
"Only if I live," I added. "If I die, you're on your own."
We weren't the only ones wrestling with mixed emotion. Jerry had some agonizing decisions to make: How much to tell me about my odds for survival. How to be involved in my treatment. He could not, he decided, be my doctor. We were too close. For the first time in his career he found himself unable to muster the necessary detachment. As he phrased it years later, our mutual friend in New York had read us exactly right. I was "too much a mirror" of himself.
Cancer patients and their families know well that finding the right doctor is half the battle. There is no Consumer Report to guide you, and the decision, or the luck of the draw, may be the difference between life and death. Jerry entrusted us to a colleague in Berkeley, an extraordinarily gifted physician named Jeff Wolf. We moved into my in-laws' home in Sacramento and lived there for nine months while Jeff led me through an arduous course of chemotherapy. "It's like a marathon, and I'm your coach," Jeff told me the first day. "You put one foot in front of the other. You will fall, and I will pick you up." In the midst of the treatment, my daughter Rafaela was born.
In the fall of 1995, with no trace of lymphoma remaining, I went to Boston to visit the Groopmans on the happiest of occasions, Steven's Bar Mitzvah. It was Rosh Hodesh Kislev and Jerry asked me to serve as chazan for the chanting of "Hallel," the prayer of thanksgiving. Neither he nor I needed to articulate the depth of our feeling on that blessed day.
Less than six months later, the unthinkable. A secondary malignancy: acute leukemia. Jerry and Jeff quickly agreed that the only way out was a bone marrow transplant. My brothers were tested; Josh, a Jerusalem lawyer, was a perfect match. Jeff transplanted me in Berkeley on July 26, 1996, Rafaela's fifth birthday, one day past Tisha B'Av. Here is the e-mail, signed with the Hebrew nickname Jerry always calls me by, that I blurted from my laptop in my hospital room the next night, a mash of medical jargon and Jewish shorthand emblematic of our redoubled bond:
It's Saturday night of Shabbat Nahamu and I am consoled that things have gone very smoothly so far. Ten bags of stem cells infused yesterday with only the garlic odor of DMSO and a few little hives quickly dispatched by Benadryl to cloud the experience... Jeff has started me on Cyclosporin and Methotrexate to ward off the GVH effects, and insulin to keep sugars in line, and IV Heparin to prevent Hickman tsuris and maybe benefit my liver, and IV Flagyl, plus a menu of IV antibiotics and pills against herpes and fungi, and every time a tray of the most execrable food you wouldn't feed your dog arrives on my table I ring the nurse and request 0.5 mg of Ativan and manage somehow to get the glop down... Sang Carlebach songs to myself during TBI, read Eicha in my room with two friends, read Tehillim during the transplant, and watching the Olympics - triumph! health! - is a palpable tonic. Terror is everywhere, but that's where the Zoloft really helps... Seems to me that in the specs for Zoloft they ought to indicate that it enables the patient to differentiate between chicken shit and chicken salad, as they say in Texas. Shavuah tov.
It is that last differentiation, too often obscured in the hurly-burly of normal life, which Henry James more elegantly had in mind, and which, during these Days of Awe, Jews the world over are pondering anew. What is important, and what is trivial? How can we be better people in the year to come, more alert to the real needs of our families, our communities? How can a sense of our own fragility, dramatized by the Judgment Day scenario of the High Holidays, enhance our appreciation of every New Year, every new morning?
In his powerful and profound book "The Measure of Our Days," Jerry writes of a colleague he calls "Dan," a scientist newly diagnosed with AIDS, an agnostic Jew, who invokes the stark, familiar liturgy as he speaks for the first time of his illness: "On Rosh Hashanah it is written and on Yom Kippur it is sealed/ ...Who shall live and who shall die/Who early and who late/Who by fire and who by water..." These shattering lines, according to legend, were composed by one Rabbi Amnon, as he lay bleeding to death in medieval Ashkenaz, the victim of murderous anti-Semites.
You don't have to be a leukemia patient, or otherwise in extremis, to savor "the marrow of life," in Henry David Thoreau's apt phrase, but it helps. We lucky ones who have been there and are still here have learned to make a virtue of necessity, to find our footing in the minefield of mortality. As Jerry wrote so movingly of his late colleague: "He taught me that accepting life's uncertainty can paradoxically overcome fear and enhance survival." For Jerry and me, that shared recognition is an article of friendship, and of faith.
Stuart Schoffman is an Associate Editor of the Jerusalem Report and a columnist for the JUF News of Chicago. His e-mail address firstname.lastname@example.org