Rethinking Who Shall Live & Who Shall Die – Kveller
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cancer

Rethinking Who Shall Live & Who Shall Die

In 2006, my 35-year-old stepbrother was diagnosed with advanced metastatic prostate cancer. Jeremy faced his disease with tremendous grace and humor.

He died less than two years later.

His death was devastating for me. Although we had different biological parents, we became brother and sister when we were both just 2 years old. Only three months separated us, and some of my fondest childhood memories involve our make believe games and mischief together.

When Jer was hospitalized leading up to his diagnosis, I went to see him. For a few months prior to that, we had argued about something trivial. I wanted to tell him how silly the whole thing was and ask his forgiveness. Tearfully, I apologized.

With my arms around him, my voice shaking, I said, “I just need you to know this. I am me because you are you.”

“Me too,” he said, and gave me a squeeze.

This moment was bookended by another heart-to-heart exchange that happened right before he died. This time, Jeremy, frail and in pain, initiated the conversation.

He spoke slowly. “I want you to know what you have meant to me. When I think of you, I think of comfort, acceptance, and love.”

My grief was great when he died.

Two years later, I moved across the country with my husband and three children. I felt a lump in my breast. I was 38 years old. I doubted it was cancer, but after what I had been through with Jer, I was not taking chances.

The mammogram looked “suspicious.” The radiologist followed up with an ultrasound. She moved the cold, goopy wand over my skin, with a grave expression on her face. Up until that moment, I had guessed that I would leave the clinic laughing about my hypervigilance and PTSD. I asked her, point blank, if I had cancer.

“You asked me a direct question, so I will give you a direct answer. This shows all the signs of cancer.”

I felt my world fall out from under me as she explained why.

Like Jeremy’s disease, my cancer was advanced. Like Jeremy, I had no known genetic risk and had lived a healthy lifestyle.

Several weeks later at my diagnostic appointment, the oncologist told me, “Ten years ago, I would be asking you if your affairs are in order. Your tumor is one of the most aggressive types of breast cancer, and up until recently, we had no targeted treatment for it. Without it, you have a 10% chance of being alive in five years. If it works for you, we can turn that around.”

A few years later, after chemo, surgery, six weeks of daily radiation, and the special drug that saved my life, I went to a retreat for young adult cancer survivors. I attended a workshop on spirituality. There was a lot of talk about making meaning out of the cancer experience, deepening our gratitude for the ordinary, becoming more compassionate.

After losing my brother, two breasts, and almost three years of my life to illness and hospitals, I was over these platitudes. I stood up to speak.

“This is all fine. I get it. But my problem is that I am mad at God.” I even talked about the
Unetanah Tokef
, which had been a grueling part of the High Holiday liturgy since Jeremy died. Who shall live and who shall die?

A surge went through the room. I had uttered the unspeakable. Afterwards people came up to thank me for my honesty. One was a hospice chaplain, himself a cancer survivor.

“Remember,” he said, “there is a such thing as holy anger. Think of the prophets. Anger can be a spiritual feeling.”

For the first time, I did not feel like my anger separated me from God. It was an honest description of my relationship.

Yes, I was angry. Who shall live and who shall die? Why him and not me? And why him at all?

To me, God is not a puppet master, looking down upon us at Rosh Hashanah deciding whom to inscribe in the Book of Life. To me, we have free will. There is randomness that we cannot grasp defying any sense of justice.

Allowing for my anger helped me find my way into the liturgy. Here is where I am with this passage today.

Life is not designed to be inherently fair. Despite popular tracts like 
The Secret
and simplistic notions of karma, there is cruelty in the universe. We only need to witness atrocities like the Holocaust or American slavery to know this.

But our religion has this possibility covered. Fate is not a meritocracy, with good people reaping the best outcomes of health and wealth. We do have free will and are expected to use it. In Deuteronomy, we are famously told, “Justice, justice shall you pursue.”

Justice is something we must seek. And holy anger may be the fuel for doing so.

For whatever reason–randomness, divine will–cancer has entered my life. Out of this pain, I have inadvertently become an advocate for young adults with this disease and for educating patients and caregivers, particularly about the social and emotional aspects of treatment and survivorship. I don’t pretend to know if I am just making meaning out of suffering or fulfilling some important pre-ordained path. But I do know it brings me comfort.

Because of Jeremy, I am not afraid to embrace those who are dying or whose loved ones are near death. I know how precious that transition is and I can be present for that. I know how much more we need to learn about cancer and what people have to endure when they are beyond the limits of medical knowledge.

Because of my own experience, I can speak to the importance of research. It saved my life, just as it stood between Jeremy and his. I can teach people to advocate for themselves and their loved ones as they navigate the frightening journey through this awful illness. I can educate people about the challenges of life after cancer.

With this perspective, the final part of the Unetanah Tokef brings me the most comfort:

But repentance, prayer and acts of lovingkindness can reduce the severity of the decree.

The severity of the decree. I like that part. Jeremy died, but he died with love and grace because he had been a good person. I got cancer and lost so much, but I have reaped rewards through my writing and advocacy.

Inscription in the Book of Life is not punishment or reward for our behavior. That is just the arbitrary way of the universe, whether or not you call that God. But our responses to what happens to us allow us to survive the intolerable.

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