Sunday, November 30, 2008

Solomon & The City of Brass

The following tale, brought down in Legends of the Jews, Volume 2, page 972, of one of King Solomon's adventures, bears a marked resemblance to the Arabian Nights' tale of "The City of Brass."
    Next he came to a magnificent building, into which he sought to enter in vain; he could find no door leading into it. After long search the demons came upon an eagle seven hundred years old, and he, unable to give them any information, sent him to his nine hundred years old brother, whose eyrie was higher than his own, and who would probably be in a position to advise them. But he in turn directed them to go to his still older brother. His age counted thirteen hundred years, and he had more knowledge than himself. This oldest one of the eagles reported that he remembered having heard his father say there was a door on the west side, but it was covered up by the dust of the ages that had passed since it was last used. So it turned out to be. They found an old iron door with the inscription: "We, the dwellers in this palace, for many years lived in comfort and luxury; then, forced by hunger, we ground pearls into flour instead of wheat — but to no avail, and so, when we were about to die, we bequeathed this palace to the eagles." A second statement contained a detailed description of the wonderful palace, and mentioned where the keys for the different chambers were to be found. Following the directions on the door, Solomon inspected the remarkable building, whose apartments were made of pearls and precious stones. Inscribed on the doors he found the following three wise proverbs, dealing with the vanity of all earthly things, and admonishing men to be humble:

    1. O son of man, let not time deceive thee; thou must wither away, and leave thy place, to rest in the bosom of the earth.

    2. Haste thee not, move slowly, for the world is taken from one and bestowed upon another.

    3. Furnish thyself with food for the journey, prepare thy meal while daylight lasts, for thou wilt not remain on earth forever, and thou knowest not the day of thy death. (78)

    In one of the chambers, Solomon saw a number of statues, among them one that looked as though alive. When he approached it, it called out in a loud voice: "Hither, ye satans, Solomon has come to undo you." Suddenly there arose great noise and tumult among the statues. Solomon pronounced the Name, and quiet was restored. The statues were overthrown, and the sons of the satans ran into the sea and were drowned. From the throat of the lifelike statue he drew a silver plate inscribed with characters which he could not decipher, but a youth from the desert told the king: "These letters are Greek, and the words mean: 'I, Shadad ben Ad, ruled over a thousand thousand provinces, rode on a thousand thousand horses, had a thousand thousand kings under me, and slew a thousand thousand heroes, and when the Angel of Death approached me, I was powerless.'" (79)
Compare to the following excerpt from "The City of Brass:"
    They then passed on, and found a saloon constructed of polished marble adorned with jewels. The beholder imagined that upon its floor was running water, and if any one walked upon it he would slip. The Emir Musa therefore ordered the sheykh ‘Abd-Es-Samad to throw upon it something that they might be enabled to walk on it; and he did this, and contrived so that they passed on. And they found in it a great dome constructed of stones gilded with red gold. The party had not beheld, in all that they had seen, any thing more beautiful than it. And in the midst of that dome was a great dome-crowned structure of alabaster, around which were lattice-windows, decorated, and adorned with oblong emeralds, such as none of the Kings could procure. In it was a pavilion of brocade, raised upon columns of red gold, and within this were birds, the feet of which were of emeralds; beneath each bird was a net of brilliant pearls, spread over a fountain; and by the brink of the fountain was placed a couch adorned with pearls and jewels and jacinths, whereon was a damsel resembling the shining sun. Eyes had not beheld one more beautiful. Upon her was a garment of brilliant pearls, on her head was a crown of red gold, with a fillet of jewels, on her neck was a necklace of jewels in the middle of which were refulgent gems, and upon her forehead were two jewels the light of which was like that of the sun; and she seemed as though she were looking at the people, and observing them to the right and left. When the Emir Musa beheld this damsel, he wondered extremely at her loveliness, and was confounded by her beauty and the redness of her cheeks and the blackness of her hair. Any beholder would imagine that she was alive, and not dead. And they said to her, Peace be on thee, O damsel! But Talib the son of Sahl said to the Emir, May God amend thy state. Know that this damsel is dead. There is no life in her. How then can she return the salutation?—And he added, O Emir, she is skillfully embalmed; and her eyes have been taken out after her death, and quicksilver hath been put beneath them, after which they have been restored to their places; so they gleam; and whenever the air putteth them in motion, the beholder imagineth that she twinkleth her eyes, though she is dead.—Upon this the Emir Musa said, Extolled be the perfection of God, who hath subdued his servants by death!—And as to the couch upon which was the damsel, it had steps, and upon the steps were two slaves, one of them white and the other black; and in the hand of one of them was a weapon of steel, and in the hand of the other a jewelled sword that blinded the eyes; and before the two slaves was a tablet of gold, whereon was read an inscription, which was this:—
    In the name of God, the Compassionate, the Merciful. Praise be to God, the Creator of man; and He is the Lord of lords, and the Cause of causes. In the name of God, the Everlasting, the Eternal: in the name of God, the Ordainer of fate and destiny. O son of Adam, how ignorant art thou in the long indulgence of hope! and how unmindful art thou of the arrival of the predestined period! Knowest thou not that death hath called for thee, and hath advanced to seize thy soul? Be ready then for departure, and make provision in the world; for thou wilt quit it soon. Where is Adam, the father of mankind? Where are Nuh and his offspring? Where are the sovereign Kisras and Cæsars? Where are the kings of India and El-’Irak? Where are the Kings of the regions of the earth? Where are the Amalekites? Where are the mighty monarchs? The mansions are void of their presence, and they have quitted their families and homes. Where are the Kings of the foreigners and the Arabs? They have all died, and become rotten bones. Where are the lords of high degree? They have all died. Where are Karun and Haman? 9 Where is Sheddad the son of ‘Ad? Where are Ken’an and the Lord of the Stakes? 10 God hath cut them off, and it is He who cutteth short the lives of mankind, and He hath made the mansions to be void of their presence. Did they prepare provision for the day of resurrection, and make themselves ready to reply to the Lord of men?—O thou, if thou know me not, I will acquaint thee with my name and my descent. I am Tedmur, the daughter of the King of the Amalekites, of those who ruled the countries with equity. I possessed what none of the Kings possessed, and ruled with justice, and acted impartially towards my subjects; I gave and bestowed, and I lived a long time in the enjoyment of happiness and an easy life, and possessing emancipated female and male slaves. Thus I did until the summoner of death came to my abode, and disasters occurred before me. And the case was this:—Seven years in succession came upon us, during which no water descended on us from heaven, nor did any grass grow for us on the face of the earth. So we ate what food we had in our dwellings, and after that we fell upon the beasts and ate them, and there remained nothing. Upon this, therefore, I caused the wealth to be brought, and meted it with a measure, and sent it by trusty men, who went about with it through all the districts, not leaving unvisited a single large city, to seek for some food. But they found it not; and they returned to us with the wealth, after a long absence. So thereupon we exposed to view our riches and our treasures, locked the gates of the fortresses in our city, and submitted ourselves to the decree of our Lord, committing our case to our Master; and thus we all died, as thou beholdest, and left what we had built and what we had treasured. This is the story: and after the substance there remaineth not aught save the vestige.
Both tales feature the exploratory King, the magical city, beautiful gems and other brilliant jewels and posessions, a statue bearing a placard that tells of the downfall of the city, and most importantly, the fact that the city has fallen due to its hunger. Each city declares that at the last, they resorted to displaying their wealth, because it did them no good, or alternatively leaving the city to the advances of the eagles.

Happily, Louis Ginzberg agrees with me, as his comment on the Solomon tale states:
    79. Ma'aseh ha-Nemalah published several times eparately and also in BHM V, 22-26. The Arabic origin of this legend is obvious, and the Arabic original is still in existence, though less known than the Hebrew translation; see Hebraische Bibliographie, XIII, 105, and Jellinek, Introduction to BHM V, 11-13. Salzberger, Salamo-Sage, 90, published an Arabic text containing the first part of Ma'aseh ha-Nemalah, but did not recognize the nature of the text. Comp. also Gaster, Exempla, No. 343 and Seymour Tales of King Solomon 80-99. See further Ben ha-Meleh, XVI, where David is said to have found an inscription upon which a king told of himself that he had ruled a thousand years, destroyed a thousand cities, annihilated a thousand armies, and married a thousand princesses. This is only a somewhat different version of the inscription by Shadad supposed to have been found by Solomon.
It's fascinating what similarities lie between our legends and folklore in general.

Daniel Deronda & The House of Mirth

It's amusing when almost exactly the same scene occurs in two works of literature. In The House of Mirth:
    "Ah, don't say that -- don't say that what you have told me has made no difference. It seems to shut me out -- to leave me all alone with the other people." She had risen and stood before him, once more completely mastered by the inner urgency of the moment. The consciousness of his half-divined reluctance had vanished. Whether he wished it or not, he must see her wholly for once before they parted.

    Her voice had gathered strength, and she looked him gravely in the eyes as she continued. "Once -- twice -- you gave me the chance to escape from my life, and I refused it: refused it because I was a coward. Afterward I saw my mistake -- I saw I could never be happy with what had contented me before. But it was too late: you had judged me -- I understood. It was too late for happiness -- but not too late to be helped by the thought of what I had missed. That is all I have lived on -- don't take it from me now! Even in my worst moments it has been like a little light in the darkness. Some women are strong enough to be good by themselves, but I needed the help of your belief in me. Perhaps I might have resisted a great temptation, but the little ones would have pulled me down. And then I remembered -- I remembered your saying that such a life could never satisfy me; and I was ashamed to admit to myself that it could. That is what you did for me -- that is what I wanted to thank you for. I wanted to tell you that I have always remembered; and that I have tried -- tried hard . . ."

    She broke off suddenly. Her tears had risen again, and in drawing out her handkerchief her fingers touched the packet in the folds of her dress. A wave of colour suffused her, and the words died on her lips. Then she lifted her eyes to his and went on in an altered voice.

    "I have tried hard -- but life is difficult, and I am a very useless person. I can hardly be said to have an independent existence. I was just a screw or a cog in the great machine I called life, and when I dropped out of it I found I was of no use anywhere else. What can one do when one finds that one only fits into one hole? One must get back to it or be thrown out into the rubbish heap -- and you don't know what it's like in the rubbish heap!"

    Her lips wavered into a smile -- she had been distracted by the whimsical remembrance of the confidences she had made to him, two years earlier, in that very room. Then she had been planning to marry Percy Gryce -- what was it she was planning now?

    The blood had risen strongly under Selden's dark skin, but his emotion showed itself only in an added seriousness of manner.

    "You have something to tell me -- do you mean to marry?" he said abruptly.

    Lily's eyes did not falter, but a look of wonder, of puzzled self-interrogation, formed itself slowly in their depths. In the light of his question, she had paused to ask herself if her decision had really been taken when she entered the room.

    "You always told me I should have to come to it sooner or later!" she said with a faint smile.

    "And you have come to it now?"

    "I shall have to come to it -- presently. But there is something else I must come to first." She paused again, trying to transmit to her voice the steadiness of her recovered smile. "There is some one I must say goodbye to. Oh, not YOU -- we are sure to see each other again -- but the Lily Bart you knew. I have kept her with me all this time, but now we are going to part, and I have brought her back to you -- I am going to leave her here. When I go out presently she will not go with me. I shall like to think that she has stayed with you -- and she'll be no trouble, she'll take up no room."

    She went toward him, and put out her hand, still smiling. "Will you let her stay with you?" she asked.

    He caught her hand, and she felt in his the vibration of feeling that had not yet risen to his lips. "Lily -- can't I help you?" he exclaimed.

    She looked at him gently. "Do you remember what you said to me once? That you could help me only by loving me? Well -- you did love me for a moment; and it helped me. It has always helped me. But the moment is gone -- it was I who let it go. And one must go on living. Goodbye."

    She laid her other hand on his, and they looked at each other with a kind of solemnity, as though they stood in the presence of death. Something in truth lay dead between them -- the love she had killed in him and could no longer call to life. But something lived between them also, and leaped up in her like an imperishable flame: it was the love his love had kindled, the passion of her soul for his.

    In its light everything else dwindled and fell away from her. She understood now that she could not go forth and leave her old self with him: that self must indeed live on in his presence, but it must still continue to be hers.

    Selden had retained her hand, and continued to scrutinize her with a strange sense of foreboding. The external aspect of the situation had vanished for him as completely as for her: he felt it only as one of those rare moments which lift the veil from their faces as they pass.

    "Lily," he said in a low voice, "you mustn't speak in this way. I can't let you go without knowing what you mean to do. Things may change -- but they don't pass. You can never go out of my life."

    She met his eyes with an illumined look. "No," she said. "I see that now. Let us always be friends. Then I shall feel safe, whatever happens."
And almost the same exact scene occurs within Daniel Deronda, the first time here, and the second time, here:
    "I said--I said--it should be better--better with me--for having known you."

    His eyes too were larger with tears. She wrested one of her hands from his, and returned his action, pressing his tears away.

    "We shall not be quite parted," he said. "I will write to you always, when I can, and you will answer?"

    He waited till she said in a whisper, "I will try."

    "I shall be more with you than I used to be," Deronda said with gentle urgency, releasing her hands and rising from his kneeling posture. "If we had been much together before, we should have felt our differences more, and seemed to get farther apart. Now we can perhaps never see each other again. But our minds may get nearer."

    Gwendolen said nothing, but rose too, automatically. Her withered look of grief, such as the sun often shines on when the blinds are drawn up after the burial of life's joy, made him hate his own words: they seemed to have the hardness of easy consolation in them. She felt that he was going, and that nothing could hinder it. The sense of it was like a dreadful whisper in her ear, which dulled all other consciousness; and she had not known that she was rising.

    Deronda could not speak again. He thought that they must part in silence, but it was difficult to move toward the parting, till she looked at him with a sort of intention in her eyes, which helped him. He advanced to put out his hand silently, and when she had placed hers within it, she said what her mind had been laboring with--

    "You have been very good to me. I have deserved nothing. I will try--try to live. I shall think of you. What good have I been? Only harm. Don't let me be harm to you. It shall be the better for me--"

    She could not finish. It was not that she was sobbing, but that the intense effort with which she spoke made her too tremulous. The burden of that difficult rectitude toward him was a weight her frame tottered under.

    She bent forward to kiss his cheek, and he kissed hers. Then they looked at each other for an instant with clasped hands, and he turned away.
All these unfortunate women who abuse themselves, their ignorance and their lack of understanding while adoring the brilliant men who welcome them to a world of ideas which they have not been privy to before then...it's amusing in a somewhat disturbing way.

Wednesday, November 26, 2008

Toes & Thumbs

There are two interesting verses in Judges 1:6-7:
    וַיָּנָס אֲדֹנִי בֶזֶק, וַיִּרְדְּפוּ אַחֲרָיו; וַיֹּאחֲזוּ אוֹתוֹ--וַיְקַצְּצוּ, אֶת-בְּהֹנוֹת יָדָיו וְרַגְלָיו.

    6 But Adoni-bezek fled; and they pursued after him, and caught him, and cut off his thumbs and his great toes.

    ז וַיֹּאמֶר אֲדֹנִי-בֶזֶק, שִׁבְעִים מְלָכִים בְּהֹנוֹת יְדֵיהֶם וְרַגְלֵיהֶם מְקֻצָּצִים הָיוּ מְלַקְּטִים תַּחַת שֻׁלְחָנִי--כַּאֲשֶׁר עָשִׂיתִי, כֵּן שִׁלַּם-לִי אֱלֹהִים; וַיְבִיאֻהוּ יְרוּשָׁלִַם, וַיָּמָת שָׁם. {פ}

    7 And Adoni-bezek said: 'Threescore and ten kings, having their thumbs and their great toes cut off, gathered food under my table; as I have done, so God hath requited me.' And they brought him to Jerusalem, and he died there. {P}
Of all the forms of torture that Adoni-bezek could employ, why did he choose to cut off his captives' thumbs and great toes? For that matter, why these digits and not others? Why not act like Hanun and shave off half his victims' beards, or use other ways to degrade his captives? (And yes, I know Adoni-bezek lived before Hanun, but still, why not use other methods of inflicting pain?)

I believe the answer lies in the following verses:
    1) כ וְשָׁחַטְתָּ אֶת-הָאַיִל, וְלָקַחְתָּ מִדָּמוֹ וְנָתַתָּה עַל-תְּנוּךְ אֹזֶן אַהֲרֹן וְעַל-תְּנוּךְ אֹזֶן בָּנָיו הַיְמָנִית, וְעַל-בֹּהֶן יָדָם הַיְמָנִית, וְעַל-בֹּהֶן רַגְלָם הַיְמָנִית; וְזָרַקְתָּ אֶת-הַדָּם עַל-הַמִּזְבֵּחַ, סָבִיב.

    20 Then shalt thou kill the ram, and take of its blood, and put it upon the tip of the right ear of Aaron, and upon the tip of the right ear of his sons, and upon the thumb of their right hand, and upon the great toe of their right foot, and dash the blood against the altar round about. (Exodus 29:20)

    2) יז וּמִיֶּתֶר הַשֶּׁמֶן אֲשֶׁר עַל-כַּפּוֹ, יִתֵּן הַכֹּהֵן עַל-תְּנוּךְ אֹזֶן הַמִּטַּהֵר הַיְמָנִית, וְעַל-בֹּהֶן יָדוֹ הַיְמָנִית, וְעַל-בֹּהֶן רַגְלוֹ הַיְמָנִית--עַל, דַּם הָאָשָׁם.

    17 And of the rest of the oil that is in his hand shall the priest put upon the tip of the right ear of him that is to be cleansed, and upon the thumb of his right hand, and upon the great toe of his right foot, upon the blood of the guilt-offering. (Leviticus 14:17)
See Leviticus 14:14, 14:25 and 14:28 for other mentions of the blood being placed upon the thumbs and toes of people.

The question becomes: what exactly is happening here, when either one is annointed with oil placed upon one's thumb and toe, or has the blood of one's offering placed upon these digits?

In the case of Aaron and his sons, this marks their inauguration into the priesthood. Placing the blood upon their thumb and toe is part of dedicating them to serve as priests to God and setting them aside as holy.

Similarly, in the case of the leper who has come to bring an offering, placing the oil upon his thumb and toe is part of the cleansing process utilized in making him pure again, and allowing him to rejoin the congregation of God in its full capacity.

In both cases, therefore, placing blood or oil upon one's thumbs and toes is part of the process used in making oneself holy or pure, and setting oneself aside to serve God, whether it be in a special capacity such as that utilized by the priest, or simply as a full devotee, having repented of sin, such as the leper.

What, then, was it, that Adoni-Bezek was doing when he chose to torture his captives by cutting off their thumbs and toes? Why, it was simply another form of what occurs by the Eved-Ivri, the Hebrew slave who chooses to serve his master for an additional period of time. An Eved-Ivri has a hole bored into his ear as though to say: "The ear which heard at Sinai that he was to serve God, who is his Master, chose a human master for himself instead!" Similarly, by cutting off his captives' thumbs and toes, Adoni-Bezek proclaimed himself mightier than God. "You desired to set yourselves aside for God, to make yourselves pure and holy? Observe how you have been set aside for me instead, your human master!" While the captives upon whom he inflicted these tortures were not necessarily the Israelites or Jews themselves, the imagery holds fast nonetheless. Doubtless, the other Kings from the various kingdoms had imagined themselves as ruling by the strength of their god or gods; in cutting off their toes and thumbs, Adoni-Bezek divested them of this symbolic power.

It is in this way that we can understand Adoni-Bezek's words, "As I have done, so God has requited me." On the simple level, he means that in the same way that he had dismembered his captives, so too has he now been dismembered. But on a deeper level, Adoni-Bezek refers to his intent. "As I have done," i.e. in declaring myself to be master over those who truly belong to God, "so God has requited me," i.e. He has let me fall into the hands of the Jews, in order to prove to me that they are indeed set aside for Him, and I cannot make them mine. Thus it is with perfect and dramatic irony that the Jews cut off Adoni-Bezek's thumbs and great toes, as they assert the supremacy of God, and their devotion to Him.

Tuesday, November 25, 2008

The Observer: Issue 3!


Well, what does this issue of The Observer have in store for you?

First things first, the Orthodox Union (OU) has been spearheading a project to inform the Orthodox Jewish community about eating disorders. They are going to release their film, which is a documentary entitled "Hungry To Be Heard" featuring clinicians, Rabbanim, psychologists and other prominent people, in the very near future (it premieres in Israel on November 27, and will premiere here in New York in either December or January.

Readers will also appreciate the additional information on eating disorders provided in the Features section.

Then, read how students at Yeshiva University reacted to Obama's election, the incredible number of people who were drawn to the recent Tanakh Yom Iyun, and the start of a book club here.

There are also two pieces by international students, one a girl from Moscow, the other the head of the Political Society at YU.

Then we explore Orthodox Theater and other performing arts, such as musicians who perform in subways. There's also a review of "The Secrets," Avi Nesher's film from the Israel Film Festival, which I personally found extremely interesting.

We have an intrepid adventurer who would like to abolish styrofoam, an introduction to WYUR, YU's radio station, commentary on the politics of fashion in the election, a review of the musical "13," which stars teenagers in lead roles, and much more, including published Letters to the Editor.

Enjoy- and comment away!

Monday, November 24, 2008

Peah 1:1 (Yerushalmi)


אמו של ר' טרפון ירדה לטייל לתוך חצירה בשבת והלך ר' טרפון והניח שתי ידיו תחת פרסותיה והיתה מהלכת עליהן עד שהגיעה למיטתה פעם אחת חלה ונכנסו חכמים לבקרו אמרה להן התפללו על טרפון בני שהוא נוהג בי כבוד יותר מדאי אמרו לה מה עביד ליך ותניית להון עובדא אמרו לה אפילו עושה כן אלף אלפים עדיין לחצי כבוד שאמרה התורה

Finally! They should buy *this* for Bar Mitzvah boys!

Today I discovered a book entitled The Oral Law by H. Chaim Schimmel. He begins his work by stating:
    Were all the laws of the Oral Torah of Sinaitic origin? If so, how did disputes arise? Why and how are certain laws deduced by the Sages from scripture? And what was the practice before such laws had been so deduced? To what extend did the Sages enjoy legislative powers. Why are Rabbinic laws binding? When was the text of the Mishnah first settled? And previous to that, how has the law been stated?

    This book written by an amateur for amateurs is an attempt to answer some of these problems. I have found that many Yeshivah students, or former Yeshivah students like myself, are puzzled by these problems and they baffle even some Talmudic scholars. I have not made a critical study of the whole subject, but I have attempted to find an answer to these questions in the classical Jewish Literature and in the writings of recognised Rabbinical Authorities.

Yes, yes, yes, and yes! This book should be added to the collection of those about which we ask...why did they never teach us this in high school?!

God bless you, Mr. Schimmel!

Sunday, November 23, 2008

YU Medical Ethics: Catching Cancer Before It Catches You- Medical and Halachic Implications of BRCA Gene Testing

These notes are unofficial and unedited. Any and all mistakes are mine

YU MedEthics Folks: On behalf of the YU MedEthics Society, we’d like to welcome you to “Catching Cancer Before It Catches You.” Cancer therapy is a medical topic that is important. Just last week there was an article in the New England Journal of Medicine on inherited cancers- tonight we are honored to have four distinguished speakers come to address us on this important subject- Dr. Stanley Weintraub, Director of Oncology at Hackensack University- completed internship and residency at Metropolitan Hospital in New York City. Board certified in hemotology, medical oncology etc- he will speak about the BRCA gene, etc. Aliza Ricklis is a genetic counselor at Hackensack University- discussing the genetic testing process, which is complicated and emotional but relevant. Rabbi Willig is the Rosh Yeshiva, etc- and he will address the halakhic aspect. Ms. Anne Frisch tonight will share her personal experience as a cancer survivor and patient with Dr. Waintraub. Thank you to speakers, boardmembers, etc for ensuring the success of this event- CJF, Stern College for Women Student Council, YCSA, SOY, etc for sponsoring this event. YU MedEthics is a medethics society available to promote understanding, etc.

Please hold all questions until the end of the evening, when our speakers will be more than happy to answer them.

*

Dr. Stanley Waintraub:

First of all, I want to thank Tali, Jenny, Rivka and my good friend Aaron Kogut for organizing this event. I’m honored to be here with Aliza and Rav Willig and I’m overwhelmed by the attendance. I think this is incredibly heartwarming to me- I don’t mind coming on a Sunday night, but for you, it’s here. I hope we don’t scare you too much- our job tonight is really to educate you. We just want you to be educated about what the gene is, where it affects the population at large- this lecture will be very few jokes because this is a very serious topic.

Identifying and Managing Hereditary Breast and Ovarian Cancer Syndrome

LEARNING OBJECTIVES

- Cancer risks associated with BRCA mutations
- Use of genetic test results in medical management
- Features of hereditary breast and ovarian cancer syndrome (HBOC)
- Relevant health insurance issues

There is a test called the BRCA test- done by only one company in the entire world, this is one of their pieces of paper that they give out for who gets tested.

HEREDITARY BREAST AND OVARIAN CANCER SYNDROME

-Characterized by significantly increased risks for breast and ovarian cancer
Most cases are caused by a BRCA 1 or BRCA 2 mutation
Clinical testing is available to identify individuals with mutations

WHAT IS THE BRCA GENE?

There are normal tumor suppressor genes that tell the cancer to undergo apoptosis, aka programmed cell death
-In BRCA and p-53 mutations, the tumor suppressor gene is defective
This allows the tumors to grow

Most people, when they get exposed to a cancer cell, realize it is foreign- the cell is taught to die, to undergo programmed cell death. The problem with people who have BRCA 1 or 2 is that they have an abnormal tumor suppressor gene- the tumor suppressor gene is defective and cancer grows unchecked.

What is BRCA 1 and BRCA 2? Two of the 30,000 genes that we inherit from our parents- they are genes located on chromosome 17 and 13 respectively that normally produce a protein that helps to correct mistakes in the DNA. The BRCA1 and BRCA2 mutation interferes with the genes- not just mother to daughter, but could be father to daughter, also.

Every woman is born with the BRCA 1 and BRCA2 genes- when functioning normally, they pose no risk to a woman- a functioning BRCA gene prevents tumor growth by limiting cell division. Individuals predisposed to breast cancer are born with a mutation in one of their two copies of a BRCA gene- for breast cancer to occur, both BRCA genes must be defective.

A normal woman who doesn’t have the gene, will have one damaged gene, then two damaged genes and the tumor develops- so her chances of getting cancer are 1 in 8. In hereditary cancer, you start off with a damaged gene, the second one becomes acquired and cancer develops. For example, a 30 year old woman with the mutation now has a 1 in 3 chance of developing breast cancer. Over her entire life, are 50%- 80% chance of getting cancer.

WHO DO WE LIKE TO TEST?

Breast cancer in two or more close relatives, such as a mother and two sisters
early onset of breast cancer in family members, often before age 50
history of breast cancer in more than one generation
one or more BRCA positive relatives
frequent occurrence of ovarian cancer
eastern and central European (Ashkenazi) Jewish ancestry with a family history of breast or ovarian cancer

Once we refer patients- the policy in my cancer center, which is the 5th largest cancer center in the USA- we refer them to a genetic counselor for reasons that Aliza will explain to you about genetic counseling and why we don’t want to do it in the office.

WHY SHOULD WOMEN BE TESTED?

- Women are relieved to know if they are positive
- If they are positive, can make an educated decision as to how to proceed/ what treatment should be done to try to prevent cancer or catch cancer before it catches them
- Whether other family members should be tested

DISADVANTAGES

- Many women are very scared when they are tested
- Scared if they are positive
- And what do you tell your family, etc?
- Women who test negative- doesn’t mean they won’t get cancer- they are still in the pool of 1/ 8- there are other genes out there that we don’t know about yet

HEALTH INSURANCE-
Can you be denied health insurance/ can you be discriminated against?

1 out of 500 women will be BRCA 1 or 2 positive- they will get breast cancer about 50% of the time by age 50 and 56-87% before 80. They also have a 27-44% risk of developing ovarian cancer by age 70.

If you have a BRCA gene mutation, you can reduce your risk of developing breast and ovarian cancer up to 96%. 7% of breast and 10% of ovarian cancer cases are hereditary! The most common cause of these hereditary cancers is a mutation of the BRCA1 and BRCA2 genes.

A BRCA mutation increases breast and ovarian cancer risks.

Family history is important for the risk of cancer but the gene really indicates what will happen with the patient about 90% of the time. In fact, if you develop breast cancer you have a greatly increased risk of a second cancer if you carry a mutation in BRCA1 or BRCA2. The risk of a contralateral breast cancer is increased up to 64% by age 70 or 27 (%).

Lifetime risk of breast cancer: 50-85%/ Risk of breast cancer before age 50

OVARIAN CANCER AFTER BREAST CANCER IN BRCA CARRIERS

10-fold increased risk compared to noncarriers- no effective ovarian cancer screening, despite the tests we have- prophylactic suggested- they should have their ovaries removed
FALLACY- MEN CAN’T GET BREAST CANCER

Many men are BRCA positive, and they get breast cancer. Prostate cancer is probably seen more in BRCA than the general population. Both men and women with the mutations have an increased risk of other cancers- pancreatic cancer, melanoma, etc.

A woman’s lifetime chance of developing breast or ovarian cancer is obviously higher if she has the gene- but she also has an increased chance of getting it at a very young age. Also an increased risk of colin cancer; men have prostate cancer; both have increased pancreas cancer, bile duct cancer, stomach cancer.

What about the BART TEST?

Recently, we found a number of women who are BRCA 1 or 2 negative, but still have a huge family risk. We’re finding about 2-3% of these women have the BART gene; they are treated the same way as the women with BRCA.

Not trying to scare you, but educate you.

MANAGING HEREDITARY CANCER RISK

The way to reduce cancer in a BRCA patient is to remove the organ that could become cancerous. That’s what’s so drastic about this- cancer free, but weighing a mastectomy was on front page of New York Times Magazine- Deborah Lindner’s Family Tree.

Part of the tree:

-2 of Robert and Eleanor Price’s sister had BC; 1 had OC
-Eleanor Price Veith- age 87; h/o OC
-Gloria Veith Spurlock- does not want to be tested
Joan Veith Lindner- 64 BC at 58; PM/O; +BRCA 1
Lori Lindner- neg for BRCA
- Robert Milton Price- Died of CC at age 50

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CASE STUDY- He shows us a chart of one of his patients, Lucille. She ends up having her ovaries removed- she tells her sister to get tested, and her sister Nancy removes normal organs, and caught a 5mm cancer growth.

Obviously, you are all young adults and have been taught breast self-exam. Mammography is way too early for most of you in the room. When do women need mammograms and MRIs with the BRCA gene, though? Without the BRCA gene, age 40. With it, age 25.

BREAST CLINCIAL EXAM- Very few cancers are picked this way. Most are picked up through the mammogram.

MRI SCREENING IN WOMEN WITH HEREDITARY RISK FOR BC- MRI, wich insurance companies are fighting against because it’s expensive, is still catching up twice as many as the mammogram, but still not all

What about Tamoxifen? It doesn’t actually work that well and in the end of the day, the only way to prevent breast cancer for BRCA is to remove the remaining breast.

Now, to cut off my breasts or not- this is a woman who wrote a book about the BRCA gene. Her name is Jessica Queller.

Birth control pills decreasing risk of ovarian cancer? A) They don’t work that well and B) that increases risk of getting breast cancer.

IF a woman does have the BRCA gene, we remove her ovaries and breasts- prophylactic oophorectomy- have your children if you are BRCA positive, and after you have completed having children, we will remove your ovaries. That decreases risk over 96% and that is very good. You decrease estrogen that way, actually, and cut down the breast cancer risk as well.

What about occult cancers in BRCA carriers at BSO?

Prevalence of occult tumors: up to 23.5%

This is AR, one of my patients, and she is 47 years old- she had a right breast cancer, invasive ductile cancer- her mother had bilateral breast cancer and ovarian cancer- she decided to remove her ovaries and what we found unexpectedly was an 8mm right ovarian cancer- that was not detectable by Catskans or ultrasounds- we probably saved her life there.

CANCER RISKS FOR MEN
We are not protected. They get cancer- breast cancer, prostate cancer- etc

LIFETIME RISK OF BREAST CANCER
BRCA 1 gene- some increased risk
BRCA 2 gene- 6% increased risk

Now, this is NB- this is a tragedy. One of my patients is currently dying of breast cancer- no older than 45; she has BRCA 2. She had her ovaries and breasts cancer; she is dying of metasthetic breast cancer. One of her sisters has already died of pancreatic cancer. She has another sister who is also positive- she has removed her breasts but she has a brother who is young in his 40s, with prostate cancer.

About 22% of breast cancer patients are now at risk for this syndrome- so what are the red flags for hereditary breast and ovarian cancer? From my end, family history and women under the age of 50.

½ of BRCA carriers inherit the mutation from their father- it’s parent to child, not mother to daughter. All ovarian cancer patients should be tested as well.

INTERPRETING TEST RESULTS

Tests come back as positive for a deleterious mutation, no mutation detected, or the horrible thing of genetic variant of uncertain significance.

We’ve told you why we want women tested; we know there is a medical and surgical management for them, but remember, there are other genes that we don’t know about today.

INSURANCE

A lot of fear that if you are BRCA-positive and perhaps Anne will discuss this- whether the insurance companies can discriminate against you. There is a law that prohibits genetic discrimination because of the test- this is Julie Auden who has the gene, and President Bush signed the GINA act- which protects people from genetic discrimination by health insurers or employees.

Now, recently, Christina Applegate, star of sitcom “Samantha Who,” opened up about her battle with breast cancer and made a startling confession- at 36 she was diagnosed with an early form of breast cancer. She made the decision to remove her breasts and she is BRCA 1 positive and her mother Nancy had breast cancer and also had a mastectomy. The good part about a famous person getting this is that it helps everyone gain awareness about this.

If I’ve scared you, I apologize- but if we catch cancer before it catches us, we’ve saved lives.

Knowledge is Power and Hope.

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They’ve given me an honor to present to you Aliza Rickliss- not one geneticist but a whole group and a whole department, which I think is a very sophisticated way of dealing with a very important issue.

Aliza: Thank you. Dr. Waintraub. I can start by talking Dr. Waintraub for just a minute- he is respeted very much by his colleagues- greatest things are things that come from his patients- what I have to say is that this is my first time doing this kind of thing, so I want to thank my family and brother-in-law because when he saw me post a note for today’s presentation and said: “This is a joke, right?”

The background is a cancer joke called Dr. Rubinson.

Catching Cancer Before It Catches You: Practical Considerations of Genetic Testing

The first question is: Is the cancer in this family genetic? But that’s a trick question, because cancer is always genetic. A lot of you are students who have taken biology, and cancer is something that has to do with replication of DNA- so cancer is always genetic. Question is: Is the cancer hereditary? Is there something where we see a pattern in the family- is there something uncommon about the cancer- and when we think hereditary matters, we an think about genes that are related to cancer.

How much breast and ovarian cancer is hereditary?

BREAST CANCER: 15-20% familial, 5-10% hereditary
OVARIAN CANCER: 5-10% hereditary

Those are the people where the cancer was caused by some underlying genetic or hereditary factor and that is what will be of interest to us-

Who may have a BRCA 1 or BRCA2 mutation?

-Breast Cancer
Early onset- under age 50
Bilateral
Multiple individuals (siblings, parent/ child)
Male breast cancer
Ashkenazi Jewish ancestry

-Ovarian cancer
-Breast and ovarian cancer in one individual
-Other BRCA1 or BRCA2 associated cdancers
-Autosomal dominant inheritance

Although most cases of ovarian cancer are not caused by genetic mutations, it’s something that leads us to think about it.

AUTOSOMAL DOMINANT INHERITANCE

-AUTOSOMAL
-Carried on one of the numbered chromosomes
Mutation transmitted irrespective of the gender of parent or child

DOMINANT- Each child has a 50% chance of inheriting the mutation
BRCA1 and BRCA2 are located on chromosomes that are not related to gender- they are on chromosomes 13 and 17.

THE TESTING PROCESS

Review personal and family medical history
Decide: Should testing occur? Why should I be tested?
Draw blood (1 tube)
Insurance verification
Review results

We like to begin in a family by testing someone already affected by cancer. I’ll explain why later. Testing process is relatively simple by a pure physical perspective. We had an opportunity to explain the results, and then say to the person: now that you know this information, where do you think that we are going to go from there?

NEGATIVE RESULT

Why would someone get a negative result?

Cancer is sporadic or environmental- could be it’s not caused by a hereditary mutation, but because DNA in its replication process spun out of control. DNA doing its normal thing is always on the brink of causing cancer- yet it maintains its normalcy in most cases. Environmental causes I typically don’t discuss, but for a patient who suspects that, they can pursue that.

Mutation cannot be detected by this test- Gene cannot be detected by this test, even though he does have a mutation. This is why we prefer to test the affected individual first as opposed to the unaffected individual. A test doesn’t always catch all the mutations in a gene.

Familial mutation was not inherited

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ARE YOU POSITIVE? Management options for BRCA1 and BRCA2 mutation positive women.

SURVEILLANCE
-self breast exam (monthly)
-clincial breast exam (3-6 months)
-mamogram (yearly)
-breast MRI (yearly)
-pelvic exam (yearly)
-transvaginal U/S (yearly)
-ca-125 (yearly)

SURGERY
-biltaeral mastectomy (90% risk reduction)
-bilateral salpingo-oophorectomy (95% risk reduction)

CHEMOPREVENTION
-tamoxifen

ORAL CONTRACEPTIVES

Usually we do not recommend surgeries/ prophylactic mastectomies to college-age people; it is not the right thing for everyone; it depends on age and more. When we talk about removal of ovaries, we suggest removal of fallopian tubes as well because the same mutations can cause cancer of the fallopian tubes as well.

A Man with BRCA1 or BRCA2 is that some men are more aware and do the things they should be doing, more of a motivator to do the things they were already doing- CBE (clinical breast exam), Prostate screening

Do preventive measures help? The most dramatic reduction in incidence of cancer comes along with mastectomy or oophorectomy.

VARIANT OF UNCERTAIN SIGNIFICANCE- What that means is that it may or may not be associated with increased risk of cancer, and may be reclassified.

Looking at length of gene and may find something that is a change- that’s a mutation in most cases (specifically if it is known to be deleterious- but some changes in a gene don’t have any consequences that we can perceive.) Change in one of the nucleotides doesn’t cause a change in amino acids, etc. So the laboratory calls that a variant of uncertain significance- they hold the information and give it to us, but also, as more people are tested, they see, how many people in the family who have that variation have been affected by cancer? What we hope for when we see one of these is that it will be reclassified as having no significance.

SOME OTHER CANCERS ASSOCIATED WITH BRCA1 AND 2 MUTATIONS

Prostate/ Colorectal/ Pancreas/ Endometrium (Uterus)/ Cervix/ Skin (Melanoma) – melanoma is more with BRCA2

Ashkenazi Jewish population- has a lot of fame in the world of genetics. A lot of people have misimpressions- once had a patient who said, “Yeah, I’m Jewish, so I’m a ball of mutations.” Well-studied population, can be of use to us when we try to understand our own genetics- shouldn’t allow us to scare us, though- in different populations, there are different populations that have been found in BRCA 1 and BRCA 2 genes- when we have a mutation that is specific to a population and we believe it started out in one person many generations ago– we call that a founder mutation.

ASHKENAZIC JEWISH FOUNDER MUTATIONS

-If an AJ individual has a mutation in BRCA1 or BRCA2, there is a 90% chance that is one of thsese-

BRCA1 185delAG
BRCA1 5382insC
BRCA2 6174delT

Population prevalence of 2.65%

~

But the risk is not greater in the Ashkenazi Jewish population-

DISEASE PREVALENCE IN BRCA1 AND BRCA 2 MUTATION-POSITIVE AJ WOMEN

-Initial studies included patients with significant family histories (-85%)

Chart provided by the company that does the testing- provide us with information, saying if you have a person with this history etc

OTHER HEREDITARY BREAST CANCER SYNDROMES

-Cowden Syndromes: breast, uterus, thyroid
Li-Fraumeni Syndrome: breast (sarcoma), leukemia, brain, adrenal
Hereditary Diffuse Gastric Cancer Syndrome: stomach, breast (lobular)

There are two points that I will make tangentially- one is about stomach cancer. Especially if that is something that happened way back, stomach cancer could be cancer of the ovaries, abdomen, etc. Another way of getting that is to ask with actual pathology reports from grandparents, etc, if possible.

HEREDITARY COLON CANCER SYNDROMES

Hereditary Non-Polyposis Colon Caner- another

WHO DIRECTS PEOPLE TO GENETIC COUNSELING?

Oncologists/ oncology surgeons/ primary care/ OB/ gyn/ self-referral

TESTING LOGISTICS

Usually covered by insurance (as long as most people in medicine believe the testing is warranted)

HIPAA prevents discrimination for medical insurance

WHAT DO I DO IF I’M POSITIVE?

All the information we’re trying to emphasize tonight is to say there is a very significant risk of getting cancer for someone who has one of these mutations. But there is no dramatic action we would suggest or expect from someone who is college-age.

“The only normal people are people you don’t know very well” ~Dr. Robert Wallerstein, one of my favorite mentors says this.

RABBI MORDECHAI WILLIG- I see in the audience a number of accomplished individuals who feel that medicine, biology- I recommend that you go to them because they are observant, halakhically commited individuals and they have much to teach you. Any kind of genetic testing is scary, even the most benign testing is scary- we’re talking about heavy stuff- but many of us remember that in the early years, when Tay-Sachs testing got on the scene, many of us were very scared- in fact in a landmark teshuva, R’ Moshe Feinstein takes into account that such evidence of being positive can be frighteining to youngsters. Even though it should not be frightening at all! Tay-Sachs, put in perspective, shouldn’t scare you- it should only save you, because nothing will happen to you as long as you make the right marriage choice.

There’s the No-Nothing population for Dor Yesharim, which is very good for those who want to go that way- and the more sophisticated population, where knowledge is power, where you choose to know and just imagine then, that these great rabbinc scholars were concerned about the population for testing for recessive genes, where there is not much cause for it, what would they say about testing for dominant genes? And the sad reality is that in the broader rabbinic world you hear nary a peep about this. It’s just untalked about. A number of years ago, two physicians who I know personally, and I’m giving you a source- it’s in the journal of halakhic contemporary society in Fall 2001- it came out 7 years ago- there’s an article on “Preventative Medicine” by Dr. Depos and Dr. Bookbinder ( heard wrong? not sure if these are the names)- this is what he has dedicated his life to- precisely to preventing breast cancer and he has attempted to receive rabbinic approbation for these kind of mammograms (before we get to the more radical procedures, let’s talk about mammograms.) Unfortunately he was unable to get the support in the rabbinic world to get the kind of Kol Koreis about this- you don’t find any such thing, as a matter of fact he and some other physicians from my own synagogue came to discuss a different but seemingly also preventable disease, colon cancer. The physician I once went to said, screaming and almost crying, “Colon cancer is a preventable disease! If you get tested early enough and more frequently enough, then that’s important!’ How can you not save lives? The only Rav in these 30 pages is our own R’ Hershel Schachter and I have spoken to him myself and I know that this is takka his position, even as a I know full well that in the rabbinical world at large it is not a popular position. What we were able to get form the big Rabbis was that it was a permissible test- which . Now, what they like to say is what you don’t know won’t hurt you, and there will be miracles- that is not my attitude; I am a major advocate of testing in accordance with the experts. I have no expertise in the field; I was very anxious to hear the most recent statistics in tehse matters- I am not here to tell you the medical stuff; you have got to go to the experts- in my view, whatever they say you should do, you should do, and in my view it is halakhically required to do- and in my view, if not required, then certainly advised. Now, another very thorny issue is what happens if in fact you do discover some medical genetic predisposition to these things- may you in fact involve yourself in prophylactic surgery- to catch cancer before it catches you?

The only teshuva we have once again from the Igros Moshe- also, not a full story- Chosehen Mishpat, 2nd volume, page siman ayin gimmel, os zayin, referring to a particular case (thus a very limiting case)- as he puts it, once you do a hysterectomy, generally speaking the doctors take away the ovaries and fallopian tubes even though there is nothing wrong with them because they are afraid it will become cancerous. Now, the teshuva was written in the word 1982, quite a while ago- 5%. And the topic of this teshuva is may you in fact remove these ovaries and fallopian tubes- clearly there is no issue of fertility- this woman is not going to have any children! Guess today it’s not necessarily the case because you have surrogacy- so he says that it’s permissible- it does not constitute a violation of what we call in our language sirus- generally, damaging the reproductive organs is prohibited- it’s a violation called sirus. Even though it is only 5% we should consider it a sakanah- in his view, it is a “chashash gadol” – a significant danger. If I give you a gun with 20 and only 1 has a bullet in it- no one in this room is going to volunteer to shoot with it; who will play Russian roulette with 5%? No one is going to have surgery for a 5% chance because the surgery itslef is dangerous, but here where the surgery is being done anyway, it is advisable that we have.

This is what I have to offer to you- not much! One article in the Journal of Halakhic and Contemporary Society and the other this teshuva referring to specifics of oopherectomies and the like. It seems to me, although R’ Moshe was concerned about the danger of these surgeries, today it is not considered a risk factor- it is a very significant psychological factor (we don’t disregard this- if we are concerned for that in terms of mere testing, how much the more so in terms of full procedures)- mastectomies, reconstructive surgeries, etc- even an oopherectomy which is not as open can still be psychologically devastating- even if someone is not considering having more children, nonetheless, though we do not dismiss this lightly, we are of the halakhic view that saving lives comes first. And if R’ Moshe’s only reason not to remove under 5% chance is because of risk of surgery itself, one has to reevalute when the risk of such surgery is now almost nil. As I am learning incraseignly, not always unanimity in the medical community. Well, there’s no unanimity in the rabbinical community either, so fair is fair! [LAUGHTER] I strongly recommend from the halakhic perspective that any women- there might be men, too- but any woman who is recommended to be tested should do so and should do so right away- nonetheless important to know it right now.

Here I come to my next sensitive point: Shidduchim. In certain circles, don’t test, don’t test, don’t test. Why? Because knowledge can be dangerous and ignorance is bliss! Everyone who is not married yet is thinking about marriage, maybe the female population of the room- why do I have to add another level of drama- to think about this, when do I tell, how do I tell? It’s much more relaxing; this slide through life where ignorance is bliss…true! But it can cost lives. People in this room will know of families- I don’t want to say it’s your family, but it could be with 1, 2, 3 cases of breast cancer- you know in Shulchan Aruch in Second Siman of Even Ezer says that if a disease exists in 2 generations of your family ________ . If a person knows that in your family there were 3 situations of breast cancer- maybe if they were BRCA positive and you were BRCA negative, that would solve the problem!

I had a shaila from someone whose son was dating a woman and the father calls me and says: “Gevalt! I heard there were three cases of cancer in the family.” This lady had a grandfather, an aunt and a cousin- so what do you think? Should I maybe decide to call it off because of this? So I went to the president of my shul, a radiologist primarily of cancer therapy who says- three in a family? That’s about average. They were different cancers, and does not necessarily predict anything wrong with this individual. But three of the *same* - breast and ovarian are considered to be related- then there is a significant problem. I don’t believe it’s wise to sail through life without testing- and say ignorance is bliss and let’s be happy-go-lucky. Halivai if you should be happy-go-lucky, but what if it’s happy but unlucky?

As Rabbanim, we are responsible to save lives. It says that a rabbi who does not instruct his congregants that in cases of a problem on shabbos you must run to save lives, that individual, that rabbis, is called a not-nice name- a “shofech dam.” I say: Tomorrow they are coming to the mikveh with one of those trucks that come to do mammographies and I tell them to get tested.

I had a woman at my shul with a complex niddah shailah. I asked when were you at an OB/GYN next? She said she had no doctor and nothing- so I told her I won’t talk to her (put her in cheirem)- until you get a Pap Smear. Pap Smears save lives! The Rabbis in Israel will disagree with me…but…I have told the people of my shul, from the pulpit, that they must do everything they can to maximize their health, including losing weight- because ifsomeone unfortunately weighs too much he can get diabetes, cancers according to the latest research- in my view, and I may be a minority- it is halakhically requied to do everything we can within reason to live as long as we can. Hashem put us into this world to live lives of Torah and mitzvos and how can we do that unless we live? My bracha to all of you- you should follow the halakhic process, live long and happy lives; Hashem should bless everyone in this room.

Dr. Waintraub: Just 3 things- Rabbi Willig, you are now Rabbi Dr. Willig. Also, the Giants won and the Nets won.

My son who is now at Netiv had to do his senior thesis at MTA and he did it on who is a hero. Now, I have been a doctor for 31 years and I know who my heroes are- my heroes are my patients. A real incredible hero is someone who will come here before this crowd of people and talk about her personal struggle- Ann Frisch.

Ann: Certainly hope I can live up to the hero image that he’s painted for all of you. I think it’s important for all of you to know that I am a nurse by profession- so some of this is based on the knowledge I gleaned by being in nursing for 30 years. I wanted to be a nurse for as long as I can remember- I was a nurse’s aid, registered nurse- came into the position to help patients with many illnesses and ironically those who had cancers as well. First rather suprising, because I was very nervous and scared around cancer patients- but I found working around them to be an incredible gift. Even though I was young then, I saw the world the way you do when you are young, just like many of you- I was proud to be helping all the patients. Back then, for all my patients, their hopes started with me. Because I loved my job, I excelled professionally- I was offered positions that allowed me to care for more than the individual patient- the more people that you meet, the more you discover people who have now or who have had cancer. Like it is for everyone, cancer became part of my relationship with colleagues and friends, and I’m one of those people for whom this kind of thing gets personal. You don’t know me, but I do tend to get involved in the lives of those who have to face down cancer. Hope starts with me- and wouldn’t it be ironic if I too developed cancer.

Mother developed cancer, thunderbolt hit. While working and raising my two daughters, I prayed for her to be okay- walked for the cure- hung in there because her hope, of course, started with me. Last year, once again, hope started with me- because one week before I accepted to lead my employer, New York City Corporation in their fight against cancer- I went to my annual mammography- shockingly surreal experience of being informed that I too had breast cancer and now I know, a year and a half later, that there were other complications, none of which I would have known had I not been screened. Today I am finished with my initial treatments, committed to efforts to inform patients, family etc to help catch cancer before it catches you. Hope starts with me and ladies and gentlemen, tonight, with you as well.

Many of you may feel that individuals are afraid to talk about cancer. My friends certainly are. I am not afraid to talk about it; none of us can be afraid to talk about it- we have to talk about it to inspire others to take our place on the front line of this battle, to cry and to laugh about it. Telling the truth about cancer is hard, it’s empowering and it helps us do the one thing we must do each day- celebrate life. Who better than me to do all these things- fortunately, this is the mere beginning of my story, although to many of you, it may seem like enough. After being diagnosed with __ 1 cancer, had a lumpectomy, was referred to fabulous, incredibly intelligent physician, Dr. Stanley Weintraub. Dr. Weintraub handed me a card to my genetic counselor and told me I needed to get tested to see if I had the BRCA mutation. I looked at him in astonishment because various physicians I had seen before had not said anything about this. He explained quite firmly that there was no way of knowing for sure without being tested. I placed the card he gave me in my wallet. He had a follow-up with me. “Did you have the test?” I said “Give me a @#$%# break.” I’m not going to tell you what he said back to me- I felt like he was badgering me, etc.
Decided to be tested in February 2008. Upon meeting genetic counselor, gave me a high degree of encouragement that she would be surprised if I tested positive- then, as required to do, said if I were positive- I said that I would have my ovaries removed because I was aware that it was much more difficult to detect ovarian cancer, etc. After that, my husband and I left the office and prepared to return in a month for good news.

I did replay in my mind how I would feel when she said I was negative- that morning, I started thinking maybe I could be positive- after all, my mother had had breast cancer, etc. I told myself Dr. Weintraub was just being cautious, etc. I tried to look at the genetic counselor’s look on her face. She blurted out, “You tested positive” and I was shocked. Initial thoughts: How unlucky could someone be? First being diagnosed with breast cancer at 50 years old, and then being told I carried this gene which would haunt my children, grandchildren, etc. I began to cry- I was left to deal with this news in my very own personal way. My husband and I left the office and proceeded to drive to work. I’m not even sure how I got through the rest of the day, especially because that afternoon I was supposed to meet with the president of my corporation. Went back home, lay in bed and absorbed this information- those 3 days in bed were not pleasant- I was crying and struggling with that- so 3 days later, when I finally emerged from my bed and returned to work I had sorted out in my mind how I, Anne Frisch, was going to use this information to empower me and others.

Called my surgeon and asked for a referral to a gynelogical – first thing to do was to remove my ovaries which were nothing but a ticking time bomb- many of you may think of this as a cavalier attitude, but I decided to battle this genetic nightmare. Having breasts removed, met with a plastic surgeon- we discussed various breast reconstruction options- we scheduled to have this on December 1, 2008- one week from tomorrow, I will once again return to the hospital for what I hope is the final stage in my battle with cancer- 10 hour surgery to remove and reconstruct breasts. My family and I want to use this information to help us catch cancer before it catches us. There is hope for us to continue to celebrate life. If someone told you that there was something you could do to save your life or someone else’s, wouldn’t you want to do it and wouldn’t you want to know what it was- isn’t our goal to celebrate life in very real ways? We all have fears of surgery and loss of body parts- I will confide in you that I feel this very way but I fear cancer more. I want to see my children and grandchildren married- I want to spend the golden years with my husband. I want to help my eldest daughter Jaimie cope with the fact that she recently found out that she is a BRCA carrier as well and more than anything, I want to help […] catch cancer before it catches us.

QUESTIONS

Yonah: Rav Willig, based on what we have seen tonight and based on what you said, would you then say that there is a halakhic mandate to actually do something?

Rav Willig: Do something means the surgeries?

Yonah: Yeah

Rav Willig: I thought I said it before but I’ll say it again. In the Igros Moshe we quoted, that was only a 5% risk- we only discouraged surgery because of the risk factor associated, without this risk factor, how much more so a 55% chance- so I believe these surgeries should be done, may be done and maybe from the halakhic perspective MUST be done in order to save lives.

QUESTION: For Dr. Waintrabu- there was an article in Nature about using microarrays to look for metasteses of breast cancer- is that technology used

ANSWER: Microarrays are not being used to diagnose breast cancer or used for risk of cancer. The only thing for which they are being used are different sensitivities to different thereapeutic options for each cancer- not yet in this group of patients, though.

QUESTION: Getting back to the issue about shidduchim, would it be a halakhic mandate for the woman/ man to say they are BRCA positive? Let’s say if they have a

ANSWER: Kay. That was the hardest question of the night. I spoke on the past about disclosure in shidduchim. I believe that matters of health can be divided into various categories- there are some that obviously have to be disclosed as soon as possible, dramatic, radical issues that a person has, male or female; there are some that are so insignificant that they need not be disclosed and there are many that I believe need be disclosed but not initially, not at the very beginning, because if a person is required to disclose at the very beginning, then there is a serious posisiblity of compromising this. I think this is one which belongs in the middle (disclosed in the middle of dating.) This young man asks around or maybe his parents ask around about the health of the family say oh no, this must be osme kind of a hereditary situation- may be something which people are presuming- not required in my view to reveal it upfront, but she should reveal it as the relationship progresses. It is absolutely a halakhic requirement? My Rebbe R’ Soloveitchik told a person it need not be disclosed (for Morfan’s Disease) and then it came out anyway and this woman then had a broken engagement. Igros Moshe Teshuva- incredible teshuva about a girl who never had a period- you get married and hope it gets better and agree that if it doesn’t get better, three years later you agree to take a get. And then this man is divorced after three weeks! How could he say that? Because his heart goes out to every Jewish woman- I don’t know if I could give such advice. What will happen if after six weeks of going out and saying I have diabetes? I’m going to discontinue the relationship and how come you didn’t tell me in advance! I always say- send them to me. And then I pull out R’ Moshe’s teshuva and show something much more dramatic than I would say and say don’t look at me- we care for every Jewish man and every Jewish woman- we try to do the best we can, very delicate balance- some of the parameters involved.

QUESTION: This is for Dr. Waintraub. About what percentage of your patients opt for intense surveillance?

ANSWER: Almost all of them, just like the ___ that I showed you from the internet, will have ovaries removed, mastectomies, etc in due time- the question is when. Women who have had their children- it’s not too difficult to convince them under laproscopy to have them removed. Ovaries are fine, but breasts are a different story- there is a tremendous emotional attachment which we respect. On the other hand, we have a whole group of women who don’t have this gene, who are taking their breasts off- this has been written up in the New York Times- some who are taking them off barbarically for no reason!

QUESTION: For women in your intense surveillance program, do you have psychological counseling available to them?

ANSWER: Yes- blessed to have a very strong group of people who work with these patients to talk to them and work them through. Remember it’s not just the patient- it’s children, brothers, sisters- and you saw on the slide, not everyone wants to be tested! The answer is yes.

QUESTION: Considering the fact that most women our age won’t have their ovaries removed, why would we get tested before we have children? Why not just wait till we have children?

ANSWER: I’d love to have my daughter answer the question- this is my daughter who is 21 years old and opted to be tested. STACY: We went to a genetic counselor and she basically sat down with us an explained almost everything the genetic counselor here explained- my mom was like, maybe you shouldn’t get tested till after you have kids- we both agreed together; me and my sister don’t’ think it will emotionally affect us SO much at this point. My sister did test positive; I tested negative – she’s 24- bittersweet- I know that my sister is going to start being tested, yearly MRIs and mammographies each year- I tell people from experience if you have someone in your family who is positive, get tested for it- it is a decision to make amongst individuals. For me and my sister, I have supported my sister and my mother- it was a decision we made within a month’s time- she is at an advantage- she is allowed to get that extra screening that I am not able to receive.

DR. WAINTRAUB: Couldn’t have answered that any better. Normal woman gets started at age ____ but with her sister, we’ll start her at age 25. But look what happened- Anne’s mother had cancer at 60, when Anne got it at 50, 10 years before, so we need to worry about Jaimie 10 years before, probably around 40. I have patients who don’t want to know- I give out referrals all day long; most patients throw them in the garbage. The young girl who died whom I have never recovered from- 20 year old girl who was pregnant from Monsey- and when I told her to get cancer the mother said absolutely not, and the Rebbe said no. Knowledge will help people- R’ Willig is right.

AARON: This is going to be our last question- any other questions you can approach the speakers.

QUESTION: In other discussions, we discuss about predetermined genetic- in vitro- that hasn’t been discussed at all-

GENETIC COUNSELOR: IVF is usually used for people who are unable to conceive spontaneously and conception takes place in a laboratory – pregnancy takes place in the usual manner. PGD is to say that we are aware that one or both members of this couple have a genetic mutation and would like to avoid having a child with this mutation. So if your question is can PGD be utilized to hopefully avoid having a child with that mutation (BRCA) and the answer is yes.

QUESTION: In that case- get tested and then don’t have kids who have it! Doesn’t that sound more like-

ANSWER: Certainly sounds like an option- reasonable strategy for one person’s situation, not for all people.

*

Thank you.

Twilight, A Parody

'Ware the spoilers.

*

SCENE 1

Bambi gone wrong.

SCENE 2

England has suddenly become a small town named Forks.

SCENE 3

VerySexyBella arrives. VerySexyBella is suddenly solicited by the Geek, the Jock, and ignored by Edward Cullen, Mr. Mysterious.

SCENE 4

VerySexyBella has biology class with the Mystery Man. His jaw muscles tighten when she walks in and he contorts his face as though he smells something bad. VerySexyBella wonders whether her perfume has gone skeevy on her, and smells her hair. Mystery Man chokes back a sigh of longing and dashes out of class.

SCENE 5

More teenage angst

SCENE 6

Nemesis Wolf-Man (nee Jacob) hangs around with VerySexyBella. Mystery Man doesn't like this.

SCENE 7

VerySexyBella has her life saved by Mystery Dude, who later seems to regret it.

SCENE 8

VerySexyBella hangs out with MysteryDude, whom she has identified as a Vampire. Lots of painfully bad dialogue ensues, including takeoffs from the Garden of Eden and Snow White. At this point in time, Edward morphs into Tarzan and jumps around a lot of trees. To make it all perfectly fantastic, we steal from Rip Van Winkle and play baseball (no longer bowling) during thunderstorms.

SCENE 9

VerySexyBella is in danger and has a "hurt him to save him" moment with her dad.

SCENE 10

VerySexyBella goes off at breakneck speak to hurtle into danger. Later on, there is a ripoff of Harry Potter & the Sirius Black scene with a VerySexyBella & her Mom scene instead. However, rather than the Department of Mysteries, we have a Ballet Studio. Not as cool. At all.

SCENE 11

Edward/Tarzan arrives on the scene and saves Bella's life, then almost kills her (that heroin blood will getcha every time.) He regrets this for about....two minutes, but then assures her, in her hospital bed, that it's all going to be fine.

SCENE 12

Werewolf Guy (Nemesis Wolf-Man, nee Jacob) has been paid by his father to tell VerySexyBella to break up with her undead boyfriend, which she refuses to do. VerySexyBella's love affair with her would-be-murderer continues at the prom, where he dances with her (more ripoff from the Yule Ball. Tarzan, you've got yourself confused with Diggory).

SCENE 13

Woman who has clearly killed Iorek and wears his panda white skin as her trophy (unless she's masquerading as Narnia's White Witch) comes sweeping down the stairs with ill intent, clearly paving the way to sequel movies 2, 3, 4 and god knows how many more

ENDING

insert fangirls: *swoon*
insert audience: holy crap, I can't believe I paid $12.50 for this ticket
insert moviemakers: haha, we hauled in a bunch of fangirls with this sheer and utter trash
insert cleolinda jones: i am going to make a rocking movies in 15 minutes out of "twilight"
insert guys: *scanning movie theater approvingly* this is totally the pickup place for all the hot girls
insert me: why the hell didn't they make a movie out of amelia atwater-rhodes' freaking beautiful vampire books?

Saturday, November 22, 2008

My Boyfriend

Today in shul, a boy came up to me and said, "I didn't know you!"

To which I explained that he had not seen me before because I was a guest, and therefore new.

After which, after thinking it over, he inquired as to whether I had been there last week, because he believed he recognized me. However, I had not been there, and so I told him that he was mistaken.

Later, he came over to me and told me, "I would like to kiss you!" In shul, in front of all the ladies- can you believe it?

So of course I let him give me a kiss.

He informed me that I was his girlfriend now, and complimented me on my attire.

He is four years old, and his name is Andrew. Andrew darling, I love you!

Friday, November 21, 2008

Wednesday, November 19, 2008

The First Kill

A story

Hiding beneath the table, she cowered in fear. Her eyes were wide and huge, beautifully fringed by black lashes, and she struggled to muffle the sounds of her breathing, lest he hear her. There he stood and he was her friend, Nate, whom she had loved since she was young. Nate had been at all her Christmas parties, had grown up helping her rip the paper from her presents and exclaim in glee as she had shouted in delight, and thrown her arms around him to hug him.

But now Nate hunted her with a gun, stepping over the glass and rubble that was her apartment, carelessly walking over the body of her father, which was lying on the floor. Melanie choked back a sob. Nate stood to attention, coming closer. She almost wanted to stand up and just shout at him: “Don’t you know me? Don’t you remember me? How can you hate me!” but she knew to do so would be stupid. She had watched him and his family burst into their apartment and begin firing bullets at random; she had watched stupidly; she had not even known he had owned a gun. Then, frightened, she had heard her mother scream her name, and she had run and tried to hide- but her hiding place was clear, and sooner rather than later, Nate would come to her.

The problem had to do with her sign. When she was younger, she had never thought much of it, but everyone was tattooed at birth with the sign of their caste and status. She was a swan, rare and respected, while Nate was a sun. The tattoos were on your cheek, and so there was no way you could hide them, and if you tried to tattoo over them, in order to blot out the swanlike shape, anyone could tell. If you covered your face with powder, you would be killed for not having the symbol, because it was the law. And so she, a Swan, once a member of the ruling caste, was now to be murdered and shot down by a simple Sun.

She had never thought of Nate that way, though, had never seen him as nothing but his cast, nothing but the image on his cheek. She had loved him like a brother, had danced with him, played with him, otherwise spent her childhood benefiting from his guidance and direction. And she believed he had loved her, too; she remembered all the different times that they had been happy together. Could it really be that he believed that everyone other than a Sun was automatically evil, automatically deserving of death? How could this be the Nate she knew? Frightened, she heard him step closer, the glass crunching under his feet. She could not help but involuntarily shiver, pulling her arms tightly around herself, trying not to let the whimper she knew she was making escape.

And then he was there, right in front of her, looking down at her, and there was such compassion in his eyes. “Melanie,” he breathed, and it was different from what she had expected, different from the automatic bullet she had expected to greet her. Dumbly, she accepted his hand as he lifted her up, stood her on her own two feet. He looked at her and his breath came faster, became labored, almost as though he was drinking her in with his eyes, memorizing her. She looked at the gun in his hand, which he had placed by his side. What was this? Was she, through some miracle she could not possibly comprehend, to be saved? She was tentative, frightened, wondered what to do. But he simply looked at her and continued looking at her.

Then he kissed her.

Forbidden, illicit, for a Sun and a Swan to kiss! People only married within their own caste, within the sign under which they were born, as all of this was determined astrologically- who would be best suited for whom, and why. But there was a sweetness to this for the very fact that it was forbidden, and she found herself reaching up higher, pushing aside the awareness that only that morning she had watched his family murder hers, watched him destroy everything she loved- she overrode everything because she hoped, in desperation, that this would be her ticket out, and her way to escape.

But then she saw him step back, cock his gun, and bring it to his hip. “It’s a pity,” he said, and then he shot her and she staggered, fell back, slammed against the floor, and with a cold precision he smiled, and said, “Filth.”

He watched her as she struggled, twisting and jerking on the floor, “You are filth; did you know that? You Swans have oppressed us for far too long a time. We will finally get what we deserve; we will finally triumph.”

Angry tears came to her eyes and she struggled to speak but could not. She did not have the words, and she did not have the power. All that she had was her rage, and the darkness that flooded her as she was embraced by another world. Gone was her ability to retaliate, to fight back, even to explain to Nate where he had erred, the fact that he had listened to the lies on the radio, that he could not even realize what he was doing, that he was truly killing another person- no, he could only do it if he saw her as filth, as vermin. In truth, he was a coward. In truth, he had no ability to kill. It was only the demon image of his imagination, which had been constructed by him for those who stood the most to gain, whom he could kill, whom he could shoot.

And she saw it fill him, the recognition, the realization, and he threw down the gun and trembling, trembling, he seized her in his arms and words dropped from his lips, of self-recrimination and self-loathing, and even then she knew that he was destined to become hardened; this would have been the most difficult kill for him, because he could not help but see her as a person, as a human, living, vibrant, breathing- but she knew that he would not see anyone else that way. A cold iron would fill his soul and dance through his eyes, and every time he looked at a person, he would see not them, but their symbol, a Swan turned into a demon, a vulture, oppressing its prey with its great, unfurled wings.

And so she struggled to do the only humane thing- the only compassionate thing- and scrabbled her hands against the floor, searching for the gun. But she could not find it, and instead, she lay in his arms as her blood soaked his shirt, and he kissed her again before laying her down, finally, and turning on his heel, to walk into darkness.

~

Credits: The Glasswright’s Apprentice

Excerpts from Rav Kook

Love of all creatures requires great effort, that it may be broadened to the fullest extent. Due to our lack of experience, this love may appear to be a matter of little importance, even contrary to the Torah and common ethics. However, [in truth,] it must constantly fill all the chambers of the soul.

The highest level of our love for all creatures must be the love of humanity, which should extend to all its members. Despite the differences of religion and ideology, despite the differences of race and environment, one should try to understand the mentality of the various nations and factions as much as possible, in order to appreciate their character and nature. Then one can know how to base the love of humanity on foundations that lead to actual deed.

Only when the soul is enriched by the love of all creatures and all humanity can the love of [Israel] be elevated to its lofty station and attain greatness, both in spirit and in practice. It is a mean eye that causes one to see only ugliness and impurity in everything beyond the bounds of Israel, the unique nation. This is one of the most awful, debased forms of darkness. It damages the entire edifice of spiritual virtue, the light of which every sensitive soul seeks (Rabbi Avraham Yitzchak Kook, manuscript cited in Mishnato Shel HaRav Kook, pp. 306-307)

~Compassion for Humanity in the Jewish Tradition, 9

*

The purpose of Israel has always been to serve as a "vessel that contains blessing" and goodness for all mankind, inasmuch as it was prepared for this from its birth. Therefore, even when [Israel] sins, turning aside from the path of God, it does so only because it has been misled to think that it will actually fulfill its spiritual mission by repudiating the Lord, its God. However, its true motivation is [nevertheless] to be a blessing unto all who are created in the Divine image and to delight in bringing benefit and happiness to all mankind, [a calling] that is permanently fixed in the innermost depths of its soul (Rabbi Avraham Yitzchak Kook, Ein Ayah, Berachos II: 115)

~Compassion for Humanity in the Jewish Tradition, 143

Tuesday, November 18, 2008

Joseph's "Crime"

I watched "Joseph" last night and found myself stunned by the simplicity of a brilliant point they made. Of all the crimes that Joseph is accused of, the idea that he would try to force himself on Zelicha (Potiphar's wife) is the most ironic, due to the fact that he had been alive, would have witnessed and seen the rape of Dinah and its aftermath (the brothers killing out the males and despoiling the city.)
    ב וַיַּרְא אֹתָהּ שְׁכֶם בֶּן-חֲמוֹר, הַחִוִּי--נְשִׂיא הָאָרֶץ; וַיִּקַּח אֹתָהּ וַיִּשְׁכַּב אֹתָהּ, וַיְעַנֶּהָ.

    2 And Shechem the son of Hamor the Hivite, the prince of the land, saw her; and he took her, and lay with her, and humbled her.

    ~Genesis 34:2
Compare to:

    יד וַתִּקְרָא לְאַנְשֵׁי בֵיתָהּ, וַתֹּאמֶר לָהֶם לֵאמֹר, רְאוּ הֵבִיא לָנוּ אִישׁ עִבְרִי, לְצַחֶק בָּנוּ: בָּא אֵלַי לִשְׁכַּב עִמִּי, וָאֶקְרָא בְּקוֹל גָּדוֹל.

    14 that she called unto the men of her house, and spoke unto them, saying: 'See, he hath brought in a Hebrew unto us to mock us; he came in unto me to lie with me, and I cried with a loud voice.

    טו וַיְהִי כְשָׁמְעוֹ, כִּי-הֲרִימֹתִי קוֹלִי וָאֶקְרָא; וַיַּעֲזֹב בִּגְדוֹ אֶצְלִי, וַיָּנָס וַיֵּצֵא הַחוּצָה.

    15 And it came to pass, when he heard that I lifted up my voice and cried, that he left his garment by me, and fled, and got him out.'

    ~Genesis 39: 14-15
Does it make logical sense that Joseph would ever force himself on anyone, having seen how it affected his sister, or the consequences of that action [on the part of his brothers?] Logically, certainly not! Which is why it is so ironic that is the crime he should be accused of...

David's Origins

With thanks to Malka, who taught this to me

In spite of his piety, Jesse was not always proof against temptation. One of his slaves caught his fancy, and he would have entered into illicit relations with her, had his wife, Nazbat, the daughter of Adiel, not frustrated the plan. She disguised herself as the slave, and Jesse, deceived by the ruse, met his own wife. The child borne by Nazbat was given out as the son of the freed slave, so that the father might not discover the deception practiced upon him. This child was David.

~Legends of the Jews by Louis Ginzberg, page 911

Source: An unknown Midrash quoted by Makiri, Ps. 118, 214. On the references to this legend by the medieval authors, see Zunz, Synagogale Poesie, 129. Comp, also Kele Yakar, 1 Sam. 17; Azulai, Midbar Kedemot, s. v. Yishai, No 20; R' Elijah Wilna in his commentary on Yoreh De'ah 157.24. Comp. note 23. Josephus, Antiqui, XII, 4.6, narrates a similar story about Hyrcanus the son of Joseph the tax collector. As to the names of Nazbat and Adiel (which occur only in Baba Batra 91a), see Gudermann, Religiousgeschichtliche Studien, 49, seq. The reading Adael and Ada instead of Adiel are incorrect; see 1 Chron. 27.25 where a son of Adiel is mentioned as King David's treasurer.

*

Compare to: Tamar deceiving Judah, Rebecca deceiving Isaac by covering Jacob in the hairy goatskins, Leah deceiving Jacob, the story of Shulamit who slept with the Egyptian because she thought it was her husband, loads of fairytales and mythological tales in various forms (Uther taking the form of Gorlois, Siguror and Gunnar in the Brynhild story), Sanhedrin 75a

Monday, November 17, 2008

Abraham

Some people do not like biblical movies, but I love them, because they generally help me understand Tanakh much better. Of course, it is not wise to watch them unless you already have a handle on the true understanding of the verses (with commentaries and suchlike.)

The Richard Harris version of "Abraham" is one such film. Watching it truly changed my life- aside from which, it made me cry. I felt like I finally connected with the story of who he was and the kind of hardships he faced which, while expressed beautifully in the Torah, take on a whole other dimension when one is watching them.

You can watch it here.

My Soul Should Be As Dust

When I was little, my father read me poems. He also told me stories, and cuddled up with me before he put me to sleep, but the things which remind me most of him are his tempered, even, but nevertheless evocative readings of "The King's Breakfast" and his playing Horsie with me. I cannot remember the number of times that I ran up to Daddy with my book and requested, "Daddy, read me a story," or begged him to play Horse with me. This, of course, is aside from the fact that all my very serious discussions have always taken place with him, no matter the hours of the night, and he has established a very clear way of explaining which of my actions are or are not appropriate.

When I was little, I didn't know about everything that my father gave up or had sacrificed in order to make sure that we would all have the lives that we do. Thank God, we have wonderful lives, with a beautiful array of possessions, and lack for nothing. When I was little, I simply assumed it was this way for everyone, but as I grew older, I learned more about my father, his personality, his teachings, his sensitivity, his kindness, his amazing ability to sacrifice despite his personal dreams and aspirations, and the humility with which he lives his life.

My father's favorite verse is found at the end of the Amidah, where we recite, "Nafshi l'afar la'kol tihiyeh" or, "My soul should be as dust to everyone." Why should one's soul be as dust? While this is discussed in Berachos 17a, my father taught me a different interpretation. If one scoops up a handful of dust, it is soft, and trickles through one's fingers. However, if one stomps upon it or beats it with a stick, it becomes more compact, hard and impossible to move [just as we learned with regard to the child's walker, agalah shel katan, Daddy!] My father believes that one's soul should be just like that. To one who treats one kindly, you should be sweet, compassionate, soft, "trickling through their fingers." And to one who treats you harshly, you should simply become compact, hard, impossible to break- but you yourself do not strike back.

This past year, my father was honored by his congregation for his years of service in the capacity of Ba'al Korei. My father does not accept honors lightly; indeed, he likes to flee from them; it is only when he feels that he has no choice that he accepts them. It was very special to be at that dinner, especially because, as Rabbi Paysach Krohn was speaking, he mentioned my father several times. He spoke about my father's capacity to truly connect with the leining as he was reading, and how beautiful that is.

Yet another illustration of my father's sensitivity is evident when you consider the letter he wrote to Rabbi Aaron Rakeffet-Rothkoff, and how much Rabbi Rothkoff appreciated it. If you listen to the beginning of this lecture, you will hear Rabbi Rothkoff mention his "talmid in Chicago"- that is my father.

My father is a beautiful person- extremely caring, extremely sensitive to others, and a greater person than the majority of you will ever have experience to know (the greatness of a man lies in what he does not do, as opposed to what he does. No one knows what a man refrains from doing; they can only judge his actual actions- it is only God who knows what is in your heart.)

Happy Birthday, Daddy! My much beloved Daddy. May you be blessed and have all your wonderful wishes fulfilled throughout this year.