That this seemingly simple mechanism--cell growth without barriers--can lie at the heart of this grotesque and multi-faceted illness is a testament to the unfathomable power of cell growth. Cell division allows us as organisms to grow, to adapt, to recover, to repair--to live. And distorted and unleashed, it allows cancer cells to grow, to flourish, to adapt, to recover and to repair--to live at the cost of our living. Cancer cells grow faster, adapt better. They are more perfect versions of ourselves. (Siddhartha Mukherjee, The Emperor of All Maladies)To grow, to adapt, to recover, to repair--to live.
Those words weigh heavily when we prepare to face death.
I was once talking to a friend who had lost his wife to a sudden death. Talking to one another one afternoon, reading the paper, game on tv, when suddenly, like a burst of thunder, she was gone. My dad died that way, I told him. And we talked about which is better: to lose a loved one in an instant or to prepare the way, to visit, console, make plans, and then say good-bye.
"I'd take the 'sudden' route again," he said quietly. I leaned the other way.
As I re-read Siddhartha Mukherjee's extraordinary work--a volume I have learned from enormously along with Jerome Groopman's The Anatomy of Hope--I am reminded of exactly this critical point: That to live is to master the difficult work of growth, adaptation, recovery and repair. Those individuals who tragically don't have an opportunity to do so (because of sudden death) or who live inside of the remarkably powerful human capacity for denial that anything is actually terminal--miss the chance to live on the dimension of life that leads to death: a journey that is the most difficult but that ironically is the journey that brings the greatest blessing to our existence.
Who would we be without the lives and deaths of all those who came before us? In what ways are our lives already impacting those who will long outlive us? And what does it require of us to be cognizant of these interconnected realities, their lessons, their many-dimensioned meanings?
Mukherjee reminds us of Solzhenitsyn's Cancer Ward, in which Pavel Rusanov speaks of his illness as a prison, a metaphor often described by those we've met facing terminal illness. An inexorable, inescapable closing off of possibility, of life.
Still seared in my own memory, however, is a text to which I return over and over; a real life text from the moment we buried my grandfather on a cold winter day in Wisconsin. Snow on the ground, ice in the trees, and my grandmother, Russian-born, throwing herself on the ground and crying out, "A dead man, a dead man." I was about to turn ten that winter but at that moment did not feel terror at the site but rather love. Love for my grandfather, my grandmother, my father (broken that day) and then later, at Shiva, utter fascination and comfort with the celebration and warmth of the community back in my grandmother's apartment. So much language, so much food, so much life.
One night at Shiva, while in the back bedroom at my grandparents' apartment, looking through my grandpa's doctor's bag, I laid out all the instruments of his work: blood pressure pump; stethoscope; reflex hammer. A cousin burst into tears at Grandpa's absence and then I had a flashback to the last time I saw him. My dad had driven us to Mount Sinai Hospital, parked the car on the street, and then went upstairs to his room, where he brought him over to the window to wave good-bye. Down on the sidewalk, on a cold winter day, I looked up toward heaven, at my hero, diminished within the walls of his illness but smiling, sending kindness and love in my direction. This is the image of an uncontainable man: no illness, no plain pine box, no hole in the ground.
The prison, to be sure, is in our minds.
הכל צפוי והרשות נתונה ובטוב העולם נדון והכל לפי רב המעשה -- Rabbi Akiva taught that "all is foreseen yet free choice is granted; the world is judged with with goodness; yet all is according to the predominance of deeds.
What we make of our time comprise the blessings and the curses of our lives.
That's why when someone dies we say, "May his memory be a blessing." Because our own unavoidable experience of death, our own coming to terms with our own mortality, necessitates our own 'growth, recovery and repair.'
Not a closing but an opening, into life.
רבי יעקב אומר העולם הזה דומה לפרוזדור בפני העולם הבא התקן עצמך בפרוזדור כדי שתכנס לטרקלין--Rabbi Yakov said, 'This world is like a vestibule before the world-to-come; prepare yourself in the vestibule, that you may enter into the banquet hall.'
The catering there is even better.