It first hit me when I went to the fridge for some apple juice. Having just given blood, in another battery of tests to prepare to be a "stem-cell donor" for a man who has chronic myelogenous leukemia, I was a bit thirsty and wanted a quick shot of something nutritious. A kindly nurse directed me to an infusion room, filled with patients hooked up to various IV devices and receiving their doses of chemotherapy to fight off the various forms of cancer that were being battled in the oncology unit of the hospital where I was being tested.
Like a deep February wind off the porch on a cold, white morning, the truth hit: Mom sat in one of those chairs, hope dripping into her veins, a crossword puzzle on her knees, and after the treatment, some crunchy graham crackers and a container of apple juice, purveyed immediately following the therapy, to facilitate "getting that shitty taste" out of her mouth. As I reached down into the fridge to find the handy Mott's Apple Juice, I saw one patient meet my glance, and another look away while wondering myself, in the poetry of the season, "who shall live and who shall die?"
The liturgists who created the order of prayers for Rosh Hashanah awakened us, long ago, to the idea that the Jew is invited, in this season, to imagine his death: to face it, to contemplate it, and to decide, in radical introspection, if he has it in him to plead for mercy and change his ways so that he may be rewarded another year of life.
It's a powerful, useful, but troubling metaphor. On one hand, we can change our patterns of behavior and live, even "earn," the grace of another year of life. On the other hand, the randomness of cancer's insidious march (or that of an earthquake, a car crash, a dropped bomb--you get the point) impresses us as an unpredictable line of attack, leaving the victim as innocent, civilian casualties, helpless and without defense.
"Who shall live and who shall die" may read as "How dare you deign to say who shall live and who shall die? What God made you God?!"
All while bending down to get an apple juice. Gevalt.
It's still just less than two months since Mom died. Considerable anger and a frustrated befuddlement hover, like bad exhaust in a roundabout; and a tortuously endless abstraction of time elapses between DON'T and WALK.
At Shloshim--the end of the thirty day mourning period--I received word that based on a cheek swab from 2001 on the NYU campus, I was a clear match for a stem-cell transplant for a 49 year old male suffering from chronic myelogenous leukemia. Tests required would be intensive blood-work, full-body work-up, chest x-rays and an EKG. Assuming I pass that grade, its five days of neupogen to increase production of stem cells in the bone marrow; and then, for six hours in October I will centrifuge my blood, collect healthy stem cells, and give them to my anonymous recipient.
Yes, I said.
And that's when I knew that, despite being dead, Mom was still very much alive.
The apple juice was delicious. The doctors, brilliant. The nurses, skilled and handsome. Even the hospital elevators seemed to run on time. The heavens played beautiful music and all around was amity and love.
Back in April, when faced with the choice that we knew would likely shorten her life, Mom elected one more round of chemo. There would be insurmountable bone, skin and organ pain; vomiting, diarrhea, loss of appetite and severe depression; temporary dementia, disorientation, and anger; continued paralysis, lethargy and total dependence on others. Mom went for it. "Beats the alternative," she deadpanned.
"Who shall live?"
She did: from April to late July; and on that journey she took her children on a walk "through the valley of the shadow of death." She feared no evil. Goodness and kindness did pursue her, all the rest of the days of her life.
There were so many days, so many texts among us, so many phone calls, so many sighs and words shared over lunches and dinners and breakfasts and coffees and beers, wrestling the reasoning down to the ground about the right and the wrong of the decision to seek more treatment, to shine light one more time in the dark corners of cancer's death sentence, to accept or reject a doctor's heroic gesture or determined statistical struggle with cellular development, chemical compounds and disease.
But through four and a half hours of tests on Wednesday, as I watched my deep red blood flow into test tubes and then heard like a Philip Glass opera my EKG beep and print its map onto a page, I came to see that Mom took us through the valley of the shadow of death not only for her but for others: for others' blood and others' lives; for others' hopes and others' tears; for herself and not herself. For all those places, blank spaces, pure white hope of no assignation: for the not-yet-dead and not-yet-alive.
"How awesome and full of dread."
I can't believe there's a God who has asked me to choose between the lessons of a dying mother and someone else's dying son--who is exactly my age. I can't believe it until I hit the wall of paradox right before my eyes. I don't have to choose.
More often than not, we're chosen.
And the question remains one that has "always been asked on these hills."
What did Amichai write? "Have you seen my sheep?" "Have you seen my shepherd?" And the door of my house stands open like a tomb where someone was resurrected."
A choice we make every moment of every day.
Who is the sheep?
Who is the shepherd?