I have written over and over again that the purpose of prayer is to change us, not to change God. How has this theology stood up to my current medical crisis?
As I had requested, my physicians were impeccably honest.
Before surgery: "Due to excessive barium residual from your upper G.I. tests, we can't get as clear a picture as we would like from the CAT scan. What we do know for sure is that you have a large obstruction in your stomach. Though we have reason to suspect malignancy, we can't be sure of that or know how extensive the surgery will have to be until we actually operate."
After surgery: "Our suspicions were accurate. In removing about half your stomach, we think we got out all the malignancy from that organ, though a couple of 'overflow' spots remain outside the stomach. After your wounds have healed sufficiently, we'll probably treat these with chemotherapy. The healing, however, must come first."
I quickly learned that there are degrees in honesty. Or, more accurately, significant differences in the transmission of honesty. A gastroenterologist, called in as consultant, burst into my room while my children and two grandchildren were visiting, and-with no more sensitivity or emotion than if he were announcing last night's football score-proclaimed: "It was definitely stomach cancer!"
What a contrast from the behavior of my regular urologist who, four years earlier, after prostate tests, had softly said, "We seem to have discovered a few abnormal cells. I'd like to sit with you to discuss alternative procedures." Basically, the two were saying the same thing. One was a physician, a healer; the other was a medical mechanic.
No Escape from Truth
More starkly than ever before, I confronted my own mortality. More fearfully, even, than in military combat on Iwo Jima. For one thing, I am a half-century older now than then. In addition, nature has an uncanny way of administering a kind of emotional anesthesia to men in combat. Much of what is later labeled heroism is, at the time, just executing programmed behavior, acting out automatically things we were trained to do. The extreme emotional impact of what I had endured on Iwo Jima didn't hit me until I had boarded the ship which was to bring me back to Hawaii and a waiter in the officers' dining room served me a bowl of hot soup. For the first time in all the horrible preceding weeks I burst into tears. This time, well into my eighty-sixth year of life, there could be neither avoidance nor delay.
So-not morbidly but realistically-I confronted my mortality. Was my Living Will, drawn up and distributed years ago, still adequate? What else needed doing now to make things easier for loved ones who would survive me? I have every reason to be optimistic about the short-term outcome of my current therapy. But at this stage of life, my current medical crisis brought to the frontburner matters that should have concerned me in any event.
Next on the agenda was my own mental attitude. A hospital patient begins to feel like a piece of inert cloth, to be stitched or stretched entirely at the will of others, with no independent control, no vote on alternative procedures, no direct role in making vital decisions. To counteract this shadow of absolute impotence, I began to study alternative medical procedures, treatment approaches which had previously interested me casually, if at all, but which now became existentially imperative. Perhaps it would be more accurate and helpful to call them complementary procedures rather than alternatives. It isn't a matter of choosing one while entirely rejecting the other. A good friend of ours, a nationally known physician, has pioneered in this field by creating the curriculum for a Harvard Medical School course aimed at synthesizing the insights of Western, scientifically-oriented medicine with those of traditional Chinese medicine.
What makes the choice more difficult for patients is the intrusion of patent fraud. There are too many fakers among both therapists and drug manufacturers who prey on the anxieties and fears of those desperately searching for ways to play a conscious role toward recovery from cancer.
On Making Choices
How does one choose among the alternatives which appear legitimate? This, obviously, is a matter of individual temperament and disposition. Almost any legitimate therapy can help at least as a placebo for those who firmly believe in it. For myself, I find that such procedures as hypnosis, bio-feedback, and therapeutic or healing touch-to the extent that I even understand them-are neither persuasive nor instructive. I am not a mystic. While I have moved far enough in recent years to recognize that neither science nor reason nor any combination of the two can suffice in our quest for life's ultimate meaning, I cannot accept any approach that abandons these disciplines or detours around them. I do not resonate to any kind of "higher consciousness" that eschews human reason and investigation. Perhaps the fault is mine; perhaps I have not reached a level of experience which is still on the growing edge of evolutionary development. Perhaps in the end of days my suspicion of what I call these psychic detours will prove warranted.
True, after all our efforts at reasoning and investigating have been fully exploited, a vast area of mystery remains. My inclination at this point is to push our intellectual efforts even more vigorously, not to abandon them. I am convinced that our human minds are among God's most precious gifts, granted to no other species of life we know. To abandon our minds is to condemn God, their giver. Whatever complementary therapeutic procedures I embrace, therefore, must supplement the yield of my mind, not repudiate it. I believed this before my cancer was diagnosed; I believe it still.
The one important new approach for me is imagery. Each night-sometimes as part of my prayer, sometimes independent of it-I try to visualize the struggle going on within the cells of my abdomen. I "see" the cancer cells as bright, burning red. They are gradually being diminished and diffused by soft, blue-green cells of healing. These emanate in part from the curative chemicals being injected into my veins, in part from the great cosmic Healing Power in which I have always firmly believed. Night by night the red spaces grow dimmer and smaller, the blue-green ones slowly displacing them. Thus do I reinforce my intellectual conviction by "seeing"-visually, almost kinetically-a healing process which is, in all literal fact, occurring hour by hour.
Does this imagery, in fact, affect the eventual outcome? Only insofar as it reflects and reinforces the role my spirit and will-active adjuncts of the ineffable Healing Power which suffuses all nature, including ourselves-can play in determining the ultimate outcome of this existential drama. But for me this "only" provides a wide margin for optimism, faith, and hope. It reminds me that I am not alone in my struggle.
The Ultimate Test
In many ways this whole experience has been a crucial test for me, not least for the theology to which I have subscribed and expounded all my adult life. I have consistently taught that God operates within nature, not from outside it. I have insisted that God works within the divinely created and inspired laws of nature-both its spiritual and its moral laws-never suspending or interrupting them. I have preached that God does not perform miracles, not in the usual sense of that term, and that mature prayer does not ask for such miracles. I have written that the purpose of prayer is to change us, not to change God.
How has this theology stood up to my current medical crisis? The temptation to deny it has been great. In my initial moments of intense fright there were times I felt again like a little child, reaching out desperately for an omnipotent parental hand to alleviate my pain, assuage my fear. But I have-may I add "thank God"?-resisted that temptation. My faith has passed the test.
I pray now more frequently, probably more fervently than before. My prayers are addressed more often than ever to God as Rofay cholim, Healer of the sick. I believe, as firmly as ever, that one of God's most wondrous manifestations is as a curative Power pervading all nature, including ourselves. I am a partner of that Power. Judaism taught me that long ago when it affirmed: "Ha-adam shutafo shel ha-Kadosh Baruch Hu-Each human being is a partner of the Blessed Holy One."
There are no guarantees that our partnership will succeed. Life never offers guarantees-only the assurance that, if we do our human part as diligently as possible, God's chances of succeeding will be greatly enhanced. This gives me the assurance and strength I need.
Recently a good friend asked me, "Did you react, as so many people do under this circumstance, by wondering why God inflicted this disease specifically on you, whether this cancer is in some way a punishment for something you have done wrong?" My emphatic answer is negative! I do not believe that God is a proximate cause of my disease. As long ago as the twelfth century, Maimonides asserted that God sustains nature in its larger operations and designs, not in each immediate instance. Which means: God determines the general conditions that bring rain, not the specific occasions when rain will fall.
I agree with Maimonides. God has created and directs nature so that certain conditions cause cancer. I do not, cannot, and will not believe that God chooses me or any other individual to be afflicted with cancer. Had we human beings devoted to medical research one-tenth the energy and money we have expended on devising new methods of killing each other off in warfare, we most probably would have discovered the causes and cures of cancer long ago. The fault is ours, not God's.
One thing more: for several weeks after surgery, in the shock of absorbing such bitter-tasting truth, I found myself concentrating almost entirely on the day's immediate physical needs. I realize now that this is not the way to fulfill my partnership with God. I have always worked toward long-range ambitions and goals, always gone to sleep at night with an eager assurance that morning would bring new opportunities and challenges toward the achievement of such goals. I am trying now to renew that conviction.
I contemplated writing this article for weeks before finally sitting down at my typewriter. At this very moment, more than at any time since surgery, I feel an urge to remain at the keyboard till day's end and return to it tomorrow.
Decades have passed since I last attempted a major exposition of a Jewishly-oriented naturalistic theology. In light of what I see as today's flight from realistic acceptance of human responsibility and tendency to mystic escapism, the time has certainly come to assume that task again. I hope to commence it soon. Again, no guarantees, not even that I shall live to complete the first chapter. But merely to commence the task and pursue it is to increase the probability of healing and survival.
I see God in the tender concern and care of many among my physicians and nurses, in the tireless love and attentions of my wonderful wife, in the steady concern of children and grandchildren, in the devotion of so many friends who have traveled uncomfortable miles to visit me. And in the revival of my own spirit from moments of near despair to this time of faith and hope.
Rachel's Shining Light
I see God in one of my youngest friends. Rachel Simon will be embarrassed when she reads this. Both physically and spiritually she is one of the most beautiful persons I have ever known. At the age of twenty-one, only months after graduating from college, she was diagnosed with acute leukemia. Her prospects seemed dim, the prognosis far from encouraging. Her only long-range hope was a bone marrow transplant. She could not have survived the months of awaiting a suitable match without the encouragement and love of her parents and sister, nor they without her indomitable spirit.
Finally, an acceptable match was identified and the transplant made. For months Rachel had to endure semi-isolation. She was not allowed any social contact with friends; even her parents and sister had to be carefully gloved and masked when they were with her. She lost her hair and much of her natural immunity, but never her courage.
Determined to transpose her dreadful experience into strength for others suffering a similar plight, she created a series of illustrated posters, one of which is displayed in the oncology treatment center of Boston's Beth Israel Hospital. I have stood before it almost reverentially more than once when receiving my own treatments. Entitled "Mirror, Mirror on the Wall," the poster depicts Rachel herself reflected in a mirror at a time when her hair was just beginning to grow back. Her beauty is nonetheless transparent and transcendent. The unforgettable words inscribed below her picture read: "When my doctor told me I had Leukemia, my first thought was that I didn't want to lose my hair. I even covered my mirrors so that I wouldn't have to look at myself. Living with cancer has meant learning from the day to day challenges. Now I have the strength to uncover my mirrors, but more importantly, uncover the stronger person I have become."
I do not know the specifics of Rachel's religious faith, never having discussed them with her. Whether or not her relationship with God resembles mine is unimportant. What I do know beyond doubt is that she is one of the most genuinely spiritual individuals I have ever known, that she shines forth with the light of God within her, that she provides a wondrous model for me and for all who must confront the dread reality of cancer.
For that, I thank her with all my heart. And, in words sanctified by centuries of Jewish faith and hope, I thank God. Baruch atah Adonai, Elohenu melech ha-olam, Rofay cholim-Praised be the Eternal our God, Healer of the sick. Amen."
Roland B. Gittelsohn, z'l, was rabbi emeritus of Temple Israel in Boston and served as president of the Central Conference of American Rabbis and the Association of Reform Zionists of America. He authored numerous articles and books, including Love in Your Life, Wings of the Morning, and Partners in Destiny: Reform Judaism and Zionism (UAHC Press). He died on December 13, 1995.