Who shall live and who shall die?

Ever since this whole episode of my life started, my mind has zoomed in the Yom Kippur prayer that asks, in the new year, “Who shall live, and who shall die”, and then goes on to list all the various ways a person may die. The prayer concludes each section that prayer, attrition, and acts of loving kindness nullify the decree. I have always believed this quite literally. I grew up reciting it, singing it and truly believing that my fate was written to live or die and that how well I live and what I experience through the new year is guided by the depth of my conviction to repent my sins of the year before, to resolve to do better and to actually stick to that plan – that secret agreement with G-d. I have never thought of it as an onerous or outmoded way of thinking though many would say that it is. I believe and I simply don’t have to prove or demonstrate anything beyond that, because, as Douglas Adams (and I can’t believe I would actually bring one of the world’s best science fiction writers who had no bones with religion into this argument, but he wrote something so cogently that I can’t help but use it here) wrote, “proof denies faith and without faith [G-d] is nothing” (of course man gets run over in the next Zebra crossing, but that’s besides the point.).

My point here is that I have focussed on the death side of the Jewish equation. I was convinced I was on the list of who shall die. And while the love and will of my family wouldn’t let that happen (G-d forbid), I still had this moribund obsession with this. Then a few things happened that changed my mind.

First, after the bone marrow biopsy tests came back and were told the bad news that my marrow only went from 95% to 80% leukemic and that we were hoping for 5%, we started discussing treatment options and I requested an opportunity to seek a second opinion from outside of HUP (Hospital of University of Pennsylvania – this is where I’m being treated but it’s commonly referred to as HUP). The doctors agreed and we tried contacting three well known/qualified oncologists back in NYC. In general, I can sum up their comments like this: given my type of leukemia, I am in the best place possible to seek any opinion, and that generally, none of those other doctors were willing or qualified even though some are quite well known and respected in the medical community.

Second, I came to realize that though in my mind I knew I needed to move to Philadelphia for work, my heart was never really into it. But I had the good fortune (fate?) of meeting some wonderful people and getting acquainted to some neighborhoods and neighborhood institutions (i.e., food places of interest 🙂 ) that started making me feel like Philadelphia’s still not my first choice, and I’ll probably run up to NYC quite a bit, but it could be livable.

Overall, the revelation is this: I have this life-threatening disease and I have to believe that there was more than a little divine intervention to get me to Philadelphia and to these doctors who are probably the best qualified in the world to treat me. I am on a floor with 28 other patients. At times, between doctors, fellows, residents, interns, nurses, CNAs and other staff, the patients are the minority on the floor. We get excellent care that we most likely wouldn’t get anywhere else.

So now I am convinced that I am on Who shall live side of the equation. Look – this diagnosis of where I’m at with my leukemia levels ain’t great. A second round of chemo is not uncommon but it is also what we were hoping to avoid. To be frank, if it doesn’t go into remission after this round there are still options open but they all carry very high risks and mortality rates. But after crying to my oncologist yesterday that “I didn’t come to Philadelphia to die” she assured me that whatever it takes, however long it takes, that I will get through this. It won’t be easy, but I will live through it and go on with my life.

I think I’m so anxious to get on with my life that I want to see that light at that end of the proverbial tunnel a little closer and I don’t want it to be a year out which is an outside likely chance. But if it takes a year to save my life, then I’ll take the time.


4 Responses

  1. Dear Seth, You have amazing ability to synthesize information, emotion, thoughtfulness and the courage to express yourself despite much inner turmoil. This is truly one of your many gifts. As you say, you were guided to Phila. to get well and continue sharing your insights, outlook, creativity and love of family, friends, world. I believe we are all connected by a spark of Divine light within each of us. As we all draw closer together in support of one another, we make that light so much brighter and we all drawn strength from that light. Much love, dearheart, ABJ

  2. Seth–I admire your spirit and honesty as you confront the next steps in treatment. Your ability to write eloquently about the situation is extraordinary (Yom Kippur services and Douglas Adams woven into one paragraph!)

    I spoke to a friend who went through about a year of intense chemo (different situation medically from you, but not emotionally).

    Her advice to get through the darkest days and the physical ill effects of the chemo is to tackle everything in small chunks. The “normal” (ie driven, amibitious, intellectual) part of you is setting goals–“I want to be out of the hospital by (fill in the blank–April 15th, the first day warm enough to swim, etc.) But at times you need to quiet that side and focus on the day to day. “Today I will watch one movie, read one magazine, make one post, answer one e-mail.” Feel accomplishment in doing four things in that single day.

    I am not sure if this is helpful to you, but my friend said it was the only way she could get through the experience hour by hour without going crazy.

    Thinking of you every day,


    P.S. On a lighter note–something to look forward to–a bunch of travel magazines are on their way for you and your Mom.

  3. Amy,

    Your friend’s approach about getting through the smaller things like that on a daily basis is a wonderful idea and I’m going to remember that for the down days. Yesterday was one of them and I think if I had some realistic goals – listening to a new short story, one chapter from Barak Obama’s book, getting through X-number of emails instead of the big ambitious things I always try to do, it would certainly work out for me better.

    And we got the travel magazines today – love ’em! Thank you.


  4. Dear Seth,
    You are now, as you were when we spoke in my office many years ago, a very special kind of person. Who else that I know, could write such an beautiful and meaningful few words on the Yom Kippur question of “who shall live and who shall die”. We pray to be written in the book of life for another year. You are in it Seth, have no fear. The almighty will see you through this and you my friend, will come out a better person for it. All your friends that I have read about in this diary, who have answered your writings, attest to the kind of person you are and how they feel about you. We have kept in touch, on and off, over the past 25 years and hopefully our friendship will continue to grow for many years to come. My prayers are with you Seth.
    Your friend, Cliff

    SP> I share a very special friendship with Cliff — he was my guidance counsellor and so much more when I was in junior high school. Thank you, Cliff. I still have trouble addressing you like that instead of by your last name, but time will help all things. Thank you so much. Your daughter-in-law tried to contact me today and I think we played phone tag at the end of the day as I grew tired. We’ll try again soon. And thanks for the connection.

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