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Know where you are

A rabbi looks back at the lessons he learned in the cancer ward on the High Holy Days

Two months before the transplant, when Ronald Roth’s shul honored him, Rabbi Roth stands with his family — his son, Gabe; his wife, Rhonda, and his daughter, Deena. (Courtesy Rabbi Roth)
Two months before the transplant, when Ronald Roth’s shul honored him, Rabbi Roth stands with his family — his son, Gabe; his wife, Rhonda, and his daughter, Deena. (Courtesy Rabbi Roth)

Three and a half years ago I was diagnosed with myleofibrosis, a rare, chronic form of blood cancer.

It was relatively stable for three years, but began to progress a year and a half ago. I had to decide whether to have a bone marrow transplant, a difficult and debilitating procedure that is the only possible cure for this illness, knowing I had about a 50 percent chance of survival, or to tell the doctors that I wanted them to keep me alive as long as possible, maybe a few months, maybe longer. I chose the transplant, and now, about 14 months since that procedure, I am continuing to heal.

It has not been easy, but I want to share some of my thoughts about the recent holidays.

After leading services on the bimah for more than 40 years, this year I sat with the congregation during the Yamim Noraim (Days of Awe/High Holidays) at the Fair Lawn Jewish Center/Congregation B’nai Israel. It was a different perspective and a different spiritual experience for me. Here are some of my thoughts as I look back on the recent Holy Days.

This year I was honored with the third aliyah on the second day of Rosh Hashanah. The Torah reading for that day contains the Akedat Yitzak, the binding of Isaac, when God commanded Abraham to sacrifice Isaac, his son. In the portion for my aliyah, we read that when Abraham is about to take his son’s life “A messenger of the Lord called to him from heaven [and says] do not raise your hand against the boy, or do anything to him.”

A young boy is saved by a divine messenger, right before he may have died at his father’s hands.

Rabbi Roth while undergoing chemo.

Just a little over a year ago my doctors administered chemotherapy as part of my bone marrow transplant, killing off all of my own bone marrow and leaving me literally close to death. I had no immune system and no way to produce my own blood. Then I was saved with the infusion of the bone marrow from my son, Gabe. This year, when I completed the blessings after the aliyah was read, I turned to the gomel blessing. It is a special blessing, and let me quote from the Machzor Lev Shalem, “This b’rakhah is recited by one who has recovered from a serious illness or survived a life-threatening crisis.” It thanks God, who “bestows goodness on us despite our imperfections and who has treated me so favorably.” The congregation responds, “May the One who has shown such favor to you continue to bestow all that is good upon you.”

Reading those words made me quite emotional as I thought of all the goodness that I received during the past year, from my family and my medical team, and all the prayers said on my behalf.

When I returned to my seat, my son, Gabe — Gabriel — asked me which angel stopped Abraham’s hand. He mentioned that in an earlier passage the Bible tells of three angels who visit Abraham. While they have no names in the Torah, in rabbinic commentaries they are called Michael, Raphael, and Gabriel. Was Gabriel the angel who saved a life in the reading we had just heard?

I started to look that up after the holiday. I was home, without the books I left in the synagogue, but with the help of my friend and colleague, Rabbi Lee Paskind, I learned that some Jewish sources give that angel, the lifesaving angel, a name. It is Michael in one commentary, and Metatron in another.

No matter. For me, there is only one name for that lifesaving angel. It is Gabriel, my son, and the donor for my bone marrow transplant.

This year I also thought of the first time I led High Holiday services when I was a student at the Jewish Theological Seminary. It was in the next-to-last year before I was ordained. I did not go to a small congregation or lead an overflow service, as did many of my classmates. I chose instead to lead services at Memorial Sloan Kettering Hospital. It was a sobering experience to be with so many patients who were battling cancer. I recall an abbreviated service in a room where the patients came in wheelchairs; I recall praying with them and blowing the shofar for them. There also were many patients whom I visited in their rooms, and there were many family members I tried to comfort.

Rabbi Roth with Gabe on the first anniversary of his bone marrow transplant. 

Then, a year ago, I was in Mount Sinai Hospital, during my last year as a pulpit rabbi. I was a patient in an isolation room for people with blood cancer. The beginning and end of my professional life were bookended by cancer wards.

It is a reminder to me, as is the liturgy of these Holy Days, that we live with vulnerability and unpredictability. The prayer Unetanah Tokef proclaims in memorable words that we don’t know who will live and who will die each year. Yet there is some cause for hope, because, as the prayer reminds us, no matter what the length of our life may be, it is within our power to live it with meaning.

Specifically, the prayer says that we should live with t’shuvah, tefillah, and tzedakah, with a turning toward our better selves, with a regular connection to the Divine, and with acts of kindness. Between those Holy Days that I spent on two cancer wards, one as student rabbi and one as patient, I hope that I have been equal to the task of living a life with those values.

I want to end with one other holiday experience. Last year, I was in bed at Mount Sinai Medical Center on Yom Kip0pur, recovering from the transplant, when the Delirium Team came into my room. I understand that there is a need to assess a patient’s mental state. Chemo brain is real, and so are all the other disorienting effects of a long hospital stay. I hope, however, that at some point they rename that group, for “delirium” is just not the right word.

During some of the team’s visits earlier in my hospital stay, I had not done well with its questions. I barely knew the date, and for some reason when I was asked which hospital I was in, twice I responded “NYU.” This time, however, I knew I was in Mount Sinai, and when they asked me the date, I replied, “the tenth of Tishri 5779.” Sometimes we really know where we are and what day it is.

For me this also was a step on my return to health, a path I continue to be on, as I look forward to celebrating many Holy Days in the future with my family and community. We should all know where we are physically and spiritually, as well as the time we live in, although we cannot know whether it will be the beginning of more or fewer years. Sobering thoughts — but thoughts for all of us.

Maybe it should be the Yamim Noraim team, not the delirium team, that makes us aware of those realities.

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