Rhythm

Heart2

 

 

The sea is good medicine after a heart attack. This is how you do it, heart. Listen to this unceasing rhythm.

Flowing in, pouring out. Pushing and pulling. Kissing the shore, then dancing away.

 

 

Like Shabbes

followed by week

followed by Shabbes

followed by week

forever and ever.

 

 

Slipper shells and pebbles of quartz and granite tumble against the shore.

Then pull away. Then return.

 

 

A distant seawall marks the horizon.

The tug and release pulls at my ankles, shifting the ground beneath my feet.

Months from now there will still be grains of sand in my car.

 

 


Lake

Bend low, dipping
until my fingers
skim the warm water
near the surface.

This syllable
means death in Hebrew
but let's prolong
hope's steady drip.

A tor rises
from the hillside:
aspiring only
to keep existing.

Listen to the trill
of cricket opera
as my little boat
glides on.

Not certain, but maybe
something trails behind,
a string dragging
lines across the lake.

And you, hovering
over the face
of the waters
like a mother bird.

 


The list of medications I am now taking is long, and their names can sound like a foreign language. Scanning my meds, I remembered a poetry technique from my time at Bennington -- "translating" words into English (seeking out homophones, more or less), and then using that somewhat random assemblage of words to spark a poem. This poem arose out of my list of meds in that way.


Heart

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When I woke with chest tightness and pain and numbness down both arms, at first I thought I had slept funny and one arm had fallen asleep. But then I realized it was both arms, which didn't make sense. And also my chest felt really tight, as though compressed with a strong, thick, solid rubber band.

These are sensations I've come to know well over the last 18 months. Carrying in the groceries, or schlepping the laundry -- almost any exertion can bring this on. It always goes away within a few minutes if I sit and breathe. But it had never happened before during the night, while I was at rest.

I picked up my phone and googled "heart attack symptoms." Shortness of breath, chest tightness, numbness or discomfort in the arms: those have been my regular companions for a while now. Breaking a sweat for no reason: find me anyone peri-menopausal who doesn't experience that sometimes?

I thought about calling an ambulance. I imagined having to wake up my twelve year old, the ride to the hospital, the hours of tests, the likelihood that the doctors would say, "It's just anxiety," or "Nothing clinical here." Maybe it's nothing, I thought. I wanted it to be nothing. I went back to sleep.

In the morning, on urging from friends, I reluctantly called my doctor, who instructed me to go to the ED. There they diagnosed an NSTEMI: non-ST-elevation myocardial infarction. Eventually an ambulance took me to Baystate: riding backwards, strapped to a gurney, watching the green hills go by.

I arrived at the Davis Heart and Vascular Center late on Friday. Procedures like cardiac catheterization don't happen on weekends. Enter electrode stickers, an Intellivue MX40 wearable monitor, a heparin drip via IV. Every two hours a phlebotomist arrived to draw more blood, charting troponin levels. 

In the subsequent days, sometimes I could maintain equanimity. I could reach my gratitude practices, maintain perspective, feel how lucky I am that we caught this quickly. Other times I couldn't help leaking tears, swallowing around a painful lump in my throat: feeling shaken, vulnerable, afraid.

I discovered that when they draw blood, I make the same pained sounds my mother made. Also, when there are IV ports on my hands, they remind me of her hands once she fell ill. That's not how she would want to be remembered. She'd be pleased that people complimented my manicure, though. 

A fabulous nurse told me amazing stories about his ancestors buried in the North Adams cemetery. An ultrasound tech asked me what I do for a living as she slathered me with conductive gel. When I told her, she asked if I could explain to her what Jews believe about the apocalypse and the End Times. 

As a pastoral caregiver I know that both laughter and tears are normal in a hospital. (Not just in a hospital; always! But emotions are heightened at times like these.) Sometimes I could lift up and let the current carry me. Sometimes I sank to the bottom and crashed into the riverbed rocks. 

On erev Shavuot I joined, via Zoom, the festival service I had planned to co-lead. I sang Hallel very quietly. I may never forget singing לֹא הַמֵּתִים יְהַלְלוּ־יָהּ וְלֹ֗א כּל־יֹרְדֵי דוּמָה ("The dead do not praise You, nor all those who go down into silence," Ps. 115:16) attached to a heparin drip and cardiac monitors.

Now I am home, learning about MINOCA (myocardial infarction with non-obstructive coronary arteries), and preparing to seek out diagnosticians who might be able to weave my strokes 15 years ago, my shortness of breath, and this heart attack into a coherent narrative with a clear action plan.

After my strokes, I saw specialist after specialist in Boston. Eventually I leaned into not-knowing, into taking Mystery as a spiritual teacher. But now that I've added a heart attack to the mix, I'm hoping anew for a grand unifying theory. For now, I remain in the not-knowing, with gratitude to be alive.

 

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The ones who come after: Vayechi

Vayechi

This week's parsha is Vayechi, "He lived." It opens, "Jacob lived seventeen years in the land of Egypt, so that the span of Jacob’s life came to one hundred and forty-seven years." (Genesis 47:28) As with Chayyei Sarah ("The Life of Sarah") earlier in Genesis, this parsha named after someone's life is actually about their death, because only at the end of a life can its wholeness be measured. 

Joseph brings his sons to their grandfather's bed, and Jacob asks, "Who are they?" Maybe he doesn't recognize them. Maybe he knows they're related to him, but just can't recall their names. Joseph says, "these are my sons, whom God has given me here." I like to imagine that his voice and demeanor are gentle. It's okay that you don't remember; I can tell you who they are. 

I learned the term "benign senescent forgetfulness" from John Jerome z"l in his book On Turning Sixty-Five: Notes from the Field. As a writer and a runner he was fascinated by the effects of aging on body and mind. Benign senescent forgetfulness is the natural tendency of the human brain to start losing track of things. It's normal. As we age, some of what's in our brain just... falls out.

Of course, memory loss can become disabling. I wonder how Jacob handled his inability to remember his grandsons. Did he get frustrated by the mental holes where knowledge used to be? More broadly: could he take comfort in memories of his wives and children, his travels and adventures -- or did disappointments and losses take center stage as other memories slipped away?

Sometimes memory loss sparks paranoia. Because the world doesn't feel right, and words and memories aren't within reach, elders with dementia often lash out at their children or caregivers. That came to mind this year when I read Jacob's parting words for each of his sons. Some of those words are loving and kind; I like reading those. But some of his words seem belligerent, even cruel. 

In Jacob's case, given what we know of his children's lives, some of his anger may be justified. For instance, he accuses Shimon and Levi of violence. I can understand where that's coming from, because they did make violent choices. He intimates that Reuben encroached on Jacob's marriage bed with Bilhah, which may be supported in Torah - though some commentators disagree.

What jumps out at me is how common that accusation is. My grandfather z"l levied a similar accusation  near the end of his life. (Women often accuse their children or caregivers of stealing their things.) We all knew it wasn't true; it was dementia clouding his mind. But it's still painful to hear words like those, especially from someone who had previously been generous of spirit. 

This year I wonder: how did Jacob's deathbed words land with his grown children? Did they find any comfort in the knowledge that some of these words might have been rooted in dementia? And is it fair to blame the curses on dementia while holding on to the blessings that accompanied them? Because some of what Jacob says at the end of his life is gentle and tender!

He compares Judah to a mighty lion; Naftali to a beautiful deer; Joseph to a colt strengthened by God. And to his grandsons Ephraim and Menashe he offers a poignant blessing, saying, "May the angel who keeps me from harm bless the ones who come after!" (That's R. Irwin Keller's singable translation.) And then Jacob pleads, "In their name, may my name be recalled." (Genesis 48:16)

You may recall that he had two names: Ya'akov, "the Heel," and Israel, "God-wrestler." Remembering his names means remembering the whole: the shrewd young trickster, and the patriarch changed by his wrestle with God, and all of his roles and identities in between. When we look at the whole of Jacob's life in this way, I think it's easier to have empathy for how his story ends.

I do think it's okay to blame the curses on dementia while holding on to the blessings. For me, the blessings come from a true place. They come from a heart flowing with love that wants to bestow that love on the generations. The bitter words or curses come from a false place, a mind clouded by confusion. I believe that the loving words are real, and the hurtful words aren't.

And what about us, "the ones who come after?" We're called to compassionate memory. When we remember all of who he was, his "name is recalled in us." Our task is to recall the choices and adventures and accomplishments of our patriarch's lifetime. To hold with compassion the whole of his story: the beginning and middle that came before this runway toward an end.

 

This is the d'varling I offered at my shul at Kabbalat Shabbat services (cross-posted to my From the Rabbi blog.) Art by Yoram Raanan

 


Dislocation

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I haven't been to Texas since the unveiling of mom's headstone. The backpack I use when traveling has been in the closet a long time. In its pockets I find paper remnants from the Cuba trip in 2019.

I also unearth my pocket Koren siddur which I had given up for lost, and a wooden coin that reads (after Simcha Bunim) on one side "for my sake was the world created" and on the other "I am dust and ashes."

Flying for the first time in almost two years was always going to be strange. Flying for the first time during a global pandemic, even more so. Thankfully no one is belligerent about wearing a mask.

To make the day even more surreal, it turns out my local airport has been redone. New parking garage, new traffic flow, new everything. Delta still flies out of the B gates; at least that hasn't changed.

On the first plane I watch Roadrunner, the Tony Bourdain film. I loved his writing, and the way he brought the world into our living rooms. I loved how much he seemed to love the wide world.

There's a sense of dislocation in the film. The dislocation of travel, especially the kind of travel he did 250 days a year. The dislocation of a world where his light shines now only in memory.

My mother was still alive when he killed himself, because I remember talking with her about it a little bit. She was shocked. He seemed to have it all, she said more than once. She admired his work too.

Of course, Tony's suicide shapes the story. Not only his absence, but how much the people who knew him best miss him. I ached to see their anger and grief at his inability to stay in the world with them.

Then again, his loved ones didn't have to see him live to lose his words and his machete-sharp wit and his prodigious memory. Maybe he thought he was doing them a kindness, making his own exit.

Still, I'll bet his daughter would've chosen to get more time with him, even if that meant that she would one day endure the heartbreak of watching his mind and his memory and his awareness disappear.

Loss of memory is the most profound dislocation I can think of. It's often old memories that linger like cigar smoke. The hardest thing is making space to grieve what's been lost -- what's being lost. 

Or maybe the hardest thing is grieving the losses without perseveration, without getting stuck in them. Feeling them, and then letting them go -- like the words and memories that recede into mist.


Breathless

Heart-lungs-xray-teaser

It's disconcerting to be short of breath during a global pandemic that can trigger respiratory infection. Granted, the shortness of breath isn't new, though it has been notably worse in the last year. At first I shrugged it off, evidence that I really ought to try again to establish an exercise practice. 

But then friends started pointing out that it's not normal to get out of breath when doing ordinary household tasks. And then there was the day when two different people, on two different phone calls, said, "You sound really out of breath. Are you okay?" (Subtext: do you think you have COVID?) 

I noted that I'm always out of breath, it's nothing to worry about. "On the contrary," they said. "If you're always short of breath, that makes me even more worried about it. Go see a doctor, please." I rolled my eyes, but I made an appointment to speak with a doctor about it. That was many months ago.

The first thing we tried was a course of steroids, which didn't do much. Next came a cardiac stress test. Predictably, jogging on a treadmill made me wheeze. Then there was a nuclear stress test that made me radioactive, which my kid thought was hilarious. (Alas, it didn't make me glow in the dark.)

Maybe the strangest experience was the hour that I spent sitting inside a small glass box, like Clark Kent crammed into a phone booth, breathing on command into a tube with a clamp over my nose. The technician was gowned, gloved, triply masked. Standard COVID precautionary protocol.

From that pulmonary function test we learned that the amount of air I can forcefully exhale in one second is around half of what it should be. There was a strange relief in learning that. It's so easy to minimize my breathlessness, or to blame it on being "out of shape," but that's not what this is.

I have learned a new phrase: "severe eosinophilic asthma." We're trying injections to improve my breathing. After my first shot, while I was waiting an hour in the doctor's office to make sure my throat didn't close up, I looked up the biologic agent. It turns out to be a form of monoclonal antibody.

I had never heard of monoclonal antibodies before the COVID-19 pandemic. Who among us had? Now, of course, we all know the term. It's fascinating to think about all of the medical terms and treatment methods, the pandemic-related language that has entered common public parlance in the last year.

During the pandemic it has sometimes felt like the whole world has been holding our breath, waiting for this to end. I realize now that that's the wrong frame. I miss the days when we thought the pandemic would end. (And of course I think of George Floyd and Eric Garner and "I can't breathe...") 

For now, these days, I often have to sit down and catch my breath in the middle of simple household tasks. I am working on extending compassion toward myself as we try new medications and interventions to see whether and how my lungs will respond. This is the day that God has made...

Sometimes when I need to center and calm myself, there's a breathing meditation I practice. I learned it many years ago on retreat. It's a simple meditation, mapping the four letter Name of God to four moments: the empty-lungs moment before breath; inhale; lungs full of air; exhale. 

י / Empty -- ה / inhale -- ו / full -- ה / exhale. And again. A letter of God's name for the pause before breathing, for the inbreath, for the pause with lungs full, for the outbreath. A reminder that God is always with me: in the moments when breathing comes easy, and in the breathless moments too. 

 


Stillness


I had hopes of working on a new poem during Shabbat, but my body had other plans. I spent most of Shabbat lying on a heating pad, remembering that when the sciatica flares up, poetry is hard to come by.

The world becomes very immediate. Past and future both recede. I'm firmly in the now of pressing into the heating pad in hopes that spasming muscles and pinched nerve will yield into release.

I remember an on-call shift when I was doing my chaplaincy training some fifteen years ago now. I was having an allergic reaction to a drug I didn't yet know I shouldn't take, and as a result I was unwell.

In those pre-parenthood days, sleep wasn't so precious. I used to stay awake on hospital overnights. They were my opportunity to tend to people, and I didn't want to miss anyone who might need me.

So when my pager buzzed, I would go where it called. And when no one had an emergency need, I would just make my rounds again. Visit the ED again, or one of the ICUs. Someone always needed an ear.

I remember how humbling it was to discover that I couldn't walk the hospital halls in search of people in crisis. Instead I held still on the twin bed in the chaplain's room, praying no one would need me.

I'm thankful that no one needed me yesterday. I'm working on being thankful that my body is reminding me that I need to make time to stretch. This Shabbat was for gentle yoga and for lying very still. 


Pulse

Two-fingers-feeling-for-radial-pulse

This week I am reading up on cardiac catheterization. It sounds like sometimes they go in through the wrist, and sometimes at the groin. My wrists are tiny: I can't imagine that the blood vessel there is large enough to thread anything through. Then again, it's an easy place to feel my pulse. The radial artery, according to the internet. Radial makes me think of radiant. When I had the stress test with nuclear imaging, were my arteries temporarily radiant? I wonder if I could use that image in a poem. 

I wonder what became of the images of the inside of my body from when I had my strokes. Did the trans-esophageal echocardiogram yield still pictures, or only a live video feed? I remember being asked to count backwards, but I don't remember the procedure itself. I know there were brain scans; I remember seeing grainy images, with white blemishes in the places where the strokes left their damage. I probably have the images on a CD-ROM somewhere, though I no longer have a disk drive.

I often notice the pulse point at the wrist when I'm laying tefillin. I learned to map the ten wraps of the arm strap to the ten sefirot of our mystical tradition. Above the elbow, the top three windings are for chochmah, binah, da'at -- wisdom, understanding, knowledge. Then come chesed, gevurah, tiferet, netzach, hod, yesod, malchut -- lovingkindness, boundaried strength, harmony, endurance, humble gratitude, foundations, and Shechinah, the indwelling divine Presence.

That final wrapping goes right over my pulse point.  Divine presence, pressing on that place where my life-force is palpably present. "God is as close to me as the beating of my heart." I don't remember the citation for that, though a quick google search suggests that this idea can be found across many religious traditions. What could be closer to us than the beating of our own hearts? It's an intimate, embodied metaphor, and that too makes me think of Shechinah: God with/in us, with/in creation.

I don't lay tefillin every day. My early mornings feel packed -- wake the kid, make breakfast, pack lunch, help him wedge the bass into the car, get him to school  -- and I cling to sleep too much to wake up before him to daven. Once he's on summer vacation, I hope to get back into the habit of making more time for morning prayer. Meanwhile, I think tomorrow I might lay tefillin even if all I manage is the seven-minute daven. Feel God's presence wrapped around my wrist, Shechinah holding my hand.


With both eyes open

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I said to my therapist recently (over FaceTime, of course; everything is mediated by screens now) that this moment in time reminds me a lot of the months right after my strokes. When I felt fine, and probably was fine, but we were investigating all kinds of horrific possibilities for what might have caused the strokes -- and might therefore cause them to recur.

I remember feeling as though I were looking at the world through stereoscopic glasses with one red lens and one blue one. (Those were a regular feature in my childhood ophthalmologist visits.) Through one eye, everything looked rosy and I was fine. Through the other eye, everything looked terrifying and maybe I would die at any moment. Red lens, blue lens. 

Ultimately the specialists concluded that the strokes were cryptogenic. (Of unknown origin.) They concluded that as long as I keep my blood pressure low, I should be okay. But there was an odd sense that my body might be lying to me. I might feel fine but have a ticking time bomb in me, some kind of disorder or brokenness or haywire tumor we hadn't yet discovered...

Over the weekend I woke to news about covid-19 causing strokes in asymptomatic people who didn't know they were sick. The more we learn about this virus, the scarier it becomes. According to that piece in the Washington Post (a media source I trust), the virus can attack almost every system in the body, even in someone asymptomatic. That shook me.

And then I thought back to the time right after my strokes. Now does feel a lot like then. The difference is that now, everyone who's paying attention to the world is navigating these anxieties. We're all living with the possibility that an invisible virus might unexpectedly destroy any organ system in our bodies. Even if we're doing all the right things. We might feel fine, and still...

There's a lot of cognitive dissonance. Between "I feel fine" and "I might be harboring a deadly virus and not know it." Between "I'm doing okay" and "the world is coming apart at the seams." (And I'm speaking as someone who has the luxury of feeling okay, having a home and a job, and enough food, electricity, internet...! I recognize how fortunate that makes me.)

The cognitive dissonance and uncertainty is exhausting. Trying to navigate ordinary life -- childcare, work responsibilities -- along with that cognitive dissonance is exhausting. But "whatever gets in the way of the work, is the work" (thank you Jason Shinder z"l), so sitting with the cognitive dissonance itself must be part of the spiritual work of this moment for me.

After I had my strokes in my early 30s, I did a lot of reading and thinking and praying and spiritual direction, trying to come to terms with the mortality they had shown me. I studied the Baal Shem Tov's writing on equanimity. I journaled endlessly. Eventually I reached the conclusion that yes, I could die at any time. But until that happens, my job is to live as best I can.

The strokes brought home my participation in our common human mortality. In truth, none of us know when our lives will end. I don't mean that to be depressing or paralyzing: on the contrary! I mean it as a reminder that the only time we have is now. The time to be the person we want to be is now. Because now is what we have. It's all anyone has. It's all anyone has ever had.

"Tell me, what is it you plan to do / with your one wild and precious life?" wrote Mary Oliver. This, right now, is our wild and precious life. Even in quarantine or lockdown or shelter-in-place. Even in uncertainty. (Especially in uncertainty.) Life isn't on pause until a hoped-for return to normalcy comes. This is life, right here, right now. Our job is to live it as best we can.

Even with the possibility that we're already incubating the virus. Because so what if I am? What can I do about it, other than what I'm already doing: wearing a mask in public, keeping my distance to protect others in case I'm an asymptomatic carrier, and meanwhile doing what I can to care for my child, my congregation, my beloveds, in the ways that are open to me?

I've more or less made my peace with that. I have not made my peace with the possibility that someone I love could fall ill or die. It's easier for me to face the end of my story than to face the possibility of losing someone who matters to me. But that too is outside of my control. All I can do is be real with the people in my life, so important things don't go unspoken.

I've been thinking lately about how I want to be remembered, when I die, whenever that is. What acts, what words, what principles, what choices will add up to me being remembered in the ways I want to be? I hope not to die for a very long time. I trust I will emerge from the constrictions of this pandemic. And... if I don't, or if I do, how do I want to be remembered?

If our purpose is to be real, to help others, to build justice and love in the world however we can -- that purpose holds, pandemic or no. That purpose holds whether I die now or in forty years. If I knew I were going to die before morning... I've explored that question before. Those answers still hold true, even if some details would need to shift for social distancing reasons.

Right now, physical distancing and mask-wearing and doing rabbi work via Zoom are how I can help others and build greater justice and love in the world. (And comforting my kid, and feeding us, and making our home as safe as I can for him.) And accepting uncertainty and sitting with the dissonance are part of how I can be real -- and maybe help others through it, too.

One of the things I'm trying to teach my kid is that it's possible to feel gratitude and grief at the same time. Gratitude that we're okay (so far); grief at everything we've lost (and the world has lost). One doesn't cancel the other. They can coexist in us, in an ever-shifting balance, all the time. Like the red lens and the blue lens. The trick is to learn to use both eyes at once.

 

 


The tiniest spark of joy

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We read in the Tikkunei Zohar that Purim is like Yom Kippur. This is hinted-at in the way that on Yom Kippur, one must fast and do teshuvah (repentance / return) not only if one feels like it, but whether or not one wants to do it. This is an enduring decree from the Holy One of Blessing. Rejoicing on Purim is similar. One is obligated to rejoice on Purim, not only if one is happy in oneself, or is in a situation where it's easy to feel joy. On the contrary: even if one is in a low place and completely broken-hearted, body and spirit laid low, it's still an obligation to seek out whatever tiny spark of joy is possible, and welcome that spark into the heart.

On both of these holy days, there's a flow from on high to us here below. Just as Yom Kippur itself atones for us, even if our teshuvah feels inadequate (according to Talmud in tractate Yoma), just so on Purim. Even if a person isn't feeling joyful the way one's supposed to, and therefore one's service of God doesn't feel whole, even in that case the salvation and joy of Purim will flow -- and that potential is open to us even now.

-- The Piazeczyner aka The Aish Kodesh aka R' Kalonymos Kalmish Shapira, Purim 1940

 

Last year, Purim happened a scant few weeks after my mother's death. I was shellshocked. I was in a fog. I scarcely remember the holiday at all. But I remember taking comfort in a text that R' David Markus taught me over the phone. The text said that Purim itself would do its work in me and on me, as Yom Kippur does, and that even if I couldn't access real joy, there would still be a flow from on high that would come through me to those whom I serve.

This year I sat down twice to study this short text from the Aish Kodesh, once with my Bayit hevre, and once with my other hevruta R' Megan Doherty. And only today, on Purim itself, did I realize why this text resonates with me so deeply and why it feels so familiar: this is the teaching R' David shared with me last year when I was in the pit of grief. And, in fact, it turns out this is a teaching I had shared with him a few years prior and had forgotten!

What jumps out at me in this text this year is the idea that we are obligated to welcome into our hearts whatever tiny spark of joy we can find. This isn't spiritual bypassing. This isn't "put on a happy face." This is the spiritual practice of opening our hearts even in difficult circumstances, so that some measure of blessing can flow in. The Aish Kodesh was writing from the Warsaw Ghetto; he knew something about difficult circumstances.

 

God would like us to be joyful
Even when our hearts lie panting on the floor.
How much more can we be joyful
When there's really something
To be joyful for?

-- To Life, To Life, L'Chayim / Fiddler on the Roof

 

I thought of this teaching a few days ago when I was blessed to see the national touring production of Fiddler on the Roof. "God would like us to be joyful / even when our hearts lie panting on the floor" -- Tevye might have been citing the Piazeczyner! Even when our hearts lie panting on the floor, Purim invites us to open our broken hearts to a spark of joy. Even when our circumstances (individual or collective) are dark, our tradition invites us to open to joy.

And when there is within reach "something to be joyful for," in Fiddler's words -- maybe a birth, or a wedding, a friendship, a sign of hope, a Shabbes -- we've got to seize that joy with both hands. Because joy is part of what fuels us. Because without joy, we can't go on. And the world needs us to go on, because there's a lot of work we need to do to bring justice and hope and ethics and opportunity and peace to everyone everywhere, and that's what we're here for.

So if today we're in the narrow straits of a personal grief, a loss or an illness or a sorrow... or if we're in the narrow straits of communal anxiety about the election, or the economy, or the pandemic that is sweeping the globe... we shouldn't kick ourselves for not being able to fulfill the mitzvah of rejoicing. Instead, let's open our hearts the tiniest crack, and let the tiniest spark of joy and hope come in -- and trust that the day itself will do the rest. 

 


Preparing for Pesach in a time of covid-19

ESVqeXEWoAI0SzsI've been reading a lot of posts and articles about why we should be stocking our pantries and medicine cabinets against the possibility of illness, quarantine, and/or disrupted supply chains. The most compelling piece I've read thus far is this one in Scientific American by Zeynep Tufekci. She argues that being prepared is our civic duty and is something we can do as a favor to those who cannot prepare. "We should prepare," she writes, "so that we can help lessen the risk for everyone."

One suggestion that a lot of people are making is: stock up on dried foods, and on the things that members of your household like to eat. This way if you become ill (or if there is a quarantine, or if you are staying home to avoid infection or to reduce strain on grocery workers who may be ill, or if supply chains are disrupted because of widespread illness) you'll have what you need. My kid's favorite foods include bagels, pasta, and toaster waffles. Oh, and granola bars. And buttered English muffins. 

And on the Jewish calendar we're five weeks away from Pesach, when it's customary to remove all of the leaven from one's home. So should I be trying to "eat down" all the hametz in my home in the coming month to make it easier to clean for Pesach in the ways that I want to do? Or should I be picking up an extra box of pasta, an extra box of blueberry Eggos, and an extra box of shells and cheese every time I go to the grocery store, so that we're well-prepared in the event that we need to stay home?

I can argue that Jewishly I have a civic obligation to do what is best for the most vulnerable in the general population (that's the thrust of Torah's repeated injunction to care for the widow, the orphan, and the stranger.) That may mean making sure I have two weeks' worth of shelf-stable food on hand, and stocking up on the things my kid will actually eat -- because as Tufekci argues, preparing is "one of the most pro-social, altruistic things you can do in response to potential disruptions of this kind." 

I can also argue that Jewishly I have a religious obligation to remove hametz for Pesach: that's a practice I've taken on in recent years and it matters to me both practically and spiritually. So I'm laying in a store of the wheat-filled foods my kid likes to eat... and during Pesach, I will move them to the extra freezer in the garage so that they are not in my home proper, and I will "sell" them to a non-Jewish friend, and will declare them temporarily not mine. It's a legal fiction, but this year a very useful one.

Intellectually I know that selling my hametz means there's no problem here. But emotionally I'm finding this jarring.  It feels truly strange to be stocking up now on foods that in any other year I would be trying to consume and not replace. One way to understand Pesach is as a spiritual call to leave familiar constriction and go, even if we don't feel ready. Buying extra stuff to have on hand is the opposite of "drop everything and go" -- though the "not feeling ready" part still holds. 

It feels weird to be buying extra hametz when Pesach is little more than a month away. But I accept Tufekci's argument that preparing for the possibility of staying home (if I can afford a few extra groceries every time I shop, which I can) is my civic obligation, and I think it's a Jewish obligation as well. I'm willing to live with some cognitive dissonance in order to fulfill that obligation, even as I also prepare to fulfill a different obligation that will temporarily make some of these foods not-mine.

Tradition says we left Egypt as a mixed multitude; it wasn't just we who fled Pharaoh. An illness that spreads like this one is a powerful reminder that we are always a "mixed multitude." As a society, we are only as healthy as those who are most at-risk. Preparing now is what I can do to lessen the strain on the system later, and thereby to help those who may be harder-hit than I expect to be... even if that means I'll be schlepping an extra few boxes of pasta into and out of storage this year.


A body that mostly works

TOS

That I have thoracic outlet syndrome is not particularly interesting. That a lot of major league pitchers have it too -- according to my brother-in-law -- is marginally more interesting, but not by much.

Here is my layperson's understanding: the cluster of muscles in and around the "thoracic collar" seize up and won't unclench. Nerves and blood vessels  constrict. Symptoms ensue.

It's mostly low level pain, unless I move in the wrong way. (Trying to put on a coat right-arm-first, for instance, and then wriggle my left arm in.) I've learned to adjust the way I move, the way I sleep, the way I wash my hair. 

I don't like the chronic pain or the inability to lift my arm. But what I really don't like is how it impacts my ability to play guitar. I don't feel like I'm a "serious" guitar player, but my guitar feels to me like an extension of my hands and arms even so. 

Thoracic outlet syndrome can cause pain, and/or weakness, and/or numbness. I'm not always able to manage barre chords these days. Sometimes I can play them; sometimes not. Sometimes I start a song and midway through realize I can't barre. 

It's a little bit funny when I stop and think about it. The pain is annoying but bearable. The limited range of motion is annoying but bearable. But if it gets in the way of my ability to make music? Whoa, hold up there, I can't live like that!

I will put up with pain, discomfort, and numbness. But if they are impinging on my ability to make music -- which is interwoven with one of the ways I most love to pray -- then that's a non-starter. Music is necessary to my soul, like breathing.

I can still lead prayer with my guitar. I'm just aware that it's more difficult than I want it to be. I have to work around the limitations imposed by my neck and shoulder and arm. I'm aware that my body isn't working quite as well as I want it to be.

Blessed are You, Adonai our God, source of all being: You form the human body with wisdom, creating the body's many pathways and openings... 

My thoracic outlet syndrome has given me another point of engagement with Asher Yatzar. That's the blessing that reminds us that we can't pray if our bodies malfunction too profoundly -- if something opens that should be closed, or vice versa.

Sometimes we offer this prayer during Shabbat morning services. It appears in our siddur alongside the prayer for the soul. I call it "the prayer for having bodies that mostly work, most of the time." That usually gets a rueful laugh from someone.

Because even the healthiest among us have bodies that don't always work the way we want them to. Or if they do now, we know that if we live long enough, they won't anymore. This fragility, this imperfection, seems to be built into embodied life. 

Maybe that's why this balancing act feels built-in, too. Making music with an arm that doesn't always work; praying with a heart and mind that don't always work; balancing our broken places with our whole ones -- isn't that always what we're here to do?

Praise God in market and workplace,
With computer, with hammer and nails,

Praise him in bedroom and kitchen;
Praise him with pots and pans.

(So writes Stephen Mitchell in his rendering of Psalm 150.)  In that vein... Praise God in physical therapy and on the massage table, with resistance bands and heating pads. Praise God with the range of motion that might become possible again. 

Or in the words of Psalm 118:5, "From the narrow place I called to You; You answered me with expansiveness." May the Holy One of Blessing answer all of our constricted places, our tight and painful places, our restricted-motion places, with freedom.

 


Rabbi Roundtable on the opioid epidemic

6a00d8341c019953ef01bb09ce0114970d-320wiI think their general intention is to publish these responses once a week, but given that the opioid epidemic is in the news, the folks at the Forward decided to publish a second Rabbi Roundtable this week: 

We asked 22 rabbis: What can the Jewish community do to fight the opioid epidemic?

This is a subject we need to grapple with as a community, and I'm glad that the Forward is putting it in the spotlight.


Healing and second chances

HealingA few days ago we entered into the new month of Iyar. Here's my favorite teaching about the month of Iyar: its name is an acronym for something beautiful. Torah teaches that after the children of Israel crossed through the Sea of Reeds and reached the far shore, they sang and danced -- and then, once they began their journey in the wilderness, they became afraid. What if there were no potable water for them to drink? What if there weren't enough to nourish them in life's journey?

So God instructed Moshe to throw a piece of wood into a stagnant pond, and the water became sweet. And then God offered one of Torah's most beautiful reassurances, saying "I am YHVH your healer." That's the phrase we can see hidden in the name of the month Iyar: אני יה רפאך / I am God, your healer.

In the words of my friend and teacher Rabbi Yael Levy of A Way In:

Iyar is an acronym for this promise the Divine Mystery has made to us: I am your healer. On life’s journeys you will face the seas of struggle, celebration, fear and joy, and whatever comes, I am there to heal and guide you. (Exodus 15:26)

She continues:

Iyar is a month of second chances because the full moon of Iyar provides the opportunity to make up for something that has been missed. During Temple times, it was considered essential for a person’s spiritual and material wellbeing to compete a sacrificial offering for Passover. If circumstances kept someone from someone from making this offering, he/she was given another opportunity to do so on the 15th day of the month of Iyar.

Iyar says it is never too late -- no matter what situation we find ourselves in, no matter how far away we have traveled from our intentions or goals, it is possible to find our way back.

Every life contains missteps and missed opportunities -- times when we look back and realize we wish we'd chosen differently. If only I had reached out to that person then, instead of staying silent. If only I had walked through that door, instead of staying outside. If only I had said "I love you" while I still could. If only, if only.

Part of what it means to me to say that God is our healer is to say that God accompanies us into our second chances. I don't have a time turner; I can't actually go back in time to undo my mistakes, so that I could do then what I wish now that I had done. But Rabbi Levy points out that just as our ancestors were given the opportunity to offer the Pesach sacrifice late, we too can find opportunities to make up for where we missed the mark... and I think that's one way that God can help us to find healing.

Illness and healing are major themes in this week's Torah portion, Tazria-Metzora. Torah's ancient paradigm of tamei and tahor, impure and pure -- or charged-up with the energy of life and death, and absent that psycho-spiritual "electricity" -- may not speak to us. But part of what I relearn from this Torah portion each year is that when one is sick, whether physically or emotionally or spiritually, one may feel exiled from the community. Cut off and isolated. "Outside the camp" in an existential sense: alone even when surrounded by other human beings.

And in those times God comes to us and reminds us אני יה רפאך -- I am God, your healer. I am the One Who is with you in sickness and in health, the One Who accompanies you even when you feel most existentially alone.

When we are sick and feel isolated, the One Who Accompanies is with us. And when we are sick at heart because of the places where we missed the mark, the One Who Accompanies is with us too. May this month of Iyar be a time when our second chances gleam bright before us, so we can find healing in making amends, and making new choices, and remembering that -- as Rabbi Levy teaches -- no matter how far we've strayed from where we meant to be, it's never too late to find our way back. 

 

This is the d'var Torah I offered at CBI this morning. (Cross-posted to my From the Rabbi blog.)


Childhood cancer: I have no words.

A few years ago I posted about two little boys who were fighting cancer, named Gus and Sam. At the time, Gus was four and had recently undergone brain surgery to remove a tumor; Sam was six and was undergoing treatment for leukemia. Sam -- a.k.a. Superman Sam -- died of his cancer. Gus went into remission.

Until now. Gus' mom Sasha recently posted that the doctors have found more tumors in Gus's brain. They are going to operate again, a few days after he finishes kindergarten.

I have no words to offer in response to the horror which is pediatric cancer. I am holding Gus and his family in my heart and in my prayers. Jewish tradition teaches that prayers are uplifted by our tzedakah, our righteous giving. Perhaps my prayers for Gus will have more "oomph," as it were, because I am accompanying them with a gift of money in his honor / toward his treatment or care.

If you would like to help defray the expenses of Gus's treatment, his family has established a dedicated PayPal account at [email protected] -- but they request especially that we donate to the Tanner Seebaum Foundation. His mom writes, "It's run by friends of ours and directly supports research into Gus' cancer, most of which is done by his oncologists. Right now, that research is going to save his life."

If you can spare a few dollars, the Tanner Seebaum foundation is a good place to give them. Give in honor of Gus; give in hopes that the research that foundation is doing will find better ways to help kids like Gus and their families who are dealing with tumors of the brain and spine.

In memory of Sam, donations are also welcomed at the Sam Sommer Fund, established by Rabbi Phyllis Sommer and Rabbi Michael Sommer, Sam's parents. That fund supports pediatric cancer research and pediatric cancer patients and their families. The Sommer family has also supported the St. Baldrick's Shave for the Brave campaign.

On a related note: those who follow me on Facebook may have seen recently that I posted a link to Rabbi Phyllis Sommer's TEDx talk Dead is Dead: Euphemisms and the Power of Words. It's about fifteen minutes long and it is incredibly powerful. (It has also shaped my willingness, in this post, to use real words like "Sam died" instead of euphemisms like "Phyllis and Michael lost their son.") I recommend the video highly.

Please join me in praying for Gus and his family.

May the One who blessed our ancestors, Abraham, Isaac and Jacob, Sarah, Rebecca, Rachel and Leah, bless those in need of healing of body, mind and spirit.  May the compassion of the Holy One be upon them and watch over them.  Strengthen them with courage in each day, along with all who are ill, now and swiftly.  And let us say: Amen.


 


Praying for what's possible

MiShebeirach Card (front)What does it mean to cultivate hope when the doctors say "there's nothing more we can do"? Hopes for a cure have to be set aside. There will be no miracle, no Hail Mary pass, no eleventh-hour wonder. Every specialist has been seen, every possible avenue of treatment or exploration exhausted. All of the tests have been run. What does it mean to pray for healing when the body cannot be healed?

Every Shabbat morning after we read from Torah we offer a prayer called Mi Sheberach, "May the One Who Blessed..." It asks God, Who blessed our ancestors, to bless our sick loved ones with healing. Some years ago at my shul we began using an alternative text. We still ask God to bless those in need of healing of body, mind, and spirit. To be with them, comfort them, strengthen them and revive them.

But not to heal them. Because we recognize that not everyone who is ill can be healed. And as one of my congregants has taught me, asking God repeatedly for healing which we know is never coming can be painful. And it can lead to (entirely understandable) fury at God for not fulfilling the yearned-for wish. Her perspective is actually quite aligned with Jewish tradition, in a certain way. Tradition teaches us not to pray for the impossible, lest we damage our own faith in the Source of blessing.

During the dry season in the land of Israel, it never rains. So all over the world during that season, when we reach the line in our daily prayer which asks God for the nourishment we derive from water, Jews pray instead for dew. Because rain is simply not possible (in the place where our prayers originated), and we don't pray for things which are impossible, perhaps because doing so would be tantamount to "testing" God.

Jewish tradition teaches that when one hears a fire truck going by with sirens wailing, one shouldn't pray "please, God, let it not be my house burning" -- either it is, or it isn't, but the prayer won't change whatever is already real. I learned this when I first studied Mishna several years ago (see Brachot chapter 9) -- one who prays over something which has already happened is praying in vain. Sometimes a medical diagnosis can be like that. All we can change is how we respond to what is.

When a loved one cannot be healed, perhaps a time comes when we stop asking God for healing. We can ask for perspective, for strength, for loving care. We can ask God to be with our loved one and help them find blessings in each day. We can ask for comfort, for some sweetness to mitigate our loved one's suffering or grief. We can ask God to be with their caregivers, and to strengthen the work of their hands. We can ask for what is possible, and that has to be enough.


Dealing With Chronic Illness at The Wisdom Daily

Logo-twd-header

I'm deeply delighted that the folks at The Wisdom Daily, a publication which I greatly admire, wanted to reprint a version of a blog post which first appeared here.

They reposted my piece about Toni Bernhard's book How to Be Sick as Dealing With Chronic Illness: Can You Do Well At Being Sick?

If you didn't read that post when it appeared here, or if you'd like a refresher, feel free to click through and read the (deftly edited) version they shared with their readers.

Thanks, Wisdom Daily!


How to be sick well: Toni Bernhard's guide for the chronically ill

How+To+Be+SickThis book is written for people who are ill and aren't going to get better, and also for their caregivers, people who love them and suffer along with them in wishing that things were different. It speaks most specifically about physical illness. In the largest sense, though, I feel that this book is for all of us. Sooner or later, we are all going to not "get better."

That's acclaimed Jewish-Buddhist teacher Sylvia Boorstein in her introduction to How to Be Sick: A Buddhist-Inspired Guide for the Chronically Ill and Their Caregivers by Toni Bernhard.

The book was recommended to me by one of my congregants who cares for a chronically ill loved one. She described Bernhard's book as "How to be sick well" -- how to achieve emotional and spiritual wellness even when one's body remains sick.

Bernhard became ill in 2001 and has suffered from chronic illness ever since. The first two chapters tell the story of her illness. Beginning in chapter three she shares how her Buddhist learning offered her a way of approaching her illness as a spiritual practice. She wanted to know "how to live a life of equanimity and joy despite my physical and energetic limitations." This book offers her answers to that question.

Early in that third chapter she writes about the power of "just being" with what is:

Just "being" life as it is for me has meant ending my professional career years before I expected to, being house-bound and even bed-bound much of the time, feeling continually sick in the body, and not being able to socialize very often. [Drawing on Buddhist teaching,] I was able to use these facts that make up my life as a starting point. I began to bow down to these facts, to accept them, to be them. And then from there, I looked around to see what life had to offer. And I found a lot.

I struggle a little bit with her language of "bowing down to" these facts. And yet I recognize that there is wisdom in accepting what is, instead of getting caught up in wishing that things were different. I know that in my own life I get into trouble when I get attached to my expectations of how something will be, and I feel more open to blessings when I can simply be with what is.

Continue reading "How to be sick well: Toni Bernhard's guide for the chronically ill" »


Good grief

Grief is a funny thing. A peculiar thing, I mean, not an entertaining one. It creeps in unexpectedly when everything seems fine, silent as Carl Sandburg's fog which "comes / on little cat feet." It does not listen to reason. It pays no attention to any list of gratitudes. When it wells up, cue the waterworks.

Grief brings fragility. As though the delicate eggshell of the heart could crack open at any moment, revealing an endless salt wellspring. Even writing about it from a distance, I want to keep it at arm's-length. I use stock phrases: "a funny thing," "cue the waterworks." I'm deflecting to keep it at bay.

Grief doesn't only come in the aftermath of loss. There's anticipatory grief, awareness that a loss is coming. And sometimes losses compound one another. The loss of health. The loss of the unthinking freedom which comes with health. The loss of an anticipated future, of what one thought would be.

Grief is, I find, not like depression. When I have experienced depression it has placed a scrim between me and the world, whereas grief leaves one exposed and open. When I can head depression off at the pass, that's a good thing, whereas trying to evade grief seems emotionally and spiritually unwise.

Also unlike depression, grief has a known cause: loss, or the expectation of loss. It's not an existential sadness without explanation. Grief has meaning. As Rabbi Matthew Gewirtz has written, grief can offer the gift of transformation when we allow ourselves to feel it fully and to be changed.

Continue reading "Good grief" »


Learning to greet collapse with joy: from Tisha b'Av to Sukkot

This concatenation of ritual -- this dance that begins on Tisha b'Av and ends on Sukkot, that begins with the mournful collapse of a house and ends with the joyful collapse of a house, this intentional spasm that awakens us and carries us through death and back to life again -- stands for the journey the soul is always on.

That's Rabbi Alan Lew in the book I begin rereading every year around this time. This Is Real And You Are Completely Unprepared: The Days of Awe as a Journey of Transformation.

Every year some of the same passages leap out at me. And every year there are some different lines which strike a chord. This is very like my experience of reading Torah every year, too.

This year I'm struck by his reminder that this period of holy time begins with the mournful collapse of a house -- the fallen Temples -- and ends with the joyful collapse of a house -- the sukkot we dismantle at the end of our festival season.

Impermanence is inevitable. The house is going to collapse. Our bodies fail. Our lives come to an end. But do we greet that inevitable collapse with anxiety, or with faith in whatever comes next?

[W]e can regard the ninth of Av as a time when we are reminded that catastrophes will keep recurring in our lives until we get things right, until we learn what we need to learn from them. Tisha b'Av comes exactly seven weeks before Rosh Hashanah, beginning the process that culminates on Rosh Hashanah and Yom Kippur. Tisha b'Av is the moment of turning, the moment when we turn away from denial and begin to face exile and alienation as they manifest themselves in our own lives -- in our alienation and estrangement from God, in our alienation from ourselves and from others.

The moment when we turn away from denial and begin to face exile and alienation. For most of us this doesn't mean exile from the Land. But everyone experiences exile, even if only from the childhood innocence to which we can no longer return.

It is so tempting to deny that everyone feels alienation and exile. I want to pretend that I don't feel these things, and that my loved ones don't either. It is so tempting to put a band-aid over everything that hurts and pretend that we can make it okay.

But today is the day to face the fact that a band-aid isn't going to cut it. That loss and fear, sickness and death, alienation and estrangement are part of every life. And in that existential turning, we can begin to change how we relate to all of these.

As Rabbi Lew writes, "Tisha b'Av is the beginning of Teshuvah, the process of turning that we hope to complete on Yom Kippur, the process of returning to ourselves and to God." Today, because we are willing to face grief, we begin to return home.

Tisha b'Av has a hot tip for us: Take the suffering. Take the loss. Turn toward it. Embrace it. Let the walls come down. // And Tisha b'Av has a few questions for us as well. Where are we? What transition point are we standing at? What is causing sharp feeling in us, disturbing us, knocking us a little off balance? Where is our suffering? What is making us feel bad? What is making us feel at all? How long will we keep the walls up? How long will we furiously defend against what we know deep down to be the truth of our lives?

There's no escaping loss. All we can do is let the walls crumble -- the walls of "holding ourselves together," the walls of "bad things happen to them but not to me," the walls behind which we've allowed ourselves to become complacent and comfortable.

Because every moment is a transition point. And in every moment we can choose to accept the truth of our lives -- that life is temporary; that we come from Mystery and we return to Mystery; that we can't protect our loved ones from sorrow and pain.

All we can do is let the walls fall, and grieve their falling, and pour out our hearts before God -- throwing ourselves wholly into the journey toward that other home demolition, the one at Sukkot which we will greet with song and processional and joy.

Because if we can learn to greet that home demolition with joy, then maybe we can learn to greet the collapse which is at the heart of human existence with joy. Things fall apart. Can we use the next two months to learn how to greet that with celebration?