Effort and Trust

August 2, 2013 Trust No comments
This following is a philosophical discussion on various topics. By no means should a halachic decision be made as a result of these articles. One should contact both a Rabbi who is an expert in such matters as well as a physician who specializes in these fields.
excerpts taken from the New York Times editorial
My Medical Choice
by ANGELINA JOLIE
MY MOTHER fought cancer for almost a decade and died at 56. She held out long enough to meet the first of her grandchildren and to hold them in her arms. But my other children will never have the chance to know her and experience how loving and gracious she was.

 

We often speak of “Mommy’s mommy,” and I find myself trying to explain the illness that took her away from us. They have asked if the same could happen to me. I have always told them not to worry, but the truth is I carry a “faulty” gene, BRCA1, which sharply increases my risk of developing breast cancer and ovarian cancer.

 

My doctors estimated that I had an 87 percent risk of breast cancer and a 50 percent risk of ovarian cancer, although the risk is different in the case of each woman.

 

Only a fraction of breast cancers result from an inherited gene mutation. Those with a defect in BRCA1 have a 65 percent risk of getting it, on average.

Once I knew that this was my reality, I decided to be proactive and to minimize the risk as much I could. I made a decision to have a preventive double mastectomy. I started with the breasts, as my risk of breast cancer is higher than my risk of ovarian cancer, and the surgery is more complex.

On April 27, I finished the three months of medical procedures that the mastectomies involved. During that time I have been able to keep this private and to carry on with my work.

 

But I am writing about it now because I hope that other women can benefit from my experience. Cancer is still a word that strikes fear into people’s hearts, producing a deep sense of powerlessness. But today it is possible to find out through a blood test whether you are highly susceptible to breast and ovarian cancer, and then take action.

 

I wanted to write this to tell other women that the decision to have a mastectomy was not easy. But it is one I am very happy that I made. My chances of developing breast cancer have dropped from 87 percent to under 5 percent. I can tell my children that they don’t need to fear they will lose me to breast cancer.

It is reassuring that they see nothing that makes them uncomfortable. They can see my small scars and that’s it. Everything else is just Mommy, the same as she always was. And they know that I love them and will do anything to be with them as long as I can. On a personal note, I do not feel any less of a woman. I feel empowered that I made a strong choice that in no way diminishes my femininity.

I am fortunate to have a partner, Brad Pitt, who is so loving and supportive. So to anyone who has a wife or girlfriend going through this, know that you are a very important part of the transition. Brad was at the Pink Lotus Breast Center, where I was treated, for every minute of the surgeries. We managed to find moments to laugh together. We knew this was the right thing to do for our family and that it would bring us closer. And it has.

 

For any woman reading this, I hope it helps you to know you have options. I want to encourage every woman, especially if you have a family history of breast or ovarian cancer, to seek out the information and medical experts who can help you through this aspect of your life, and to make your own informed choices.

I acknowledge that there are many wonderful holistic doctors working on alternatives to surgery. My own regimen will be posted in due course on the Web site of the Pink Lotus Breast Center. I hope that this will be helpful to other women.

 

Breast cancer alone kills some 458,000 people each year, according to the World Health Organization, mainly in low- and middle-income countries. It has got to be a priority to ensure that more women can access gene testing and lifesaving preventive treatment, whatever their means and background, wherever they live. The cost of testing for BRCA1 and BRCA2, at more than $3,000 in the United States, remains an obstacle for many women.

 

I choose not to keep my story private because there are many women who do not know that they might be living under the shadow of cancer. It is my hope that they, too, will be able to get gene tested, and that if they have a high risk they, too, will know that they have strong options.

 

Life comes with many challenges. The ones that should not scare us are the ones we can take on and take control of.

 

Angelina Jolie is an actress and director.

 

In this week’s parsha we find the Israelite nation requesting Moshe, their leader, for permission to scout out the land before entering. Moshe reluctantly acquiesced to the request  Upon returning from their secret mission, they reported, as per Moshe’s instructions, 1)  the status of the land whether it’s fertile or not etc. and 2) the military strength of the inhabitants. Additionally, however, the spies presented  their unauthorized opinion to the nation. Their opinion caused a panic among the nation which therein angered G-d. The ten spies were found guilty of giving a negative report and were killed by G-d as punishment.

 

WHY DIDN’T THEY BELIEVE IN G-D AND TRUST THAT THE LAND WAS GOOD FOR THEM?
 One of the opinions as to what motivated the spies to speak badly about the land was that they thought their good merits which shined in the desert would not be enough to protect them once they were residing in the land. They thought that protection will only be provided if they live up to the standards of what they achieved in the desert. “That’s not possible” they reasoned, “and we will be destroyed by our enemies”.
They projected that they did not stand a chance against the powerful giants who were inhabiting the land. The spies minimized the promise G-d gave proclaiming that they will live in the land unscathed, and therefor made an effort to sabotage the idea of the Jewish people residing there. Instead of trusting G-d and going into the land with raised heads, they took matters into their own hands.

 

In both the case of the actress and the spies, a test has been presented.
The spies had to trust G-d and they failed. A guarantee was made. One can be certain that the evil inclination (Yetzer Hara)  placed strong doubts in their minds of not being able to overcome the giants due to lack of confidence in their people. However, they should have overcome the obstacle; they miscalculated.

 

Did the actress have to trust G-d that nothing will happen to her? No
We find no prophet approaching her and reassuring her that she will be disease free. Some would argue that’s it’s actually very commendable on her part and she did her required effort. Furthermore, the Jews experienced a supernatural existence with miracles galore, where the actress did not. Also, she did her proper “hishtadlut” effort  by going to the right doctors. She should therefor be rest assured that all will be alright because the Doctor is a messenger of G-d.
There’s an old story where G-d tells a man he’ll live till 120. Once while on a boat, it capsized and he’s drowning. However, he continues to have faith and says  “G-d will save me”. Well, a minute later a boat comes and they call out “grab the life boat”. He screams out “no, no, G-d will come and save me”. A while later a helicopter comes and throws down a latter. But the man ignores it and says “G-d will come and save me”. The man eventually drowns. He goes up to heaven and asks G-d “I thought I will live till 120, why didn’t you come and rescue me?” To which G-d replied, “I did I send you a boat and a helicopter!”
 Angelina Jolie has done her part in ensuring her survival.
On the other hand, one can argue that genetic disposition is merely a statistical probability, and though it might be a strong  indication, it still is only a probability.
They are many cases where Doctors were wrong in assessing pregnancies. Someone I know mentioned that he personally knows of a pregnancy of 4 months in which the Doctor advised the couple to abort the child, since there were indicators that the unborn child has down syndrome. The couple did not abort, citing the Torah ruling which considers this an act of murder. The child turned out to be healthy and normal.
 Furthermore, Jolie can receive early screening which is extremely helpful and lifesaving. One can argue that she didn’t have to go through that procedure.
 However, barring the surgery, she would have to live with the fear every day that the disease might resurface.  Perhaps it was undetected in the mammogram. Life can be nerve racking.
Has Angelina Jolie done too much HISHTODLUT- effort?
Did she over do it?
Or, perhaps she made the right decision.
 One can argue both positions.
Regardless, perhaps a lesson can be learned as to the attitude of the individual after the effort has been made. If one has done it properly, he should rest assured, knowing that he has done what Hashem wills. Then, one should leave it up to G-d; it’s in His hands; He’s responsible. If the person gets hurt in any way, after he’s done the effort, then so be it!!. It was meant to be.
No extra effort was needed with the spies. They, and all the the Jewish people, had to believe that the situation was safe to go in.
If the actress made a decision, giving it deep thought, weighing all the factors, whether she should have the removal or not, it’s truthfully irrelevant at this point, since she did what she was supposed to do and whatever happens is what is meant to be.

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