A Donation: Saving and Treasuring Life
Rabbi Samuel M. Cohon, Yikzor 5787, Congregation Beit Simcha, Tucson, Arizona
Life is precious, my friends. Above all, this amazing gift we have each received is a sacred trust, simply to be, is given once to each of us. It is sacred. When those we love are threatened with its loss the feelings can be overwhelming.
Life and love. In many ways, these are all we have to treasure in this world.
I recently learned an old story from a member of our congregation, Sherry Cunial, a cancer survivor. She told me about a Jewish oncologist, Dr. Stephen Forman, who treated her own cancer years ago at The City of Hope Hospital in California, and had a most unusual patient and family, an extraordinary, unique experience that speaks to the holiness of life.
You may or not be familiar with The City of Hope; long ago, during rabbinical school in Los Angeles, I had the privilege of serving a chaplaincy internship at that remarkable facility, visiting bone marrow transplant patients in the suburb of Duarte, in the San Gabriel Valley outside of LA. The City of Hope does incredible work, and I will always be grateful for what I learned there.
The hospital was founded in 1913 by the Jewish Consumptive Relief Association as an institution to care for destitute patients suffering from tuberculosis, TB, which was a common and uncurable disease in those days. Its Los Angeles Sanatorium opened its doors in 1914, treating its first 31 patients in canvas cottages. It became the premier TB treatment location in the west. In those days, the dry western air was considered a panacea for those suffering with tuberculosis, as was the bright sun; like Tucson, Southern California became a magnet for urban easterners seeking a chance to breathe again. Often those people were Jews, usually recent immigrants; many of our original Tucson Jewish community members came out to try to cure TB with sunlight and desert air. Both St. Mary’s Hospital and the VA Medical Center were originally built as TB hospitals.
By the 1940s, as new antibiotics successfully treated and cured tuberculosis, the City of Hope redirected its mission to treating cancer and other life-threatening diseases, with great success. Scientific medical developments allowed its doctors to pioneer new and effective treatments. It was one of the pioneering centers of bone marrow transplantation for leukemia and other blood cancers, and it has saved the lives of many people over the decades. In bone marrow transplantation the donor is not harmed, and if the matching bone marrow is accepted by the recipient they can, essentially, be cured and live a long, healthy life thereafter.
For those who don’t know, blood cancers, like leukemia and lymphoma, are extremely difficult to treat, since they start in the bone marrow and lymphatic system where blood cells are made, meaning abnormal cells circulate through the entire body instead of forming a single, localized tumor that can be removed by surgery. Bone marrow creates the white blood cells that fight off infections. When it goes wrong, is changed by cancer, instead of producing infection-killing white blood cells it spreads the malignant cells throughout the patient.
The standard medical treatment for blood cancer is to literally kill all the bone marrow in the body of the affected patient and then transplant healthy bone marrow from a matching donor into the patient. It is delicate work that requires full isolation of the patient from any and all germs, since until the new, healthy bone marrow has taken hold the patient has essentially no immune system to ward off infections. A minor cold or flu, even an infected cut, is likely to kill the patient. As student chaplains this was our first experience of what they later called PPP, and we had to learn how to communicate compassion and caring with bone marrow transplant patients while completely gowned, masked, and covered up. It was a powerful learning experience.
The story that Sherri told me when I visited her in the hospital recently—she has, thank God, recovered from that episode—took place 35 years ago, and involved a teenage girl who developed leukemia. She was treated at the City of Hope hospital by a Jewish doctor, Dr. Stephen Forman, originally from Galveston, Texas—Sherri’s doctor at around the same time. The problem for Dr. Forman and the teen patient and her family was that there was no matching donor for the 16 year-old girl, Anissa Ayala. When there is no matching donor, the patient’s survival rate is essentially nonexistent.
Anissa’s parents decided to take a series of long chances to save their daughter. There were no outside matches in the database for her bone marrow, and neither parent was a match for donating bone marrow to their child. But there was a chance—perhaps one in four, the doctors calculated, 25%, 4 to 1 against if you are betting person—that a sibling would have the matching bone marrow, and could serve as a donor. Unfortunately, the girl’s only sibling, the Ayalas older son was not a match.
And so they decided to try to get pregnant. They had to overcome a series of obstacles. The husband had had a vasectomy, and that had to be reversed, a standard procedure that often works, but not always, to restore fertility. Then, her mother was 43 years old, making pregnancy a far from certain thing. And of course, Anissa needed to survive and be strong enough for the operation to take place.
The Ayalas were given a 10 percent chance to conceive. Time was running out. They weren’t sure if Anissa would live long enough to receive a transplant. They took her on vacations to Yosemite and Hawaii.
Against the odds, a new baby was conceived, and born, and named Marissa. Against the odds, her bone marrow matched her sister’s. When she was 14 months old and weighed enough to be a donor, Dr. Forman transplanted the bone marrow from the baby—who had a sore hip for a few days but otherwise was unaffected by the surgery—into the now 19 year-old young woman. The transplant was accepted, and the recovery, which is not instantaneous, was completely successful. Anissa recovered, married, had a career and a family. Marissa grew up, graduated from college, and became a speech pathologist. Her parents raised her with love, and she remained close to her older sister, even moving in with her after college for a while. This time, we know that there was a happily-ever-after.
It is a beautiful true story, a near-miraculous one.
There was much criticism at the time this story came out in the media of that day: how could you have a child just to save another child? Isn’t it wrong to have a child just to save another child? Isn’t that like harvesting one human being to save another? Are we on the road to an immoral world of choosing one life over another, manufacturing human beings to save or elongate the lives of other human beings?
And so on.
The ethical implications were complex and raised an entire constellation of issues that our society hasn’t fully grappled with yet, three decades later.
Now, my friends, people have children for so many reasons: to perpetuate their family traditions; to fulfill religious doctrines; in order to have an heir, or even a spare; to try to save a failing marriage; by complete accident, against their own preferences; because they think it will be easy, or fun. Giving life is a powerful thing indeed, a beautiful and sacred thing, but many people—more than we would like to think—do so without anywhere near enough thought about just how it will all play out, about the responsibility and care that are essential to creating not only another being but a good life for that child.
Giving life is—should be—a kind of sacred trust.
But saving a life is more than that. Treasuring a life—treasuring life—so much that you willingly take long, even crazy chances in order to rescue that life, that is something else. That is uniquely holy. That sanctifies life in a way we must not only respect but revere.
Because, you see, it is life itself that is sacred, unique. That is the gift God has given us, that we have the capacity to make valuable, meaningful, special, even holy. That is what we have prayed for throughout these High Holy Days—to be written in the metaphoric Book of Life.
As we enter this time of Yizkor, the service in which we remember the lives of all the people who have touched us, and whom we have touched, in which we bring back their memories and our feelings of love and care, may we also take this gift: that our lives, like theirs, have the innate spark of the divine that can create and give life, but also save life. That our ability to treasure this amazing gift we have received, our very lives, is something we must know, always.
That is what Yizkor can mean: a time to celebrate the lives of those we have loved but can no longer touch, or save. And a time to embrace the reality, and the goodness, of our own lives.