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Rabbi's Blog: Thoughts From, and Conversations With, Rabbi Levi Shemtov

Cancer Gene: Chabad of Riverdale Seeks Jewish Answer to Jewish Problem

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The Susan G. Komen Foundation have promoted our upcoming class, "Ounce of Protection," which aims to raise community awareness about the heightened risk of breast and ovarian cancer among Jewish families. The class, which is the first in the six-week course, "Life in the Balance: Jewish Perspectives on Everyday Medical Dilemmas," will take place this Sunday, October 27.

The risk of carrying a BRCA gene mutation that causes breast and ovarian cancer is ten times greater among women of Ashkenazi Jewish descent than among the general population. With growing concern over what preventive measures Jewish women should take, Chabad of Riverdale, in conjunction with the Rohr Jewish Learning Institute (JLI), is organizing a community awareness workshop on how Jewish law views this modern day medical dilemma.

 The class - which will be held at Chabad of Riverdale, 535 West 246th Street, on Sunday, October 27, between 9:45-11:15 am - will explore the biblical requirement to safeguard one's health, and whether it obligates Jews of Ashkenazi descent to test for BRCA-1 and BRCA-2 gene mutations. Even more importantly, it will discuss whether Jewish law recommends women to undergo radical mastectomies or oophorectomies in case they do test positive, in order to save their lives.

Entitled "An Ounce of Prevention: BRCA, Genetic Testing, and Preventive Measures," the class is being offered by JLI in 362 communities in honor of National Breast Cancer Awareness Month. It is the first class of a new six-week course, titled Life in the Balance, about the Jewish perspective on everyday medical dilemmas. The course is accredited for Continuing Medical and Legal Education, and can help medical professionals develop a greater sensitivity to the concerns and decisions facing some of their Jewish patients.

One in forty women of Ashkenazi Jewish descent carry a BRCA gene mutation compared to about one in four hundred in the general population. If a woman carries the mutation, there is a 50 to 80 percent risk she will develop breast cancer, starting as early as her twenties, and a 20 to 40 percent risk she will develop ovarian cancer as early as her thirties. Although the risk is much lower for ovarian cancer it is much deadlier, since blood tests and ultrasound exams rarely diagnose the cancer until it has already reached stage three or four, and is then difficult to treat.

"Statistics like these are leaving women in the Jewish community with some tough decisions to make," said Rabbi Yanky Raskin, course instructor. "Some are reluctant to get tested, worried about the medical and financial repercussions, and the prospect of facing radical surgeries that could affect their self-image or ability to have children. Having to face decisions of such complexity has led many women to avoid addressing the issue altogether. But with mortality rates so high, this is hardly a problem the Jewish community can afford to ignore."

The issue of testing for the BRCA mutations and undergoing radical surgery to prevent the onset of cancer drew national media attention following Angelina Jolie's recent announcement that she had undergone a prophylactic mastectomy upon having been tested positive for a BRCA-1 mutation and learning she had an 85 percent risk of developing breast cancer. 

While the media spotlight made many women more aware of the risks, it also sparked some confusion in the Jewish community and intensified a debate among geneticists and medical professionals whether all women of Ashkenazi Jewish descent should be tested, or only those with family histories of breast or ovarian cancer.

Until recently it was thought that only women with a family history of these cancers should be screened for BRCA mutations, but Dr. Wendy Rubinstein, director of the National Institute of Health's genetic testing registry, calculated that testing all women of Ashkenazi Jewish descent would save 2,800 lives a year and be extremely cost-effective despite the relatively high cost of testing.

 "I still believe in family history. It tells you an enormous amount," said Rubenstein, one of the geneticists whose opinions will be shared in the JLI class. "The professional guidelines are that [family history] is enough and I really don't want to contradict that and say we ought to go farther. What I do think is that we ought to think seriously about a screening program as a community like we did for Tay-Sachs...which was so effective reducing the birth of Tay-Sachs-affected babies. I want to see a dialogue begin between the Jewish community, the medical community, and the public health community."

Others, such as geneticists at the Program for Jewish Genetic Health of Yeshiva University/Albert Einstein College of Medicine, say that because most BRCA studies have so far been limited to women with a family history of cancer, no one can know for certain whether a positive test result is a conclusive predictor for those with no family history of cancer.

In the JLI class students will be presented with different voices from the medical community as well as the perspective of Jewish law, so they can be prepared to make an informed decision in consultation with their physician and geneticist. 

"Some 1,500 years ago when rabbinic scholars wrote the Talmud, they didn't have questions about screening for cancer genes like we have today," said Rabbi Raskin. "However, there are guiding principles found in the Talmud that can help us determine how to respond to these very perplexing and life-altering medical quandaries. One of the Talmud's most important lessons that must guide our response is that saving one life is like saving an entire world."

Like all JLI programs, Life in the Balance is designed to appeal to people at all levels of Jewish knowledge, including those without any prior experience or background in Jewish learning.

 

Don’t Be Kissed by a Fool or Fooled by a Kiss

Large numbers of Jews read King Solomon’s poem Aishes Chayil every Friday night while remaining clueless as to its underlying powerful mystical meanings.  These meanings have profound messages for our relationships with our spouses.

The poem is purposely esoteric.  One has to dig to find its instructions, many of which are the exact opposite of its surface, literal  words.

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The very reciting of the poem is a Jewish paradox.  There is a well-known expression, “ two Jews, three opinions”.  It is rare in the Jewish liturgy that we find a custom that all segments of Orthodox Jewry do the same way, chanting the same set of words at the same moment in time.  Even with as powerful a prayer as Kaddish, we don’t all use the same “script” or timing.

Yet, Aishes Chayil is said using the identical verses, at the identical time, by all Orthodox Jews, be they Litvak or Lubavitch,  Yekkeh or Yemenite. And most people, including Rabbis, don’t even know where and how this custom began.

Ok, perhaps that question is a puzzle of interest primarily to scholars. But in the same way, people are unaware of the magic in the verses, and their practical meanings for guided our marriages, as well as our understanding of the spiritual forces controlling the world.  

Aishes Chayil  is a potent 8-level metaphor about  the interplay of Female and Male universal currents.  Come join us for a swim.

 Enjoy Rabbi Susskind's lecture "The Mystical Metaphors in King Solomon's Eishet Chayil: Guidelines for Marriage from Psychology and Kabbalah" on Saturday Night, October 19, at 8:30 pm at Chabad. Call 718-549-1100 Ext. 10 to register.

Bringing Heaven Down to Earth

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The day has arrived. You have enjoyed a heavenly month in Europe: your experiences in France, Italy, and Spain were rich and vivid, and you enjoyed the most breathtaking sights along the way. But now, after all those months of planning meticulously for your vacation and crafting a detailed itinerary, it is already time to pack up your bags and head back home. Back to reality.

Your feet have landed on American soil, and your adventure is over. What now? How do you make the switch from being in vacation mode to "real life"?

The answer lies in memories. Your trip might be over, but the memories aren't. 

As you unpack your suitcase, you come across magnets you picked up in Venice and place them on your fridge. You upload the pictures from your camera, and save the one of you and your spouse standing in front of the Eiffel Tower on your desktop. Now, you are back in your routine. But every time you open the fridge to take out the milk, you smile as the magnet reminds you of magical Venice. As you turn on your computer to begin a day of work, the picture on your desktop transports you back to that rainy but unforgettable day in Paris. The memories live on.

The Jewish people have just returned from their own incredible trip: Tishrei. The seventh month in the Jewish calendar year, Tishrei is filled to the brim with four major Holidays: Rosh Hashanah, Yom Kippur, Sukkot, and Simchat Torah. There is no month in the Jewish calendar as intense and emotional as Tishrei.

At Chabad of Riverdale, hundreds packed into our shul for Rosh Hashanah and Yom Kippur services. Spirits soared on Rosh Hashanah as we crowned G-d as King of the world. On Yom Kippur, we were invigorated by inspirational prayer on the holiest day of the year.

During Sukkot, our community was enveloped by beautiful and fragrant Mitzvot. Friends, new and old, from all different backgrounds gathered in our Sukkah, shared meals and engaged in the holy commandment of the Four Kinds.

On Simchat Torah, the joy was palpable as once again, we united, holding hands and dancing during the Hakafot. Our celebration reached a climax as we embraced the conclusion—and restart—of the annual Torah-reading cycle. This Simchat Torah was especially meaningful for us here at Chabad as we used our brand new Sefer Torah, gifted to us by Rabbi Faitel Lewin (Click here to watch our memories of this joyous day).

Friendships were intensified, memories were made, and joy filled our hearts.

We heard from so many that their Simchat Torah experience at Chabad this year was their most spiritual and uplifting yet. It truly was amazing. 

But what now? Tishrei is over. Where do we go from here?

We do what our traveler friend did following his remarkable experience in Europe. 

As we "unpack" our memories, we write down and record a special verse from the High Holiday services that particularly resonated with us.

We download to our phone a song that lifted our spirits on Sukkot.

We place in the top drawer of our desk, where it can be easily accessed, a paper with two resolutions that we made before Rosh Hashanah.

Then, as we return to reality, to the barren month of Cheshvan and beyond, we hold on to the beauty of Tishrei by replaying that special Sukkot song, reading the verse that gave us so much hope and resolve during the High Holiday prayers, and opening our drawer to check in on how we are doing with our resolutions. These beautiful reminders are here to stay. Until next Tishrei. 

Sorah and I want to personally bless you with health, happiness, peace, parnasa, domestic happiness, and may all your blessings be fulfilled for the good.

 

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