It all started with a toe. A discoloration on a toenail, actually, that turned out to be melanoma skin cancer. My father, Rabbi Dovid Ross, was a tall, strong, healthy man. It seemed impossible that a little toe could cause him all this trouble. But it did.
We had never heard of melanoma. If we had, perhaps things would have been different. But melanoma was unknown to us. It was simply not on our radar.
The paradox of melanoma is that if it is caught early enough, it can be almost entirely treatable. If it is not, it is one of the most deadly cancers.
But my father was not the type to dwell on what could have been, what should have been. He believed that everything came from God. His cancer was decreed by God and only He could take it away.
During one of his first biopsies, he apologized to the technician for crying out in pain, making his job more difficult.
He approached his situation with complete faith in God and with sunny optimism. He never focused on himself or his discomfort, only on the feelings of others. In fact, when he went in for one of his first biopsies, he apologized to the technician for crying out in pain, making his job more difficult.
The Quest for a Cure
Immunotherapy is the treatment of choice for melanoma, and my father was accepted into a clinical trial at Memorial Sloan Kettering Hospital that combined two different immunotherapy drugs. This very same treatment cured a well-known journalist, who wrote about it extensively in her online column. My father was considered fortunate to have access to this cutting edge treatment. But God clearly had something different in mind. Not only did the treatment not cure my father’s melanoma, but it damaged some of his vital organs - wreaking havoc and rendering him almost unrecognizable from the healthy man he appeared just weeks before. It also made him ineligible for just about any further meaningful treatment. This was an incredibly traumatic blow for our family.
Yet my father forged on, accepting God’s will while at the same time pursuing every avenue for treatment.
Our next step was finding out if my father’s cancer had any identified genetic mutation, as the newer field of personalized medicine targets the specific cancer mutation. Most of the research and available treatments focus around a few identified mutations, especially the BRAF mutation, which over 50% of melanoma patients have. My father’s test results came back and we learned that he was one of a small percentage of melanoma patients whose tumors had no identified mutation, excluding him from many of the treatment options.
Despite all the disappointments coming our way, my father was not discouraged. In fact, as amazing as this may sound, he did not even view these developments as bad. They were directed by God, and therefore, were exactly as they were supposed to be.
During some of these hard times, I would ask my father, “Daddy, are you okay?” His answer: “I’m the most okay guy in the world.” And he meant it.
My father rarely talked of the unspeakable fear we all had, that he wouldn’t win this battle. In the very beginning of his illness, though, he told me: “There are only two things I want from my children. The first is that you should always be close to one another. The second is that you should never have any complaints against God.” The first request was easy to fulfill, as my parents had always raised their children to be close. As my father’s condition worsened, the second request turned out to be a little harder.
While there weren’t many systemic treatments available for my father’s rare form of cancer, he was able to have several surgeries and treatments which provided some short-term relief. My brother called this the “whack-a-mole” approach– every time a tumor popped up, we nuked it – either through surgery, chemotherapy or radiation. And that worked, for a short while.
During one of his many surgeries, we heard of a Jewish man in the hospital who was alone and without family. My father urged us to go visit him, while he was in surgery. When we protested that we wanted to stay nearby, in case he needed us, he insisted, “There’s no better thing you can do for me.”
Before another one of his surgeries, I was in the room when the anesthesiologist was reciting his required script of risks created by the anesthesia for consent purposes. “There is a risk of stroke, cardiac arrest, etc.” He droned on. “Of course the risk is minimal, but you should be aware that you can have these side effects…” My father interrupted him. “I want you to know, if that happens, it’s not your fault!” The anesthesiologist stopped in his tracks. He looked at my father, stunned. I don’t think in the thousands of times he recited this speech, he ever got that response.
One particularly grueling surgery resulted in a recovery period where my father was not allowed to eat or drink. Not a morsel of food, a chip of ice, nor a sip of water for about 8 days. The day it was finally allowed, he rejoiced: “Do you know what a miracle a sip of water is?” I will always remember that moment, when he transformed what could have made him bitter into a blessing expressed to God with all his heart.
And in the midst of all the darkness, there were indeed glimpses of light. There were treatments that worked for a tantalizing few weeks; there were promises of other treatments that never materialized. At a very low point, we received word that my father may be accepted into a very exciting clinical trial at the National Cancer Institute in Bethesda, Maryland. The treatment offered was considered to be very rigorous, but with a potential outcome of full remission. We sent my father's medical file, and eagerly awaited their decision. Expecting a call from the doctor, I was surprised when my father called me instead.
It seemed the nurse from the Cancer Institute accidentally copied my father in her email response to his doctors, letting them know they would not be accepting him. After breaking the news to me, my father's first words were: "I'm calling you because I know you'll be upset. I want you to know: I’m not upset. Not at all. And I don't want you to be either. It makes no difference to me if I am sitting in Bethesda, Maryland or Memorial Sloan Kettering Hospital or in my living room. It all comes from God. Everyone else is playing their part."
Coping with Suffering
I will not even attempt to describe my father’s suffering as his condition worsened. I had never before seen such suffering up close on another human being, and hope to never again. For those who don’t know, may you never know. For those who do, no words are necessary.
Yet my father drew closer to God in those days of suffering than he was in his prior years of comfort and health. He knew that everything that was happening to him was being personally directed by God. He knew that God had an eternal plan, and that he was not privy to the details, but he trusted in it. He accepted the good and the seemingly bad with equal serenity, and boundless faith.
I never heard my father complain, even when treatment after treatment failed him. When every last vestige of comfort was taken away, when his vision started diminishing from new cancer that was cropping up behind his eye, he didn’t complain. The only distress I heard him express about his illness was that it prevented him from taking care of his mother, in the hands-on and completely dedicated way that he used to, and that it made it more difficult for him to learn Torah. This indeed caused him great anguish. I would hear him repeat to himself during the times when he felt most keenly the limitations of his illness: “This is from God, this is what I need to be doing right now, I have to strengthen my faith,” over and over again. Those thoughts strengthened his spirit and carried him through the depths of his pain.
Always To God
It was a particularly hard day. The kind of day where the sheer ringing of a cell phone was enough to make my father flinch. Where the constant battle my father waged, between the excruciating pain vs. the confusion of mind that the painkillers brought, left him no choice at all.
It was later that night, in the stillness of the room, that I finally broached the subject that had been bothering me for so long. For the words of my father were forever before me: "My children should never have any complaints against God." No complaints. My father truly had none. And the last thing I wanted was to disappoint my father.
“You can have complaints. Just turn to God with your questions. Not away. Always to God."
So I unburdened myself to him. And my father, whose love, faith and gratitude toward God was boundless, had the wisdom and generosity to let me work toward those goals at my own pace. I will never forget what he told me. " I didn't mean to put pressure on you. You can have questions. You can have complaints. Just turn to God with your questions. Not away. Always to God."
That was the first night since my father's illness that I had any semblance of peace. And these words carried me through the dark days still to come.
Over the next few weeks, every treatment attempted for my father failed. Even the palliative treatments did not seem to relieve his suffering. By the time he died, his cancer had spread from his toe to every single vital organ in his body. On March 12, 2013, his pure soul was returned to its Maker. The same God that had given me my most precious, extraordinary father, took him away.
I know that my father is finally at peace, that he is looking down on us, guiding us ever still. While we feel the pain of his absence every day, the light that he shone for us throughout his life can never be extinguished. And I know exactly what he would say:
Melanoma can often be detected early, when it is most likely to be cured. Monthly skin self-exams and awareness of the warning signs of melanomas are the best prevention strategies. To learn more about melanoma, please click here: http://www.melanoma.org
Dedicated to the memory of my beloved father, Avrohom Dovid ben Alter Boruch