Saturday, October 12, 2019

Thankful for Every New Moment - My Heart Bypass Story


The last weekend in January, I took a few days of vacation to run the Arizona Rock ‘n Roll Half Marathon in Tempe, Arizona. I raised several hundred dollars for St. Jude’s Childhood Cancer research. My time was a bit slower than my normal, but I figured maybe I was just a bit off from having flown in the day before.

The second weekend in April, I drove down to Kansas City and finished the Garmin Land of Oz Half Marathon. By the end, I was dragging. I finished nearly a half an hour off of my best time. I’ve finished 15 Half Marathons, 13.1 mile races, and one Marathon, 26.2 miles, over the past 5 years. Six in the calendar year, when I finished the race in April. Though, I wasn’t exactly setting land-speed records, I thought I was in pretty good cardio-vascular shape.

When I go to camp, in July, I take some time to run. This year, I tried. I could run for a bit, but mostly had to walk. I thought I had bronchitis, which I probably did. My doctor called in a prescription for anti-biotics and soon my cough went away.

A few days after I returned to Des Moines from camp, we flew to Orlando, to Universal Studios, for a family vacation. We walked all over the parks. Probably six miles a day. I had to rest every now and then, but we rode just about every ride, including going on some of those “People with Heart Problems are discouraged from riding this ride” roller coasters multiple times in row. Yes, I am a roller coaster fan. The faster and more time spent upside down the better!

We went to Volcano Bay, Universal Studios waterpark, and of course, I had to go on the fastest, most intense water slide, right away. Over 200 steps up and a straight vertical drop for a couple of seconds. You reach the bottom pool in seven seconds. I had to stop and rest to catch my breath about ¾ of the way up the stairs, each of the five times that I climbed them. Since, I’ve been running long distances, I have gotten fairly used to never being tired unless I’ve been doing something fairly intense. I was a surprised at being tired.

We were back in Des Moines for a few days and then we flew to North Carolina for my wife’s family’s reunion. With a brother in Japan and nephews in France and Switzerland as well as in a couple of different US states, it isn’t often that they’re all together. As it is, one of the French nephews couldn’t attend.
One of the things one does in the mountains is hike. When we went hiking, I found myself winded pretty easily. I couldn’t keep up. I started to suspect that a medicine that I had been taking for a while might be preventing my heart from working as fast as it needed to work. I didn’t feel bad, just tired, and I was fine after I slowed down. I called to set an appointment to meet with my doctor about it after I got back. The appointment was a couple of weeks out.

We got back to Des Moines in time for the state fair. I went three times. Each time, I was tired pretty easily walking around. I never went up the hill this year. On the way back to the car, the second time I went, I had to stop several times to catch my breath. Again, after resting a bit, things seemed okay. That night I was winded walking up a flight of stairs at home.

Now, I was quite concerned. It’s scary to not be able to breathe.

I didn’t want to wait for my scheduled doctor’s appointment, the next day. I called and asked to see whomever was available. I got in with a different doctor that afternoon.

My EKG was normal. My heart sounded normal. My blood pressure was slightly up, but not high. My cholesterol was good. He wasn’t sure what was going on, but said, “If this is only happening when your system is under stress, we should get a stress test. It might be something electrical. The stress test would show that.” The first available stress test was nearly a week out on Wednesday.

The next day, we went to the fair again, on our 25th wedding anniversary, we went to see our favorite comedian perform. Again, I had to stop several times on the way back to the car. It felt like I was under water too long. But again, after resting a bit, things seemed okay.

The day before the stress test, I drove three other local Jewish professionals to Cedar Rapids, over 2 hours each way, for our Iowa Jewish Professionals meeting.

The next day, Wednesday, I took my stress test.

They started off giving me an EKG, which was again clear. They did an Echocardiogram as well, which looked good. Then they had me get on the treadmill. It was fairly clear fairly quickly that something was wrong. My heart rate needed to get up to 90% of my max, but well short of that my EKG started to get wonky. They stopped the test and had me lay down to do another Echocardiogram. A few minutes later, I was downstairs in the cardiologist’s office.

They did another EKG then, which came back normal.

A few minutes after that, the doctor came in to see me:

I think it fairly certain that you have a blockage and I’m fairly certain that it’s in a pretty bad location. You need an angiogram. They’ll inject dye into your veins and that will show them where the blockage is. My guess is that you’ll need a stent and probably will have to stay overnight at the hospital. Normally, I’d ask you which doctor and which hospital you want, but you’re lucky. You get to have the first available appointment! As long as your EKG stays normal, you can go home tonight, but if you feel like you have felt when you’ve been short of breath, don’t call your wife or me, call 911.

On Thursday morning, I went downtown for the angiogram. They explained what they were going to do and all the risks. If they found something, which they anticipated, they would put in a stent if they thought that would work. Otherwise, if things were bad, they’d stop and we’d reassess for treatment another day. Then the nurse put in the IV line. They wheeled me into the OR and I was out like a light.

I woke up a while later and the doctor came in to see us. “We had to stop. You have several major blockages. You need bypass surgery.” Another doctor told me that one of the blockages is normally discovered by the forensic pathologist and that I was extremely lucky.

They weren’t going to let me go anywhere. Rather quickly, I was given a room and put on a blood thinner. They scheduled the surgery for Monday, an expected Triple Bypass, but told me that if anything happened in the interim, I’d be going to surgery right away.

My cardiologist came in and told me that I’d had this condition to a pretty severe degree for a very long time. My heart had created natural bypasses, collaterals, veins that went around the blockages. Those were what was enabling my heart to perform okay on a resting EKG. They just weren’t providing enough blood flow to allow my heart to do anything more than that at this point, because blood flow was so limited.

That Saturday, I walked a little in the hallway with my IV pole in tow. I could walk about 100 feet before I was very tired. I was afraid that I would need the surgery right away; that I wasn’t even going to make it to Monday. But I did.

People kept asking me if I was afraid about the surgery. I really wasn’t. I had been afraid all of those times when I couldn’t breathe. I was upset that I had made my family stress out. When I started running in early 2015, I did so because I wanted to prevent exactly this sort of thing. I wanted to get myself healthy and thought I had done a pretty good job of it, shedding weight and getting my heart in shape. I didn’t know that by that point, most, if not almost all, of the damage was already done.

I just kept thinking of all of the times, running dozens upon dozens of examples through my mind, when the worst could have happened. I thought about how miraculous it is, in fact, that it didn’t happen, all things considered. How many times had I gone on long runs? How many trips had I been on? Several times to Israel. Long drives in the car by myself? Those times when I was running by myself on the sports’ fields at camp while everyone else was at lunch. No one else around for an hour. And on and on.

No, I wasn’t afraid of the surgery so much as relieved for having made it to surgery and hopeful that it would be fixed. One doctor told me that with decent blood flow to my heart, I would likely find myself able to do far better at my running than I had before. I was hopeful.

I ended up having Quadruple Bypass surgery, which they tell me, went extremely well.

Recovery isn’t and hasn’t been easy. I have been able to get moving a little easier than most people would. The rest of me was in pretty good shape. But coughing and laughing hurt for a while. Sneezing, hurt a lot. And a week after surgery, when my kids decided to play some funny videos on their phones and were laughing, it hurt when I joined in. I had to ask them to stop making me laugh and I love to laugh.

It’s was especially hard for me not to be able to do all of the things I would like to do with my family and friends over the past few weeks. No, I am not going to be running the Des Moines Half Marathon again this month. I deferred my entry to next October. It’s also been difficult for me to not be able to be there for you as rabbi as much and in the ways that I would have liked since this began. Being tired while recovering is a real thing.

What has made it all better for me is the tremendous amount of support that my family and I have received. So many people have reached out in concern. Again, your support has meant a great deal. Thank you.

Today, Yom Kippur, it is said that we Jews rehearse our death. We contemplate what will happen when the end comes. What will be accrued to our benefit? What to our detriment? Have we had a positive impact on people’s lives? Can we do better? If we heard eulogies about us, what would they say?

Over the past couple of months, I have had the opportunity to hear some of these things about me. Thank you for all of your beautiful sentiments, heartfelt thanks and concerns, and wishes for a full and speedy recovery.

I have also had ample opportunity to imagine not being here today. To not have been here, to not have experienced so many wonderful things over the years, to not have been able to be there to help others either. It’s been quite a time of Cheshbon Nefesh, of an accounting of the soul.

This morning, we read, “Atem Nitzavim hayom kul’chem lifnei Adonai Eloheichem,” “You stand this day, all of you, before Adonai your God.” It is a passage that reminds us that today, we should humble ourselves, recalling the dictum of the rabbis, “Da lifnei mi atah omeid,” “Know before whom you stand.” Think about what it means to be where you are. For me, this is not just about before whom, but how and why.

Why are we here today? What has our journey been to reach this place? Thinking not only of physical movement, but of thoughts and feelings. Am I appreciative? Do I want things to change? Am I willing to do what is necessary to bring about the changes that I would like to see? In my life, what do I stand for? How did I arrive here at this moment? Would I like to be in a different place physically, spiritually, mentally?

This afternoon, during our Healing service, I will come up to stand before the open ark thanking God for allowing me to reach this day, for the many miracles, far too many to count, that have enabled it to come to pass, for the skill of my healthcare providers, for loving family and friends who lifted my spirits and may well have given me a lift in their cars to go out as well, and for all of those whose thoughts and prayers helped bring me healing of spirit as well as body. It will be all the more meaningful a service this year and every year going forward for me.

I have come to realize that every moment is one deserving a Shehecheyanu:

Baruch atah, Adonai Eloheinu, Melech haolam, shehecheyanu, v'kiy'manu, v'higiyanu laz'man hazeh.”

“Blessed are you, Adonai, our God, Ruler of the Universe, for keeping us alive, sustaining us, and enabling us to reach this moment.”

L’shanah Tovah tikateivu v’teihateimu.
May we all be inscribed and sealed in the book of life for a good and healthy new year.

Unetaneh Tokef. Life Happens.


***Six weeks before delivering this sermon, I had quadruple bypass surgery.***

Many things have happened in this past year, some good, some not so good. On the bright side, this past year, over the past couple of months, I learned to be less concerned about having my blood drawn.

I am thankful to be able to be here today. I’m not 100% yet. It isn’t an easy or short recovery. My voice isn’t what it normally is and you’ll have to bear with me coughing now and then.

Before I continue, I wanted to thank you for the tremendous amount of support that my family and I have received. So many people have reached out in concern, sent notes of support, and made donations for my recovery. Your support has meant a great deal. Thank you. 

[Personal thank yous to my family, friends, and congregational leaders followed, which I have not included here.]

Today, in the context of what happened to me, I want to talk about a traditional prayer that is difficult for most of us to deal with conceptually. The Unetaneh Tokef prayer tells us that God determines not only who lives and who dies, inscribing some in the Book of Life and not others. We are told:

On Rosh Hashanah it is inscribed,
And on Yom Kippur it is sealed.
How many shall pass away and how many shall be born,
Who shall live and who shall die,
Who shall reach the end of his days and who shall not,
Who shall perish by water and who by fire,
Who by sword and who by wild beast,
Who by famine and who by thirst,
Who by earthquake and who by plague…
The statement concludes:
But repentance, prayer and righteousness avert the severe decree.
Most of us do not believe in this sort of theodicy, this sort of understanding of divine judgement, the causing of blessing or curse, with reward or punishment. I have long argued against this concept as traditionally understood. With my recent ailment, though I’m still not a believer in this idea, I’ve come to see this portion of our service in a slightly different way.

The purpose of this prayer is truly to try to help us to find order in what otherwise would appear to be chaos, seemingly random chance. We know that bad things happen. We know too that they don’t just happen to bad people; they happen to good people as well. And more importantly than this abstract conception:

They happen to us and they can happen suddenly.

  • ·      We live in a world in which we can set the temperature of our homes and cars to whatever temperature we like.
  • ·      We can wear clothing that is impervious to rain, keeping us dry in the worst of downpours.
  • ·      We can have food from just about every restaurant in town delivered to our homes for a nominal delivery fee or even for free!
  • ·      We know about and can monitor and treat high cholesterol and high blood pressure.
  • ·      We can use a laser to fix our eyesight in addition to wearing glasses.
  • ·      We have ways to treat some of the worst of diseases, ones that once would have taken lives before we were even aware of them.
  • ·      We can ask a wireless device in our homes to turn on the lights, open the shades, play our favorite music, read us a book, change the channel, or order us a new pair of jeans to be delivered free of charge to our doorstep in less than two days. We can even do these things from wherever we are on our cell phones.

We appear to be in control of our lives, much of the time. But we’re not. We’re truly not. It’s an illusion.

Life happens. Some people prefer to use a different word than “life” in that statement, especially when the results are not good ones. Life happens and sometimes what life brings isn’t remotely ideal.

This High Holidays, Jews around the world remember those who were killed over the past year, simply because they were Jews. It has not been a good year for us as a people.

Lori Kaye was shot and killed in the shooting in Poway, California five months ago. It’s hard to believe it was only at the end of April. Lori evidently confronted the shooter near the door. In addition to supporting the synagogue, Lori was heavily involved in raising money to combat Childhood Cancer and for Chai Lifeline which aids families with seriously ill children. By all accounts, she was an eishet chayil, a woman of valor, a woman of courage. She fought her own battle with illness and was doing well. A few months prior, she celebrated her 60th Birthday and posted about it on Facebook. She wrote:

"Fearless at 60! As I enter a new decade, I am full of "gratitude" & thankfulness for the many blessings in my life. As I said on my 40th & 50th birthdays:
Life is not measured by the breaths we take, but by the moments that take our breath away."

Unetaneh Tokef. “The moments that take our breath away.”

So many of us here have our own lived examples and those of our loved ones, times when life happened. Unetaneh Tokef is a painful prayer. It makes us remember. It makes us think about seeming randomness, chaos, and things beyond our control that happen to us, to our friends and family members, or to others. It’s both the hurricanes far away from us and the whirlwinds that strike our homes.

Some of us have had the opportunity to live in times of blessing, of prosperity and relative security. For others, the Kol Nidrei prayer, for which this evening’s service is named, was a way of coping with being forced to face and do what they neither wanted to face or do. Living under threat, they had to swear oaths that they did not believe and act as they would not or could not act.

Unetaneh Tokef. Life in the places and times they lived brought them challenges, difficulties, threats, not just opportunities and blessings.

The Unetaneh Tokef prayer is both about those who died before their time and those who lived ad meah v’esrim, to 120. It’s about those whose businesses became successful and those who tried, tried again, and failed over and over. It’s also about those who have been struck with illness. Some of us, this past year, found out that we weren’t quite as healthy as we thought and suddenly faced severe challenges.

Unetaneh Tokef. You need surgery. Or
Unetaneh Tokef. You need radiation. Or
Unetaneh Tokef. You need to radically change your diet, your lifestyle. No more fried cheesecake at the fair for you! No more rushing from task to task while barely taking the time to breathe or taking time to care for yourself.

New priorities---- breathe. Take time for yourself to make yourself what you need to be. Prioritize your health.

But Unetaneh Tokef. Sometimes, no matter what you do… Life happens.

You can get out there and run, three times a week. Three 10Ks a week. You can run Half Marathons. You can be on the right medicines and seeing a doctor regularly.

Unetaneh Tokef. Do you have a family history? Yes.

“You won the lottery,” the doctor said, “Genetics.” Control is a delusion. No matter how much control we think we have, we really don’t have the ability to bring it all under our control. We may not have much of an ability to control at all.

Unetaneh Tokef. Life happens.

What we can do is do our best to adapt to it in the best ways. How we respond when life happens is really what defines who we are.

  • ·      It’s not difficult to smile when everything goes our way. It may be difficult to remain humble when everything and everyone around us seem to elevate us.
  • ·      It’s not difficult to feel depressed or sad when everything is going wrong, when bad things have happened. It may be difficult to react with hopefulness and seek happiness, when they do.
  • ·      It’s not difficult to avoid action when action is painful. “Doctor, it hurts when I do this.” “Don’t do that.” So easy. But it may be difficult to get moving and endure it as we move on and get better. Rehab can be painful and tiring. But after rehab, hopefully, less pain and more energy.


Unetaneh Tokef. Life happens. The challenge before us when it does happen is to do what is difficult.

L’shanah Tovah Tikateivu v’teiteimu.

May we all be inscribed and sealed for a good and sweet and healthy and blessed New Year.
But if the coming year doesn’t bring some or even any of these things,
May we do our best to do the difficult and
Help and support each other as we do so, 
Just as you have done for me and for my family.

We’ll make the next year and the years to come, the best that we can make them.

Good yom tov.

Monday, April 29, 2019

All Too Prophetic - The Night BEFORE Poway


I offered this sermon the night before a 19 year-old man entered a Chabad Congregation in Poway, California, killed an Eishet Chayil, Lori Kaye z"l, and injured Rabbi Goldstein and two others.

Dvar Torah on Sri Lanka Attacks
April 26, 2019

Last weekend, on Easter morning in Sri Lanka, a series of explosions at Churches and at upscale hotels sent the overwhelmingly Buddhist country into panic. Over 250 people were killed in the terrorist attacks carried out by a Muslim Ethno-Nationalist terrorist group that had affiliated itself with Da’esh, the Caliphatist Terrorist group often commonly called “ISIS.”

Da’esh claimed that this attack was carried out in response to the attacks against mosques in Christchurch, New Zealand. In that attack, of course, a Christian Ethno-Nationalist attacked worshippers at mosques. Following on the heels of a Christian Ethno-Nationalist attack on the Tree of Life Synagogue in Pittsburgh, we have been increasingly concerned about rising violence based in religious conflict.

Christians generally respond differently to these kinds of attacks than we Jews do. To an extent, this is based on collective memory. We know well that when hatred of Jews becomes violence against Jews, it can spread quickly if we do not assert ourselves and have allies join us. We cherish our allies. When we have lacked them or they have failed to stand with us in generations past, our meager number has been overwhelmed time and again. Jews represent 0.2% of the world’s population. Two-tenths of one percent.

And we respond as a people, not as a diverse faith community as Christians do. We connect to members of Jewish communities everywhere, no matter what kind of Judaism they practice or if they practice Judaism at all. We feel their joy and their pain. We know the struggles of persecuted minorities.

It has been our role in many nations, to lead the fight to defend minority rights, to not only stand at the forefront of the cause of immigrants, but to walk into the waters of hatred, like the midrash tells us that Nachshon did when the sea split, demonstrating faith and courage. We walk into the waters of hatred with faith and courage that we will make those waters split too. We will part the waters of hatred and march ever forward toward the promised land in which our house will be the house of all peoples, welcoming, embracing. Not all of our brethren, of course, are similarly welcoming, but the vast majority are, around the world.

Others do not share this vision. Ethno-nationalists who believe that people who are like them are the only ones who should be able to live among them and who are willing to engage in violence to make that happen are among the greatest of threats to peace wherever they are.

There are certainly very fine people who are devoutly religious Christians, Muslims, and Jews. We know that. But there are no fine Ethno-Nationalist advocates for violence against anyone not of their in-group. It is not acceptable to allow political correctness or concern about harm done to the image of the broader group to avoid both severe condemnation of and taking action against Ethno-Nationists.

We condemn Kahanists. Those who preach Meir Kahane’s hatred were banned from the K’nesset for decades. A party that is somewhat related to it rose up and was again condemned even though it did not take close to the same position. Israelis and American Jews alike are concerned to even have one representative of that political party in the Knesset, as a member of the United Right party, and attention will be paid not to allow hateful views to impact how Israel treats its minority populations. Just as we will all pay attention to how confrontational rhetoric that at times may have crossed the bounds into overt bigotry will or will not result in changes in policy.

We also perceive the threats coming against Jewish communities from Christians and from Muslims in different parts of the world. We cannot understand attacking innocents. The lone example that people can name, Baruch Goldstein, stands out in glaring uniqueness in our people’s long history.

Never have we as a people believed that sacrificing ourselves to harm others will benefit us in the world to come. We’ve never had a tradition in which Jews would willingly sacrifice their own lives to harm members of other religious or ethnic communities. It didn’t even happen before or during the Holocaust when such extreme action under duress may have made some sense. Instead, our tradition repeatedly stressed, even then, “Whoever saves a single life, it is as if they saved the entire world.”

So it is all the more difficult for us to look at what happened in Sri Lanka and understand, how wealthy and successful educated people could, based on their religious views, calmly walk into the midst of innocents and commit atrocities. How a pregnant mother could do so, ending the lives of her two children as well in order to harm police officers. In our tradition, there is no question that we would rather die ourselves. That much has been proven by our history.

We respond to that level of evil, evil that we have seen in generation after generation, so often affecting our community—we respond to that evil with a commitment to not follow it with our own hatred as pained as we have been at many of those times.

Having just come through the holiday of Passover, we easily recall the story to mind. “Let my people go,” we said. “We cried out time and again.” “We walked away.” “When horse and chariot came against us,” we did not turn. “We walked on.” “When Amalek attacked the weak and vulnerable,” we pledged to remember. Only once from the time we entered Egypt to the time we left and wandered the wilderness did any Israelite lift a hand, and Moses fled for having done so. God fought our battles for us.

This Wednesday is Yom HaShoah, the day on which we remember and mourn. We do not do so with pledges of retaliation and vengeance, nor with anger and hatred. We remember to remind ourselves that it is our duty to never let it happen again, to never again allow that kind of hatred that could result in the slaughter of innocents to occur. This year, we not only mark the day amid a time of rising Antisemitism, but at a time when the world mourns the effects of irrational hatred.

It reminds us, as we look back into the darkness of the past and out into the darkness of the world around us, that our mission as a people has long been, “To be a light unto the nations,” a beacon in the darkness. And as Hillel said, “At a time when there is no humanity around you, be a human being.” That is our challenge. Let us be lights of caring and love amid the darkness of indifference and hatred.

Shabbat Shalom.