Friday, June 10, 2005

What causes cancer? Why dropsy, diphtheria and death? (oy vey)

She took me in after college, until I moved in with the earnest LawProf
(to be) and The Organizer. My Dad’s Cousin. Very much his kindred
spirit, always on the go: the Peace Corps, public health advocacy,
state legislature. Diagnosed with a rare spinal cancer, she dutifully
enlisted for numerous medical tests and quasi-experimental intrusions.
Painful, debilitating seven months. At the funeral last month, her
daughter expressed what many around her felt: Why did such a good woman
have to suffer so?
(Today’s posting is dedicated to her wit, beauty, strength and good will.)

What causes cancer? Why do these people get those cancers? For half a century, such questions have nagged us. The search for explanation. In the 1950s, we asked, does smoking cause cancer? Later: are there synergistic factors? (E.g., tobacco and asbestos combined.) What about pesticides? Are there cancer “hotspots” caused by hazardous waste sites? We seem to be straddling scientific research and a political /culture war. I suspect many of us gravitate to one pole, e.g. cancer is caused or facilitated by diet and lifestyle, or by toxic pollution, or by our genetic inheritance. But we are all far from able to explain the decline or rise of particular types of cancer.

“What causes disease?” also troubles the Talmud. The chapter shifts to
a mishna (bShab 31a) that posits 3 explanations for death during
childbirth. The answer: Sin. Or, perhaps more precisely, violations of halakha
(Jewish law) that are victimless misdeeds (i.e., neglecting to light
the candles, separate the challah offering, or follow purity
regulations). Divine punishment is meted during childbirth, say later
rabbis, because she is vulnerable at that time, like one crossing a
bridge (32a). Inspired by the mishna, the gemara looks at an array of
diseases, deaths and disasters (32-33). Sins that cause or explain
welts and wounds, jaundice, dropsy (hydroqan) and diphtheria (askarah 33a).

The Talmud does not provide scientific answers and the back-and-forth argument piles up doubts about its own theological doctrines. Eventually, some individual deaths cannot be explained away except by the sins of the generation (33b).

Inevitably, the Talmud also tries to explain deaths caused by other
people, not only disease. For instance, what happens when somebody
falls from a rooftop? In the Torah (Dt. 22:8), the guilt is placed upon
whomever failed to build a safety railing. But this would at best
identify a negligent party, not the specific lot of the victim. Hence,
the academy of Rabbi Ishmael reasons that such victims must have
deserved to die due to their sins. If they were already slated to die,
however, why does the Torah state the failure to build a railing bring
bloodguilt upon your house? The text comes to teach us that the wheel
of fate/providence ensures that accidental deaths are accounted those
guilty of sin (bShab 32a). …. Incidentally, the Deuteronomic railing
law serves as a grounding for later rabbinic rulings on occupational
safety and health duties.

At the personal level, I sense that we are comforted by neither contemporary scientific explanations nor rabbinic theology. After a few long eulogies for my Dad's cousin, her daughter-in-law spoke. She said that the woman who suffered those many months would not dwell on the question of Why. She would merely insist, What should we do next?

May a few modest answers be revealed to us during the coming Shavuos holiday.

Good shabbos,

Kaspit כספית


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