Gazing at the little white pill on my palm, I stood in my kitchen, trembling with apprehension. In the months leading up to this moment, I was diagnosed with breast cancer, underwent surgery, and was treated with radiation. Now it was time to start a five-year course of Tamoxifen, a hormone therapy drug designed to block estrogen from binding with receptors on residual breast cancer cells, thereby preventing a recurrence of my original cancer or the development of a new cancer on the other side. It was also said to have horrible side effects.
“Is there a blessing for Tamoxifen?” I asked my husband, since it seemed strange not to offer words of thanks before taking a pill that could potentially save my life. “I don’t know what blessing you say when you start taking Tamoxifen,” he answered, “but I do know the one you say when you are finished.”
Within a day, I had found my blessing. A brief incantation that can be recited before any medical procedure or taking any medication, it has its origins in the Babylonian Talmud and was originally said by patients before being treated with bloodletting:
|May it be Your will, Lord my God,
that this treatment heal me,
for you are a doctor who heals for free.
|יְהִי רָצוֹן מִלְּפָנֶיךָ ה’ אֱלקֵינוּ [וֵאֱלקֵי אֲבוֹתֵינוּ]
שֶׁיִּהְיֶה עֵסֶק זֶה לִי לִרְפוּאָה
כִּי רוֹפֵא חִנָּם אַתָּה.
I found myself drawn to the imagery of God as a purely altruistic healer — a benevolent doctor who is not concerned about health insurance and has no fees; a healer whose sole objective is to restore the health of the patient — health of the body and health of the soul; a physician who would heal me, whether I was deserving or not. I welcomed the opportunity to turn my pill-taking into a ritual and to express my hope for its efficacy. So I embraced the prayer and incorporated it into my daily pharmacological routine.
For the first few months, I lived in fear of side effects — the terribly ominous ones like uterine cancer, blood clots, cataracts, strokes, and liver problems, as well as a slew of other side effects such as hot flashes, nausea, fatigue, mood swings, depression, headaches, joint pain, back pain, weight gain, loss of libido, pins and needles, and mental fogginess, some of which have been proven clinically, while others reported anecdotally. I spoke to several women who had suffered so much while on the medication that they abandoned their treatment, foregoing its potential benefits, while others reported that they had experienced no side effects at all.
I was quick to ascribe any fleeting malaise to the drug. When I found myself reaching for words in Hebrew and English and finding them in neither, I was sure that it was due to Tamoxifen brain; happily, it passed after a good night’s sleep. In the end, in addition to sudden and intense menopause symptoms, I experienced unexplained cramps in my feet and toes. They made me writhe in pain and dust the cobwebs off my Lamaze breathing, and lasted for three years. But the pain was never bad enough to convince me to abandon a medication that could decrease my risk of a recurrence in the future.
For five years, every evening, I turned to a God who treats me for free and silently chanted my hope for the success of the pill that I was about to take. During those five years, I saw my eldest son standing under a marriage canopy with his bride. I saw my two younger sons graduate high school, enlist in the Israeli Defense Forces, become officers, and complete their compulsory military service. I discovered the joy of becoming a grandmother and the pain of losing a parent. I changed jobs twice, eventually landing in one I hope to stay in until I retire, and moved homes once, to an apartment we hope to live in forever. And I became a writer, usually late at night and most often on this platform.
A great deal can happen in five years. Your appreciation of that is heightened when you live with the knowledge that your body had cells that had turned against you and that they could return. And when you reach your five-year cancer-free milestone, you are acutely aware of how much you want another five years, and another.
Each day during those five years, there was a moment when I was reminded that I was treated for cancer — and that is traumatic, no matter how early it is detected or how good your chances of survival may be. Each time I took my Tamoxifen, I was reminded that I could be diagnosed with cancer again. Now that I have completed the course of medication, I will no longer confront that fear on a daily basis. But it will come back every time I hear of someone who has been diagnosed with cancer, or pray for someone who has had a recurrence or a second kind of cancer, or when someone I know tragically succumbs to the disease.
I will not miss the Tamoxifen, nor its side effects. But a part of me will miss the feeling that I am cloaking myself in a protective shield and doing something active to prevent a recurrence. I have an increased sense of vulnerability. I have done all that modern medicine recommends that I do; now it’s in the hands of my Creator.
When I stood in my kitchen several months after my surgery, gazing at the pill in my hand and wondering whether there’s a blessing for Tamoxifen, my husband didn’t know the prayer that should be recited before taking your first pill, but he knew what should be said when you take your last. And he was right.
Blessed are You, Lord my God, Ruler of the universe, who has given me life, sustained me, and allowed me to reach this day.
Dedicated to the memory of breast cancer warrior Rochie Schitskovsky Ivker, z”l, with prayers for the complete recovery of Devora bat Nisa Etel.