Shmuel Polin
ניט מיט שעלטן/לאַכן קען מען די וועלט איבערמאַכן

Parshas Toldos, Twin-twin transfusion syndrome and Chayei Sarah

Last week, we read Parshas Chayei Sarah. This week we are in Parshas Toldos. Interestingly, some of the themes overlap from last week’s Parsha unto this week’s Parsha. Love, matches, and progeny appear to be important in this week’s Parsha. I found interesting the similarities of this week’s parsha from last week’s parsha. I also found something interesting of this week’s parsha that may be accounted for in medical journals.

Summarizing first of this week’s parsha, in our parshas hashavua, we read, Isaac and Rebecca endure 20 some odd childless years until Rebecca conceives. The pregnancy is described as difficult, and the children are said to struggle inside of Rebecca. G-d tells Rebecca during this time that there are two nations in her womb. G-d also tells Rebecca that the younger will prevail over the other.

Esau is born first, then is Jacob. Esau develops into a hunter, a grunt. Jacob develops into a wholesome man of leaning. Isaac and Rebecca favor Esau over his brother. Returning one day exhausted from hunting, Esau sells out his birthright for a pot of red lentil soup.

The Parsha goes on to describe while in Gerar, Isaac presents Rebecca as his sister out of fear he may be killed by someone coveting her beauty. In Gerar, Isaac grows old and blind. Isaac expresses the desire to bless Esau before he dies. While Esau goes off to hunt for his father, Rebecca dresses Jacob in Esau’s clothing and sends him to see his father. Jacob then receives his father’s blessing for the “dew of the heaven and the fat of the land” and mastery over his brother. When Esau returns and the deception is revealed, all Isaac can say is that Esau will live by the sword but forever be diminutive to his brother. Jacob then leaves to flee Esau’s wrath.

Again, some of the themes overlap from last week’s Parsha unto this week’s Parsha. Love, matches, and progeny appear to be important in this week’s Parsha. Recall, in this week’s Parsha, when in Gerar, Isaac abandons Rebecca. In Gerar, Isaac presents her as his sister, out of fear he will be killed by someone coveting her beauty. But also recall from last week’s Parsha how I commented in a derasha that in Parshas Chayei Sarah we reminisce upon an idealized relationship between Abraham and Sarah. Abraham and Sarah were not without their complexities. In Genesis 12, Abraham abandons Sarah in Egypt. Although we like to remember them as the romantic perfection of fidelity, this was far from the truth.

Abraham’s son, Isaac was his father’s progeny. Isaac made the same missteps as his father in Egypt. In Gerar, Isaac, also abandons his wife, out of fear. But we still remember Isaac and Rebecca in the same light as Abraham and Sarah. Their relationship was problematic, but remembering them in an idealized light is always more useful to us as readers.

Secondly, let us review something else from this week’s Parsha I found interesting, that may be accounted for in medical journals. As we know, the story of Esau and Jacob is an epic of two brothers. Jacob is deemed to inherit the birthright of the Jewish people, while Esau is condemned in the rabbinic commentary as being the progenitor of Seir, the forerunner of Rome. The story of sibling rivalry is a common theme that appears and reappears in the Tanakh. Rather, it is uncommon that two siblings are not marked by a deep rivalry. But I would like to focus our attention on something medically that I cannot avoid thinking about when reading into the text.

My wife is a nurse, and I served as a medic in Israel for two years and worked as an emergency medical technician for a year outside of Philadelphia, Pennsylvania. This background gave us both a wealth of medical knowledge. I cannot avoid thinking about the syndrome described to me by a doctor before entering into rabbinical school. Twin-twin transfusion syndrome (TTTS) is an imbalance in the blood flow between identical twins who share a single placenta but have separate amniotic sacs. The syndrome has considerable implications for the development of the twins. Classically, one baby is born larger and is born with a dark red hue, while the other is born smaller and extremely pale. The red child is typically born first and struggles with developmental stages.

Esau is described as red in the Tanakh, and his development appears to be flawed in a number of examples. His decision to sell his birthright to his brother for a cup of soup is characteristic of someone truly challenged with developmental abilities.

Whether we choose to believe the characters of the Tanakh are allegorical or that they were actual people, the decision to describe the brothers in such detail offers us insight into how TTTS may have been understood by our ancestors.

Our ancestors were searching for understanding in stories like Jacob and Esau, which was an understanding of the medical phenomena. And following in their footsteps we, Am Yisrael will continue to search for understanding of biblical texts.

About the Author
Shmuel Polin is a fourth-year rabbinical student at the Hebrew Union College-Jewish Institute of Religion (HUC-JIR). A Greater Philadelphia/New Jersey native, he completed his B.A. at American University in Washington D.C. where he studied Jewish Studies and International Studies. He also completed both an M.A. in Holocaust and Genocide Studies and an M.A. in Jewish Studies from Gratz College of Melrose Park, Pennsylvania. His thesis focused on the depiction of European antisemitism in 1930's-1940's American and foreign cinema. Shmuel has years of experience of teaching Hebrew School at Kehillat HaNahar of New Hope, Pennsylvania, leading as a student rabbi at Beth Boruk Temple (Richmond, Indiana) and Temple Israel (Paducah, Kentucky), and also working for Israeli non-governmental organizations. Currently living in Cincinnati, he is finishing up his studies at HUC-JIR, while serving as the rabbinic intern of Adath Israel and as the student rabbi of Beth Boruk Temple.
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