Nothing lays bare the extreme nature of living in Israel more than this country’s remarkably decisive vaccination drive happening at precisely the same time as Israelis are suffering through a third coronavirus lockdown – making Israel one of the few countries to reach such a dubious milestone. 

First the positives: Israel has stepped up to the plate in a way that few other countries have, rolling out a campaign for vaccination that has been breathtaking in its speed and efficiency. In the first days of the drive, Israel shot up to take the top spot worldwide in the number of vaccinations administered per capita. 

Moreover, unlike other countries, the minimum age for receiving a vaccine in the first weeks was set at only 60. After complaining in this column previously about how disheartened I was having such a significant milestone birthday during a pandemic, I finally got a present I really wanted. 

So, when Keren the nurse jabbed my arm at Jerusalem’s Pais Arena, where the Maccabi HMO had eight shot stands up and running, I was practically in tears, not from pain but rather the hope that an end to this international nightmare is finally in sight.

And yet, it was just a few months earlier that Israel held another extreme Covid-19 distinction – as the country with the greatest number of new cases per capita in the world. 

That came as a direct result of the government’s woeful management of the corona crisis – months of setting redlines that were repeatedly breached; enacting last minute decisions only to be scrapped or revised; prescribing quarantines that were not enforced; and carving out exceptions for some groups and not others due to barefaced political calculations.

Now, Israel has risen once again, like a relentless, demented phoenix, to a perch near the top of the new cases per capita list.

The vaccination campaign is part of the Israel “that takes care of its citizens in often astonishing ways,” writes Yossi Klein Halevi, whose latest book Letters to My Palestinian Neighbor became a New York Times bestseller. “Israelis know they live in a country that not only demands unparalleled sacrifices from its citizens but also earns that right.”

But there is another Israel, Klein Halevi continues, “an increasingly dysfunctional nation that has lost the most basic trust in its leadership, whose democratic institutions are under sustained attack and that is now, in the midst of a pandemic and the worst economic crisis in decades, being dragged into an inexplicable fourth election in less than two years.”

The extremes Israelis have experienced living through this year like no other are not exclusive to the pandemic. 

While our high-tech sector is a respected world leader, local customer service too often comes up lacking. 

The gap between rich and poor continues to grow; Israel has one of the highest levels of income inequality in the OECD.

Israelis love nature, yet we can’t seem to bring home our garbage left on the trail.

We overpay for imported goods and it’s become near impossible to afford an apartment in a metropolitan area, yet our system of universal healthcare, even as it is chronically underfunded, remains one of the best in the world and costs a pittance per month.

You can transfer money to a friend or service provider with three taps using an app like Bit or Pay but visit one of the dwindling numbers of brick and mortar bank branches and prepare to be yelled at. Someone’s sent you a package? Expect the post office to lose it.

The Abraham Accords brought a surprisingly warm peace with the United Arab Emirates, but closer to home, there’s never-ending tension with our Palestinian neighbors.

Israel’s extremes are even represented in our geography: You can go from snow to desert within just a few hours’ drive.

Sometimes, though, Israelis come together in truly wonderful ways and the extremes momentarily evaporate. Israel’s vaccination drive has been one of those times, writes Daniel Gordis in Bloomberg.

“Friends of ours, just a few years too young to have been eligible for the vaccine, look after an elderly woman,” Gordis explains. “She, of course, was eligible and got an appointment. So, they drove her downtown to her HMO’s location.”

The wife took the woman in for her shot while her husband waited in the car – until the wife called and told her partner to come inside immediately. 

“They’re going to vaccinate us,” she told him. 

“But we’re too young,” the husband protested.

The nurse had the final word. “You brought in an elderly person who needed to get here. You deserve to get the vaccine, too.” 

Former Health Ministry director-general Moshe Bar Siman Tov has described Israel’s extremes as a kind of “national disorder [with a] tendency to vacillate between feelings of euphoria and anxiety.”

It can all make your mind spin. But for this miraculous moment, I am choosing to focus on the salubrious. Indeed, I barely even noticed that my arm, post-vaccination, hurt like the dickens for a few days. 

That was Klein Halevi’s response, too, after his first Pfizer jab – a moment of “quiet pride, of knowing I made the right decision when, four decades ago, I’d entrusted the state of Israel with my future and the future of my family.” In a few months, he adds, if all goes well, Israel will be “the first fully vaccinated country, the first to defeat Covid-19.”

Now, that’s an extreme statement I’ll be happy to own.

I first highlighted Israel’s extremes in The Jerusalem Post.

{ 0 comments }

When I was first diagnosed with follicular lymphoma three years ago this month, it was clear I was going to write about it – that’s just what I do. What I didn’t realize was how documenting my journey publicly would change me and, in particular, my commitment to honesty with friends, family and readers.

Writing about health challenges is nothing new – witness the growing number of websites, articles and book-length memoirs from people who are either suffering from or have beaten their illness into remission, even if just temporarily.

More recently, the number of articles appearing online about Covid-19 – from heartbreaking health challenges to practical steps for coping pre- and post-lockdown – have multiplied even more rapidly.

There are many more medical stories that take place farther from the limelight. In the last 20 plus years, for example, over 850,000 people have created a health journal through the website CaringBridge, which claims that one in eight people in the U.S. visited the site in 2019.

Writing about health can be a kind of therapy, a means of turning a bad break into something with a more positive (if not altogether happy) ending.

I’ve been doing this for years – and not just with illness. 

When my wife, Jody, and I got caught outdoors in a sudden downpour on a hike in Norway, I connected that experience with ACT, an analytical technique that blends mindfulness with cognitive behavioral therapy, as a way of flipping the script on our extreme dampness. 

Crafting such a column forces the writer to conceptualize an event as a story with a beginning, middle and end, maybe an uplifting moral. After a while, the writer may even come to believe the ending he or she has written for this “fictionalized” version of the story.

In this way, writing publicly about health challenges becomes a version of what behavioral economists call a “commitment device.”

Freakonomics author and podcast host Stephen Dubner describes a commitment device as “a clever means to help you commit to a course of action that you know will be hard. That might mean losing weight, quitting smoking or anything else involving willpower.”

Imagine two versions of yourself, Dubner proposes: current you and future you. If you know that your future self will want to follow a behavior that your current self is not comfortable with, you can “make a deal to punish (or reward) yourself if the future self doesn’t follow through on the current self’s promise.”

Odysseus essentially did that when he had himself “lashed to the mast of his ship so he couldn’t succumb to the song of the Sirens,” Dubner explains. 

Buying a gym membership (and committing to posting a selfie a day) to force yourself to get in shape is another example. 

There are even websites like Stickk.com, where users join a public community (say, “Diet and Exercise”), state their goal (“lose 10 pounds in a month”), put down some money ($200 is a good starting point) and define what will happen to the money if they don’t stick to their commitment. Stickk says that adding financial stakes triples one’s chances of success and that its users have put “$50 million on the line.”

Dubner describes the case of Adam Scott who wanted to reduce his unhealthy habits – everything from drinking too much to watching excessive TV. If he failed, he declared on YouTube, he would send a $750 check to someone “whom he really, really didn’t want to give his money to: Oprah Winfrey.” 

Now, you might be a fan of Oprah, but you get the point. By going public with his commitment, Scott was signaling that he would do whatever it took to carry through with his pledge. 

Writing about one’s health publicly can have a similar effect. When I end a story with a positive, that helps shape my attitude – even if it’s just for the hour I’m writing down the words. When I know that thousands of people are reading that affirmation, it creates a feedback loop: I’ve put it out there; now I’m being held accountable.

What if I don’t feel so positive by the time the article is published? Embedded in this public contract is a commitment to honesty. If my health deteriorates, I will tell you about that, too.

At the same time, I can also access the happy ending that I wrote previously to remind myself that, however lousy I may feel at the moment, there was a time not so long before when things were different – and it’s likely that things will change again soon. 

That’s certainly a message we could all stand to hear with Covid-19 still raging around us. 

One more benefit: Sharing your story publicly when you’re having a good day can help mitigate the propensity to feel sorry for yourself on the bad ones.

While commitment devices can be effective tools for keeping yourself on a productive path and are particularly relevant on days like today, January 1 – New Year’s Day, when making resolutions is a time-honored tradition – they’re not foolproof. Adam Scott wound up mailing that check to Oprah for a relatively minor infraction – he pledged to cut out milk from his diet, then accidentally put a couple of small containers of two-percent cream in his coffee.

Still, should you find yourself in a health crisis feeling understandably down, consider writing – publicly, privately, on CaringBridge, Stickk or another support site. Think about your pain as part of a bigger story and, if you’re feeling up to it, craft an ending that gives you hope.

I first wrote about making this year’s New Year’s resolutions stick at The Jerusalem Post.

Computer image from Glenn Carstens-Peters on Unsplash

{ 0 comments }

Covid, cancer and self-image

by Brian on December 19, 2020

in Cancer,Covid-19,Health,Science

What do Covid and cancer have in common? In addition to the very real physical impact, there is a not insignificant mental health component associated with Covid lockdowns and cancer limitations. These can feel especially burdensome because of the way they strip away chunks of one’s self-image.

Recognizing how this plays out in our bodies and our brains can help us better understand why we’re feeling down; it can also serve as a source of hope. For when freedom of movement is eventually restored – be that through a vaccine for Covid-19 or a prayed-for remission for those with cancer – so too may be our moods. 

Here are six ways today’s two “Big Cs” are changing the images we hold of ourselves. 

1. Healthy and young. A worrying fiction has emerged in the midst of the pandemic. It’s one I’ve heard in my cancer journey as well: If you’re in good shape, you eat well, exercise and have no prior illness, you won’t get sick. 

It’s simply not true.

“The majority of patients in our intensive care unit currently are below 60,” Michigan Medical’s Jakob McSparron told USA Today earlier this month. Indeed, the median age for hospitalized Covid-19 patients in the U.S. is now hovering around 40. 

Cancer, similarly, was “supposed” to be a disease you got when you were older. I was 57 when I was diagnosed, hardly a senior citizen. Shedding the self-image that one is invincible comes naturally with age. Covid-19 and cancer only accelerate the process. 

2. The pious one. For many, self-image is intricately tied to a religious identity. Orthodox Jews are regulars in synagogue and study groups. Shabbat invitations are a key part of the faith. But Covid-19 has made us keep our distance. That’s something I had already experienced when I was going through chemotherapy and needed to avoid any unnecessary exposure to illness. 

What happens when one’s religious self-image comes into conflict with health restrictions, though? In some cases, there’s defiance, with mass weddings and communal activities taking precedence over saving lives. For others, the dissonance is driving adherents away. The Hillel NGO, which helps ultra-Orthodox youth in Israel looking to leave their communities, reports that the number of people turning to the organization in 2020 has doubled. 

How will the Jewish world look on the other side of the pandemic?

3. The artist. Our youngest son, Aviv, is a musician. He studies at the Israel Conservatory of Music. Well, he did, until corona. Now his theoretical classes are on Zoom while his practical sessions have been on hold.

Aviv says that while Covid-19 hasn’t dramatically affected his self-image as an artist, he does feel less motivated. Even if his ensemble is able to meet again in person, it’s unlikely they will be performing in front of an audience. If they’re lucky, they’ll broadcast a few concerts via Facebook. “It’s just not the same without the live feedback,” Aviv told me. Other artists are feeling more depressed – and financially destitute.

That said, Aviv has used the time to blossom creatively, recording Internet collaborations with artists all over the world. A special corona discount from Jerusalem’s Yellow Submarine music club made it possible for Aviv to record his first album. Watch for it on Spotify later this year. 

4. The sexual single. For those who want to stay safe – whether due to the pandemic or because of a compromised immune system – romance is off the table for the most part unless one has a regular partner. As a result, Tinder reports that, in the month prior to rolling out a new virtual video dating feature, half of its U.S. users arranged dates via video.

But what happens when two romantics can’t resist the urge to get together in real life? Dr. Theresa Tam, Canada’s chief public health officer, raised eyebrows in September when she recommended wearing a face mask during sexual encounters with someone outside your quarantine group.

Hookups aside, what’s the impact on one’s self-image as an active player on the dating scene when your favorite places of leisure and entertainment are shut?

5. Productive member of society. When you’re no longer able to earn a living because your place of work has temporarily closed, been forced to downsize or has been entirely eviscerated (see: the tourism industry), the blow to your self-image as a provider can be devastating. The same applies if you become unable to work due to cancer.

The flipside: one might become so comfortable receiving disability or unemployment benefits as a result of being put on “halat” – the Israeli acronym for “leave without pay” – that the prospect of going back to the office feels intimidating or even no longer of interest, another shock to one’s self-image that may have long-term repercussions personally and for society as a whole.

6. The adventurer. The hit to this self-image starts with the inability to travel overseas but it’s much more than that. Identifying as an adventurer, for me, means being open to new experiences – exotic places, ethnic foods, challenging music and art, making aliyah (maybe the most adventurous things I’ve ever done…or was that getting married and having kids?) 

While we can still order take-out meals and hike Israel’s abundant mountain trails, Covid and cancer have made my world smaller. How can you call yourself an adventurer when the riskiest thing you can do becomes shopping in the mall?

Despite the challenges, I remain optimistic. Covid-19 will be tamed, hopefully soon. Breakthrough treatments may do the same for cancer in the coming years. Self-image, similarly, can take a hit and bounce back. Hope is the best antidote to the Big Cs of 2020. 

I first explored Covid & cancer’s hit on self-image in The Jerusalem Post.

Photo by Alin Luna on Unsplash

{ 0 comments }

A coronavirus wake-up call

by Brian on December 6, 2020

in Cancer,Covid-19,Health,Mindfulness

We dodged a corona bullet a few weeks ago.

Grey’s Anatomy serves as a Covid-19 wake-up call

For most of the past year, my wife, Jody, and I have erred on the side of caution when it comes to staying safe from Covid-19. We have scrupulously maintained social distance, eschewed most social gatherings, and insisted that anyone coming into our home, including our adult children, mask-up when indoors. Since May, we’ve eaten all our family meals outside on our terrace. 

Now, with winter coming, I’m at a loss as to what to do when the kids want to come visit. If it’s too cold or rainy outside, are we going to go back to the situation we had in the spring where we were completely isolated from our children for several months? I don’t think I could stand that.

Mind you, our kids are not rule-breaking party people. They want to stay healthy, too. Could we relax the guidelines, just a bit, I wondered, and enact some sort of compromise to be together indoors?

A few weeks ago, the new season of Grey’s Anatomy came out. Both Jody and our daughter, Merav, are big fans of the show, which now in its 17th season has embraced a full-on pandemic narrative. Would Jody like to come over, Merav asked, and they’ll watch the opening double-episode together?

Jody and I discussed it. They’d have to wear masks the entire time and keep the windows open. Still, they would be indoors, together on the same couch, for clearly more than 15 minutes. Our antimicrobial nanoparticle zinc-infused Sonovia masks are good, but they aren’t 100% foolproof. 

And yet, we so craved some sense of normalcy.

Two days after they had their first in-person extended indoor get-together in months, Merav WhatsApp’d us. She wasn’t feeling well. Fever, body aches, dry cough. 

My heart sank.

When Merav’s symptoms hadn’t abated after another day, she went to get a Covid test. Jody and I, meanwhile– already anticipating the worst – researched quarantine regulations. Who would walk the dog? What rooms would we sleep in?

Less than 12 hours later, Merav got her results back. Negative. She had something, but it wasn’t corona.

We all breathed a sigh of relief, although I insisted we give it another few days to be sure – a not insignificant portion of PCR nasal swab tests come back with false negatives

A week later and we were all fine. Still, it was a close call that shook us out of our corona fatigue. 

“It’s really important to understand that the coronavirus hitches a ride on our trust and our love for our family and friends,” wrote Isaac Chotiner in The New Yorker. “It’s actually the people we trust most whom we’re most likely to infect and who are most likely to infect us, because we’re not going to take [the] same precautions.”

The idea that we were toying with just a few days previously – that we could move our gatherings indoors for the winter – now seemed hopelessly off the table. 

Or was it? We sprung into creativity mode. 

Could we still get together indoors, just not for meals? A masked board game, perhaps? But that would mean being in the same space for more than 15 minutes, just like the Grey’s Anatomy scare.

How about if Jody and I were to sit at one end of the table with the kids far away at the other? Or we could implement a “staggered eating” protocol, where one side of the table wears masks while the other side is eating, then we reverse. 

But could anyone really keep to such an arrangement scrupulously? Moreover, doesn’t the virus remain in the air for a few hours, so that any mask removal is risky?

Researchers at the Riken Center for Computational Science and Kobe University in Japan used a supercomputer to model a seating arrangement that would be the least likely to spread infection if a Covid-positive person is in your midst. As reported in The Asahi Shimbun, sitting across the table is bad, they found; speaking to someone at your side by turning your head is even worse, by a magnitude of five. But diagonal spacing reduces the chances of getting hit by virus particles by 75%. 

Craig Mod wrote an in-depth article in The Atlantic in September about how he ventilates his home using high speed fans and open windows to ensure that air is circulating and virus particles can’t build up. Mod created his system to combat mold but notes that it’s applicable to Covid protection, too. 

What about adding a HEPA filter to the mix? The jury is out on whether these air purifiers really make a difference, but combined with other mitigation strategies, it could give us some additional peace of mind. 

Maybe the best bet would be to buy a couple of those restaurant-grade kerosene heaters and continue our tradition of eating on the terrace even when the temperature plunges.

Or perhaps we should simply skip meals for the next few months and go for bundled-up family dog walks.

The only thing that seems clear is that the panic those two days in November evoked, when we were kicking ourselves for taking unnecessary chances, was enough to wake us from our pandemic lassitude and set us on a more scrupulous path as we head into the most precarious period of this awful 2020.

With effective vaccines tantalizing close, now is not the time to let down our guard. 

As epidemiologist Michael Osterholm remarked pithily but providentially in The New York Times, “This is your Covid year — just get through it — then hope that next year we’ll be in a very different situation.”

We first dodged our corona bullet at The Jerusalem Post.

{ 0 comments }

Covid-19’s silver linings

by Brian on November 21, 2020

in Cancer,Covid-19,Health

Covid-19 has changed all of our lives, not necessarily for the better. But beyond the risk entailed by simply stepping out of the house, there have been a few silver linings. In addition to what are by now almost cliches (“more time for reflection,” “working from home cuts the commute”), here are eight surprising benefits. 

1. Yoga with Adriene. At the beginning of the first lockdown, with extra time and anxiety addling my brain, I decided to add yoga to my morning routine. I couldn’t go to a physical class, of course. That’s where Adriene Mishler comes in. Search “yoga” on Google and Adriene comes up first on the video search results – and for good reason. With hundreds of free sessions, there’s always something fresh to watch from the popular Austin, Texas-based YouTuber who bears a fair resemblance to another flexible star, Israel’s Wonder Woman, Gal Gadot. My wife, Jody, was already working out with Adriene videos; now we laugh together at her corny jokes during downward dog.

2. A safer outdoors. In March and April, the Internet was awash in images of skies suddenly free of pollution. A picture of New Delhi’s India Gate, now strikingly visible, went viral. CO2 emissions in New Zealand and San Francisco dropped about 80%. These trends were unfortunately short-lived; when the lockdowns lifted, air quality jumped back to pre-pandemic levels. But one area of outdoor improvement seems to have stuck: a reduction in road accidents. Jerusalem, for example, saw a drop in road casualties in April of 54%, according to the Central Bureau of Statistics. When the closure lifted, injuries shot up, but there was still a decrease of 27% in May and 21% in June compared to the previous year. 

3. Less non-Covid illnesses. It was at some point in August that Jody and I realized neither of us had gotten sick with summer colds. In southern hemisphere countries, the incidence of winter flu was way down, too: In July and August 2019, Australia recorded more than 131,000 cases of influenza. This year: 315. Credit that to masks, social distancing, handwashing and restrictions on large events. Perhaps the flu + Covid-19 double header dreaded for this winter may not come to pass. The flipside: We could be protecting ourselves too much. Exposure to pathogens (the less virulent ones, at least) helps build overall immunity.

4. No more invitation pressure. The constant back and forth of social invitations, whether that’s for a Shabbat meal or a coffee date, can be stressful. Who do you want to reach out to that you’ve never had over before? To whom do you “owe” a reciprocal invitation? Is the ball in someone else’s court now? With corona, there are no invitations, so no worries. That’s a glass half-full way of looking at things, because no invitations also means more loneliness and isolation. A weird bonus which I’ve come to appreciate: The doorbell rarely rings anymore since no one just “stops over,” so I don’t have to pause what I’m doing to see who’s there.

5. Reduced FOMO. Before corona, Jody and I were out a lot: concerts, classes, Kabbalot Shabbat. While I miss the cultural richness, sometimes it seemed the Fear of Missing Out was driving our decisions more than desire. It was exhausting. Do I prefer watching Michael and Shimrit Greilsammer perform on Facebook Live, even if I can replay the concert later? Not really. But I don’t miss the crowds, the pushing, the cell phones ringing, and the whispering (or outright talking) in public spaces. I had long ago stopped going to the movies; I’d rather stay at home where it’s quiet and I’m in control of the remote. Now I can. 

6. Reservations at nature reserves. Fifty-nine percent of Israelis surveyed in Shmuel Rosner’s book #IsraeliJudaism: Portrait of a Cultural Revolution say they may go hiking or to the beach on Shabbat and holidays. Accordingly, Israel’s national parks are overflowing on weekends and, even though being outdoors is safer than gathering indoors when it comes to virus transmission, an overabundance of picnickers is still a concern. So, when Israel’s national parks reopened after the first lockdown, they required visitors to pre-register online. The approach seemed too radical. “Israelis are spontaneous, they will never abide by such rules.” But it’s working. And park goers report they’ve never enjoyed a visit to the nature reserves as much as they have in recent months. 

7. That Zoom Seder. We weren’t looking forward to spending Pesach alone. Plus, this year, the grandparents had planned to join us in Israel. Therefore, I welcomed the ruling by Rabbi Eliyahu Abergel and other municipal rabbis who decreed that video conferencing could be used for the holiday as long as video was turned on beforehand. In addition to conferencing in our kids in Sderot, we also included the family in California. Sure, it was morning there, but it made for one of our most memorable Seders. The ruling was formally for “times of emergency,” but I suspect it may become a new Passover tradition. 

8. Road-tripping. With overseas travel effectively canceled for now, Jody and I have been exploring what’s right here. Instead of one two-week long vacation blowout, we’ve been taking half-day midweek excursions to outdoor hotspots we’ve heard about for years but never visited: the Appolonia and Hof HaSharon national parks, Jerusalem’s Emek Ha’arazim between Ramot and Motza, the Hula Valley to watch the bird migration. It only took a pandemic to prompt us to check out what’s in our own backyard.

I first wrote about Covid-19’s silver linings for The Jerusalem Post.

Yoga with Adriene image from YouTube.

{ 0 comments }

Punctured on the way to a flu shot

November 8, 2020

It wasn’t just the needle that left a puncture when I went to my doctor to get a flu shot.  Until last week, I’d never gotten the vaccine for annual influenza before, mostly because, over the course of my 60 years, I’ve sailed through winters without getting particularly sick. But with Covid-19 literally in the […]

Read the full article →

The Covid-19 fertility crisis: a short story

October 25, 2020

The dystopian future if

Read the full article →

7 mantras to cope with challenging times

October 11, 2020

Seven mantras that can help cope with challenging times. Repeat and rinse, just like the dishes.

Read the full article →

How to not celebrate a birthday during corona

September 27, 2020

I wanted to skip my birthday this year in the midst of corona. Here’s how I transformed a singular birth date into a year-long, hopeful process.

Read the full article →

What I want to believe about Covid-19

September 13, 2020

As the pandemic draws on, I am finding myself drawn towards theories I want to believe are true, even when the data isn’t there yet.

Read the full article →