Gam Zu L’Tova

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Photo by Dalya Holder

I’m not a very spiritual person. (If you know me in real life, you’re probably rolling on the floor laughing at that understatement). I believe in G-d, and I’m shomer mitzvot, but the process of becoming a ba’alas teshuva was a long one, as things had to make sense to me before I took them on. I wasn’t seeking out some higher connection to G-d. I didn’t set out to be on a path of spiritual growth. So now, 20 years later, the fact that I can see spiritual concepts like “Hashgacha Pratis” (Divine Intervention) and “Gam Zu L’Tova” (it’s all for the good) being played out in my life through horribly upsetting events is as shocking to me as the events themselves. I’m left wondering if maybe I was struck by lightning and somehow missed it.

Last August, I turned 50, and despite my loud and proud declarations that “50 is the new 35!”, my body appears firmly rooted in its new half-century identity. In fact, it seems to have been preparing for this milestone birthday for a few years, starting with my ovaries. As we age, our menstrual cycles change; they slow down, skip months, come early…or really, whenever they feel like it. And they get lighter. So when I had a “regularly-heavy” period, I just attributed it to perimenopause. It happened right before my annual exam, so I mentioned it to my doctor. And here is where my first up-close-and-personal experience of both Hashgacha Pratis and Gam Zu L’tova occurred.

My email inbox had had a reminder in it for months to schedule my annual exam, and by the time I got around to it in June, my doctor was already scheduling for August. Okay, happy birthday to me! Well, in August, my doctor’s office called to say that they needed to reschedule, because she would not be available on the day of our appointment. I was irritated, but what could I do? We scheduled the appointment for October. In the two weeks prior to my rescheduled appointment, I got the now infamous “regularly-heavy” period. So I mentioned it.  Why? I’m not really sure, but I attribute it to Divine Intervention.

My doctor picked up on the unusual occurrence of a “regularly-heavy” menstruation and ran with it, suggesting a biopsy. That seemed a little extreme to me for just a period, and so with my vast medical knowledge (read, none), I asked if there was something else we could do. She agreed to an ultrasound. As I was having the ultrasound, the technician began marking things off on the screen, which is never a good sign, but I’d had an ovarian cyst 5 years before, so I was prepared for that. However, I wasn’t prepared for what followed.

That offhand comment I had made to the doctor detailing my recent menstrual cycle had led to an ultrasound, which then led to a biopsy, which led to the dreaded phone call from my doctor telling me I had precancerous cells and needed a hysterectomy. I definitely wasn’t expecting to hear that.

I wasn’t prepared for any of it. I was not yet in menopause, and I wasn’t ready to be thrown into it. I had no idea what symptoms to expect. I could no longer ask my mom. She had had a hysterectomy when I was 18, but had then started on hormone replacement therapy, so she had never had any menopause symptoms that I knew of. Unfortunately, it’s thought that those hormones were what led to the breast cancer in her later years which took her life. Knowing that history, my doctor told me that “no doctor in their right mind would ever give you hormones.” Great. I was on my own here. I had no idea what to expect and no solid way of dealing with it.

My husband and I were in shock. The doctor connected us to a gynecological oncology surgeon, who insisted that I needed a radical hysterectomy and did her best to put the fear of G-d into us by telling us that other women who had also not been in menopause, but were battling ovarian cancer, would gladly have given up their uterus and ovary to avoid the cancer they now had. Well, that approach didn’t work well with me now, just like the fire and brimstone approach to making me observant didn’t work as a new ba’alas teshuva, so we explored our options over the next several months and ultimately switched to a doctor who could work at my unbelieving, needing-to-process-this-all pace.

So now, the rescheduled appointment, the unusual period, the comment, the ultrasound, and the biopsy led to a D&C (where the contents of the uterus are removed), which then led us to the point of acceptance that I needed a hysterectomy.

It was a heartbreaking decision. My husband and I had held out hope (ok, I had come to think of it as his fantasy, but I had some unrealistic hope too) that we might have a child together. We’d only been married 3 years, and despite my age, we had clung to that small shred of hope (well, for me it was a shred, but for my husband, it was a big chunk of hope). This put an end to that. This also brought up my all-too-real fear of having cancer, as it ran in my family. My husband was terrified of losing me, but at the same time, he didn’t want me to undergo a surgery that, from my perspective, was taking away my identity as a woman. I had always assumed I’d have children, and despite my age, and my very conscious decision not to become a single mother but rather wait for Mr. Right and have a family together, I was now panicking and grieving the idea that this would never come to be.

As heartbreaking and grief-inducing as it was to have a hysterectomy, it turned out that I really did need it, as they found I had Stage 1 Endometrial cancer, which was completely removed with the hysterectomy. Gam Zu L’Tova, right?

So, now what? How do I move on in my life with this sadness, this grief for what will never be? What happens the next time some very thoughtful couple asks us to be the k’vater at their bris (the couple who holds the baby—an act thought to bring about good luck in having children), as others have done before? Or how do I respond when someone gives us a bracha (blessing) for children? These are what-ifs, but the reality is, the first time I saw a pregnant woman at my doctor’s office, I immediately burst into tears. I know that with time, the intensity of my grief will lessen, and I’m hopeful that the pain will subside. Now, instead of crying immediately, it takes me hours of socializing at events as the only childless couple before the sight of a beautiful child triggers a flood of tears.

And so far, this has all been very focused on me. But what about my husband? As emotionally supportive as he is, he’s also programmed the way many men are, which is for action, to DO something. How does he cope with not being able to DO anything to stop this from happening? Like many men, “just listening” doesn’t feel like he’s actually doing anything, which leaves him with a sense of helplessness. How does he go from praying for a child every day, three times a day, to not being able to do that? What replaces that emptiness for him?

How does he cope with sleeping in a chair all night next to my bed in the recovery room (because apparently, hospitals are now like airplanes and overbook themselves!), or holding my hand while I’m crying in the doctor’s waiting room, looking at that very pregnant lady, or comforting me at a social event when I can no longer just smile at the cute kids running around? How does he do this and still deal with his own feelings of loss? What’s his own spiritual connection which allows him to move through this pain? He became frum through Chabad, and while we aren’t Lubavitch, he has reminded me on more than one occasion that the Rebbe didn’t have any children, and if someone of his stature didn’t merit children, then that should be of some comfort to us “mere mortals”.  I think that’s about as close to Gam Zu L’Tova as he can get for now.

I can see how things had to happen the way they did in order to save me from a worse case of cancer, so that’s the Hashgacha Pratis. What I have left to work on is the Gam Zu L’Tova. How do we, as people, come to terms with our lives turning out so much differently from what we had always imagined they would be—and not in a good way? How do we understand that even the painful things in life are part of its goodness? I’ll let you know when I figure it out.