Akiva
As a little boy, Akiva’s dream was to be Israel’s first astronaut. Perhaps he was inspired by the rowdy games of rocket ship his father led the children in, blasting off on imaginary adventures to distant galaxies. After high school, he was inducted into a more ordinary form of army service and the dream faded. After getting out of the army, he followed his brother, Yitzi to New York to work and study.
Last summer, Akiva returned home to lead some American youth groups touring Israel. Between the birthright group and the teen journalists, he had five weeks to visit family and friends. At Shabbat dinner, he casually mentions an odd sensation.
“It’s weird,” he says. “Suddenly I’m seeing double.”
“How strange,” his mother is perplexed. Akiva spends his vacation shuttling between doctors. The ophthalmologist rules out an eye problem and refers him to a neurologist. The neurologist orders an MRI. Magnetic imaging confirms a tumor pressing into the optic nerve. Mercifully, this is the only symptom. There are no headaches. There is no pain. It’s impossible to know how long the tumor has been there. It could have been present but dormant since childhood. It’s in a delicate area too dangerous to biopsy. Impossible to determine whether it’s malignant or benign. Nothing can be done except to wait and see how much changes over the summer.
Akiva is open to all suggestions. Although he’s an analytic person, he readily agrees to learn a visualization technique to tap into the tumor’s symbolic dimension. It can’t do any harm to experiment with meditation. It’s better than waiting all summer worrying.
But meditation isn’t Akiva’s thing. Humor is. He gives his tumor a name – Marvin - easier to pronounce than the medical terms. He makes jokes about Marvin, the freeloading guest who’s stealing his sight and is beginning to paralyze that side of his body. The numbness scares him.
He leads his teen group, challenging them to find ways to report on their impressions of the Middle East. At the end of the summer, he returns to New York, where he’s president of the senior class at Columbia University, and registers for fewer classes, figuring a light load will permit medical treatment if need be. He can spread his senior year out over two years. The unknowns, though terrifying, recede in a flurry of classes and doctor’s appointments.
The good news about the follow-up MRI is that the tumor hasn’t grown over the summer. The bad news is a hitchhiking cyst growing on the tumor. The numbness spreads. Akiva does not give the cyst a name.
His doctors recommend radiation treatments, but his research suggests that radiation can cause scar tissue, and future surgery, should it come to that, will be even more difficult.
No surgeon in New York will touch a brain stem tumor. It’s too risky, and malpractice premiums are too high. On the internet, one of Akiva’s brothers, Yossi, finds a neurosurgeon in Phoenix. They fly out to meet him, returning the same night. Dr. Spetzler has a 95% success rate and agrees to take Akiva as a patient. The operation will be during Thanksgiving week. Akiva requests an earlier date if there’s a cancellation. Surgery is rescheduled for two weeks earlier.
Akiva catches a ride on a “Corporate Angels” jet repositioning in Phoenix, part of a program that provides free transportation for patients in need of urgent medical treatment. His parents fly in from Jerusalem and take a room at a motel near the hospital.
We met Akiva when we lived next door to his family fifteen years ago. For his Bar Mitzvah, he wanted a Game Boy. We gave him one and listened as our kids played in tandem, peppering their conversations with curious phrases like “I died,” but “I got another life!” Apparently, each game began with three lives (past, present and future?). Successful navigations could bring other lives (Incarnations? Second chances? More playing time?) Akiva was a skillful player; he got lots of other lives.
I put Akiva Reuven ben Rivka Devora’s name at the top of my prayer list and into a crack in the Western Wall. In my own visualizations, I imagine shrinking Marvin, zapping the tumor with lasers of prayer energy, like in the movie “Honey, I Shrunk the Kids,” or like the “shrinky dink” cartoon toys my kids used to color and then cook in the toaster oven.
At the synagogue I attend, there’s a window overlooking a courtyard garden. Last year, for reasons unknown to me, two lovely spruces were cruelly topped. All winter, I gazed at the decapitated trees, wondering why their tops had been lobbed off.
Then, in the spring, the miracle of re-growth unfolded. Before my very eyes, both trees suddenly boasted proud new crowns. You have to look very closely at the tree trunk to see where the new growth sprouted, at the point where the lower branches droop downward and the new growth is upward. The new branches form Stars of David - snowflake configurations, several clusters, each with six new branches around a single point on the new trunk. The new growth returns wholeness and vitality to the trees.
All summer, I looked at those trees as I prayed for Akiva’s healing. I just knew: no matter what happens to Akiva, he will bounce back like these trees, vital and whole. I continue to hold that image in my heart.
The morning of Akiva’s surgery, scheduled for 5 AM, we pray for him and later, when we think it must be over, we call the hospital. There’s been a delay. They haven’t even begun. We speak to Akiva and wish him well. They’ve all been waiting for hours. The surgery lasts another four and a half hours. Finally, the surgeon emerges. He thinks he’s gotten it all out. It looks like the tumor is benign.
After the operation, Akiva’s brain and neck are swollen and some of his brain reflexes aren’t working. They keep him on a respirator, heavily sedated to avoid movement. The steroids administered to reduce the swelling give him amnesia. When he comes to, he’s highly agitated but unable to speak. He must be told what has happened over and over again. Rivka and Avi keep a vigil at his bedside. His friend, Yaniv and his siblings take turns flying in to be with them.
That Shabbat, I notice that Akiva’s anesthesia experience is echoed in the Torah portion. When Abram comes into Canaan, G’d causes a TARDEMA, a deep sleep to come over him, during the daylight. While in this altered state, he sees a vision of the future. He watches his descendants go down into Egypt, become enlaved and then return after three generations to inherit the Promised Land. The word TARDEMA is used in modern Hebrew for anesthesia…
Akiva celebrates his 26th birthday in the hospital. He is taken off the respirator and allowed to get up on his feet. He walks, wearing a lopsided half smile. The right side of his face is paralyzed for now, but he must feel like the first astronaut to walk on the moon. He’s lost his swallowing reflex, and for a few days a suction tube removes his saliva. But he begins to eat, feasting on applesauce and pudding, washed down with thickened liquids.
Rivka says: “Akiva always had strange fears as a kid, but now he’s afraid to sleep. What if he chokes on his saliva? The occupational therapist told him not to worry. His brain will resume that function.”
Akiva has other worries, as well. He cannot distinguish between the real and the imagined, a problem with medication-induced hallucinations.
“What’s behind my head?” he asks his mother.
“Some equipment,” she answers, puzzled.
“What about the hole in the wall?”
“There is no hole.”
“Yes there is,” he insists. “The one the people keep floating in and out of.”
Is Akiva seeing the ghosts of former residents of room B704 or his guardian angels? One night, he’s so agitated that the hospital calls his family to stay with him. His brother, Yitzi and best friend, Yaniv, arrive to stand guard in his room.
When he is released from this hospital, he will need acute physiotherapy rehabilitation. He needs swallowing therapy, smiling therapy, physical therapy, all kinds of therapy. He is offered a room at the rehabilitation center in Phoenix, but his family and friends live back east. He adamantly insists on returning to New York, threatening to call a student strike at Columbia if his wish is denied. There are three facilities in New York City. He will enter Rusk, the rehab center at NYU Medical Center. His insurance won’t cover the flight across country in the medical airbus, so he flies Jet Blue with his brother. His parents leave before them, before the Thanksgiving rush.
Akiva checks into the rehab center for several weeks of intensive, exhausting work. Luckily, he is young and in good health. He has motivation and stamina. He will heal fast. He astonishes the hospital staff with strides made in the first week following his surgery. Every hour brings a new challenge, a new mustering of energy, a new triumph. After a few weeks, Akiva is sent home and back to school. He does physical therapy as an outpatient.
Akiva is every bit as much a hero as any astronaut, flying with great faith and determination into a dangerous unknown. He seized the moment, persuading his physicians to change their minds. He opted for risky surgery. We leave birthday greetings on his cell phone, telling him he’s our hero and our inspiration. We pray for him and bless him with a full recovery.
We don’t ask him what visions he saw under anesthesia. Perhaps we’ll hear about his thoughts and dreams at a future Shabbat dinner with his family. We’ll toast his return to health, to this orbit, with songs of thanksgiving.
Like the skilled game boy player he was as a teenager, Akiva beat the odds. He got another life.
Birthright calls to see if Akiva is available to lead a winter group? No, but summer is coming. Who knows? Perhaps he will!
In the weeks following Akiva’s return to New York, he returns to school, walking with a cane and assisted by a home health aide, and makes progress in his recovery. The right side of his face remains paralyzed. The cornea of his right eye dries out and he has to use eye drops and protect the eye with an eye patch. He eagerly searches for all the hi-tech gadgets that can assist his recovery. His parents buy him a TENS machine to electrically stimulate the paralyzed muscles of his face. It helps. Next he wants to try a machine that can stretch the jaw on that side.
When his parents fly to America in February for the birth of their newest grandson, they see Akiva for the first time since Thanksgiving.
“He’s a walking miracle,” Rivka reports.
When Israel’s Prime Minister, Ariel Sharon, suffers a series of strokes that leave him in a coma, each news report reopens the details of Akiva’s neurological travails.
But unlike Sharon, Akiva bounces back in leaps and bounds. He no longer needs a cane for walking, and though the doctor never promised the surgery would eliminate his presenting symptoms - the double vision and numbness – he is relieved that he’s overcoming post-operative complications faster than expected. He’s doing well in school, and this summer, he will be leading another birthright group to Israel, and another teen journalism group afterwards.
Akiva’s humor and ingenuity continue to carry him through. He paints the inside of one lens of his sunglasses, so if he goes out without his eye patch, he won’t see double. When he does wear the patch, people think he’s a pirate. His long, curly black hair and slightly lopsided grin round out the characterization.
“They wouldn’t let me resign as class president,” he tells us at Shabbat dinner five months after surgery, when he comes home for a visit during the Passover holiday,
“even though they’re better organized without me. Now we are planning all the special graduation events – from security logistics to a formal boat ride – dinner.”
He’ll look dashing in a tux with or without the eye patch.
Akiva gets around. He was in the Dominican Republic for spring break, made it back to Israel for Passover, and will return to lead birthright and teen journalism groups again this summer. At graduation, he received an award as the most inspirational member of his class. Like the astronaut who fixed the shuttle while orbiting the earth’s gravitational field, Akiva continues to break every barrier, beating the odds.
Like his mother said, he’s a walking miracle and an inspiration.
By
Rolinda Schonwald
Jerusalem
June 4, 2006