What I Learned from T-Cell Treatment

In an article, Rabbi Akiva Wagner shares what he learned from a new and novel treatment that he began this week which harnesses the body’s own cells to fight the disease.

By Rabbi Akiva Wagner – Rosh Yeshivas Lubavitch Toronto

The following story is recorded in the Reshimos of the Rebbe, and was shared publicly (in part) by the Rebbe by a Lag b’Omer farbrengen (5710), and during a Shavuos farbrengen (5742). I am writing a rough translation below based on my understanding of what was written, ואם שגיתי וכו’:

The year was 5692 (1932). The Frierdige Rebbe was, at that time, suffering from ill-health. One night, his father, the Rebbe Rashab, appeared to him. The Rebbe Rashab was in a very good mood.

During the encounter, the Frierdige Rebbe complained about how much he suffers on account of his health. The Rebbe Rashab replied:

“It says (in a possuk read in the haftorah of Shavuos) “ובהנשא החיות ינשאו האופנים” (literally – when the chayos – one type of angel – become elevated, then, as a result, the ofanim – other angels – also become carried higher in turn). The Rebbe Rashab explained that the avoda of a person has to be to elevate his “chayus”, that his neshomo and life should be immersed in higher matters, in spirituality. As a result the “ofanim” (ofanim are lower levels of malochim, thus we know that gashmiyus originates from the שמרי האופנים. The “ofanim” therefore, represent the physical aspects of a person’s life and his physical needs) will also be elevated, i.e., they will be removed from their difficulties.

The Frierdige Rebbe was (seemingly) not satisfied with his father’s reply. He seemed to feel that the Rebbe Rashab was not empathizing enough with his physical suffering, by suggesting that the solution was merely immersing oneself more intensely in spirituality.

He said to his father: “It seems that when one departs from this world, he forgets what it was like in this world” (and the Rebbe Rashab was, therefore, not fully relating with the way the physical suffering was experienced in olam hazeh).

But, the Rebbe Rashab disagreed. He said to the Frierdige Rebbe: “On the contrary, even while in this world, you have the ability to elevate yourself to a higher plane. It depends on the person. If you focus on seeking “natural” solutions to your challenges, then you lock yourself into the laws (and world) of nature and their ramifications. If, however, you choose to immerse yourself in a higher, more spiritual world, then your whole life – and even its physical elements – become elevated. ובהנשא החיות ינשאו האופנים!”

The Frierdige Rebbe was a neshomo klolis, and his complaint was, surely, not about his personal suffering, but about the physical troubles that face klal Yisroel in general and every Yid specifically. [Which explains what appears puzzling about the story: We know the hiskashrus of the Frierdige Rebbe with his father, and how precious such a vision was to him. And after that, and after hearing such a vort from his father, would he still care about gashmyus, kaveyochol, and complain? But the Frierdige Rebbe was not complaining about himself as an individual but about klal Yisroel]. We all have physical needs, and, occasionally, physical difficulties (whether in בני or in חיי or in מזוני). We run to doctors and financial planners and therapists and seek all kinds of ideas and strategies (and, of course, an eitzah from Shmuel Eizik never hurts…).

But the Rebbe Rashab gives us a dependable solution for every difficult situation: Instead of pursuing all the natural remedies (that are never dependable and never certain), try elevating yourself to a higher plane. Immerse yourself in learning, in davening, in being connected with Elokus. Pick yourself up into a higher world, and all aspects of your life will be uplifted with you.

ובהנשא החיות ינשאו האופנים!

[And this story was given by the Frierdige Rebbe to the Rebbe as a gift (as recorded in Reshimos), and the Rebbe then shared it with all of us. So, it has a special connection with our generation, chassidim of the Rebbe]. As the chosid R’ Peretz Mochkin said: “There is no difficulty in the world, that one may encounter, that he can’t liberate himself from and extricate himself from through ‘shtein a tefach hecher’” [ascending to a higher plane].

You say, ‘that is too hard, it’s too challenging, I’m on too low of a level and couldn’t manage that’. But that conclusion is incorrect. You spent 6 or 7 years in Tomchei Tmimim, you took part in farbrengens, you learned sichos and maamorim of the Rebbe. What do you think you were doing all this time? This is what we were being prepared for and being trained for. We were given all of the tools, every single person has the ability. It’s up to us to apply these teachings, to make them a part of our lives.

[And the first step is, as the possuk says, ובהנשא החיות מעל הארץ, – at least detach yourself from the artziyus, from the obsession with physical pleasures. Lig nisht in gashmyus! Lig nisht in chumryus!].

This is, after all, the central theme of this week’s parsha: בהעלותך את הנרות. נר, as we all know, represents the neshomo, נר ה’ נשמת אדם. The shlichus of Aharon, the kohein godol, was to elevate every neshomo, to change our perspective, to make us be drawn to what’s above us, בהעלותך, to G-dliness and ruchniyus. But we can’t expect the kohein godol to forever take us by the hand and spoon-feed us. Rather (as Rashi explains) it’s עד שתהא שלהבת עולה מאליה. He started us off and gave us the tools and the foundation so that, now, we’re able to continue independently. At this point, we are each able to immerse ourselves in a maamar, in a davening, in a manner in which our whole life, our entire being, is lifted to a higher daled amos.

ובהנשא החיות ינשאו האופנים!

A wealthy chosid once lost all of his money (he invested in cryptocurrency or something). In despair, he came to Alter Rebbe, and poured out his heart during yechidus. He was distraught, and he said to the Alter Rebbe: “If it is decreed that I live out the remainder of my life in poverty, I am prepared to accept it. But I have committed to help out various poor relatives with their financial needs, and if I don’t, now, keep my word, it will be a chillul Hashem! All I need”, he exclaimed, “are 400 rubles to be able to honor the commitments that I already made, and then I am prepared to live out the remainder of my life in poverty”!

The Alter Rebbe replied: “You are telling me about what you need, but you are forgetting to think about what you are needed for” (i.e., – what Hashem (so to speak) “needs” from you).

The chosid was so shaken by the words of the Alter Rebbe, that he fainted on the spot! The chassidim who were in the adjoining room heard the commotion, and immediately came in and revived him. The chosid took the words of the Alter Rebbe to heart; – he went out to the beis midrash, and devoted himself wholeheartedly to Torah and avodas Hashem, forgetting completely about his material woes.

The Alter Rebbe, with his response, wasn’t brushing off the concerns of the chosid ch”v. On the contrary, the Alter Rebbe was giving him the best advice of how to deal with situation. ‘Change your perspective’, the Alter Rebbe instructed him, ‘focus on Elokus, elevate yourself. Lig in hecher!’. [And, as we all know the end of the story, this was what, in fact happened, and the wealth of the chosid was, ultimately, restored in full].

ובהנשא החיות ינשאו האופנים

•••

On a personal note…

I have just started a new treatment today, so the last few days have been quite hectic. On Tuesday were multiple tests and procedures, on Wednesday I had a catheter inserted to my chest (which is basically tubes through which my blood can be taken out and then returned to my body), and today I started the process for my new treatment.

I want to tell you about the treatment itself, which is quite different from the previous ones. Prior to this, I had two general kinds of treatments; chemo, in which drugs are used to introduce poison into our body to kill the cancer cells (and some other things along the way), and immunotherapy, in which the drugs are designed primarily to strengthen the body’s immune system. But the current treatment is not about introducing any drugs into the body. It merely makes use of the cells that are already present:

Our body is made up of many cells, – somewhere in the area of 30 trillion (give or take a few, I think whoever was counting them must have lost count at that point). There are many different kinds of cells, that are responsible for every function of a human being.

One kind of cells, found in our blood (part of the white blood cells), are T cells (also known as lymphocytes), of which we only have about a billion (give or take). These cells play an extremely crucial role in our overall health, in that they are what make our immune system work, so they are the force that fights off whatever doesn’t belong, such as bacteria and viruses. And they fight cancerous cells, and don’t allow them to develop or spread. So, if our T cells are functioning properly, that is the best defence against cancer.

Sometimes, however, the disease manages to outsmart the T cells, disabling them, or becoming invisible to them. That is what is happening when someone is suffering from this disease, lo aleinu. In my current treatment, they removed all of my blood, and they had it flow through a machine that filtered it and removed the T cells (I think they’re trying to get somewhere between half a billion and a billion. Now if I could charge a dollar for each one…). They will then be sent to a lab where they will genetically modify them, or play around with them and reprogram them so that they stop sleeping on the job and start doing what they’re supposed to. The T cells are then returned to the bloodstream (a few weeks later). And the thinking is that the body would then be equipped on its own to fight and get rid of the disease, without any need for outside intervention. In fact, the idea is that I get only one treatment with modified T cells, and I shouldn’t need any further treatments because everything is now working on its own, remote control [imagine we had a machine in yeshiva that could genetically modify all of the talmidim, so that they would wake up to chassidus on their own, and learn with hasmodo, and daven with avoda etc., שלהבת עולה מאליה, with no need for outside intervention…].

It is a “stage 1” trial, which means it hasn’t been tried much with my type of the disease, it’s still fairly new. But in theory, it makes a lot of sense, and the doctors are very optimistic about it. Not that that really matters (as I wrote in my previous email about נהנו מסעודתו etc.). The healing will come from the Eibishter, and He doesn’t need any treatments or interventions at all and they don’t make an iota of a difference, אין מעצור לה’ להושיע ברב או במעט. But because we are instructed to make a keli, וברכך ה”א בכל אשר תעשה, we have to take all these things into consideration when choosing one option over others.

But the treatment itself, and the idea behind it, I found fascinating. At first, I thought: ‘Wow, isn’t that incredible, look at how advanced medical science is today, to be able to genetically modify and program our own T cells so that they themselves fight the disease! How brilliant contemporary doctors must be to be able to perform such a wondrous feat! [When man first landed on the moon, Rabbi Menachem Mendel Kasher (a tremendous gaon, and author of the Torah Shleimah and numerous other works) wrote an article, in which he questioned – amongst other things – how it would now be possible to contemplate שפלות האדם, – the shortcomings of a human being, in the face of such an astounding achievement (an article that elicited a letter/response from the Rebbe, where he rejected this question and numerous of his other premises). What would he have said if he witnessed cell therapy?]

But, when you think about it, I don’t think that is really accurate. Why are the doctors able to genetically modify the cells? Obviously, because the cells were created in such a way that enables them to be modified and to help fight disease. The doctors are merely taking advantage of the features that are already built in to the system. [They can’t, after all, modify a potato, or a chocolate bar, and turn it into human cells or into a rocket ship…]. The credit (and brilliance), then, belongs to the Creator, who manufactured these amazing programmable cells that enable human beings to modify them as needed.

אשר יצר את האדם בחכמה!

 Imagine someone tells you: ‘Look how brilliant I am, I can adjust the air-conditioning in my house from hundreds of miles away. Or turn the lights on or off, or get the music to start playing’. You say to him: ‘No, there’s nothing impressive about that, any five-year-old kid knows how to use nexus or Alexa to remotely control the appliances or sing Benny Friedmans latest song or get the car to drive itself’. [True, some people – like me – can’t figure these things it for the life of us, but we’re just dumb, no reason for someone who knows how to use them to feel proud about that]. There was a lot of wisdom that, perhaps, went in to inventing all these gadgets. But once they were created, you don’t have to be a rocket scientist to figure out how to use the built-in features.

So, the wonder, here, is the wondrous creation of the רופא כל בשר ומפליא לעשות, who put all of these amazing features into His product that man is – slowly and gradually – learning how to tap into and take advantage of. Indeed, מפליא לעשות!

Why does all of this matter? Besides to increase our awe and appreciation of the Programmer and Creator who was יצר את האדם בחכמה…ומפליא לעשות, I think there is another important lesson: Sometimes, when we consider what is expected of us, we can become overwhelmed. Whether it is לשנות טבע מדותיו – refining our nature, or improving our learning and davening, or being a proper chassidisher Yid in general to the point of שלהבת עולה מאליה, we say ‘I know myself, and I know my limitations, ידע איניש בנפשי’ (and odom neeman al atzmoi yoiser etc.), and I know that this is beyond my abilities. I can’t fool myself, I’m a grobbe yung, and I’m not capable of ascending to a higher plane, of ובהנשא החיות etc.’

But that reasoning is erroneous. The truth is, it has nothing to do with our capabilities. It’s all about the programming. If we see that it’s like that in gashmyus, then certainly that is the case regarding ruchnyus. We have the ability to refine our nature and to elevate ourselves, because our Creator built it into our system, – we our preprogrammed to enable us to transform ourselves (and our surroundings and חלקו בעולם) into a dira lo yisborach. We have to just have the good sense to take advantage of all of the amazing features that are built in to the “product”.

One would have to be foolish to use his phone, today, just to make phone calls. It is your flashlight and alarm clock and office manager and camera and Rambam and chitas and so much more. Not because of your brilliance, but because of the way it was designed, and of course it’s elementary that everyone will take advantage of it.

Our neshomo is so much more complex and sophisticated (don’t forget it’s 7th generation), and its features are mind boggling, and one would be foolish not to take advantage of them. All we need to do is follow the instruction manual; – wake up like a chosid, learn a shiur chassidus, daven like a chosid, have a shiur in nigleh and be constantly striving to improve and increase in your Yiddishkeit and chassidishkeit. The results, while no credit to us, are astounding, we ascend to a higher way of life. And every part of our life becomes elevated with us.

ובהנשא החיות ינשאו האופנים!

Let us take advantage of the lesson – and nesinas koach – of parshas Behaaloscha: to refocus our lives, to work on being ‘into’ higher things and living “a tefach hecher”. And it should be in a way of שלהבת עולה מאליה, – not needing a constant helping hand, but being able to live that way on our own. And any difficulties that we need to be extricated from will cease to exist, – ינשאו האופנים!

L’chaim! As we read the parsha of Behaaloscha in the Torah, let us recognize that we have already been empowered to grow and ascend independently, שלהבת עולה מאליה, and may our using these kochos lead to ינשאו האופנים- to the entire world, the olam hazeh hagashmi, being elevated together with us and transformed into a world of G-dliness and a dira for the Eibishter with the immediate hisgalus of Melech haMoshiach TUMYM!!!

Discussion
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  1. If you refer to the new treatment called CarT, myself – (not) having יענע מחלה – being a good candidate for this kind of transplant (after failing the regular treatments by immunotherapy, and a stem cells transplant), I wasn’t completely sure if the Rebbe would agree on modifying the T cells. So, I went to R. Leibel Groner ז”ל a few weeks before he passed away, to ask him about it. Unfortunately, I couldn’t explain to him what exactly was this kind of transplant. But he told me, that the Rebbe was for any transplant. (I don’t remember the words he used, but i understood from him that the Rebbe would agree with new treatments).
    He added that the Rebbe told him to tell everyone who needs to go through a medical procedure, to check the תפילין and מזוזות.

  2. Rabbi Wagner you are someone who has been truly tested (we don’t know why) and who is and has emerged victorious!! Thank you so much for sharing your strength with the rest of us and empowering us to grow. It takes great strength to not only strengthen oneself but strengthen others as one is still in the crisis. I’m blown away thank you!!

  3. Thank you rabbi Wagner for giving chizuk and being a live example for me and many others going through their personal hardships!

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