Friday, June 08, 2018

Shelach: The Delivery

When the spies return, we expect them to tell the truth.  When they said they saw Giants, that is  what Rashi, quoting Chazal  says that they saw.  When they saw the earth  swallowing it's inhabitants, the report was again accurate, as confirmed by Chazal via Rashi. An attempt to conquer the land, by the ordinary means that they understood, at that time, honestly seemed impossible. This is confirmed, when Moshe pleads on the people's behalf.  He says that outside, objective, observers will say that entering the land was a task that was even beyond Gd. 

The report itself was not the problem.  It was the conclusions.  It was the despondent state, based upon the reports that generated Gd's genocidal anger.  It was honest and true to say that they saw giants and funerals, but the conclusion that entry is impossible was not justified. 

These people had experienced the Exodus and the splitting of the sea.  Even Moshe had thought that feeding 600,000 families meat for a month was outside the possible.  But they had all seen it, and tasted it..  How could they think that entry into the land was beyond the reach of  their guarantor? 

Perhaps there was an element of the availability heuristic Kahneman and Tversky, the scouts who explored the processes ( and errors) of decisions, showed that decisions are deeply influenced by the most accessible memories, like the most recent events.  The people had seen the splitting of the sea, but recent events were more frightening. The burning of the edge of the camp, Miriam's tzoraath.  Their memory of Sinai  included the Golden Calf, and the threat of annihilation. 


As a result of their despair, they cannot enter the Promised Land.  The decision to complain, this time, leads to a terrible, irrevocable consequence. 


As an oncologist, I deal with negative information daily.  The CAT scan shows progression, the laboratory numbers look bad.  I take a lesson from this story. The truth must be presented, but the conclusion must be left open.  I do not know every possible path to the future. 


When I send patients to research institutions, I try to immunize them against the errors of judgment that follow from despair. I tell them that the doctors at the research institution will probably paint a bleak picture.  The near hopelessness that follows from the dark predictions allows a person to volunteer for any study that is presented as offering a glimmer of hope, it can lead to a regrettable decision.  An outside expert should look at the offered clinical trial before signing on.  The data needs to be reviewed in detail, from the perspective of the patient, as well from the perspective of the study. 


I have participated in remissions that I thought were impossible.  Chronic myelogenous leukemia went from uniformly fatal to almost never fatal.  Melanoma  metastatic to brain and spine disappeared  with non-cytotoxic immunotherapy .  I am convinced that I do not know the full range of miracles that can occur.  I can not use the term hopeless, it has no objective meaning. 


Gd performs miracles.  They are, however, very rare. 

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