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Thursday, June 09, 2005

What color ribbon does your bogeyman wear?

There is a well accepted practice among Jewish 'alte kockers' (old folks) of talking about death without, you know, talking about it.  Many of us grew up hearing our older relatives lowering their voices mid-sentence to stage-whisper words like 'cancer', 'stroke' and 'heart attack'.  One intuitively knows without being told that these sotto voce dips in the conversation are veiled references to the enemy... the bogeyman who waits in the dark to take friends and loved ones away.

The thing is, among my grandparent's generation there was no particular preference, or perhaps deference is the word I'm looking for, given to one bogeyman over another.  Sick was sick, and dead was forever.

But today when I talk with friends and read the papers, I am finding that the bogeyman has been narrowed to a couple of prime candidates... and when diseases are talked about, they are no longer discussed in hushed tones.

For women the undisputed heavyweight champion bogeyman is breast cancer. 

Of course there's a big world of other 'women's diseases' out there about which women can and should be worried.  But breast cancer is the one that has the clout to be able to tag along with a group of eight women to a pleasant brunch and have each of them looking around the table wondering, "which one of us will it be?".

A couple of the female bloggers I read on a regular basis have wrestled with this bogeyman and come out on top.  One or two others have heard him shuffle by their door and were relieved to find that he wasn't looking for a fight... at least this time.

But what about men?  I've often wondered whether we have our own bogeyman.

Prostate cancer is obviously a likely candidate since it is fairly gender specific and statistically just as common as breast cancer.  But somehow prostate cancer doesn't seem to strike terror into the male heart the same way it's mammary-based cousin terrifies women.

One reason for this could be that when prostate cancer culls the herd, it seems to take mostly the septuagenarians who have already had their good long innings. 

The breast cancer bogeyman, by comparison, has far less patience, preferring to take women at the height of their vitality... and leaves those who survive to live in disfigured fear of his return. 

No, prostate cancer is a bother and a worry (and yes, a potential killer)... but for those who submit to the tyranny of the rubber glove on a regular basis, it is no bogeyman... just something potentially unpleasant far in the future, like liver spots or a predilection for matching white belt/ shoe sets.

However, I think I caught a glimpse of the bogeyman this year.  While there is no colored ribbon (that I know of) for heart attacks, I am starting to understand that the silent sledgehammer to the chest is the bogeyman that stalks men at the prime of their lives.  I have friends and coworkers my age who have met this bogeyman.  Some have lived to tell the tale... others are taking the long dirt nap.

I was recently following a funny travel thread over at Lonely Planet when the following paragraph caught me flat-footed:

"It's a proven international medical fact, that males who have heart attacks, minor, major or fatal, are aged between 42 and 58, weight, height and eye or hair colouring, educational qualifications, have no or little effect in altering the statistic."

Granted the person who wrote this was not a doctor or a researcher... and in fact had provided nothing in the way of documentation to back up his statement... but I looked at that age bracket and suddenly the thread wasn't so funny anymore.  I had caught a glimpse of the bogeyman.

Just as a woman knows precisely when she enters her 'breast cancer years', I knew without having to look further than this statement that I'd officially entered my heart attack years. 

This is the span of 15 - 20 years when gas pains feel suspiciously like the bogeyman tapping on your shoulder.  I don't know about the accuracy of the information quoted above... but I have yet to see a pattern of fitness, age or ethnicity in those around me who have met the bogeyman face-to-face.

All I know is that these days when I get a little indigestion, or a gas pain that seems a little too high to be gas, I unconsciously rub my chest and idly wonder why men seldom talk about the bogeyman... and why our bogeyman has no colored ribbon.


Posted by David Bogner on June 9, 2005 | Permalink


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Mine is definitely the red ribbon.The Dark continent has alot to offer in terms of 'bogeymen' - 'cancer', 'stroke' and 'heart attack', are just a tip of the iceberg! 'AIDS' 'Ebola n strains' call the shots, seeing infected people leaves the bogeyman's ribbon colored.

Posted by: kakarizz | Jun 9, 2005 1:06:44 PM

Thanks for an insightful post, David. Recently I've caught a few glimpses of the bogeyman in various guises. He hasn't snuck up on me just yet, but I've watched him exit stage left with some of my closest friends over the past several years. I admit that as a result of both that and a recent birthday, I've started listening for the echoes of his footfalls too.

(If the green ribbon isn't taken, I'd suggest it for heart disease.)

Posted by: Rahel | Jun 9, 2005 2:11:51 PM

Hi, David. Sorry you are having such grim thoughts.

The truth is, far more women die of heart disease than of breast cancer. But perhaps they tend to do so later on, as you were saying about prostate cancer for men?

Let's see. I'm 32, and I've had contemporaries die of: pulmonary embolisms (2 different friends), brain tumor, terrorist attack, complications from cystic fibrosis, mysterious circumstances that I suspect may have been a suicide, and, oh yes, I have a friend with breast cancer- but bli ayin hara her treatment seems to be going well, I think.

My bogeymen: Uterine/cervical cancer, being in a car accident, diabetes, skin cancer.

Oh, happy happy thoughts.

Posted by: Sarah | Jun 9, 2005 2:56:48 PM

Kakarizz... I am aware that AIDS is spreading nearly unchecked throughout Africa, but it was my impression that this was largely among uneducated people who don't know (or care) how it is spread. Having read through your writing, I would hardly consider you a person for whom AIDS should pose much of a threat. Also, while Ebola and similar hemorrhagic fevers are the stuff of horror films, I need you to help me understand if they are really that common in your part of Africa? I ask because the little I have read had left me with the impression that the outbreaks are horrifying, but few/far between. If these blood-borne diseases are really the demons that haunt your dreams, then nobody has the right to question your fears. But the things that I fear most are those that I can neither fully avoid nor even properly anticipate.

Rahel... I haven't gotten to the point where I open the paper to the obituaries... yet. But, like you, I have witnessed a little too much death in the past year or two. I know this post was a bit of a downer, but what shows up here is what is on my mind when I wake up in the morning. This should give you some idea of my mood this morning. :-)

Sarah... That's me... spreading sunshine around the blogosphere! :-) Here... something in your comment reminded me of a joke, so to make up for some of the gloom I brought you, here is a story of how two people can experience the exact same thing yet come to different conclusions:

A plane crashes in the middle of the Sahara Desert and only two people survive; a Jew and a Gentile. After a few days in the hot sun with no food or water the Gentile thinks to himself, 'I'm tired, hungry, thirsty and my vision is blurry... I must be dying'. The Jew, having endured the exact same conditions thinks to himself, 'I'm tired, hungry, thirsty and my vision is blurry... I must have diabetes.'

There! Feeling better? :-)

Posted by: David | Jun 9, 2005 3:59:58 PM

very eloquent post (but try not to worry too much)

Posted by: Essie | Jun 9, 2005 4:00:27 PM

I think that perhaps another reason that notion of prostate cancer seems to have a less terrorizing effect is the fact that the survival rate is statistically higher than most other cancers -- particularly when compared with any of the cancers which strike women's reproductive organs. In addition to modern medical science finding treatments which actually work (thank G-d), they've found a fairly reliable diagnostic tool which can detect this form of cancer long before it reaches stages where hopes for survival are nil.

One of the reasons ovarian cancer is such a TERRIFYING bogeyman for some women is that not only is there no clear cut successful way to treat the disease once it is FINALLY detected, and early detection is nearly impossible.

With regards to heart disease and it's mystifying lack of bogeyman status -- I think it is because with all the sensitivity to how cholesteral, high blood pressure, obesity and the like contribute to heart disease that many people allow themselves to be comfortable with the fact that they are being proactive -- diet, exercise, and keeping an eye on problems which contribute to heart disease. It is easier to be rationale with a "plan of attack" and some familiarity with the course of treatment.

Sadly the heart-disease bogeyman cases which you've described seem to have been come out of the blue -- no known history, no prior indications.... Always make you shake because, let's face it, the fickle-finger-of-fate -- it could have been (chas v'shalom!) pointed at any one of us.....

Posted by: zahava | Jun 9, 2005 4:26:02 PM

This is so interesting, you’ve touched on what I wrote in my most recent post, about being tapped on ones shoulder by G-d. http://frummer.blogspot.com/2005/06/scratch-my-back-and-ill-scratch-yours.html

My take on the “bogyman”:

“If someone, God forbid, has cancer, it will never be spoken of as such. Instead we will tell each other in hushed tones that they have “yenne machle”, as if they have contracted some filthy disease. God forbid, one of us contracts AIDs from some contaminated bodily fluids, we would probably tell each other in somewhat louder hushed tones that “yenne” has the “andrere machle”.”

From http://frummer.blogspot.com/2005/03/bobov-maases.html

Posted by: Frummer? | Jun 9, 2005 4:27:35 PM

Heart attacks are the number one killer of both men and women in the US (and I would guess in Israel too). The risk factors for the bogeyman:

  • being a man over 45 or a woman over 55

  • having a first-degree relative (parent or sibling) who has had a heart attack in middle age

  • having abnormal cholesterol, with the LDL being the most important number

  • smoking

  • having diabetes

  • having high blood pressure

  • making buletted lists in blog comments
There are risk factors that have been discovered more recently which are blood tests that can predict heart attack risk (C reactive protein, homocystein, others) but it's not clear that checking them or doing something to fix them makes a difference.

My advice: Let your doctor screen you annually for diabetes, high blood pressure and high cholesterol. Do some kind of cardiovascular excercise for at least 30 minutes a few times a week. See your doctor about anything that Zahava thinks you should see a doctor about.

Finally, re: talking about horrible diseases in hushed tones. I think it's bad luck to be superstitious.

Posted by: Doctor Bean | Jun 9, 2005 4:45:19 PM

I seem to remember that BEFORE my surgery I had fears like yours. Now, I don't anymore. I take care myself, have the usual annual screenings (actually 6-month screenings in my case, due to elevated risk factors and history).

I've been probed in every concievable way and had tumors removed from various innards. The nature of the human body is, to my mind, that the perfect blueprint fades as we age. When we are 25, a cell dies and a cell is born, following the DNA pattern perfectly. But at 45, the reborn cell may be slightly off-kilter. Several off-kilter cells and you have a problem.

Run up and down the stairs four times a day; eat lots of fruit and veggies; smile a lot; hug your kids and dogs. All in all, your body will still be fading, gradually meandering towards the inevitable moment of parting ways. But G-d willing, we will all have long and healthy lives, up until the moment we're cordially invited to jump into Olam Haba.

Posted by: mirty12 | Jun 9, 2005 4:54:54 PM

As Doctor Bean says, they have very good tests to determine whether you're likely to have a heart attack. They perfected the process just weeks after my dad died (of a heart attack).

Just another reason to live life to the fullest, every day. :o)

Re: my ribbon - Overian cancer is the one that gives me the creeps. I expect to get breast cancer. But overian cancer just kills you. I don't know anyone that's survived it.

Posted by: Tanya | Jun 9, 2005 5:11:05 PM

David, Ebola is not a big threat now, but can pop up from anywhere. One time it's in Congo then Angola... AIDS on the other hand is the real bogeyman!! No one seems to care anymore about 'protection', it's a suicide mission this days down here.

Posted by: kakarizz | Jun 9, 2005 5:16:59 PM

Within the last 10 years I have lost several friends to a variety of things, but in some ways the scariest to me is that I had three friends die from brain tumors.

Two men and a woman. They ranged in age from 29-33 and aside from all being Jewish and from Los Angeles I am not aware of any other shared characteristics.

They all underwent a ton of treatment and I know for a fact in two of the cases that money was not a concern, their families were able to pay for the best.

And yet here I sit while they lie beneath the ground. I don't really worry about it, but every now and then it weirds me out a little.

Posted by: Jack | Jun 9, 2005 5:25:00 PM


It is no accident that my bogeyman comment specified ovarian cancer -- it took my Mom's life after a 2.5 year bitter struggle.

Frankly, it scares the CR*P out of me. Not in an obsessive, time-consuming way. But whenever I hear of someone being diagnosed with it, whether I know them or not, I hit a funk that takes me a while to shake.

Though my experience with that bastard is hardly positive, I am happy to share that I actually do know 2 women (personally) who've past the 5-year mark from their last day of treatment! I hope they make it to 120 years!

Posted by: zahava | Jun 9, 2005 6:23:39 PM

I thought medical training would make me less scared of disease. Quite the opposite. I know that I could have pancreatic cancer today and be dead in a year. I know that even worse is the slow death sentence of Alzheimer's. If you want to get into very rare bogeymen, how 'bout ALS (Lou Gehrig's disease) which slowly leaves victims unable to move? Stroke? Parkinson's? There's plenty of badness to go around.

Posted by: Doctor Bean | Jun 9, 2005 6:54:27 PM

Essie... You know how sometimes you will be sitting and having a cup of coffee with a bunch of really close friends... people that you trust and who seem to really 'get' you... and someone will break a long comfortable silence with a statement like, "y'know what really scares me...? And the rest of the evening will be spent drinking too much wine and talking about everyone's personal demons? Well when I got up today that's what I really needed to do... and I feel so blessed that I have such wonderful people who can join me and say, "yeah... we're scared too." Just blessed.

Zahava... The reason I mentioned the ribbon in my post is that the colored ribbon has become the symbol telling the world that it's OK to talk about something scary and potentially deadly. That my personal bogeyman doesn't have his own ribbon tells me that I'm probably just one of many people who occasionally lie awake listening to their heart beating... and wondering if the sound we hear is the steady tempo of a long beautiful symphony... or the last urgent ticks of a time bomb.

Frummer?... That is so interesting, last year I posted a journal entry called 'Itching to tell someone' which was about scratching backs! Wierd, huh? I guess great minds think alike (but fools never differ). :-)

Doctor Bean... Wow, that's a weight off my chest! I only have one of the risk factors (the one about making buletted lists)! I even have a little over a year before I turn 45!!! I feel like I just got a reprieve from the governor!

Mirty... I've wanted to tell you something since I began reading your blog and this seems like as good a time as any (since you brought it up and all). When I first read about your surgury I was tempted to leave a comment about how lucky you were that it turned out to be benign. But then I stopped myself when I realized what a profound change the tumor had forced in your life's trajectory. You are an incredibly strong and positive person to have used that chapter of your life as an opportunity to re-assess values and relationships... I learned a lot from the example you set (and continue to set). Thanks for the advice... and for setting a wonderful example.

Tanya... You and Zahava would have a lot to talk about (see her comment to you below). Shortly after we were married my mother-in-law (Z"L) was diagnosed with advanced ovarian cancer. She died within a few weeks of our oldest (Ariella) being born. The doctors actually were amazed that she was able to will herself to hang on to hold her first grandchild. Sometimes I will catch Zahava with the photo album, looking at the pictures of her mother holding Ariella and I know she is wrestling with her bogeyman.

Kakarizz... So long as you aren't counting yourself among those who don't care about protection, that particular bogeyman can't hurt you. A suicide mission is only a suicide mission if you accept it.

Jack... That right there is what gives my/our bogeyman his power. If there were some rhyme or reason you could prepare yourself. We've all played that game of "If you were told by the doctor that you had 6 months to live... what would you change about your life?" The trick is to start living like that now... before the bogyman knocks, because he often doesn't give 6 month's notice.

Doctor Bean... For a few months after reading 'Tuesdays with Maury' I adopted the ALS bogeyman... but so far I'm back to just dreading the heart attack.

Posted by: David | Jun 9, 2005 7:07:13 PM

I know an ovarian cancer survivor, but I have never heard of anyone who survived pancreatic cancer. I wonder if it is always deadly.

My father just got diagnosed with Parkinson's and I find myself thanking G-d because for a few months it appeared it could've been something worse like MSA or PSP (the horrid disease that killed Dudley Moore).

And I can't help being afraid for my own future, although the neurologists say they don't think it's genetic. Who really knows?

Posted by: Stacey | Jun 9, 2005 7:12:25 PM

my own bogeyman has passed since I was always afraid that I might die like my grandmother, when she still had small kids (and with all the hush-hush, I'm not sure if it was heart, or obesity, or what?).
now we're on to my husband who, just in the last year, seems to have multiple prescriptions: potential diabetes, cholesterol, and the vitamins and aspirin that are meant to be preventative. I want him around for a really long time into the future.

I'm so cheery today.

looking forward to being in Israel in 2 weeks, assuming our passports stop travelling without us (last seen delivered by UPS to someone 2 states away).

Posted by: timna | Jun 9, 2005 7:29:42 PM

Stacey... With all due respect to Doctor Bean, Psychotoddler and their fellow practitioners, that is what scares us all, isn't it?: "Who really knows?"

Timna... I hope you will get in touch when you arrive. We're not that far off the beaten track, and quite close to Jerusalem! Good luck with the passport adventure.

Posted by: David | Jun 9, 2005 9:29:46 PM

In the end you really have to just live your life and enjoy the time that we have because you don't know what day or what time the end will come.

Posted by: Jack | Jun 9, 2005 11:07:11 PM

Speaking as a person who is claustrophobic, I am terrified of anything that makes you "locked in." You know, unable to move, unable to communicate. I once read a story about a woman who suddenly had a stroke and woke up years later in a hospital unable to move or speak and with no knowledge of what had happened. A nurse happened to see her crying and figured out that she had regained consciousness. I read this years ago, and I still freak myself out about it. Neither dying nor pain frightens me as much.
Hey, I feel much better sharing it with you. You?

Posted by: ball-and-chain | Jun 9, 2005 11:46:00 PM

Of course I could name my bogeymen--and there are a few. But I won't...for the following reason:
My husband always pulls up this expression to use in applicable situations, such as this one. And that is "Al tiftechi peh l'Satan." (don't open your mouth to the devil, ie. don't give yourself an evil eye) Very recently I noticed that the Hebrew word for devil is very close to the Hebrew word for cancer. "Satan" and "Sartan."
Think about that...

Posted by: Pearl | Jun 10, 2005 12:04:51 AM

My grandmother died of Parkinsons. I remember when she was diagnosed I used to hold her hand and the only sign I saw was her fingers gently tapping on my hand, like playing the piano. She died about 4 years later. Now I hold my moms hand, and hope that I never feel her "playing the piano" on my hand.

Posted by: ac | Jun 10, 2005 3:10:10 AM

Geez, a few hours after I read this I got a call from my sister (who is 45, herself a survivor of colon cancer that she got in her mid-thirties after it returned once, and who is now the president of a local, well-known breast cancer foundation). She told me that our friend Cathy went to get a mamogram because she just had her 50th bday, and found out that she has- you got it-breast cancer.

Get mamograms and if you have colon cancer in your family, get checked. They found my sister's by accident (in stage one) and had they not, or had they waited until the recommended age BTW, she would most certainly not be here today.

Posted by: Alice | Jun 10, 2005 3:35:45 AM

The other thing over which I lose sleep is that I might get hit by a truck before David puts up the next photo Friday!

Posted by: Doctor Bean | Jun 10, 2005 8:00:17 AM

Thought-provoking and a bit scary! Time to see if DH has plans for a checkup...

Posted by: AmyS | Jun 10, 2005 1:08:15 PM

Jack... To quote the Beatles: "And in the end... the love you take... is equal to the love... you make."

Ball & Chain... You and my wife would have soooo much to talk about on this subject. She can't go into our walk-in closet without breaking out in the sweats!

Pearl... A few years ago there was an anti-smoking poster which was aimed at the religious crowd that showed a religious guy smoking... and the caption was 'Al Tiftach Pe l' Sartan'

ac... That was a wonderful desccription. I hope you never to either.

Alice... I hope and pray that they caught this woman's cancer in time!

Doctor Bean... That is a very real possibility since Friday is the only day I get to sleep in!

AmyS... Yes, please do.

Posted by: David | Jun 10, 2005 3:42:29 PM

Rahel, medically the green ribbon is used for organ donation support. I did a little search - blue doesn't seem to be taken. David, I think that would be a good symbolic color for heart disease.

A very dear friend of mine is an ovarian cancer survivor, which she got in her early twenties and which wasn't detected until the cancer had spread to the base of her spine. That was over ten years ago and she's still very much around, thank heavens, with a beautiful family. I think the only reasons she survived the disease and agressive chemotherapy were her youth and her fighting instinct, which is very strong.

My personal bogeymen? Heart disease and adult onset diabetes. Both run in the family on my father's side. My father has both, as did his late brother, who died from heart disease. Both grandfathers died of heart disease and my father has had angioplasty. Granted, none of them took care of themselves, so it's not excatly surprising.

I had my own scare a few years ago, but the sharp chest pains turned out to be costochondritis - inflamation of the cartilage around the heart generally thought to be brought on by stress, though a definite cause isn't known. Funnily enough, my emergency room doctor said my ECG was one of the best he'd ever seen, even with the added stress of experiencing sharp chest pains. And yes, I have my blood sugar and heart (as well as everyting else) checked on a regular basis, especially now that I'm on the threshhold of forty.

Posted by: Carol | Jun 11, 2005 4:36:10 PM

Hey David...the new trend now is to wear color rubber bracelets...they are everywhere and for every cause trying to raise money. : )

Posted by: ginger | Jul 19, 2005 12:28:20 AM

breast cancer rubber bracelets

Here's some useful info on breast cancer rubber bracelets which you might be looking for. The url is:

Posted by: shiv | Nov 7, 2006 2:25:20 PM

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