Top of the Mornin’ to you. I’m sure Joe Biden is mighty relieved now the Presidential battle is over. The quietly spoken President-elect emerged victorious, in spite of the loud and unfounded claims by the sitting President about electoral fraud. I have personally had my fill of his tan-trumps and childish commentary. Biden has proved himself not only to be a diplomatic career politician, but to be also a  welcome foil to Trump’s brash persona. Biden’s running mate, Kamala Harris, an African-Indian-American, will be the first female VP in history, and is married to Douglas Emhoff, who will become the first Jewish spouse in the White House. Even before he knew he was winning Biden said, “after this election…there will be no blue states, or red states, I will work for the United States. I will work as hard for those who didn’t vote for me, as for those who did.” Trump has emphatically declined to make a concession speech –  as most defeated Presidents have done –  instead retreating to his presidential cave to mull over his legal options. For now, we can only hope the dust settles quickly on a very divided America, and we see a smooth transition to an optimistic, integrous new era in history. 

The past few months have brought me some troubles of my own, with stubborn back pain, which so often throws up an ominous question mark over us pancreatic patients, so I had a scan, which shows my cancer is starting to gain ground. It was a truly sobering follow-up where my oncologist said cheerily, ‘well, we always knew it would progress!’ Too right it would, especially if you’ve been kept off-chemo for nearly a year. An analogy of ‘stables and horses’ gallops into my mind, but I try to avoid conceding chemo will now prove ‘too little, too late.’ I refute any attempt to say I was in agreement with a substantive treatment holiday, as I was always reluctant, but conceded to her ‘optimistic’ consultant recommendations. Who, after all, would willingly want to slip down the slope to terminal metastatic decline? My version of a ‘holiday’ would have been 3 months on – 1 month off, not 6 months off straight followed by another long haul. It’s no good to hear someone else stayed progression free for 15 months, when that’s not the norm, and many are dead in a heartbeat. I have now had a lung biopsy which will definitively answer some outstanding questions. 

Continuing the ‘holiday’ theme here, the UK has banned entry to Danish residents, whilst visitors to Denmark are now subject to a 14-day isolation on their return. As if we didn’t have enough coronavirus troubles, it’s quite worrying to hear there might be a new strain of covid-19 poised to reach our shores. Prof Jonathan Van-Tam, deputy CMO, has told the health sector to take immediate action concerning a potential ‘mink-virus’ which has already been identified in Denmark. Vets began the task of euthanizing and incinerating 17 million mink in an effort to prevent the further spread of the ‘cluster 5’ mutation, which was first detected in June, after it made the jump from animals. The WHO has found at least 200 cases in 6 countries, and although still registering small numbers, the most worrying factor is that it is being found within the community, rather than on farms, which indicates human-human transmission. I’m sure I anticipated this new-strain scenario many months back, which has significant consequences as ‘cluster 5’ shows greater resistance to vaccines. Now there is a possibility that it could have already reached the UK’s wild mink or otter population, and that’s not good news. I guess if I do manage to take that stunning Siberian journey, I may be wearing many things, but it’s unlikely to include a mink fur. Prof Van-Tam has also shared optimistic news that the Pfizer vaccine looks set to effect a breakthrough; I was thrilled to see politicians are testing it first, followed by the most vulnerable and the elderly. Tidings of great joy are still rather premature however, as I noted my chances of actually dying from covid are a whopping 20%, falling into the cancer ‘increased mortality’ group. My chances of dying from the lung biopsy were around 1:3000, so 1:5 is not good to hear. 

Now I’m not sure if anyone else is worried about Mr Sunak extending furlough until March, but I feel uneasily that the on-off lockdown (previously more on than off) may be going to ping-pong for much longer than 4 weeks. During this time we’re being encouraged to attend surgeries and hospital appointments, at least in theory, but how is this panning out in real terms? Let’s see…. I was given an appointment recently at UCH, a mere 12 months later than planned, through an admin error. I was more impressed that I was still alive by the time it came through! The initial appointment was then a phone call, followed by a planned physical appointment. This has now been suspended because my chemo is scheduled for the same day, and I’m told there are no appointments until the end of December, as every other week is bookmarked for phone appointments. [Not doing so well then, Jacqueline]. In another department, I require some minor surgery, but was told by the consultant, ‘we can give you tablets for now to save you coming into hospital.` Hang on, I’m already jangling like a maraca with all my medications, why don’t we just fix this simple thing, and I can strike one problem off my to-do list. My knee surgery is presently on hold, to see if it can last another year, but in-between I was promised urgent physio to halt progressive muscle wasting. No sign of that appointment either. Now I’m just one person, with a mini catalogue of needs. What’s the story amongst the other 66 million citizens of the UK, or even the 50,000 potential cancer sufferers who are missing out on affirmative diagnosis and treatment?

A little side column caught my eye this week, with the headline ‘Vitamin D helps raise IQ in the womb.’ I’m sorely tempted to rush off and get myself a supply of vitamin D, except I’m certain my reproductive organs don’t need any pressing help in terms of improving IQ. It’s actually my brain that needs help, as I feel I’m mentally falling by the wayside in my haphazard cancer journey. Oh…. I think they meant – ‘helps raise IQ in babies, whilst still in the womb.’ It’s all in the detail of the language! Elsewhere in the news we hear researchers at Harvard University say health benefits of taking multivitamins ‘may be all in the mind.’ For an industry worth £424 million to hear this must be a bit of a blow, given we know vitamin D is essential for combating covid. Prof Ian Brighthope [Nat. Inst. of Integrative Medicine, Melbourne] reiterated that ‘appropriate and therapeutic vitamin D supplementation is critical to [covid prevention]. Make up your minds, people. 

We watched our Queen on Remembrance Sunday, in an unusually sombre tribute to the fallen. As Armistice Day fell this week – coincidentally on the anniversary of my fathers funeral – I thought I would share a snippet from a letter written by my great great uncle Robert, back in 1916. I was given it by my mother many years ago, and treasure its descriptive content, written in educated, flowing and impeccable fountain-pen strokes on vellum. He shows all the quiet resignation of his generation, with no bitterness over the likelihood he would not return home. The dignified courage of these soldiers who would later die in battle, was truly humbling. He precedes his text by stating his regiment, the British Expeditionary Force, 2nd Battalion, Scottish Rifles. 

<My dear sister, Just a few lines to let you know that I am quite well. I received your magnificent parcel, for which I sincerely thank you. The contents were simply luxurious. As I write we are at rest. We have a week’s rest before we go to the trenches again, which will be in a night or so and then commences some hard fighting. The trenches we’ve been occupying are about 200 yards from the Germans. We hear them singing and playing instruments. We are told that they are down-hearted, but they are forced to sing by their officers…. I have not much else to say, but if spared, will be able to write something exciting next time. Tell Father and Mother that I am thinking about them often. With best love to all. I am, Yours affectionately, Private Robert Smillie No. 8293.> 

I don’t have all the details, but it is highly unlikely he survived the campaign, far less the war. So many were lost, and we must repeat their many stories so that the youth of today, never forget. 

Finally, it is with huge sadness we report this week the passing of a Torah giant, Rabbi Lord Jonathan Sacks (72) zt”l, who has lost his battle with cancer. The eldest son of Louisa and Louis Sacks, a shopkeeper, he was also the nephew of the late Oliver Sacks, the writer. His journey took him from Christ’s College, London to Gonville & Caius College, Cambridge, where he read philosophy. Following an epiphany during his university years, he became more religious, and Cambridge was followed by Yeshiva, semicha, high level teaching posts and many roles as community rabbi, ultimately becoming UK Chief Rabbi in 1991. 

I remember listening to his inspirational words of wisdom on BBC Radio 4s Thought for the Day, and recall one of his speeches where he remarked, “some are born to greatness, some achieve greatness, and some have greatness thrust upon them.” Modest to his core, Lord Sacks may not have felt he was ‘born’ to greatness, but he undoubtedly achieved greatness, and never appeared out of his depth when greatness was thrust upon him. Amongst his prolific output were TV and radio broadcasts and a vast range of books and publications. He was quietly spoken, insightful, a light to all the nations, a friend to many (including Prime Ministers and the Royal Family), and a leader par excellence within our community. Our condolences go to his wife Lady Elaine Sacks, and their extended family  יהי זכרו ברוך  To quote Lord Sacks, “Life is a gift.” In the perennial rushing of our days, we must stand still sometimes, and remember this.

Jacqueline x