A minyan

She first attempted to avert my gaze, not wanting to spoil my state of innocence.With her hands and her body, my mother tried to shield from my vision other children my age, in wheelchairs, deformed by palsy and paralysis.As a survivor of the holocaust, she had seen too much.She did not yet want her 4-year-old son, born in the New World, to view pain, sickness, or suffering.But I was compelled to look at the faces and the eyes.Somehow, I knew we were related.This childhood experience has always been a particularly vivid and persistent memory of seemingly unknowing importance.Somehow a metaphor or an omen.As I participate in the first retreat of the Project on Death in America's Faculty Scholars Program in a rustic lodge outside of Seattle, I am years and miles from the Lower East Side of this childhood memory.Yet it forces its way into my consciousness as if to say, "Look at this. "We've just come from a 4-hour meeting in which the scholars shared personal experiences, which influenced us in choosing palliative medicine and care of the dying as a career path.The experience of sharing our personal stories was extremely powerful and energizing.Like the other scholars, I had prepared a "personal statement" as part of my scholar's award application.As I came to learn at this retreat, the others had struggled endlessly with this section of the application just as I did.In fact, I had spent weeks writing the personal statement and only 2 days writing the "scientific" section of the application.You see, despite being a psychiatrist, working in a setting where caring for the dying is an integral part of my work, and being surrounded by other psychiatrists and psychologists doing similar work, I had never really been forced before to put down on paper why I chose this field of work and what it really means to me to do this work.The process was painful, private, sad, and spiritual.We sat around a set of tables arranged in a rectangle.The sunlight, fragmented in radiating beams, lit the room in a state of calm.I looked down at my papers and scanned through my personal statement.Personal meaning of my interest in the care of the dying: I have been working as a psychiatric clinician, researcher, and educator at Memorial Sloan-Kettering Cancer Center for 10 years.In that capacity, I have been a witness to a great deal of suffering, fear, and loss.In working with individuals and their families, confronting life-threatening cancer or AIDS, I have also witnessed enormous courage and dignity.I have spent quite a bit of time over the years trying to understand how I came to this place and this work.I believe there were 3 important influences that led me down this path.The first influence was the holocaust.I am the firstborn son of survivors of the holocaust in Poland.My father lost his entire family with the exception of an older brother, Henry, who served in the Polish brigade of the English armed forces and fought in North Africa.After the war, Henry pursued Nazi criminals in South America.My mother was fortunate enough to have her parents and 2 brothers also survive the war.My parents married while in a displaced persons camp outside of Munich called Fahrenvalt.In 1949, they came to New York City's Lower East Side to make a life.When I was born in 1951, my grandmother Esther wrote in Yiddish in her diary, "This is why we survived." Throughout my adolescence, my parents and grandparents bore witness to me of the suffering, loss, courage, and dignity they had encountered in the holocaust.I was taught never to forget.I was taught compassion.I was raised to believe that I could make a difference.Growing up in this environment, I was drawn to a career that would enable me to ease suffering.The second experience that influenced my career path was the death of my grandfather from cancer.My grandfather, Moses, was a Kohane descendant of the high priests of the Temple.I was a Levi, a descendant of those who assisted the high priests.As a Levi, I assisted my grandfather in the ritual handwashing on high holy days.I attended Sabbath services with my grandfather for 25 years until his death.I was a second-year resident in psychiatry when my grandfather was diagnosed with colon cancer.We were fortunate in that the cancer had been detected early, and a resection was possible.However, serious cardiac disease made the surgery risky, and the decision to proceed with surgery was made with trepidation.Two days before surgery, I visited my grandfather in the hospital.He seemed panicked, in a depersonalized and derealized state.He was staring into the mirror, looking pale and drawn, and asked me, "Am I alive, or am I