I’ll have a medical update next week, after I meet with the oncologist. But now I want to focus on Passover. All my children came in, with of course all our grandchildren. It was crowded, hectic, chaotic, a lot of fun and very revealing. Everyone got along and the grandchildren got to know and play with their cousins.

These family times are precious, and too often I think we take these moments for granted. My grandchildren range in age from a few months to ten years old, and that gave me an opportunity to remember how my own children grew and developed. It also gave me an opportunity to see how my children and their spouses are raising their children. In many instances, it seemed they were doing a better job than I did, hopefully taking the best of my parenting and learning from my mistakes. In some instances, I felt like criticizing or explaining a different approach. But I refrained.

Inter-generational interactions, and intra-generational interactions, are very important. In many ways, they provide nourishment to the nuclear family (parents and children). Of course, such family get-togethers are becoming increasingly rare in our increasingly mobile, fractured society, especially ones where the dynamics remain positive, as opposed to the almost cliched arguments, tensions and fights that occur, the dredging up of past wounds and unresolved rivalries. 

And our digital age is a two-edged sword, on the one hand, contributing to the factions, distance and lack of communication, superficial, healing or otherwise, and on the other allowing us to stay in touch and connect much more intimately and immediately than ever before. While letters, in-depth and heart-expressive, are still important (and becoming a lost art), the immediacy of email or text, or the visuals of FaceTime or Skype, etc., allows us to communicate, to be part of each other’s lives, to defy distance and dissonance and distractions in ways only imagined before.

Of course, I’m not the first to make these observations, but their power and poignancy struck me deeply over Passover, as I watched and interacted with my children, now grown, and especially my grandchildren, even as I wrestled with my own health and its impact on my future. (As I said, I’m getting stronger and feeling better, but there is still tumor, and therefore uncertainty, that must be dealt with.)
In the face of the inevitable uncertainty of our futures, children, and perhaps especially grandchildren, give us not only a measure of hope, not only a sense of continuity, but a reassurance that our lives have value, meaning and substance. We have not only been a partner in creation, we have revealed something of the Eternal. From generation to generation includes us in a larger community, transforms us into integrated parts of a greater whole. 

Whether we play with our grandchildren, or watch them play with each other —indeed, whether we are the uncles and aunts, or even the cousins, that join or extend a family — and as we observe the interaction of the next generation with its own next generation, we participate in a continuity that both emphasizes our moments and broadens our souls. We discover a spiritual rootedness in our physical encounters, elevating the mundane spinning of a toy or reading of a book to an almost sacred experience, like the mystical attachments that arise from the repetitions of prayer.

Driving it all is the simple joy of being — being there and being with. For a grandparent, a young child’s cries for attention, for food, for a diaper, the struggle of growing into one’s self, evokes sympathy, sometimes amusement (the “been there, done that” factor), but always an identification. After all, how much of our identity, of who we are, is defined by our children, and our grandchildren? And as they struggle into competence, we, too, regain our own, finding ourselves renewed, as it were, in their joyful discoveries.
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We come together all too briefly and all too infrequently, and even as we maintain contact, interest and involvement, we yearn for the immediacy of a prolonged presence. But every moment is a blessing, and as we, the elder generation, struggle with our own inner conflicts, our own ailments, our own (still) becoming, it is a comfort to have not just the connection, but the relationship with children and grandchildren. A gift from the Almighty, we bless them, but even more, they bless us.

Trade-Off

In order to manage the symptoms and side-effects of my cancer treatment, I’m taking a lot of medications. As a result, there are days where my afternoons - or part of them - pass in a bit of a fog. As at least one medicine warns, ‘may cause drowsiness.’ Of course, a nap is permitted, and often taken, but still, there is that sense of I should be doing something productive.

It’s a trade-off - symptoms under control on the one side, slowing down on the other. 

This got me thinking about the whole concept of a trade-off because, really, so much of life is about trade-offs. We’re engaged in trade-offs all the time. It may well be that the kinds of things we’re willing to trade for, or trade-off, reveals a lot about our personalities, who we are.

A trade-off is not simply an exchange of one thing for another, although some trade-offs are ‘only’ exchanges. Buying groceries, for instance, is not a trade-off. Buying lettuce instead of cabbage, though, might be. For example, we really want cabbage for cole-slaw, but the family wants a tossed salad.

A trade-off, then, involves at least a regret, if not a loss. Now the loss may be more than compensated for - the praise and thanks we get from the family for the tossed salad more than makes up for not having (or delaying) the cole slaw. And in retrospect, the trade-off may be all to our benefit. (We put too much mayonnaise or vinegar in the cole slaw, anyway.) But at the moment of the trade-off, we have at least a tinge of regret.

Without trade-offs, then, we don’t really grow or change. We exchange a tricycle for a bicycle. We leave high school behind and move on to college. We take a job closer to home, with less pay, instead of the higher-paying job in a city where we don’t know anyone. Or vice versa.

Of necessity, a trade-off also involves a reduction of possibilities. In other words, a trade-off is not just about moving from the past to the present, it’s also about closing off future options. An obvious example is when we decide to marry our spouse,we are no longer interested in the possibility of marrying someone else.

Trade-offs also involve lifestyle changes. These can be traumatic at first - like when a Jewish person decides to start keeping kosher, and no longer eats shellfish, or anyone decides to eat healthier and stops eating all that fast food and junk food. 

Some trade-offs can’t be avoided. Doctor’s orders to maintain our health. Going from playing softball on a Sunday to sitting in the bleachers because of our age. 

Trading off is a way of reordering our priorities. When we decide to be less involved in gossip, to get less riled up over sensationalist headlines over which we have not control, we’re giving up a pleasure for being more responsible. 

We make a lot of trading off choices without necessarily thinking about them. And we often talk about our decisions in a way that may focus on that twinge of regret I mentioned, even though we have no intention of changing our minds or going backwards. 

Trading off can be hard because it forces us to confront our principles and decide what’s really important. It also forces us to recognize our limitations. We can’t have it all or do it all - so what’s really important?

In this sense, trading off may also involve self-sacrifice. This weekend was the 50th anniversary of Selma. Those who participated in that march, and there was a wide variety of people who did, sacrificed a degree of security and entered the unknown. They risked being attacked. They did not know if they would be successful, achieve the purpose of the march. 

Not all trade offs are large stage or life altering. But they do require consideration of alternatives.  To conclude with another example from my situation, this next round of chemotherapy will be more intense. There’s a risk of increased side-effects. It’s a trade off - the chance to be more aggressive attacking the tumor versus the possibility of more severe side-effects. 

The next time you’re faced with a dilemma or a tough decision, whether about something material or spiritual, consider the concept of a trade-off. It might make the process easier.

It’s Cold

I suppose those of us who live in the warmer climes shouldn’t complain too much about the cold - except cold can be relative. I find that I have a very difficult time functioning when the temperature drops. That’s probably because of my condition. I’m affected by cold weather - and I’m talking forties or even fifties fahrenheit - more, much more than the people around me. 

It wasn’t always this way. I grew up in cold weather, with snow and temperatures in the teens. I don’t like the cold, but I could function in it. Now, it goes through me. I’m sure the tumor and my body’s lower resistance has a lot to do with it.

Still, there’s a lesson everywhere, and cold - and warm - are wonderful metaphors for a lot of things. As an aside, there’s the cliche that “everyone talks about the weather, but no one does anything about it.” Kind of strange, since there’s little we can do about the weather, at least immediately. (Yes, we can reduce our personal and global carbon footprint and do something about climate change/global warming, but those who spout the cliche aren’t referring to science. They’re referring to our immediate reaction to weather that interferes with our plans - whether that be rain or sun.)

I suspect that the cliche is a way of saying we’re not in control, but even that can be suspect. After all, we do something about the weather - we react to it. We build houses with insulation (or not). We put on warm clothes, jackets, gloves, etc.; we bring umbrellas. So we’re doing something about the weather all the time.

But back to the metaphors. “Cold” is a double-sided metaphor. There’s “cold-hearted” and “cool-headed.” “Cold” as a positive metaphor is associated with calculation, logic, being rational. “Cold” as a negative metaphor is associated with indifference, lack of feeling or sympathy, even cruelty. One who is cold in this sense doesn’t care. 

(Of course, it’s possible to care too much, to be too passionate, to overheat - at least about some things. That’s when we need a “cooling off” period, to restore a balance. But not all passion is in need of cooling off. Sometimes, our enthusiasm should not be tempered. Sometimes, our energy should be all in. For righteous causes - those that conform to the Divine commandments (mitzvos). For relationships, with family, friends, G-d.)

Chassidic philosophy talks about this metaphor a lot, particularly in connection with the holiday of Purim, which is this week. (On Purim, among other mitzvos such as giving tzedekah/charity, the book of Esther is read in the synagogue.) The underlying battle of the Puriim story - of the book of Esther - is the struggle between indifference, or even the perfunctory, and the enthusiastic, the energetic. 

When it comes to doing the right thing, we all have a spot of coldness. It’s a balancing act between the demands on our time and energy. That extra minute, that extra dollar, that extra effort - sometimes giving seems to be the “warm” thing to do, a display of our involvement and caring. And it may well be. But it may also distract us from the next warm thing, the place where we should be invested at this point.

It’s a constant struggle, because the cold - the negative cold - in our hearts is insidious. It may be a small snowflake, but that may be enough to chill us, in a number of different ways. We have to be constantly on guard against self-deception - another form of “being cold.” 

So as I deal with the physical effects of being cold - even with the extra blankets or sweaters, I’m also well aware of the psychological effects of feeling cold - out of sync, disconnected, sometimes wrestling with the “what do I do now?” question. We all go through this at various points, even if we mask the confrontation with busyness - necessary things, perhaps, but busyness nevertheless.

What’s the answer then? What’s the solution? Engage, find the balance points - and then, get warmed up, enthusiastic, passionate about the Divine imperatives. If life, like the weather, is cycles, then the warmth we’re waiting for from the outside weather is already metaphorically warming our hearts.

Last week, as I noted, I had a temporary setback. Without going into details, one of the side effects of the chemo got a little out of control. I’m pretty much back to where I should be now, but the concept of a “setback” has been brewing, as it were, for several days.

We all suffer setbacks in our lives, glitches in the plan, things not working quite as they’re supposed to. We know they’re inevitable; we just don’t know when we’ll have one, or how severe it will be. 

On a simple level, a setback is like missing a question on a test when you were sure you knew the answer. It’s “not supposed to happen.”

But setbacks do happen. All the time. The difference between a “setback” and a “mistake” may be that mistakes are supposed to be under our control. The whole ten thousand hours to expertise thing. Put in the time, do the practice, go through the trial and error - make the mistakes, in other words - and eventually you find success. 

Setbacks, though, are something out of our control. Could we have planned better? Probably. But that would not necessarily prevent a setback.

Setbacks occur in all areas of our lives. In business: we have a deal worked out, but at the last moment a third party underbids us, or the boss of the other company had a fight with someone and negates all deals until he’s in a better mood. In our personal lives: we plan for an evening out with the spouse, but one of the kids get sick. Academically: the professor whose class we need is sabbatical this semester. And so it goes. We’re on our way to the stadium, when we get caught in a traffic jam and miss the first half. The company whose ladder we’ve so carefully climbed is “restructuring.” 

Some setbacks are temporary. Some are just annoying. Some, however, are quite serious. A setback in our job, a setback in the renovation of our kitchen - these can be more than just inconvenient.

The characteristic trait of a setback is that it’s unexpected - even if we planned for the unexpected. Setbacks happen all the time during construction, don’t they? Even authors suffer setbacks - not just in sales or contracts, but in the construction of the story. Sometimes the characters just won’t cooperate.

We can’t really control when a setback will occur - it’s not like we can plan for them or “order” up our daily share. (“What will you have today, sir?” “I’ll have one routine transaction, one unexpected but promising phone call and a setback.”) So really all we can do is control how we respond to them.

The first response is inevitably frustration. Why did this happen? The unanswerable question, even if we can trace the causes. Then we might get angry - at circumstances, at someone who may or may not be responsible - or even be aware that he caused us a setback.  

Eventually, though, we retrench, revise, accept the setback for what it is and figure out how to move forward. Eventually, or hopefully, we stop shaking our fists, metaphorically speaking, and recognize that setbacks, like the unexpected bonus, demonstrate that however much we like to be in control, we’re really not. What we can control is how we respond to a setback.

Indeed, our response in some ways testifies to how much we understand, or accept, the concept of Divine Providence. If we wallow in the negative effect, it doesn’t say much for our sense of purpose. It doesn’t say much for our commitment to the cause - even if the cause is as plain as a family dinner. 

But if, after analyzing the setback, figuring out how we can correct it or work around it, we recommit ourselves, that also says something about us. In other words, while we cannot prevent setbacks, we can prevent them from ruining our lives. We may just have to find a different way to get things done. If, after the initial frustration, we take the right attitude, and act on that attitude, we may very well find that the setback contains the seed of an opportunity we would not have had access to otherwise. The setback - one step back - may be the start of two steps forward - progress we could not anticipate and success equally unexpected. 

During my last visit to the doctor, as we were reviewing my treatment, he remarked about a particular area that while I had been making good progress, I seemed to have reached a plateau, a leveling off. While I wasn’t regressing, G-d Forbid, I wasn’t making progress either. He changed some prescriptions and told me to make some changes in diet, etc., to ‘kickstart’ more progress. In effect, he said, aside from the medication, I need to push myself more.

Even when struggling with a major illness, we can become complacent, thinking that what worked until now will continue work. It’s hard to do everything that’s necessary, and when we reach a stage where we’re managing, it’s natural to do continue doing what works.

In other words, while it’s hard to get into a new comfort zone, it may be harder to get out of it and do what we need to reach another new, and higher, comfort zone.

This constant struggle to adjust or move the parameters of a comfort zone applies to almost all areas of life. Consider an athlete who has a training routine, one which he or she follows rigorously and religiously. This routine has brought the athlete success, why alter it? The same applies to an artist. (Musicians might play the scales X number of times, for example, or playing certain tunes as exercises (jamming), as a way of staying in shape.) 

Obviously, if success becomes less frequent, we have to examine not just the performance, but the practice. When we fall below a comfort zone, then we review our routine, and modify it.

But what about if we’re maintaining our level of success? What if staying in the comfort zone still works? Why should we make changes? Why should we push ourselves?

Aside from the fact that we achieved success, that we got into working comfort zone, by pushing ourselves, there’s also the fact that what was good enough yesterday isn't good enough today. And what’s good enough today won’t be good enough tomorrow. And that for two reasons: there are challenges and obstacles from outside. Our success will be challenged by competition, and the unexpected in life - positive or negative - will impact us, one way or another. 

The second reason is internal: The plateaus in our lives are resting places, not dwelling places. The cliche, if you’re not moving forward, you’re moving backward is at least partially true. What is certainly true is that the status quo never stays static. We need look no further than our childhoods. How eager children are for experience. How dull ‘been there, done that’ becomes. Even as adults, we don’t lose that restless energy to be doing, to be making meaning.

So we have to adapt our routines. That doesn’t mean going from a hundred repetitions to ninety-nine. It means going to one hundred one. Or adding a new element to the routine. Pushing ourselves.

This concept of pushing ourselves, of not being satisfied when we’ve climbed high enough to reach a new plateau, applies not just to artistic endeavors. It applies to our jobs and professions. It applies to our ‘self-growth’ - our intellectual and emotional maturity. It applies to our relationships. We should not, perhaps dare not, settle into a comfort zone. Complacency begets boredom.

Of course, precisely because we’re in a comfort zone, we don’t always see how we’re stagnating. We need someone from the outside, someone we trust, to point out to us that we’ve spent enough time in this comfort zone. Time to begin the climb to the next one.

That often comes as a shock. We thought we were doing so well. We were. And we are. But we can do better. And since we can, we should. We may resist the doctor, coach, mentor, spouse. We may get angry or go into denial. But ultimately, if we’re honest with ourselves, we’ll admit that, yes, we’re not pushing ourselves as hard as we can. We’re not achieving what we can. We’re doing things naturally, the ‘normal’ way. We’ve become satisfied and challenge-deprived, so to speak.

Sometimes when we realize we’ve been dwelling in a comfort zone too long, the impulse is to knock down all the walls and make radical changes. And yes, there are times when radical change is necessary. But usually we have to exit the same way we entered: one step at a time, building on an established routine, climbing one handhold at a time. If not, we may sabotage our journey, excuse a slipping back into the old comfort zone, even, perhaps especially, if it’s no longer adequate.

There’s another aspect to this: doing more, pushing ourselves, moving our comfort zones higher is in a sense a Divine obligation. Whether the area is our health, our profession, our relationships, our community, our learning (never stop learning), our spiritual growth, since there’s room for improvement, we must improve. In a sense, that’s one of our Divinely appointed tasks - to get out of our comfort zones and improve the world, beginning with the ‘small world’ - ourselves and those around us.

One Day At a Time




“Take it one day at a time” - that’s a byword among those who have a chronic illness or disease. It also applies, though, to those who are “perfectly” healthy - because one day at a time is the only way to “take it.” It’s a common cliche, but what does the phrase mean? That we shouldn’t make long term plans? But that’s not in our nature as human beings. We have appointments, we have schedules, we have significant dates and holidays. We can’t just “live in the moment” and ignore the future, no matter how uncertain that future may be.

And let’s face it, no one can be certain about the future, because things happen and circumstances change unexpectedly. Phone calls from “nowhere” offering an “opportunity of a lifetime.” Connections we’re unaware of. Missed flights. Even changes we expect can have unexpected twists. Like meteorologists, the further out we go, the harder it is to predict or plan with certainty. And  yet, we do plan as if - a key phrase, as if - we’re certain.

So how do we reconcile the need to plan with ‘take it one day at a time’? 

There’s another cliche that seems to say the same thing as ‘take it one day at a time’ - ‘seize the day.’ Carpe diem, in Latin. But they’re not the same. ‘Seize the day’ means to grab all the enjoyment one can. It’s rooted in a commitment to physical activity. (‘Enjoyment’ often means indulgence in physical pleasure, but it doesn't have to. It can refer to activities - such as sports or games or competition in a larger sense - that bring pleasure.) 

‘Take it one day at a time’ is more about an attitude, how we approach the time of the day. If we understand the attitude the phrase refers to, we can also understand how it does not contradict the need to plan. Indeed, it may complement it, help the process. 

‘Take it one day at a time’ means, I think, that each day has its obligations and opportunities, and we must confront them, engage with them, as they come upon us. There are daily rituals, from the mundane to the sublime, from brushing teeth to prayer, for example. We may think that these are just tasks to be gotten out of the way, but actually they help structure the day. Our daily rituals and obligations are also part of taking it one day at a time, because they belong to that particular day.

Nor does the phrase mean we shouldn’t plan or anticipate future events. If there was no Superbowl, it would be foolish for players and coaches to practice, preparing for the big event. And likewise it would be silly to shop and plan and cook in the days before the game if there was no game. But, as the coaches will tell you, that day’s task, that day’s ‘one day at a time’ is the practice. While the practice, or preparation, is a means to an end, it is also an end in itself. 

Take it one day at a time means to invest as much energy and focus in that’s day’s activities as one would on a ‘more significant’ day’s activities. Significance is in the mind of the doer. Appreciate the day we have and make the most of it, whether through learning, working, communicating or throwing ball with the kids. 

There is a value in the here and now which can be overlooked when the future seems uncertain. The truth is, the future is always uncertain. It’s just that under some circumstances it seems more uncertain. And that’s the challenge: to live with the uncertainty and yet not ‘waste’ the day before us. 

As the day begins, perhaps we should ask, what does the day have to offer? Besides the obligations, besides the pre-planned activities, what else can I get from or put into the day. What makes this day unique? 

Part of the challenge is to fill the day with positive thoughts of what can be accomplished here and now, not regrets for what might or might not be. 

If our attitude is one of gratitude and appreciation, if we find meaning in and make significant our activities, then we’ve truly taken this day one day at a time. And that, G-d Willing, is how we will take the next day, when it comes. 

Caregivers

While I'm between chemotherapy treatments - G-d Willing they work - I go to the M.D. Anderson clinic twice a week to have blood drawn. That's how they monitor progress and reaction. The clinic nurses are very efficient. One doesn't have to wait long. 

But while waiting in the waiting room, I've noticed not just the state of those undergoing treatment, but also their caretakers. Rarely is anyone there alone. The caretaker - whether a spouse, a child, a parent, a sibling - looks focused, careworn, on alert. Not always: If the person being cared for is resting, the caretaker rests. But let the ill person stir, and the caretaker's full attention is turned to the patient.

When we talk about illness, we talk about those suffering and struggling, we talk about doctors and nurses - specialized caregivers, one might say - we talk about the system of healthcare, cost and delivery. Yet we often don't pay as much attention to the caregivers. 

The caregivers have many roles - chauffeur, pharmacist, accountant, etc. Often the caregiver also has to stop working, or slow down. Many of the tasks the caregiver might not have done before. While the person battling the illness goes through a gamut of reactions, physical, emotional, etc. the caregiver also has to deal with emotional stress. But who does he or she talk to? Let's face it: it's hard watching a loved one suffer, especially when the help we give can sometimes seem so peripheral.

Disease, especially chronic disease, is debilitating and disruptive. What we see from caregivers is a tremendous amount of self-sacrifice, an incredible investment in another person, love at such a deep level that it's given-ness astounds.

Sometimes we take for granted that there are caregivers. We may not acknowledge the stress and strain they're under - how even caregivers need caregivers.The disruptiveness of disease, like the proverbial ripples, extends beyond the ones we see at the side of the patient.

 Of course, and this is part of the main point, caregivers don't appear overnight. (Well, perhaps sometimes.) The intense level of investment, the rearranging of work, of home life, of so many routines, occurs because the groundwork, so to speak, has been done over the years. The relationship has been built deep and strong and with faith - layers of faith, really.

We should not make the mistake of thinking that caregiving is just a form of gratitude. There is gratitude, obviously, because in any relationship that lasts, gratitude to and for the other person helps the relationship both stabilize and grow. But caregiving is so much more than that.

In one sense, perhaps a spiritual sense, we are all caregivers. G-d has given us an environment, a part of the world over which we have influence. This includes physical objects, but also people we interact with. Not all caregiving is as intense, as raw, as what occurs when someone is sick, but the investment in the welfare of another is always under the surface of a relationship. 

We hear a lot of talk about the so-called 'self-made man,' but such a person really had, and still has, many caregivers. Perhaps if we thought more about our role as caregivers, more about how we can ease the burden of others, how we can relieve some of the pressure, how we can simply be there to lend support or push a metaphoric wheelchair, there'd be a lot less arrogance, a lot less selfishness.

In emergencies and crises, we instinctively become caregivers. But life itself is a series of challenges that, if we listen, if we're sensitive, calls for the caregiver in us.

You may recall that Adam's task in the Garden was to be the caretaker - the caregiver - for creation. At first, that seems odd, since the Garden was initially a utopia. What did it need a caregiver for? But that looking out for others, that "providing for the general welfare," is one of our essential tasks. 

Of course, caregiving can take many forms. But I think if you ask most caregivers why they are so dedicated to a spouse, parent, child, sibling (or friend), I suspect you'd get a look of incomprehension. What kind of question is that? There's just no choice.

That's the point. There is a choice, but this choice is so obvious, so much a part of one's nature, flows so naturally from the relationship, that it seems there is no choice.

So as I think about all the people waiting for treatment, and their caregivers who are, for a moment, just waiting but who in reality do so much, I want to do more than acknowledge the power and necessity of caregivers, mine in particular. I want to call to mind the caregiver in all of us. I want to issue a challenge of sorts:  G-d has given us influence over a portion of the world, an opportunity to make things better, at some level - financial, physical, emotional, spiritual - for those around us. What are we doing to be caretakers? Can we do more?

G-d Willing




"G-d Willing" is a phrase we've all used or heard. (As an aside, the reason I use a dash instead of spelling out the word is because, according to the Sages of the Talmud, there are in Hebrew seven names of G-d that are considered sacred and, if written completely, cannot be erased. There is a debate among contemporary rabbis if that rule applies to names of G-d in a language other than Hebrew. In deference to to the view that it does, I have adopted the custom of not completely spelling the word.)

The phrase "G-d Willing" (or its parallel "with G-d's help") occurs when we're talking about future plans. "I'll be at the game, G-d Willing," for example. It makes sense. Past events already testify to what G-d Willed. The future is unknown, and we hope our plans match G-d's plans.  

"G-d Willing" is an acknowledgment of Divine Providence. We have plans, hopes, desires, but we are not in control. 'Events' may intervene. It's not the 'vast eternal plan,' as Tevye sings, that gets spoiled, but our more narrow, personal ones.

Yet there might seem to be a a contradiction, or at least a paradox: if everything goes as G-d wills it, what difference does it make if I have plans or hopes? Ultimately they don't matter, right? If it's G-d's plans that matter, what happens to free choice? 

Rabbi Akiva answered this question when he said, "All is foreseen, but free will is given." Plans are linear and time-bound. I am in the present and project into the future. I go from the known (or partially known) to the unknown. And in so doing, I try to create stability and certainty. 

But, as we all know, life intervenes. The unexpected happens. And it doesn't have to be large-scale. Getting a red light, we're late for a meeting and as a result, we lose the contract, otherwise a sure thing. Back at the office in the midst of our disappointment, we go through messages we were too busy to return. One of them turns out to be from a potential client. We return the call an he tells us that, had we called earlier, he wouldn't have been in a position to do business with us. But now...we end up with a better contract than the one we lost.

Of course, not all the interventions and unexpected turn of events end up with an obvious positive result. But even when there's no message waiting, so to speak, it's still "G-d Willing." We may not understand, we may not be happy with the result, but, as we will all admit, life is more complex than our understanding.

G-d operates beyond time - where past, present and future are all one. This is "All is foreseen," because all is simultaneous. We can't really grasp this, being time-delineated, but we know it's true.

So where does that leave us? We have to live our lives, deal with the unexpected turns, make our plans, adjust them, and accept that so much is beyond our control. That's how we are and that's what's expected. With humility, or an acceptance of reality, we add G-d Willing.

We might say the more disruptive, the more life-changing the unexpected event, the more we try to adjust and create a new, life-affirming reality, the more we have to acknowledge, G-d Willing. 

At least, as I cope with my illness, as I try to live in the present and yet hope for the future, so it seems to me. I've talked to others in a similar situation, and there's a combination of what we'd call 'fighting spirit,' hope, realism as well as moments, just moments, of resignation or despair. Even from there, hope returns because although our lives will be changed and altered, still G-d Willing, the medicine will work, the surgery will be successful, and there will be a return to health.