By Becca Bakal, MPH

Last week, I had a rude awakening at my annual checkup. My cholesterol was high — embarrassingly high. Since I’m a health educator, I know a thing or two about high cholesterol. When my doctor told me that having high cholesterol would increase my risk over time for health problems like heart disease and stroke, that wasn’t news to me. I knew that I could reduce my cholesterol and, therefore, my risk.

But I left the appointment and didn’t do anything to lower my cholesterol. I didn’t start exercising, I didn’t stop eating fried food, and I didn’t pick up a prescription for cholesterol-lowering medication. I have a degree in behavioral health, and yet I couldn’t bring myself to engage in healthy behaviors. I was overwhelmed and scared by the possibility of future illness. Instead of taking action, I walked around for a couple of days trying not to think about my cholesterol.

This is a pretty normal response to health risk. People feel helpless when confronted by the prospect of a future problem and they choose avoidance rather than risk-reducing action, thereby increasing their risk even further.

And then it hit me why, when I talk to people about Jewish genetic health, they often say that it is a "scary" topic. While there is no relationship between high cholesterol and Jewish genetics, the principle we’re talking about here is the same: understanding risk is hard and acting to reduce any risk can feel even harder. Some people don’t want to know about any future risk because they are worried that they will need to live their lives differently. Someone I interviewed for our needs assessment said it well: "If you don’t know about it, then you don’t need to change anything, because change is hard." 

When it comes to Jewish genetic health, genetic counseling and screenings exist to help people better understand their risk and - if necessary - make informed, personalized decisions about how to reduce it. Understanding risk is challenging, but it doesn’t have to be scary. Getting information and taking action should feel empowering. After I knew I had high cholesterol, I ultimately had the tools to live a healthier life and, after my gyro and Netflix, I went for a run and started eating less red meat. When it comes to Jewish genetic health, learning the facts can empower people to reduce risk and improve their health and the health of their families.

By Sarah Goldberg

[Warning: Spoilers ahead for those not up-to-date with Jane the Virgin season 4]

In honor of Mother’s Day, I’m taking a moment to celebrate my favorite mother-daughter duo on TV: Jane and Xiomara of the Jane the Virgin (don’t worry, I also plan to celebrate the women in my own life!). A satirical take an overly dramatic telenovela, the CW’s hit show follows the life of a young woman who is accidentally artificially inseminated. Jane relies on her close-knit family – namely her mom, Xiomara, and her abuela – to advise her on childrearing, relationships, school and work while she simultaneously deals with kidnappers, murderers, blackmailers and other villains that soap opera dreams are made of. Though the show is perhaps best known for not taking itself too seriously, the most recent season tackled Xiomara’s breast cancer diagnosis – and the relationships between the family members – in a raw, relatable way that deserves acknowledgement. A few takeaways from the storyline:  

People handle information differently and the “right” choice isn’t the same for everyone

Xiomara, or Xo for short, understandably feels overwhelmed when she receives a diagnosis of stage three invasive lobular carcinoma. Her eyes glaze over as her doctor discusses treatment options, which include a lumpectomy, single mastectomy or preventative double mastectomy. She panics as she learns about drains and spacers and reconstruction options.  Meanwhile, Jane takes copious notes, asks questions of the doctors, and does her research. She feels strongly that Xo should have a double mastectomy. Although the cancer is only in one breast, a double mastectomy would reduce the chance of recurrence and Jane makes her opinion known. 

A genetic counselor or other medical professional can provide much-needed guidance 

Xo initially appeases Janes and agrees to have a double mastectomy (over dinner, as she asks her family to pass the chicken breasts, no less). Internally, Xiomara agonizes over the choices. How can she elect to remove healthy tissue from her unaffected breast, she wonders? Unfortunately, Xo doesn’t have a supportive doctor and there’s no genetic counselor, therapist or medical professional to provide guidance and help her make an informed decision.

Cancer is a family affair

As the family impatiently waits for Xo to choose a surgical approach, anxiety grows and tempers flare. A mother-daughter day at the spa ends with an outburst from Xiomara: “You and I have different relationships to our bodies, Jane, and I don’t know if I want to have elective surgery for your peace of mind.”

Cancer forces family members to re-examine their relationships. Jane, who has always operated as the caretaker, recognizes that ultimately the decision is not hers to make, and she needs to support her mom in the days ahead. Xiomara, who has always turned to Jane first, realizes there are some things better left to discuss with her new husband. (Rogelio, her high school sweetheart with whom she recently reunited and the father of Jane, though perhaps better known as a telenovela celebrity and for his outlandish Tweets.) The breast cancer is not hereditary, yet it affects the whole family.

Physical changes have emotional impact

Xiomara ultimately opts for a single mastectomy, a decision she comes to after weighing options carefully. Xo understands that a mastectomy will change her appearance, her body image that has long been a source of confidence, and her sexual function. She turns to her husband to discuss how this will impact their life together. Together they decide on a course of action and Xo undergoes surgery – but not without a “bye bye boob” party for them to pay tribute to Xo’s changing body.

The season ended with Xiomara navigating physical and emotional changes that followed her surgery and, of course, a dramatic cliffhanger. There’s a lot left to Xiomara’s story when Season 5 begins and I, for one, cannot wait to watch.

This Mother’s Day, honor the women in your life by sharing your own family stories and health information. While talking about breast cancer or other conditions that may affect the family isn’t easy, doing so can help you protect your health, your mom’s health, and the health of the family. The Norton & Elaine Sarnoff Center for Jewish Genetics offers tools to help you get started, and a genetic counselor is also available to help community members identify additional resources as needed.