By Yair Hoffman

During a hockey game on October 23, a fan of the opposing team spotted an NHL staffer with a strange-looking mole on the back of his neck. She took out her phone and typed out a warning to him to check out the mole.

It was at a Seattle Krakens home game against the Vancouver Canucks, according to the National Hockey League. Brian “Red” Hamilton, an assistant equipment manager for the Canucks, was clearing off the bench. Nadia Popovici, 22, seated nearby, noticed the suspicious mole on the back of his neck. She recognized the irregular mole from her time volunteering in hospitals.

A biopsy revealed malignant melanoma in situ 2, meaning that the cancer was only on the outer layer of the skin. It was detected before it could become even more dangerous.

Halachic Observation

Believe it, or not, even though what Miss Popovici did seems to be somewhat awkward, it is a full-blown halachic obligation. The Rambam (Hilchos Rotzei’ach U’Shemiras HaNefesh 1:14) writes: “Whomsoever that can save but does not save is in violation of ‘Do not stand by your brother’s blood.’ (Vayikra 19:16).

Skin Cancer Warnings

It is not so well-known, but skin cancer is by far the most common type of cancer. Detecting skin cancer early can often make the difference between life and death and certainly makes it much easier to treat. The key is to know what to look for. Many doctors recommend that everyone check his or her own skin about once a month. There are generally three types of skin cancers to check for: melanomas (the most dangerous), basal cell cancers, and squamous cell cancers.

Basal cell and squamous cell skin cancers, which are more common than melanomas, are usually very treatable. Both basal cell cancers and squamous cell cancers usually appear on parts of the body that get the most sun: the face, head, and neck. But they can actually be anywhere on the body.

Melanomas

For melanomas, one can use the “ABCDE rule” to look for the common signs.

Asymmetry. One part of a mole or birthmark doesn’t match the other.

Border. The edges are irregular, ragged, notched, or blurred.

Color. The color is not the same all over and may include shades of brown or black, sometimes with patches of pink, red, white, or blue.

Diameter. The spot is larger than ¼ inch across—about the size of a pencil eraser—although melanomas can sometimes be smaller than this.

Evolving. The mole is changing in size, shape, or color.

Basal Cell Cancers: Look For S.P.O.R.F.S.

Small translucent, shiny, pearly bumps that are pink or red and may have blue, brown, or black

Pink growths with raised edges and a lower area in their center

Open sores (that ooze out or are crusted) that don’t heal, or heal and come back

Raised reddish patches that may or may not be itchy

Flat, firm, pale, or yellow areas, similar to a scar

Spoke-like projections which indicate abnormal blood vessels spreading out on a wheel

Squamous Cell Cancers: Look For W.O.R.S.

Wart-like growths

Open sores (that ooze out or are crusted) that don’t heal, or heal and come back

Raised growths or lumps, sometimes with a lower area in the center

Scaly red patches that either bleed or crust up

Always Look For N.A.R.C.I.S.S.I.S.T.

Not all skin cancers look like these descriptions, though. Point out anything you’re concerned about to your doctor, including:

New spots

Any spot that doesn’t look like others on your body

Redness or new swelling beyond the border of a mole

Color that spreads from the border of a spot into surrounding skin

Itching, pain, or tenderness in an area that doesn’t go away or goes away then comes back

Sores that don’t heal

Surface changes of a mole: oozing, scaliness, bleeding, or a lump or bump

In the middle, the growth is lower down

Scaly patches that crust up or bleed

Translucent bumps that may have blue, brown, or black areas in it

Further Halachic Observations

Hashavas Aveidah. This mitzvah is not just for lost items. The Gemara in Sanhedrin (73a) includes within this mitzvah the obligation of returning “his own life to him as well.” This verse is the source for the mitzvah of saving someone’s life. It is probable that this is the general mitzvah referred to in Shulchan Aruch O.C. 325.

Lo Suchal L’his’alem. There is yet another negative commandment associated with saving life, and that is the verse in Devarim (22:3), “You cannot shut your eyes to it.” This verse comes directly after the mitzvah of hashavas aveidah. The Netziv, in his HeEmek She’eilah, refers to this mitzvah as well.

V’chai Achicha Imach. Rav Achai Gaon in his She’iltos (She’ilta #37), based upon the Gemara in Bava Metzia 62a, understands the words in Vayikra (25:36) “v’chai achicha imach—and your brother shall live with you” to indicate an obligation to save others with you. The Netziv in his HeEmek She’eilah understands it as a full-fledged obligation according to all opinions. He writes that one must exert every effort to save his friend’s life, until it becomes a matter of pikuach nefesh for himself.

V’ahavta L’rei’acha Kamocha. The Ramban, in Toras HaAdam Sha’ar HaSakanah (pp. 42–43), understands the verse of “And love thy neighbor as yourself” as a directive to save our peers from medical danger as well.

The following observation is going to be controversial. But let’s first pose the question: Is an expert doctor allowed to treat someone in a life-and-death situation when he knows that the patient would have refused the treatment? It is clear from the Gemara in Shabbos 108a with Shmuel, Karna, and Rav that he can do so. As a member of the Board of Ethics of a Long Island hospital, this author tried arguing the point regarding a J’s Witnesses adherent, a woman who refused to allow any blood transfusion during a difficult labor and delivery. The hospital’s lawyers overruled. Unfortunately, the woman passed away. The other Board of Ethics members, of course, would not have considered the Gemara in Shabbos as an authoritative text. However, in theory, if we have a similar situation in regard to a reliable vaccine, this Gemara may have a very pertinent role for those who do view the Talmud as an authoritative text. 

The author can be reached at yairhoffman2@gmail.com.

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