PHOTOS Daniel Binyamin
fighting for Lıfe
72 MISHPACHA 27 Adar II 5776 | April 6, 2016 MISHPACHA 73

Fighting for Life
HEADER HERE The main entrance to
the hospital — built to serve members of
every nation., while uniquely committed
to the special needs of Orthodox Jews
which reduces breast cancer recurrence, and
Gleevec, a drug that directly targets cancer
cells, all came out of ICRF research. So did
important advances in BRCA gene research,
as well as the p53 gene, whose mutation is
associated with the development of most
The patriarch of a large family and now
at an age where some people retire, Dr.
Hirshaut continues to work extremely long
hours, often visiting patients in Manhattan
late at night before returning to his home in
Lawrence, New York. He divides his time
between Lenox Hill, Beth Israel, Mount
Sinai, New York and Cornell Hospitals, and
runs a private practice from a traditionally
furnished office facing Central Park on
Fifth Avenue.
Today the office is quiet, but that’s not
the usual state of affairs. “Usually Dr.
Hirshaut’s office is chaotic,†says current
ICRF chairman Kenneth Goodman. “His
staff protects him, and it takes time to get
in to see him. But once you’re in, he gives
you all the time you need.â€
Distinguished physicians sometimes
tend toward the brusque and supercilious.
Dr. Hirshaut, on the other hand, emerges
friendly and good humored, ushering us
into the office. The phone rings numerous
times during our interview, and each time he
finds it necessary to pick up, he apologizes.
Then, in a calm, gentle fashion, he promises
the caller he‘ll get back to him soon. For us,
he seems to have all the time in the world.
During his long career, Dr. Hirshaut has
seen the field of cancer research progress in
some astonishing leaps. We settle in for an
afternoon of conversation, beginning with a
childhood launched in the middle of a war.…
Tropical Exile Born in Berlin, Dr.
Hirshaut comes from special stock: His
father would have become a doctor if the
Nuremberg laws hadn’t forced him out
of medical school, and his mother, who
intended to become a teacher, attended
the Hildesheimer seminary and spent
a year at Sarah Schenirer’s seminary in
Krakow. “But the only people she ended
up teaching were her own children,†Dr.
Hirshaut says, a bit wistfully.
At the time he was born, the Nazis had
decreed that Jewish families should name
each male child Yisrael, to better identify
them. His father chose instead to name him
Yashar, hoping the name would influence
him to grow into an honest person. As a
child, he disliked his name — no one else
he knew was named Yashar, not even when
he went to Eretz Yisrael in 1959 to visit
his grandparents. But not everyone has
found the name off-putting, he relates with
a grin. One of his patients, whose treatment
was extremely complicated and high-risk
because she was pregnant, survived under
his care and delivered a healthy baby. When
he called to ask how the baby was doing,
the new mother — a Hispanic woman —
smiled broadly and told him: “Little Yashar
is doing fine!â€
Dr. Hirshaut’s parents had the foresight to
grab any opportunity to flee Nazi Germany.
He was a German refugee
who spent the war years in the
Philipines and never set foot in
a classroom until third grade.
But the late start didn’t hamper
Dr. Yashar Hirshaut, who
went on to become a top-tiered
oncologist shepherding cuttingedge research, and in an age of
for-profit medicine, tenaciously
staying focused on putting his
patients first
being a doctor in America meant that you knew your
patients and their families. You might even have made
house calls, and patients never felt rushed out of the
office. These days, the wise, caring, Marcus Welbytype doctor is an endangered species, but there are
a few still left. Dr. Yashar Hirshaut is one of them.
But Dr. Hirshaut is much more than that. He’s a
brilliant, top-notch oncologist, a doctor’s doctor who
has produced important research of his own while
simultaneously midwifing cutting-edge discoveries
through his stewardship of the Israel Cancer Research
Fund. Drugs such as Velcade for multiple myeloma,
Doxil for breast and ovarian cancers, Herceptin,
Once upon
a time,
74 MISHPACHA 27 Adar II 5776 | April 6, 2016
When his mother saw an announcement in
a Jewish newspaper in 1938 offering visas
to the Philippines — arranged through
the efforts of President Quezon; US High
Commissioner to the Philippines Paul V.
McNutt; and the Frieder brothers, a family of
Jewish cigar manufacturers — the Hirshauts
applied and were soon aboard a boat with
their daughter and one-year-old baby Yashar.
The Philippines, then an American
Commonwealth (a territory on its way to
independence), was a radically different
environment than the Germany they’d left
behind: hot and tropical, full of mosquitoes
in the air and lizards on the ceilings. There
were only about six frum families among the
1,200 Jews who emigrated. Dr. Hirshaut’s
father wrote to Mike Tress at Agudath Israel
to request sponsorship for a community
member to learn poultry shechitah in
Shanghai. Although observance levels varied
widely, all the Jews attended the city’s only
synagogue, Temple Emil. “I remember, after
hakafos on Simchas Torah,†Dr. Hirshaut
recalls, “my mother would sort through the
candy and throw out what wasn’t kosher.â€
Temple Emil would be completely bombed at
the end of the war, the only synagogue under
American rule to be destroyed.
As a child, Dr. Hirshaut says, “the whole
world was the Philippines, and it was a
good life.†He remembers metal roofs that
amplified the pitter-patter of raindrops,
maids who washed and folded the laundry
and waxed the floors by skating across them
in special coconut shoes, highways lined
with towering banana trees and sloping
papaya trees, which children could climb
to pick fruit. The only potatoes were sweet
potatoes, he says. “I still can’t eat them.â€
The family settled on one of Manila’s main
streets, Taft Avenue, and his father found an
accounting position with an American firm.
Yashar’s sister, who was two and a half
years his senior, was eventually sent to
a school for the children of diplomats
called The American School, which still
maintains branches all over the world. (In
a droll twist of fate, this sister’s daughter
currently teaches at the Israeli branch.)
But Yashar was too young for school. His
parents befriended a non-Jewish couple
with two children about the same age as the
Hirshaut children, and the father, a lawyer,
taught reading and math to the youngsters.
Mr. Hirshaut would buy English books for
the children, and Dr. Hirshaut remembers
being able to read by the time the Japanese
invaded in 1941.
That invasion left a deep impression on
three-year-old Yashar. “We’d hear sirens,
then the noise of the bombers, then the
explosions,†he remembers. “We fled our
house during the invasion, but then we
came back.†Since the Japanese considered
the Hirshauts German (officially they were
stateless) they were left alone, although his
father’s company was seized by the state
Then the Americans came back to retake
their former territory, bombing Manila. “I
remember the dive bombers,†Dr. Hirshaut
says. “One night they hit a tanker in the
harbor. It burned so brightly that night
became like day all over Manila, until it
finally exploded. Another time the Japanese
hit a munitions dump near our house.
My mother had gone to see it and came
running back when it began exploding.†He
remembers the Japanese digging trenches
in front of the house, and his father digging a
well in the backyard in case the water supply
would be cut off.
With the war over and the Americans back
in charge, his father rejoined his old firm
and became a member of the Manila Stock
Exchange. But his children were getting
older and needed a Jewish education. They
boarded a ship for San Francisco and took a
train across the United States to New York,
a trip that left an impression on the young
Yashar: “I remember seeing the Salt Lake,
the Great Plains, sleeping in Pullman cars.â€
The family settled first on the Lower
East Side, but later moved to Boro Park;
Mr. Hirshaut took a job with an importexport company specializing in trade with
the Far East. Yashar was placed in the third
grade at the Shlomo Kluger yeshivah — his
first experience of school. It lasted about
two weeks. “It was then an old-fashioned
yeshivah where they still hit the kids on
the hands with rulers,†he says. “After that
I switched to Yeshiva Rabbi Jacob Joseph.â€
He had his eye on Columbia for college, but
his father insisted on Yeshiva University —
no secular college for his son. “My father
told me to pursue whatever field I wanted,â€
he relates, “but when he filled out my
application, he wrote ‘premed’ as a major.
When I questioned it, he replied, ‘Well, you
like science.’
“I actually always liked writing,†he
avows. “I was the editor of my high school
newspaper and my college journal.†He
would continue on to medical school, but
those writing skills served him well in the
future: In 1992, he published a book for
the layman entitled Breast Cancer: The
Complete Guide, which won an award from
the American Medical Writers Association
and sold 85,000 copies for Random House.
He indicates the bookshelf behind his desk,
which holds copies of the book translated
into French, Italian, and Chinese. Last
updated in 2008, the book has gone through
five editions, made necessary by rapid
advances in research.
Dr. Hirshaut also started the medical
journal Cancer Investigation and served as
its editor from 1982–2005. And he’s working
on a book now, although the only connection
it will have to science is its method. “I’ve
worked in cancer research for decades now,â€
Dr. Hirshaut says. “I know the techniques
of cancer research. We look at patterns of
growth, how certain pathways permit cells
to double, how DNA controls every step
of cell development. I want to take those
approaches and apply them to Torah study.â€
interns and 45-yearold administrators
are not interested
in ‘wasting money’
treating older people.
As far as they’re
concerned, 65 is
already oldâ€
—Dr. Yashar Hirshaut
Fighting for Life
76 M ISH PACHA 27 Adar II 5776 | April 6, 2016
Fighting for Life
Exactly how he will accomplish that
task will be revealed soon enough;
he’s up to chapter 30 and has only a
few more to complete. His delight in
Torah study is obvious as he takes
a few minutes to give us a rousing
synopsis of his latest chapter, dealing
with the composition of the Mishkan
and how its physical features may
correlate with the design of the human
Cancer Ward During Hir
shaut’s senior year at Yeshiva
University, his family was hit by
unexpected tragedy. His father
developed a tumor, a cancer of the
posterior nasal space that would
ultimately be traced to a virus
he’d contracted while in the Phil
ippines. During that time, he saw
firsthand the horrific suffering
cancer produces, and how little
medical science could do for a pa
tient. This gave direction and pur
pose to his medical studies — now
he would battle the scourge that
took his father’s life.
When he entered his first internship
at Montefiore Hospital in 1965, he
saw on a professional level the severe
limitations of cancer treatment. One
small medicine cabinet held the
entire arsenal of medicines available.
“The cancer ward was horrible,†he
remembers. “People lay there dying.
There was a terrible odor. The head
of the program was so afraid of going
out on the floor that he’d look at the
charts rather than directly examine
Hirshaut admits to being similarly repelled.
“I didn’t want to be on the cancer ward
either,†he confesses. But the Vietnam War
draft left him with two choices: serve in the
war, or work for the NIH at the National
Cancer Institute in Bethesda.
At the Institute, he finally encountered
grounds for optimism. There, researchers
were churning out papers at a brisk clip,
and for the first time, Hirshaut saw people
who had actually been cured of cancer.
“I met the first woman who was cured of
leukemia,†he says. “I saw people being cured
from lymphoma and Hodgkin’s disease,
using combinations of drugs. Back in New
York, at Sloan Kettering, they called that
‘alphabet soup,’ since Sloan’s approach was
to use only one drug at a time. But the cure
rate for lymphoma went up 60 percent,
and in general, combinations of drugs are
more effective than single medications.â€
Initially, cancer research was focused
on simply wiping out the bad cells. But
as research progressed, there was more
focus on learning about steps in the
development of cancers. For example,
a form of leukemia known as CML
was once a death sentence — Hirshaut
remembers it felled a bakery worker he’d
known in Boro Park, a kind man who
gave extra cookies to children. But once it
was traced to the so-called ‘Philadelphia
chromosome,’ researchers could produce
a drug to combat it. “Today, 90 percent
of CML patients are still alive after ten
years,†Dr. Hirshaut says. “Now we try
to target causes for each kind of cancer.
We reverse-engineer the cell to see how
we can impede cancers from growing.â€
For many years, researchers at
Sloan Kettering labored to prove that
deficiencies in the immune system might
be responsible for cancers. In the end,
however, no immune deficiency was
found in cancer patients. The problem
isn’t that the immune system isn’t
functioning, but rather — as we know
today — the cancer cells block the
immune system’s cells from binding to
them. “Now we’ve developed medications
to inhibit the blockers,†Dr. Hirshaut
says. “If you combine two types of
inhibitors, you get even better results.
This method was just approved for lung
cancer and melanomas (specific skin
cancers), and we’re just beginning to
What about prevention? The media
inundates us with articles extolling the
virtues of various behavior modifications
or foods thought to be cancer-preventing —
antioxidants, vegan diets, and stress
reduction, among them. When asked if any
of these claims hold water, Hirshaut waves
a hand dismissively. “The only thing that
we know for sure causes cancer is smoking,â€
he declares. “In the US, as people have cut
down on smoking, the lung cancer rate has
“The cancer
ward was
horrible, people
lay there dying.
There was a
terrible odor.
The head of the
program was so
afraid of going
out on the floor
that he’d look
at the charts
rather than
directly examine
78 M ISH PACHA 27 Adar II 5776 | April 6, 2016
Fighting for Life
dropped tremendously. You only see a spike
in women who began smoking at the time it
became okay for women to smoke.â€
Even obesity doesn’t raise one’s risk. “The
data aren’t coming through to show any
connection,†he says. “Obesity is not good
with respect to many health issues, but it
doesn’t seem to cause cancer.â€
He describes cancer research like putting
together a jigsaw puzzle with millions of
pieces. “It’s hard to find the first few pieces
to fit together. People used to spend a lifetime
mining one area,†he says. “But as you keep
searching and putting pieces together, the
next pieces become easier and easier to fit in.â€
Israel on the Map By the mid-1970s,
cancer research was starting to gain
traction, and at the forefront were many
talented Israeli scientists. But most of
them weren’t in Israel, as Dr. Daniel
Miller, the head of the Lymphoma Clinic
at Sloan Kettering, noted during a trip
there in 1975.
Israel had no lack of highly competent,
motivated researchers, but it lacked the
funding that would allow these scientists to
pursue their projects at home. The best and
brightest were leaving the country in droves.
Dr. Miller resolved to stanch the brain drain.
He pulled together a group of American
and Canadian medical professionals
and lay people to start the Israel Cancer
Research Fund, an organization dedicated
to bankrolling cancer research in Israel.
At that time, Dr. Hirshaut was also heading
the Laboratory for Immunodiagnosis at
Sloan. Dr. Miller invited him to join his
initiative, and within two years the ICRF
had awarded five grants of $5,000 each.
Today, just over 40 years later, the ICRF is
the largest funder of cancer research in Israel,
having contributed a whopping $56 million to
establish programs in Israeli universities and
research centers. “We have so far supported
2,300 scientists,†Dr. Hirshaut says with
justifiable pride. “We helped to put Israel on
the map where cancer research is concerned.â€
Dr. Hirshaut became president of the
ICRF in 1982, a position he held until he
took the title of chairman in 2006. Today,
he is chairman emeritus. “He has really been
the face of that organization,†comments
Dr. Burt Cohen, a radiologist and colleague.
Hirshaut continues to serve as the president
of the International Scientific Council of the
ICRF, while attending every meeting, serving
on review panels, and helping direct policy
and operations.
Mr. Kenneth Goodman, the current
chairman of the ICRF, met Hirshaut in 2003
when his wife was diagnosed with pancreatic
cancer. The couple had gone to France to try
an experimental drug, and upon their return
needed an oncologist who was willing to
work with a non-FDA-approved treatment.
Goodman, a pharmaceutical executive, was
impressed by Dr. Hirshaut’s dedication,
and during one late-night bedside visit they
spoke about the ICRF. “Oncologists have
to learn to live with death,†Mr. Goodman
told Mishpacha. “Because of that, some are
afraid to get too close to patients. But Yashar
isn’t — he gets to know them. He even paid
a shivah call when my wife died.†After her
passing, Goodman endowed a research
grant in pancreatic cancer to the ICRF, and
gradually assumed a more active role.
As the ICRF has grown, it has been
a tremendous source of nachas to its
“parents†and all of Klal Yisrael, as cancer
breakthroughs pour forth from Zion. ICRF
research has produced two Nobel prizes, four
Israel prizes, and one Wolf prize (the Israeli
equivalent of a Nobel). ICRF projects are
under way at more than 20 universities and
research institutions in Israel, including the
Weizmann Institute, the Technion, Hebrew
University, and major medical centers such as
Shaare Zedek and Hadassah Medical Centers.
Fast Food Medicine When
Richard Nixon declared a war on cancer
in 1971, he meant that America should
step up research. “When I started,
Sloan Kettering had floors of breast
cancer patients breathing their last,â€
Dr. Hirshaut says. “Today we’re able to
extend lives and create a better quality of
life. I have a patient, now in her 80s, who
has lived 22 years since her diagnosis.â€
But patients in their 80s are finding it
increasingly harder to convince the medical
system to treat them. Clinicians such as Dr.
Hirshaut — and these days he is primarily
a clinician, with some involvement in
pancreatic cancer research — are now
dealing with an entirely new front in the
war on cancer: the fight against ageism and
bottom-line-focused hospitals and insurance
companies, who resist spending money
on people they’re convinced will soon die
anyway. “There’s no question there’s age
discrimination,†Dr. Hirshaut maintains.
“Twenty-five-year-old interns and 45-yearold administrators are not interested in
‘wasting money’ treating older people. As
far as they’re concerned, 65 is already old.
“I was once with a group of residents
examining an 84-year-old woman, and I
said, ‘Let’s figure out what’s wrong.’ A young
resident responded, ‘It’s obvious what’s
wrong — she’s dying!’ But the patient had
asthma and breast cancer, both of which
can be treated. Now, of course, that patient
is getting better…. It’s all in the attitude.
“Another time I was called by a frum family
whose mother was unconscious and on a
respirator, and the hospital wanted to put
her into hospice. I brought in a lung specialist
and a neurologist, although her doctors were
amazed that I’d ‘waste’ time on her. In the end
we were able to take her off the respirator,
and she was moved to a rehab facility.†He
takes out his cell phone and shows a brief
clip of an elderly lady speaking to him in a
completely coherent, normal fashion. “Here
she is today,†he says triumphantly.
Dr. Burt Cohen says that few doctors today
share this deep appreciation for the value of
extending life. “When other people throw up
their hands, Yashar will look for different
approaches,†he says. “I remember a lady who
had a very serious condition. Everyone else
had thrown in the towel, but Yashar was able
to extend her life for nine months. During that
time she was able to attend grandchildren’s
Fighting for Life
weddings and see great-grandchildren born.
You can’t put a price on that.â€
But as medicine has moved to a for-profit
model, hospitals are mostly interested
in treating a restricted number of easily
resolvable conditions. Doctors who want
to ensure a top quality and length of life,
especially for older patients, have to fight for
every test and medication. “Today the drug
companies don’t even trust the insurance
companies to reimburse them,†Dr. Hirshaut
laments. “I used to be able to buy medications
directly from the manufacturers and resell
at a discount to my patients. Today, only the
hospitals can do that.†Small private practices
are being swallowed by hospitals, and
medical care is diluted by meager insurance
reimbursements that oblige doctors to see
too many patients an hour.
“We’ve moved into a fast-food model of
medical care,†Dr. Hirshaut says. “But sooner
or later, consumers will revolt.†He himself
revolts by refusing to cut back on giving
patients the time and care they need. “Yashar
sometimes takes over two hours with patients
on their first visit,†says patent attorney and
lifelong friend Dr. Samson Helfgott. “He says,
‘I have to know everything about the patient
if I’m going to treat him properly.’ In fact, he’s
gone to bat for patients so aggressively that
at one point a hospital wanted to sue him.â€
The word has spread over the years. Many
chassidic rebbes and Jewish referral agencies
send Hirshaut patients. He has a particularly
close relationship with the Skverer Rebbe.
Hirshaut’s crusade to defend patients
against those who feel they are expendable
led to his involvement with Agudath Israel’s
Chayim Aruchim project, an advocacy
initiative for patients’ rights and end-of-life
issues (he now serves on the board).
“Dr. Hirshaut was the first and only doctor
to call the Agudah and tell us there was a
problem with the original Palliative Care
Act,†says Rabbi Shmuel Lefkowitz, senior
vice president at Agudath Israel. “It said
hospitals have to provide options, but the
only option listed was palliative care. There
was no mention of aggressive treatment. So
we approached the New York legislature and
the governor, and the bill was amended.â€
Dr. Cohen descr ibes Hirshaut a s
“indefatigable,†and with his involvements
in so many clinical, research, political, and
Torah pursuits, he has a schedule that would
exhaust many a person half his age. “I’ve gone
with him to Albany numerous times and
offered to drive him home afterward, late
at night,†Rabbi Lefkowitz says. “It can be
midnight, but he’ll tell me, “Just drop me off
at Mount Sinai — there are patients I didn’t
get to see.â€
Dr. Hirshaut told Rabbi Lefkowitz he doesn’t
need vacations, despite the long hours he puts
in. “I just need to take care of my patients,â€
he said. “My life is about helping them.†—