Chaim Topol was an Israeli actor, singer, and illustrator, who was most famous for playing “Tevya “ more than 3,500 times from 1967 through 2009, in arguably the most popular musical of all time — Fiddler on the Roof. He was nominated for an Academy Award for his portrayal of Tevya in the 1971 film adaptation. He was the best known of a long line of famous actors who played the role, including Zero Mostel, Theodore Bikel, Herschel Bernardi, Leonard Nimoy and many others.
On March 8, 2023, Topol died of heart failure caused by the immobility that comes with Alzheimer’s disease.
Health Problems and Death
Two years ago, Topol fell down a flight of stairs and hit his head on the right side “which is where you form your words. so he is unable to talk clearly”. He knew what he wanted to say, but he couldn’t say it. His family has not released his health history, but in June 2022, his son said that Topol suffered from Alzheimer’s disease. In March 8, 2023, his family said that he was near death and “living his final hours.”
I have never seen his medical records, but I note that his later pictures show that he had a prominent belly, a major risk factor for diabetes. Diabetes is a major risk factor for dementia and the most common cause of death in dementia is heart failure. In the later stages of dementia, demented people do nothing but lie in bed and not move. This progressively weakens the heart muscle until the person dies of heart failure.
People who have a big belly usually store fat primarily in their liver. Extra fat in your liver prevents the liver from accepting excess sugar from your bloodstream, so you stop responding to insulin, become insulin insensitive, and have high blood sugar levels (Gastroenterology, 2008;134(5):1369–1375). The more fat you have in your liver, the greater your insulin resistance. The higher your insulin levels, the more fat you deposit in your liver (Hepatology, 2014;59(6):2178–2187) because insulin resistance causes even more fat to be deposited in your liver (J Clin Invest, 2020;130(3):1453–1460).
One of the definitions of pre-diabetes is a high rise in blood sugar after meals, and many cases of dementia are linked to these high rises in blood sugar (JAMA Netw Open, Jan 8, 2021;4(1):e2033012).
How Not Moving Causes Heart Failure
In 1914, Dr. Ernest Starling described what is today known as Starling’s Law, that strengthening skeletal muscles strengthens heart muscle and not the other way around (Circulation, 2002;106(23):2986-2992). When you contract your skeletal muscles, they squeeze the veins near them to pump extra blood back to your heart. The extra blood flowing back to your heart fills up your heart, which stretches your heart muscle, causing the heart muscle to contract with greater force and pump more blood back to your body. This, in part, explains why your heart beats harder to pump more blood when you exercise. The harder your heart muscle has to contract regularly in an exercise program, the greater the gain in heart muscle strength. On the other hand, lying in bed and not moving progressively weakens the heart muscles until a person dies of heart failure. See Your Muscles Make Your Heart Stronger
Lessons from Topol’s Death
A key to prolonging your life and preventing disease is to keep on moving. Each day that you spend not moving your muscles weakens your heart until eventually you can die of heart failure.
• Exercise will prolong your life, but you do not have to have a specific exercise program. You just need to keep on moving for a large part of each day. It is harmful just to sit or lie down all day long. It is healthful to mow your lawn, wash your dishes, make your bed, vacuum your house, go for a walk, and participate with your friends in activities in which you are moving your arms and legs — dancing, cycling, swimming, running, taking nature walks and so forth.
• To gain maximum health benefits from your skeletal muscles, you should include some sort of resistance exercise. If you are not already doing strength-training exercise, first check with your doctor to make sure you do not have any condition that may be harmed by exercise. Then join a gym and ask for instructions on how to use the weight-training machines, or see Resistance Exercise You Can Do at Home . Since lifting heavier weights is far more likely to injure you than lifting lighter weights, I recommend that you lift lighter weights with far more repetitions. Older people, in particular, can use each specific weight machine and lift and lower a lighter weight. Stop that exercise when the muscles start to feel tight or hurt. Caution: Exercise can cause a heart attack in a person who has blocked arteries or heart damage.
The Story of Fiddler on the Roof
Fiddler on the Roof is about how orthodox Jewish traditions are changed by more modern times. Tevya discusses the value of tradition in Anatevka, their small Jewish village in Russia in 1905.
• Daughter 1: Tevya ‘s oldest daughter, Tzeitel, has a marriage proposal from the much older local butcher, but she is already in love with her childhood best friend, Motel, who is a poor tailor, and marrying him would leave Tzeitel with far less money than marrying the older and richer butcher.
• Daughter 2: Tevya ‘s second-eldest daughter, Hodel, begins a romance with Perchik who has just moved into their town and does not accept many of the views of orthodox Judaism.
• Daughter 3: Tevya’s third-oldest daughter, Chava, is lent a book by a young Christian named Fyedka, and they start to converse about literature and rebel against the cruelty of czarist Russia.
So Tevya ’s orthodox Jewish views are challenged:
• Daughter 1: Tevya arranges a marriage to the butcher for Tzeitel, but Motel and Tzeitel beg him to let them marry instead. Tevya goes against everything he has learned about money and agrees. However, he has to convince his wife, Golda, and does that by faking a “dream “ warning that the marriage between Tzeitel and the butcher will harm their daughter. When Tzeitel and Motel are getting married, Russian Cossacks ride through their village shooting Jews and destroying property. Tzeitel and Motel marry, have a daughter and get a sewing machine so he can become a tailor. Then the Russians issue an edict that all Jews must now leave their homes in the village.
• Daughter 2: Perchik and Hodel get engaged and Tevya is so upset that they did not ask his permission that he refuses to allow the marriage. However his kindness eventually conquers his orthodox Jewish upbringing and he gives them his permission to marry. Then the Russians arrest Perchik for his revolutionary activities and imprison him in Siberia and Hodel follows him to Siberia.
• Daughter 3: Chava and Fyedka ask Tevya for permission to marry, but he refuses to allow Chava to wed a non-Jew. Chava and Fyedka elope and Chava is destroyed emotionally by Tevya telling the family that Chava is now considered to be dead.
The Russians then evict all the Jews from their village. Tevya and his wife Golde and their family and Motel and Zeitel, and others prepare to leave to go to America. Daughter 3 Chava and her husband Fyedka speak one last time to Golde, but Tevya refuses to talk to her although he does bless her. The musical show ends as the family leaves for America.
Meaning of Fiddler on the Roof and the Jewish Migration to the United States
A fiddler has to put all his attention into making sure that he puts his bow and fingers on the strings at exactly the precise pressure and position. However, he is also standing on a roof, and he is distracted by the fact that he may fall off and kill himself. That applies to Russian Jewish immigrants to America in the early 1900s. My father’s family migrated in 1900-1910 and my mother’s family migrated a decade later.
My father was born in 1899 into severe poverty in a small farming community near Krupka in Russia that had no formal businesses and no industry. In the early 1900’s, the Czar drafted all Jewish boys between 12 and 25 into the Russian army for the Russo-Japanese War. They were armed only with wooden sticks and were forced to march into Japanese machine guns to almost certain death. To save their children, Jewish families had to leave Russia, but poor peasants had no money. My father’s family took all of the money they had and sent their oldest son on the lowest class passenger boat to America, where he worked in the garment district in New York seven days a week and slept 10 to a room. A year later he had saved enough money to send for the next oldest son to come to America. Then over the next 10 years, they would send money for the next son, and eventually were able to bring their parents and the youngest children. Even when they were finally all here, they really had a tough time. My father told me that he sold newspapers every day. If he sold five papers, he would have his only meal of the day. If he didn’t sell five papers, he ate nothing that day. He arrived in America at age 11, which was too old for kindergarten, so he never went to school.
Dr. Gabe Mirkin is a Villager. Learn more at www.drmirkin.com