In spoken Hebrew, "The Difficult Illness" ("HaMakhalah HaKashah") is an umbrella term for cancer in all its forms.

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This is how Israelis, across all communities and streams, attempt to suppress a primal, almost demonic fear of the disease responsible for the highest number of deaths in Israel.

It is a verbal ambiguity that leaves no doubt. Some might say that the source of this subconscious fear stems from the belief in the "Evil Eye" (in Hebrew: "Ayin HaRa"), a mystical concept, yet the usage is common, both verbally and in writing, even among those who lack faith, who are secular and rational.

 

There is a consensus on this:

"Mahalah Kashah" (Difficult Illness) is the agreed-upon description to define the condition of someone who has contracted one of the known cancers, and especially those who die from it. Sometimes, people will simply use the term  "The Illness" ("HaMakalah"), or say that someone is "ill" ("holeh"), accompanied by a sad look on their face, and won't elaborate on what they are suffering from. The look and the word explain what doesn't need to be explained.

The media also employs this.

"Passed away from a difficult illness" ("Niftar MiMahalah Kashah") is a code name used in media reports about a person's death from that illness, and the public already knows what is being referred to. This code is strictly maintained, primarily by major media outlets who are sensitive to the large segments of the Israeli public and their subconscious fears of the terrible disease, sparing them the explicit name.

 

This phrasing distinguishes those afflicted by this difficult illness from other serious illnesses.

Those who suffered from illnesses that cause death, such as diabetes or heart disease, may have died in agony, but somehow... in the collective consciousness, their agony is less terrible, and it is acceptable to mention and specify what they were suffering from and what caused their death. It's fine. Those are more manageable illnesses, and they are not as threatening as that difficult illness. The demonic one. The disease is so difficult that its name must not even be mentioned. It is threatening and frightening, and those who suffer from it appear visibly unwell as they approach their death.

Even after they have passed away, the ambiguity continues. Some will use the appropriate words of comfort in the obituary notice: "The deceased has been redeemed from his suffering" (in Hebrew: "HaManouach nig’al miyissurav").

 

This phrasing also sets the Hebrew of Israelis apart from other languages and other nations.

For instance, the equivalent phrases in English, "Passed away after a long illness," or in French, "Est parti après une longue maladie"—are not exclusive to cancer. Although there is a desire there to soften the message, these general expressions are used for a wider range of chronic and fatal diseases.

 

In the 21st century, the difficult illness persists, but perhaps with less impact.

Advanced science offers life-extending treatments for cancer patients. Although the disease still leads the top of the ranking table of causes of death, it is not entirely terminal.

 

As the State of Israel marks 75 years, the code "Mahalah Kashah" (The Difficult Illness) continues to resonate in spoken Hebrew among Israelis and in the media.

However, more and more cancer patients are no longer ashamed to tell their friends about it, write about it on social networks, and allow journalists to accompany them through their hardest hours. This exposure contributes to a more open public discourse and allows the explicit name to be mentioned both during the patient's life and after their death.