JWR Outlook

Jewish World Review Nov. 9, 1999 / 28 Mar-Cheshvan, 5760

Heart and soul

By Rabbi Avi Shafran

THOUGHTS OF MORTALITY were hardly out of place, considering the fact that I was lying in a curtained-off cubicle adjacent to a hospital's emergency room, my chest bared and awaiting the sort of wired paddles that make still, supine bodies on television medical dramas jump like chopped onions in a hot, oiled frying pan.

The memory returned during this Jewish high holiday season, when, like every year, a soulfully sung part of the service presented the vivid imagery of a decree: "Who shall live and who shall die?" in the coming months.

The procedure I was about to undergo, though, several years back, was relatively routine and quite safe; it had been scheduled weeks earlier in response to my heart's march for several years to the beat of a different drummer. One means of discouraging such nonconformance is to teach the offending muscles a good, swift lesson with a well-placed jolt of electricity. Same principle as the cattle prod for obstinate livestock or electroshock for wayward brains.

No private room had been available at the hospital for so minor a chastisement as a cardioversion (or "conversion" in medical parlance; I warned the men of the frocks that they stood little chance of successfully converting an Orthodox rabbi, but I had apparently not been the first bearded, beyarmulked patient to make the comment). Thus my decidedly unprivate, if off-the beaten-path temporary digs.


As I lay there, head propped up on a pillow, awaiting the arrival of the anesthesiologist and the executioner, I was able to watch the parade of patients being chaperoned from the emergency room through the hub of activity just beyond my feet and the half-parted curtain. A bloodied head here, a broken limb there, a macabre march, the yield of a sleepy city and its mistakes on the sober morning after a Saturday night.

And then, in the middle of the procession, I saw her, and the look in her eyes.

A blanket covered all but her hoary head and one skeletal, desperate arm reaching for something that wasn't there. Her eyes, though, deeply sunken in a wizened, trembling face, were an irresistible force; they seized my own and simply would not let go, not for the eternity of that fleeting moment. What I saw in those unforgettable eyes was unfiltered, utter fear.

Maybe the fact that my heart was about to be stopped by a machine had oversensitized me to the sight. But something else was weighing on me too, 3000 years of religious tradition.

For Judaism values life to an awesome degree. One moment on this earth is cherished beyond imagining in the Torah's eyes. "Tomorrow," asserts the Talmud -- the next world -- is for our ultimate reward; only "today," though, "is for doing."

The contemporary world values an assortment of talents and skills but none so intensely as Judaism treasures the ability to confront one's life, to face reality, to wield free will, to choose, to resolve, to repent. And even immobilized and ailing in a hospital bed, a man or woman can do those most meaningful things a human being can possibly do. A Talmudic teaching has it that some "acquire their portion" in heaven through the efforts of many years, but others in a mere moment.

Even the comatose may well be functioning beyond our assumptions. Electroencephalographs that measure electrical activity in the brain do precisely that and nothing more. Who can possibly know what might be happening in the soul of a living human being?

And so,though my condition itself was benign and treatable with medication, the imminent treatment was somewhat disconcerting. A lightning-quick thought of my imminent anesthesia and what would follow stabbed at my brain.. What if my heart protested the punishment (its owner, after all, tends toward overreaction) and decided to stop beating altogether? What, I wondered, was the hospital's policy about patients who suddenly need the proverbial "heroic measures"? Old or diseased patients, I knew, can have a "DNR" -- a "Do Not Resuscitate" -- order attached to their charts. They, or their relatives, or a doctor - depending on circumstances - can direct medical personnel to allow a patient in extremis to die, rather than interfere to postpone the final event. But I knew that I, a relatively healthy 40-odd year old, would surely be rescued if things went awry. Should there, though, really be any difference, I mulled, between young and old, sick or healthy, clearly moribund or only subtly so like the rest of us? If a moment of human life is invaluable, is it not so for everyone?

Which thought made the punctuation to the apparition so striking, and fixed it forever in my mind.

For just as the eyes and arm, blanket and all disappeared to the left of my line of sight, a nurse's face entered stage right for the briefest of moments. It was a speaking part, but only one short line.

"That's a DNR," she called with chilling nonchalance, and even before the voltage, a frisson washed over my bones.

And when the electroshock came, it did nothing but burn my chest; my morning in the hospital left my heart unchanged.

Its rhythm, anyway.

Rabbi Avi Shafran is American Director of Am Echad, an international organization promoting Jewish unity. He may be reached by clicking here.


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©1999, Rabbi Avi Shafran