Heart and Soul


shafran1By Rabbi Avi Shafran
One Sunday more than a decade ago, I lay 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 medical dramas jump like chopped onions in a hot, oiled frying pan. The procedure I was about to undergo, though, 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 a cattle prod.

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 from the rolled eyes I realized I hadn’t been the first bearded, beyarmulked patient to make the comment). Thus my decidedly unprivate, if off-the beaten-path, digs.As I lay there, head propped on a pillow, awaiting the arrival of the anesthesiologist and the executioner, I watched a parade of patients being chaperoned from the emergency room through the hub of activity just beyond the half-parted curtain. A bloodied head here, a broken limb there, a macabre march, the yield of a sleepy city and its mistakes (or worse) 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 eyes and simply would not let go, not for the eternity of that fleeting moment. What I saw in those eyes was unfiltered, raw fear.

Maybe the fact that my heart was about to be stopped by a machine had oversensitized me. But something else weighed 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,” Chazal inform us – 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, resolve, 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. The Gemara teaches that some “acquire their portion” in Olam Habah through the efforts of many years, others “in a mere hour.”

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

While my condition was benign and medically treatable, the imminent procedure was disconcerting. A lightning-quick thought of the coming anesthesia and what might 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. (Agudath Israel makes available for the asking “Halachic Living Wills” designed to ensure that health care decisions in the event of incapacity are made according to halacha.) I was pretty sure that a relatively healthy middle-aged adult like me would be rescued if things went awry.

But should there really be any difference, I mulled there on the gurney, 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 coda to the apparition so striking, fixing it forever in my mind.

For just as the eyes, arm and blanket 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 she had only one line.

“That’s a DNR,” the nurse called out with startling nonchalance. Even before the voltage came, a frisson washed over my bones.

When the electroshock came, it did nothing but burn my chest. My morning in the hospital left my heart unaffected.

Its rhythm, anyway.

[Rabbi Shafran is director of public affairs for Agudath Israel of America.]

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