A Doctor's Prayer

The following is an awesome article by Marjorie Ordene featured in Tabletmag - I love its honesty and moderns sense of struggle.  I think it raises a great point regarding how tefilla, when it breaks out of the synagogue into one's professional and personal world, feels a more significant tool for an individual to connect to God.
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Praying for My Patients

As a doctor, I know there’s a power higher than me. That’s why I pray every day for the people I’m treating.

By Marjorie Ordene| February 7, 2013 7:00 AM |

Fifteen years ago, my husband came home from the daf yomi Talmud lecture he attended every day and proclaimed: “All good doctors go to hell.”

As a holistic doctor —and, I thought, a good one—I was taken aback. “Why would good doctors go to hell?” I asked. Brought up in a secular Jewish home, I had always believed in a rational, scientific world where doctors were treated with a certain respect or even awe. I had only become observant a few months before my marriage to Ethan, who’d been raised in a religious home. I wondered if this belief about doctors was common wisdom among observant Jews.

Seeming to relish my surprise, Ethan eagerly explained, “The good doctors go to hell because they don’t pray for their patients. They believe they’re doing the healing.” He waited for his words to sink in before asking, “And what about you?”

The question has stayed with me ever since. I took his point to heart and decided, after some reflection, to try bringing prayer into my medical practice. It didn't come naturally. At first, the idea of praying for anyone reminded me of my religious Christian friends, who were always offering to pray for me—which I found vaguely annoying. But then my aunt became ill and slipped into a coma. I remembered seeing my mother-in-law praying for people by name when she lit her Shabbos candles, so I decided to give it a whirl. After six weeks, my aunt recovered.

That convinced me. Ever since, I've prayed for my patients every day.

***

Growing up as a secular Jew, I had never put much stock in the power of spirituality until I took a trip to England in 1989 and stayed with my brother’s wife’s cousin, Aubrey Rose, who introduced me to a family secret: Aubrey and his wife claimed to have communicated repeatedly and reliably with their dead son David through a medium. I was so impressed with this new insight that I vowed to explore the hidden spiritual side of things—in general, and in a Jewish context. I started attending a Conservative egalitarian synagogue and, when that didn't satisfy (religion ended at the shul door), moved on to an Orthodox one.

Around the same time, my professional life as an M.D. was also shaken up. I was working at a small, not-for-profit clinic that offered alternative services like acupuncture and biofeedback. To fulfill my continuing medical education requirement, I attended a seminar in nutritional medicine at The Omega Center, a former Yiddish summer camp in Rhinebeck, New York, now serving as a retreat for holistic studies. But before settling into my assigned course, I first sat in on classes on qi gong, yoga, and mindfulness. When I returned to the clinic, I began to put my new spiritually informed medical training into practice, eventually leaving that office to open one of my own.

It was also around this time that I, a newly observant Jew, was introduced to and married Ethan.

When Ethan later made his big pronouncement about “good doctors,” I had already been praying for five or six years and practicing holistic medicine for nine or 10—but I hadn't thought about how the two might fit together. Mixing prayer with medicine can be awkward. It’s one thing to daven privately, but to introduce prayer into the doctor-patient relationship crosses a line, almost like breaching the separation of church and state. What right do I have to speak to a patient about God? What if he is an atheist?

I had read of studies showing that prayer promotes healing, but it wasn't until my aunt’s miraculous recovery that I began to consider prayer on a more personal level. Something shifted inside me. I had moved from being someone who felt uncomfortable praying for anyone to someone who felt a desire, even an obligation, to put in a good word for those who suffered. As I sat at my kitchen table each morning, I would add the names of ailing people to my prayers. I started with my parents and elderly relatives, then added the names of people I’d heard about in the community, and finally, tacked on “and all my patients,” at the end of the list. I was determined not to be one of those “good doctors” who didn't pray for her patients.

The first time I prayed for a specific patient was when a woman with ovarian cancer gave me her Hebrew name and asked me to pray for her. I added her name to my list. Later, when another Jewish patient was diagnosed with uterine cancer, it seemed appropriate that I inquire after her Hebrew name. Although not religious, she readily told me her name, Nechama, but she had to email me later with her mother’s name, which she gave as Laura. In both these cases, I was not actively treating the patients for their life-threatening condition; as a holistic physician, the conditions my patients see me to treat are rarely life-threatening.

Over the years, I've noticed that praying draws me closer to God, and it also brings me closer to my patients. If I prayed for a patient in the morning and she walks in during the afternoon, I feel a special connection, like seeing a long lost friend. I think this works both ways, like the patient who regularly calls me and begins by saying, “Hey, Doc, it’s me, Miriam bas Esther.” She knows I’m praying for her.

There was one patient, though, I couldn't help. She was suffering from terrible anxiety—so much so that she was too anxious to try any of my treatments. This patient I prayed for. I never told her, just added her name to my list. Sadly, the one treatment she wanted was estrogen, and when she later developed breast cancer, she became convinced that it was the estrogen I prescribed that caused her cancer. She decided to sue me.

Now I faced a conundrum: Should I still pray for her or drop her from my prayers like a hot potato? I decided to wait for Shabbos and ask my brother-in-law, who is a rabbi. Upon hearing my story, his answer came swiftly: “You can tell her to go to Hartford, Hereford, and Hampshire! Do not pray for her; and if she ever wants to come back, do not see her!” I dropped the potato. If the Almighty wants to heal her, I figured, he will—with or without my prayers.

***

I’d love to report all my successes with prayer, but unfortunately I’m not aware of any. Some patients—including the woman with ovarian cancer, an elderly gentleman with urinary retention, and an octogenarian with Alzheimer’s—are doing reasonably well, but I can’t say it’s because of my prayers. The patient with uterine cancer passed away. But in fact, it’s the very nature of prayer that we don’t always get what we ask for. That doesn't mean our prayers aren't answered; they are, just not in the way we expect. Still, no matter what the outcome, I know patients take comfort in having someone pray for them.

Offering to pray for a patient can feel like an admission of powerlessness. After all, patients come to doctors for answers. A physician is an authority figure. To turn around and say I need to speak to a higher authority could be seen as a sign of weakness, ignorance, or at the very least, lack of confidence. But that strikes at the heart of the Gemara—“Tov she’berofim leGehinnom— the best of doctors are destined to go to Gehinnom [hell].” I’ve researched this Gemara and discovered its real meaning. It’s not as I originally thought, that doctors who don’t pray for their patients go to Gehinnom. Rather, it’s doctors who don’t feel a need to ask anyone else, neither other doctors nor the Creator, so confident are they in their own abilities—they are the ones who go to hell. Some commentators say that these “good” doctors either omit the refa’einu blessing—the prayer for healing—in the Shemoneh Esrei or else say it without intent.

I will never have that kind of confidence. I enjoy consulting with other doctors and attend medical conferences to keep up-to-date. There I listen to the authorities, leaders in my field. Attendees sit in rows with their laptops open, taking notes. After each series of lectures, there is an “ask the experts” session with the presenters. No one talks about God, no one mentions prayer. But I for one am thinking of him. I bet some of these other doctors, these experts, are doing the same—and I bet some of them also pray for their patients.

Every morning, when I daven, I come back to the refa’einu blessing. I recite my list: Miriam bas Esther, another few patients, a sick relative, a few friends, and then “all my patients.” In praying for my patients, I’m speaking directly to the Creator, making him a partner in my medical practice. It’s not that I don’t trust my skills as a doctor; I do, but I also know that there’s a power higher than me. I’m not one of those “good” doctors who know it all. I really need his help, and that’s why I pray.

***

Marjorie Ordene practices holistic medicine in Brooklyn.

Hocus Pocas, Shortcuts, & Davening

The following in an anonymous submission from a davener:

The nature of prayer is a complicated one, because there is lots of bunk.  For me the philosophy of prayer is quite simple:

Prayer is for us not for God, it impacts our outlook and framework.  By virtue of the change we make on ourselves we can influence how we are cosmically treated.  This is perfectly rational, good prayer is good as an end, not a means.

Therefore, hocus pocus does not work. Iyun Tefilah does not work. Kishuf  (magic) does not work. Prayer on behalf of others does not work. (Although if they ask for prayer on their behalf it may.  The concept of tzadik ben tzadik is that you associate with someone ask for their advice, it too is an end in and of itself.)

There are no shortcuts.  It also explains certain halachot, like necessity for thoughtfulness before wearing tefillin and certain rishonim who argue one should not pray in the improper frame of mind.  Further, the gemara says there are three keys that God maintains, the key to parnash, to child rearing and to tchiat hameitim.  These are random events that are totally beyond our control, everything else is in our control.  Rav Schachter tells the story of when he visited the Steipler for a bracha when he and his wife were having difficulty having a child. The Steipler said OK. Then R Schachter asked for a bracha for success in learning, and the Steipler said what on earth can I offer you. Sit and learn and you will be successful, don’t sit and learn and you won’t. This is similar to the gadol offering the “segula” of washing the dishes and making the beds for a good marriage.

Bottom line, humans clamor for shortcuts and are inherently superstitious.  That is the very definition of avodah zara.

Thanksgiving & Chanukah

I know that it is a bit belated to speak about Thanksgiving but I wanted to share this Dvar Torah from Rabbi Akiva Block on the topic of giving thanks and in the spirit of singing Hallel for Chanukah.  I think his point is valid - shouldn't we have this appreciation every day?  My father in law often points out that Rav Soliveitchik taught that we say a mini Hallel each morning in the form of the Psalms 145-150 in the morning seder tefilla.  What are some other ways that you concertize your gratitude?

Thanksgiving is a time when we all come together to be thankful for our many blessings. With family, friends, feast, and football, it is a day of time-honored tradition which warms the hearts and the homes of virtually all who participate. 

It has been nearly 150 years since Abraham Lincoln’s declaration of a Day of Thanksgiving in 1863. Needless to say, the notion of giving thanks is one which was featured prominently in the Jewish tradition long before then. Three times a day, we recite in the Amidah prayer, a blessing of thanksgiving to God: “Modim anachnu lach… al nisecha sheb’chol yom imanu, v’al nifle’otecha v’tovotecha sheb’chol et, erev vavoker v’tzahoraim.” “We thank you, Lord… for your miracles which are with us each and every day, and for your wonders and your goodness which are ever-present, in the evening, the morning and the afternoon…” 

In light of our daily prayers we may be moved to ask, “Isn’t every day Thanksgiving? Why limit thanksgiving to just one day?” 

It is quite fortuitous that Thanksgiving often comes out on the week of the Torah portion of Vayetze. Upon further reflection, this week’s portion provides profound insight on the notion of giving thanks, and offers an opportunity to relate to the holiday with new-found appreciation. The Talmud (Berachot 7b) comments that in the history of the world, no one offered thanks to God until Leah did so, when she named her son Judah, saying, “this time I will thank (odeh) God, and she called him Judah (Genesis 29:35).” 

While the heroism and faith of Leah is unquestioned, thanking God despite her second class status in the house of Jacob, this comment by our sages is nonetheless quite jarring. Are we to believe that none of the greats of the previous generations ever offered thanks to God? Not Adam or Noah? Not Abraham or Sarah, or Isaac or Rebecca? Not even Jacob himself? Certainly they owed a debt of gratitude for all God had done for them. So what was unique about the gratitude of Leah? 

Perhaps Leah brought the concept of thanksgiving to a whole new level. While those before her were thankful, Leah actually concertized that thanks. She showed her gratitude by calling her son by the name Judah, a name whose very meaning is gratitude. In naming her son, she offered a lasting testament to her indebtedness to God, taking the sentiment and doing something about it, making it real. 

In truth, every day is Thanksgiving. Nonetheless, it is of inestimable value to take a day and designate it as a day called Thanksgiving. We are offered the opportunity to concertize our gratitude, to take our feelings of indebtedness that we all have and bring them to the fore. Just as Leah eternalized her gratitude by making it her son’s name, so too we take ours, which we express verbally thrice daily, and devote a day to reflection and expression of our thanks. 

Through the lessons of Leah, may the feelings and emotions of gratitude and Thanksgiving permeate within all of us.

Does Tefilla Make Better Jews?

There is a Jewish Press article making the circuit the past few hours titled Overhauling Orthodox Education To Make Better Jews by Rabbi Dov Lipman (now more well known for his articles in the Times of Israel and as one of the vocal opponents to religious radicalization in Beit Shemesh last year).

I recommend that you give it a full read for I think he raises several crucial issues that educators must face when you take an honest look at the final product graduating from your schools.  Lipman beings with a startling anecdote about a rabbi friend who tries to repay a kindness to another Jew who seemingly shakes said friend down for my money and a heavy dose of guilt.  He takes this frustration to the realm of tefilla and our pedagogical approach:

My friend related how just that morning during Shacharit he was thinking about how “off target” we are as he watched rabbis barking at children to stand during “vayevareich Dovid” and the “vihu rachum,” part of Tachanun at a youth minyan. He was not suggesting we shouldn’t find ways to encourage our children to stand when our custom dictates standing during prayers. But the degree to which the kids were being scolded for not standing struck a chord that led him to reflect upon what we teach as important and what is not important.

Not just writing to complain, Lipman boldly offers a solution to reinvigorate our students as well:

There should certainly be a Talmud track for the elite students with the intellectual, language, and attention skills necessary to enjoy and benefit from it, but for the mainstream yeshiva high school student this almost exclusive focus on Gemara wastes precious time from more productive study and actually turns most students off from interest in Torah and even Judaism. 

Tanach study should lead to meaningful discussions about the lessons each chapter seeks to convey about proper moral, ethical, and spiritual behavior. We should teach our students about meditation and connecting to their deeper selves along with the concept of personal prayer. 

Once they understand that the most important part of davening should be their personal prayers and pouring their hearts out to God in their own words, this has the capacity to change and uplift their entire prayer experience. The topic of prayer must be accompanied by Jewish philosophy courses and providing the framework for students to ask their questions and receive well-thought-out answers.

While I don't agree totally with his thesis, and others have begun to divide his points and critique, I do so appreciate Lipman sentiments about about how central prayer is to reflect to the true achievement of a Jewish education and one's personal growth.  The chief goal of this blog is to discuss how to evaluate the success of teaching tefilla and so far I have not found adequate answers from educators regarding a viable system to share and reproduce (which, by the way, is not the case for teaching Tanach, Talmud, or Jewish Thought). For too long  many of the minyanim in schools (and for that matter, community shuls) do not reflect the pinnacle Jewish experience of that very day, yet we continue to press our students with the centrality of this ritual and its spiritual potential.  If not Lipman's approach, let's reapproach the situation of the spiritual behavior of our graduates - if not now, when? 

World's Largest Synagogue

Perhaps it is unfair to say that the following article is 'ripped from the headlines' considering that some people say that is precisely what the Times of Israel does for a business, rips other news organizations headlines and makes it into their news (just one perspective, and by the way, my preferred up to date English news source on Israel).

Here is one perspective of the Siyum HaShas from yesterday:

MetLife Stadium becomes ‘world’s largest synagogue’ for Talmud celebration

You can read this article and the many others that are out or coming out this weekend about the exciting conclusion to this Torah learning experience.  I find it personally interesting that many people found the tefilla experience at the siyum to be the highlight (and I am not speaking about the upper deck mechitza that was put in special for the evening - one tweet: New York siyum set a Guinness World Record for largest mechitza. @adamkaroly).

Although the activity of Daf Yomi is considered more about Torah learning - take note that the davening was seemingly as uplifting as the great, inspirational speeches within the stadium.  I was not there - but wonder what it would have been like to mark such a great accomplishment of study, together with nearly 100K other Jews, and not to have prayed?

We have the power to daven almost anywhere - the only prohibitions are for locations that are 1) near feces or urine 2) near an object that is an anathema to our religion, and c) overly distracting - otherwise we can make anyplace a synagogue. If you were there - what was it like to have Giants stadium full of Jews?  Will the 2020 siyum be larger?

To Learn or to Daven

Within Judaism, there is a significant tension between these two primary acts, to learn Torah and to daven.  The Babylonian Talmud, in Shabbat 127a states:

אלו דברים שאדם אוכל פרותיהם בעולם הזה והקרן קימת לו לעולם הבא, ואלו הן:  כיבוד אב ואם וגמילות  חסדים והשכמת בית המדרש שחרית וערבית והכנסת אורחים ובקור חולים והכנסת כלה ולווית המת ועיון תפילה והבאת שלום בין אדם לחברו ובין איש לאשתו ותלמוד תורה כנגד כולם.

These are the precepts whose fruits a person enjoys in This World but whose principal remains intact for him in the World to Come:  They are: honoring one's father and mother, acts of kindness, early attendance at the house of study morning and evening, hospitality to guests, visiting the sick, providing for a bride, escorting the dead, absorption in prayer, bringing peace between man and his fellow, and the study of Torah is equivalent to them all.

Clearly the status of Torah study (on simple reading of this text) trumps all, including the delving into the depths of davening.  To this note, I once heard this story told over about Rabbi Soloveitchik which I found a version of here: 

Torah learning would be more beneficial than saying Tehillim during the spare time on Rosh Hashanah. Rav Y. B. Soloveitchik states that once, his father, Rav Moshe Soloveitchik, zt”l, saw him saying Tehillim on Rosh Hashanah and took the siddur from him, replacing it with Maseches Rosh Hashanah. He then said to his son, “My father (Rav Chaim) would learn the laws of shofar, etc.,  because that is what the day represents (and on Yom Kippur he would learn the rituals of that day) because that is where Hashem’s world is today.” 

Some see this approach as appropriate only for the most elite Torah learners which can be best expressed by Rabbi Ovadia Yosef's statement, also from the above article: “The talmid chacham should go as his heart desires, as it is said ‘the ones who learn Gemara, there is nothing greater.’”

For those of us who are not giants in Torah or Talmud - are we left just to chant tehilim?  After a recent conversation with a family member (@bradinsky) who shared with me a fascinating class on superstition and Jewish customs, I have been thinking deeply about which comes more natural, studying or davening? Which is more powerful and transformative on the individual? Which is easier and which is more difficult?  I am in the process of writing a longer post on this subject, but I wondered what others thought?  

Rav Schachter's Advice for Teaching Tefilla

I have been meaning to share the following interview With Rav Schachter about leading tefillah in day schools (I found this and other resources on tefilla at YU's High Sschool Chinuch Community website).

Whether you know who Rav Hershel Schachter is or not, I think that this video offers a candid glimpse into Orthodox Judaim's educational approach and qualms about tefilla.   Rarely in life do you see an interview of someone tops in their fields talking about the basic A, B's and C's of their subject field and pedagogical approaches for high schools students.

I am amazed at this interviewer's (Rabbi Kenny Schiowitz) approach to the challenging scenarios for contemporary educators and what questions were posed and not posed to this scholar.  Further, it is important to note how Rav Schachter is very open that he doesn't have much practical experience with implementing such approaches in the classrooms "with younger children".  The following are my gleanings from the Rav Schachter's answers:

• Tefilla should be considered optional in schools were students would want to opt out.
• Teaching the siddur is more important than teaching gmera (Talmud)
• Even Rav Schachter abbreviates his tefilla to accommodate what the community does - but it is important for teachers to be with their students, even if you have to interrupt your own tefilla.  
• The repetition of the leader (hazerat ha'shatz) could be dropped from school tefilla as was the practice of Morrocan Jews following the legal ruling of the Rambam (which reflected a low level of interest in the practice).
• Orthodox kids are not connecting to davening and this needs to be addressed seriously and with educational flexibility. 

As an educator, I think this session opens a lot of questions regarding how tefilla is working in schools today.  Are there Orthodox schools that are implementing any of Rav Schachter's approaches?

Best to end with his final words, "oy, we all have to improve in our davening!"

The Smooth Prayer of Rabbi Chanina Ben Dosa

    A tefilla story from the Talmud (Talmud Bavli, Masechet Berachot, 34):

Once upon a time, the son of Rabbi Gamliel fell ill. He sent two sages to Rabbi Chanina Ben Dosa to pray that his son might recover from his illness. As soon as Chanina beheld the two men, he quickly ran up to the loft of his house and began praying that the fever might disappear. And as soon as he finished he came down to them and said: “Go, the fever has left him.” They said to him, “who told you?”

Rabbi Chanina replied, “I am neither a prophet nor the son of a prophet, but I have it as a tradition from my father’s father that if a prayer run smoothly (fluently), then it is a sign that it has been heard. My prayer just now went smoothly without any problem, therefore, I am sure that it has been heard.”

They noted down the time when he had told them that the patient was better, and when they returned to Rabbi Gamliel, they told him the exact time when the turn for the better had set in and showed him the note which they had taken. Rabbi Gamliel swore by Hashem that this was the very time when the fever left the boy and he asked for a drink.

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How to train people to have a smooth/fluent tefilla?  This is the topic for tomorrow's blog.