Join host Dr. Jonathan Weinkle and guest Rabbanit Miriam Fenster on Healing People, Not Patients as she explores how Jewish law (Halacha) intersects with physical and mental illness. Discover how sensitivity to individual needs can balance religious obligations with health, fostering authentic practice and compassionate care beyond rigid rules.
How can religious obligations adapt to illness without compromising faith or well-being?
In Episode 6 of Healing People, Not Patients, Rabbanit Miriam Fenster, a Halacha advisor, discusses navigating Jewish observance amid mental and physical health challenges. Drawing from her work with the Maaglei Nefesh program and decades of advising, she addresses conflicts like fasting during Yom Kippur for those with diabetes or eating disorders, Shabbat observance in mental health crises, and tailoring guidance to personal stories. Miriam emphasizes empathy, flexibility within Halacha's "four walls," and empowering individuals to find their path, offering insights for religious practitioners and healthcare providers alike.
Top 3 Takeaways:
About the Guest:
Rabbanit Miriam Fenster is a Halachic advisor and long-time student and teacher at Matan HaSharon in Ra'anana, Israel, specializing in advanced Halacha for women. She advises individuals aged 15 to 85 on family life, life cycles, Shabbat, and Kosher laws. Through the Maaglei Nefesh program, she supports those with mental illnesses in aligning Jewish observance with their health needs, drawing from personal experiences and a compassionate, individualized approach.
🔗 Connect with Rabbanit Miriam Fenster:
https://mnefesh.org/ Maaglei Nefesh
https://www.matan.org.il/en/ Matan
Healing People, Not Patients explores ways to enhance medical practice by infusing it with compassion, humanity, and a deeper sense of purpose, aiming to help healthcare professionals rediscover the "soul" of their work. Framed around the four questions of the Passover Seder, it probes how to transform medicine for the better, promoting an empathetic and supportive approach that empowers patients to create meaningful, sober lives, while drawing on Jewish teachings about community and friendship.
"Our theme song, "Room for the Soul," is available on Bandcamp at https://jonathanweinkle.bandcamp.com/track/room-for-the-soul."
Dr. Jonathan Weinkle is an internist and pediatrician who practices primary care at a community health center in Pittsburgh. He strives to be a "nice Jewish doctor" focused on patient-centered healthcare, emphasizing effective communication and holistic well-being.
He teaches the courses, “Death and the Healthcare Professions” and “Healing and Humanity” at the University of Pittsburgh, authored the books Healing People, Not Patients and Illness to Exodus, and runs ‘Healers Who Listen’, where he blogs on healing and Jewish tradition. Once an aspiring rabbi, he now integrates faith and medicine to support other physicians and his own patients.
🌐 Website: healerswholisten.com
🔗 LinkedIn: linkedin.com/in/jonathan-weinkle-3440032a
📸 Instagram: @HealersWhoListen
📘 Facebook: @JonathanWeinkle
[00:00:00] All right. Welcome back everyone. I am super glad to be back from my little hiatus. I'm even more glad to welcome my dear friend, rabbi Miriam fester. We have been friends for a number of decades. And we go way back to our high school days in the Yday Youth Movement and in the beautiful village of Squirrel Hill, Pittsburgh , Pennsylvania .
And I will say lots of glowing things about Miriam's brother Dan, and about her parents, Walter and Eva Vogel. But we'll get to them in the course of our conversation. What's important for all of you to know about Miriam is that she has long been a student at Matan, Sharon and Ranana Israel, in the advanced HAHA program for women .
She advises people ages 15 to 85 on matters of family life, life cycle, Shabbat. Laws of Kosher and in particular is now working with a program called MAGA Neish, which is specifically geared towards advising people who are grappling with different types of mental illness and how that affects their [00:01:00] ability to observe Jewishly in their day-to-day lives.
We've had a really fascinating conversation about this already for a lecture series that I helped to coordinate at the University of Pittsburgh, and I'm really glad to be able to have a freeform, give and take with Miriam today on the podcast. I was also asked to mention that she has many lovely grandchildren who find her very boring unless she is either singing the grand old Duke of York or reading Yt of the Turtle.
But I think she's fascinating all the time. Miriam, welcome. Thank you. John, thank you so much for asking me to, I'm really excited just to, schmooze and riff with you. On all of this. Absolutely. So, I wanted to start with kind of a basic question.
one of our many links is your parents Passover Seder table. And I always do this In the form of four questions. And basically the theme is the same as it is at the Seder. Why is this thing that you do different from all other things of its nature? How does it make people's lives different?
And in particular, [00:02:00] we're at kind of the intersection between religious practice and health and wellness. Normally, I'm coming at it from the other direction where, how does bringing religion, spirituality, theology, whatever, into the conversation. Help or in some way affect somebody's ability to be, well stay, well get better from an illness.
Here we're looking at it the other way Around. We're talking about places where religious observance becomes difficult because of somebody's mental or physical condition. And I think when a lot of people hear that, they think, oh, we're talking about ways to get out of fulfilling an obligation that you're normally committed to when you're healthy based on the fact that you're not healthy right now .
But that's not how you frame it at all. So I'd love you to explain how your process works. Okay. Can I start with a story? Is that okay? Please? I love starting with stories. Okay. So Allah, my parents. Whom you knew and loved very well. And my [00:03:00] brother, whom you still, for some reason, I will never understand, still hang out with, even though he's my favorite baby brother of all time.
Mm-hmm. He's also my only baby brother. So when our father died in 2001, and we were sitting Shiva, lots of people came in and they all said a very similar statement to my brother and my mother. And it tremendously comforted them, and it made me miserable. the statement was that your father went through such horrible suffering and now he's sitting at the feet of Vu, right?
Mm-hmm. You know, he's up there in gun ed and it really helped Daniel, it really helped Mommy. It didn't speak to me at all. By the time I flew back from the United States to Israel, you know, I was, what's wrong with me?
Mm-hmm. What is wrong with me? That here's a statement that is not said in a way to hurt, but it's said to [00:04:00] help, right? Mm-hmm. And what's wrong with me that I can't deal with it? And then what happened was I wound up going to speak to somebody who was very, very close with my father, rabbi Yo Zukerman.
And I just sat there and I cried and I said, what's wrong with me? And he said, there's nothing that's wrong with you. He said, you just needed to hear something different. Now, anybody could have told me that, right? Anybody could have told me about that. But the fact that it was a arrived. Okay. Who knew my father, who knew our family,
And he said, you just needed to hear something different. And he gave me something different, which really helped. You could say that that's part of what in some place is always in the back of my head when you ask how I frame it, right? There's no one good answer. There's no one right answer.
you asked me how I frame [00:05:00] it. So I'm gonna say there's a general framing and then there's a specific framing for the person. The general frame, and it's something I really believe in, is you have the four OT of Jewish law, right? The, that you have to like fence posts, right? That you can't go past them.
But inside that space is infinitely flexible.
That the baseline frame is always, that it's not a question of getting out of, right. It's a question of where do you see yourself? lemme
reflect back to you to make sure I'm understanding. so you're saying that. There is a kind of a baseline of obligations that people have. There's a standard way of shaping it, but within that standard way of shaping it, each individual has their own path of how to get there based on certain kind of needs. [00:06:00] And those paths mostly overlap, but every once in a while they have to diverge in a particular way because of something compelling for that person.
Yes. That's definitely one way of that. Yeah. But I would say even more than that,with Jewish law, you can look at it in a very, very rigid way, right? like everything has to fit. But the thing is it's not rigid at all.
It's very fluid, and there's a very big difference between what you read in a book and when you turn to someone personally, because by definition, books are giving you a bottom line on general situations, but every single human being has their own story, right? Every single human being, it's not just what they're going through, it's also where they're coming from, where they physically are, where they emotionally are, who's dependent on them, who they are dependent [00:07:00] on, and all of those aspects have an influence on the halak answer that you give.
I guess you could say that that's why I'm saying that one of the things that's so important that I frame is that enormous horizon that they exist in that it's not this linear, static box, right? Mm-hmm. But the other thing, and I'm trying to think of the right way to say, is that it's very important to me, and again, this depends on the person, but in general, it's important to me that that person they set the tone.
so you told the story about your father's Shiva, which so I do have some non-Jewish listeners. So this is the seven day morning period after someone's funeral which is a time of folks visiting and offering condolences. But I was always taught that during a shiva, the Mourner speaks first.
Yes, [00:08:00] exactly for the reason you're talking about. So that they can set the tone of what they need to hear, rather than somebody coming in and offering sort of, there's one prescribed phrase that you say
the ever present one, comfort you among all the other mourners of Zion and Jerusalem. But that's it. That's a formula that doesn't say how you should be comforted. It certainly doesn't say that you should come with your own pre-planned speech to comfort that person. 'cause you don't know, like you said, what they need to hear.
The other thing, of course, is that you keep on using that word, and I know it means exactly what you think it means, but Right. For the folks in the background the idea of haha, which is, from the word to go right. It's the way you go about things in the world rather than from the word ho, which is law, is, you know, sort of Exactly unquestionable law.
So it's a process. And I think a lot of people, whether it's in the more liberal Jewish world or whether in the non-Jewish world, haha, will often get characterized exactly as you said, as this very rigid, very [00:09:00] stringent body of rules that doesn't change. And that sort of ropes people into very uncomfortable, restrictive situations.
And you're giving a much more alive and vibrant picture of it, which I agree with you as a more accurate picture, but, um, I think it's breaking some myths for folks.I think. I blame poorly administered or poorly taught or poorly whatever education, which makes this a very common misconception among everybody because it's very easy to start with a do and a don't because there's so many do's and don'ts.
But I think also because of the fact that in general children are taught that things are black and white. As you get older, more gray is introduced into your life by definition, but nobody updates you that, that's also the way the compendium of Jewish law works . Yeah. That it also starts [00:10:00] going gray.
As in, you are never going to find any rabbi who's going to say, oh sure, you can bake challah for the Seder night. Right, you know, rabbi is going to say that doesn't matter what denomination, they are not going to tell you that you can bake challah for the Seder night because challah is yeast, yeasted bread as opposed to unleavened bread.
But what happens if you have celiac? What happens if you know, you are on a very, very restricted diet and one of the things you have to eat involves nutrition, you know, nutritious yeast, right? Mm-hmm. Right. And then they're all gonna say, well, we were talking about this.
Mm-hmm. But you are a different case, and now we need to look at your case. Yeah. And I blame education for never helping people get over that [00:11:00] hurdle. Mm-hmm. One of my favorite light bulb moments around that, just to illustrate the, we're talking about this, not that has nothing to do with medicine, but the first time somebody gave me a kosher for Passover bottle of date ale and I turn it around and the ingredients are, water date syrup and yeast.
And I was like, what? And I realized that ADEs, the thing that you're not allowed to eat on Passover is the combination of grain flour and yeast. If you combine something else like fruit with yeast, that's not hums , And so you're putting in a different category. And so people who, because of their particular health status, in a different category at that moment
Their situation is different. You know, I'm remembering going back to the story about the Shiva, right. The text that's always taught about is from the Book of Job, where they come in and they observe the law for the first seven days.
His friends come in and they sit on the floor and they say nothing, and he says nothing, and they're waiting for him to talk. And finally the Shiva is over [00:12:00] and they're still there, and they can't keep their mouth shut any longer. And they start to talk and they say all the wrong things
Right. But I, one time was in a truly tremendous lecture given by one of my favorite teachers, where he actually said, if you look. What all of the friends say, they give all of the stock answers that are given throughout the Bible.
but what Eov is always saying to them is, yeah, but that doesn't work when you're talking about me. And he actually said, none of these answers can explain why 2 million children died in the Holocaust. That was his go-to thing where he took every single answer and he said, it works fine with all of these and now apply it to 2 million children dying in the Holocaust.
Mm-hmm. So there's no answer in the world that you can give, right? Mm-hmm. Anyway, I think that it's really, really good what you said about trajectory or wine. And I'm gonna go back to my father's Shiva and I will tell you what Robsman said. [00:13:00] Okay. Which helped me.
Because this actually fits in really well. Okay? He said, you don't think about a person being alive and a person being dead as linear, as in they're alive and then they're dead. Okay? He said, all of us, we are a mixture of body and soul, right? Mm-hmm. So we have a spiritual side and a physical side.
What happens when our physical side dies? He said, you have to think about it as two different tracks. That there's the track that humanity is on, where we live and breathe and eat and sleep and work and everything in this world. And the spiritual track, which doesn't have that body element.
He said they run side by side. Now, I know that sounds like a weird thing, but, the reason why sometimes you might [00:14:00] feel that your father is right there is because on a certain level, he always is just, you can't feel him because you still have a physical manifestation.
the reason why I'm bringing that up is because it's not that all of a sudden they're in a different group inside the same body. Right. You have different tracks, and sometimes you're on one of them and sometimes you're on another one, but they are all in the same starting point, in the same ending point.
Mm-hmm. That's why I said it's a good analogy and that's why I wanna use it because, right. 'cause I think one of the worst things that happens, and it's something that I get a lot, is the no, no, no. You're not cheating. You're not pulling the wool over anyone's eyes. You know, frequently when I say no, yes, you [00:15:00] can do this, but that's cheating.
Right? Which is the mentality that I was thinking of when I asked the question originally. and then you're saying, no, it's not cheating. Explaining to people that all of these laws, which they have been taught their entire lives are immutable, that they all have, for lack of a better word side doors built in.
Right where if you need to use them, you can. And that those side doors were always constructed into it. It's not that somebody just decided to knock a hole in the wall, right? Mm-hmm. Those doors were always in there like, you know, like going through all the tunnels in Pittsburgh. I remember a little kid being fascinated with all those doors.
I was like, who's freak? Right? All those doors in the tunnels, right? Mm-hmm. I remember once like, what are the doors for?
I always had this [00:16:00] image that if mommy and daddy dropped me off on one of the liberty tubes, if I opened the door, if I could walk through and wind up in the other one, but like. that's a very difficult concept for people to understand that it's not cheating and that you're there.
Mm-hmm. You're just on a different track. Right. You told me a bunch of stories as we were getting ready for the first talk about people who are on some of those different tracks. Okay.
I work on a hotline, right? Mm-hmm. So You can chat or you can zoom call, or it can be a telephone call. So it happened that I was on a chat with a young woman who's in a mental hospital and she said that she wanted to know if she would be allowed to paint on Shabbat,
Mm-hmm. Which is one of the things which you are prohibited from doing, which is painting, drawing, writing. because she was hospitalized, because she tried to kill [00:17:00] herself and she said, I still don't feel stable. Can I do that? Now she's contacted a hotline, right? Which tells you already several things.
One of them is that she could have very easily just decided on her own right.
She's in a mental hospital. So to make a point, to call a hotline about something like this tells you that this is a very, very, very important issue for her. But that she's really at odds with, this calms me down. But you know. But Shabbat is so important to me. What do I do? So basically the entire text chat was, okay, this is an enormous No-no.
Obviously. And so then the question was, is this part of your therapy? Because if it was part of her therapy, so then you can [00:18:00] say, there's a place to say that if she is right now in a closed ward, and in a very dangerous situation, then you say, okay That the saving of a life supersedes everything. Everything. Okay. That wasn't her situation. But again, the point wasn't telling her it's a big no-no.
The point was like, let's see if there's something else that can help you. Mm-hmm. So ultimately she said, listening to music really calms me down. Wonderful. Amazing, right? Mm-hmm. We're talking about a completely different level, right? Mm-hmm. So, I said more than writing more than painting, because it's important to me that she also know that I'm not just saying, oh, well, you know, this one's right, right?
she says, I don't know. Mm-hmm. But I think it would really help, and I wanna give it a try. [00:19:00] So again, you know, it's important that she have the agency. She says, I wanna give it a try. this is a person who's lost so much of their agency for them to say, I think I wanna do this.
I said, okay. So then listen, you set up your cell phone to play music, and you listen to it whenever you need. You don't have to worry about it because it's a totally different level. And then I said, and if it works, I'm very happy. If it doesn't help you do what you need to do in order to calm yourself down and contact me next week.
And we'll see what we can do instead. And so then you're not making a blanket pronouncement, it's basically what in my line of work, we would call a trial of therapy. Right? Yeah. So you're like, you don't just say, well, I'm gonna prescribe you this medicine and this is supposed to [00:20:00] work and keep taking it forever.
He's like, I'm gonna prescribe you this for a week, and if the side effects are terrible, we'll have to try something different. Or if it's not good enough, we'll have to increase the Dose. Yeah. I love that. Okay. you know, and so she answered with. I actually feel really positive about this.
If I don't contact you next week, it's because it worked. That was how she ended it. Now I like to think that's why there's no way of knowing, because you know, when they contact you on the hotline, you are not supposed to contact, there's all sorts of rules we have to follow.
Mm-hmm. But you know that's one story there. but then you also have people, like there was a woman on the two hours before Yum, Kipper starts, we getthe woman in charge. Like we get a note on the WhatsApp group that all of the people on the hotline work on.
We get an alert saying somebody called, she needs somebody to speak to her right now. [00:21:00] Okay. I spoke to her. She said, I have to eat. I said okay. Explain. I've tried, I've this, I've that basically what she wanted was, she wanted me to tell her, it's okay. No problem. You can eat as much as you want, however much and
All she could say was, just thinking about fasting makes me Ill I have to eat, I have to eat, I have to eat. Please tell me that I can eat as much as I want or as much as I need. At this point, I went, this is way above my pay grade. And I said to her, I need to get back to you.
And you know this as a doctor, Right. What happens when something goes above your pay grade? You go to the person who knows way more than you, right. You call a consult. Yes. So you call a consult. I called a consult with my boss. this is something that he deals with regularly. And I said, what do I do?
And he said something to me, which I [00:22:00] thought was, first of all, he says, when he gets questions like that and he says he gets them, he never tells them Yes. And he never tells them no. when he gets somebody who is convinced and they're not able to give you information
I absolutely have to. Where are you at home? when they're not, for whatever reason, able to give you more information? he tells them every person knows their own self better than anybody else does.
And that this is between them and God. And you basically say to them, listen, you know what you're allowed to do. You know what you're not allowed to do. You know, that eatingin those prescribed amounts is okay. And beyond that is your call. he never gives a straight [00:23:00] answer.
he doesn't do it because he doesn't wanna be responsible.
the way he phrased it was that, and if you tell them that they can eat, that might be the worst thing for them to hear. Mm-hmm. And if you tell them that they can't eat. he said, because they are being so very murky, you have to give them an answer that is
Mm-hmm. As in saying, I know it's on that level of murkiness, but it's saying, listen. it says in the gamara, if a person says they have to eat and they absolutely have to eat right? Mm-hmm. as in it's the murkiness is I'm not next to you. I can't know. Mm-hmm. This is the sock that is given, which is mm-hmm.
If somebody is completely hysterical and they have to eat or else they're gonna die, as in, and I don't mean physically die, I mean, as. [00:24:00] It's that kind of psychological burden, then you are the only person who can make that call. And I am giving you leave to make that call. Does that make sense ? absolutely .
Okay. So from these stories, I'm starting to get a sense of how you decide what the appropriate path is for each individual.
And having already said like there's a different track that different people need to be on. The last time we talked, you sort of laid out some guiding principles that you use to decide when you are looking for like a compromise position where they do a modified version of the usual practice and where.
You know, the sense of being obligated to do this thing is so burdensome for them that it just has to be set aside for the time and where sometimes you say, you know what? You can do this and go ahead and do it normally. Like they're different tracks for different people. Tell us a little bit about how you make that decision those core principles.
You know, the four that are really five that you [00:25:00] talked to me about the last time. Uh, whatever else you wanna throw in as well. Well, the four principles that are really five are, okay. I, I guess the fifth one is the one that really is the underpinnings of everything, right? Yes. Which you said is also for doctors, which is if you are not willing to assume full responsibility for whatever answer you give and say, if I made a mistake, it's on me, not on them.
Mm-hmm. Then you need to find another line of work. So even with that murky answer I gave her, it wasn't a question of, oh, it's not a me problem, it's a you problem. that wasn't the point of that answer because I'm still telling her, if you need to eat, then show, which means ultimately it's me who's giving that answer, right?
And the know your sources and don't be afraid to say you don't know, right? Which was [00:26:00] mommy, the great educator, where she said the easiest way to lose the respect of your students is to pretend that you know when you don't. Yeah. You know, and if you make a mistake, then you correct it.
No. Your sources, And also the empathy
Well part of it goes back to the d the limits that I have, there are limits which constrain me. Mm-hmm. Ah, that's also something else I guess you can say. A corollary to those five is something that one of my teachers said, which is, if, you have to have the courage to say yes.
Mm-hmm. But you also can't be afraid of saying no. Yeah. As it, you know, You have to be able to say, I know you think you can't, but you can. But you also have to turn around and tell that person, I'm sorry, but no. Mm-hmm. [00:27:00] Or not even the, I'm sorry. You have to be able to say no, and if you can't do those, then you need to find a different line of work.
So that always has to be there in my mind, right? Mm-hmm. Yeah. As in, there are times where I have to tell somebody, look within this parameter, I can't help you, but I can help you when we widen it. I think a lot of it is when you talk to the person, because there's different things sometimes, talking to the people and asking them questions and continuing.
To ask them questions is so important. Mm-hmm. I would say like what you do with your work. Mm-hmm. Because sometimes the person just needs handholding. Right. Sometimes, like you said, the burden is just so enormous. You have to tell them right now, you exempt from it. Right Now it's not on you we're moving it to somebody [00:28:00] else because it's too much for you.
Other times it's a question of redirection, right? Or redefining as in saying you thought that honoring and respecting your meant that they could verbally abuse you whenever they wanted. We are telling you that honoring and respecting your parents does not allow them to verbally abuse you at all, ever, right?
Yes. You know? For sure.
Sometimes it's again, that you're fighting against a block. I mean, like when I say fighting, in a way it sort of is like when sometimes you spend a lot of your time convincing someone that no, they're not actually cheating anything. Like, they're not pulling the wool over God's eyes.
Right. They're like, yeah, but that means I'm cheating. No, it does not mean you're cheating. go into that bit a little bit. You laid out [00:29:00] very beautifully the last time. the last talk that we did together, where you talked about.
Sort of the way you get from this biblical idea of, you know, in, in all your ways, no hashem in all your ways, you know, everything that you do should be following Torah to this much more nuanced situation of, sometimes the rules are different for different people and that's not breaking the rules.
That's part of the rules.
I guess it starts with, you know, the concept of you should live with them, not that you. Die by them, right? And that, them being the commandments, the meets vote. and I think one of the things is you know, in the written Torah, you have the commandments, the meets vote, the oral Torah is the halah, it's the implementation of the commandments.
So by definition, the written Torah is always static. The oral Torah is dynamic. [00:30:00] Mm-hmm. Right? And it flexes. And I think that's the evolution. The evolution by saying that the static situation is, there's a commandment that you live by them. Not that you die by them, but that they are your guide in life.
Right. And then. You break things down. What is a biblical ordinance? What's a rabbinic ordinance? What's just an extra stringency or an extra safeguard that has been appended, right? Mm-hmm. Um, I don't know if I'm doing it eloquently or beautifully, or if it's making help. But it's the fact that there's certain basic principles that mm-hmm.
As you pull it through time. I think that that was one of the things that one of my teachers said, that he said that the trick isn't to find what it says in the Bible [00:31:00] and say, oh look, this is what we do now. But to say, this is what we do now, and now we're gonna show you the provenance of how we can do the genealogy and break it down and lead it all the way back to what we're doing in the Bible. For example, nobody had typewriters Back at the time that the Bible was written. So why do we say that typing is one of the things that you're prohibited from doing? Oh, because it's similar to making words, and carving letters, but it's not it, you know, then you have to go back into ink and stamping and all of these, it's not being nitpicky to show how you get there, because it's the how you get there that gives you the knowledge and the ability to know where you branch off. you had said something also that [00:32:00] in particular, the way that that commandment of live by them is interpreted. You could say, well, if somebody's life is in danger, and interpret life being in danger very narrowly and say, well, yeah. And if somebody's like on the verge of death and doing this thing that violates Shabbat or that violates some other commandment, we'll save them then.
Yeah, absolutely. Otherwise, you've gotta strictly adhere to these things. But you brought some sources that said no, actually, even if there's, the shadow of a doubt that something might be dangerous. Yeah, right. God forbid you should take any chance of endangering somebody's life, do a hundred percent.
A hundred percent. that is one of the basic principles. And you're right. That's one of the things that EF rap show that they always say, you know, you don't play games with people's lives. And one of the things that's becoming more and more, acknowledged is that you don't play games with people's mental and spiritual wellbeing either.
And [00:33:00] mental health, you don't play games with it. You don't tell somebody, oh, you'll just snap out of it. Right. where do we learn all these things abouteating on Yom Kipper? It's from Track Tate of Yoma.
And it says a pregnant woman who smells food, do you let her eat? And the Rob who is teaching us, and he's a Diane, he's a judge. He said, if you notice, she smells it. It doesn't say she's hungry. It doesn't say she needs to eat because she's starving.
It doesn't say she has a medical condition. It says she smells it. And he said that one of the things that especially the Brisker really pointed out was it's all psychological with that woman because they have the pregnant woman who smells the food and the ill person who needs to eat, and he brings it [00:34:00] up saying that the first one, it's psychological and you still take it seriously.
In the gamara, they still take it seriously. They say, you let her eat, you find, right? Same thing with the ill person. So therefore, like you don't play games with these things. And it's not just like what's gonna happen on Yom Kipper. Right. You don't. Play games with people's lives. in my role as a doctor, I've had both Jewish and Muslim patients come to me with sort of the whole spectrum of one coming and say, well, you know, I know it says that I'm allowed to eat, but do I have to eat?
and this is somebody who may be an insulin dependent diabetic or some other very obvious situation, like in those situations. As a physician, I have to say, yes , it's dangerous for you not to eat. If you take your insulin and don't eat, your sugar will drop very, very low and you could die.
And if you. Don't eat and don't take your insulin, your sugar may go very, very, very high and you might die [00:35:00] right? Either way, you need to eat and you need to take your medicine or the very gentle, careful, Muslim gentleman who came to me one time, he said, so I heard from my friend who still lives in Baghdad, that he went to his imam and they said that if you have certain medical conditions, that there's a, ruling that that you can give zako, you can give like the Muslim equivalent of Takah that you can give charity in the amount of whatever you eat and that excuses you from fasting during the day on Ramadan.
And I said, are you asking if it's okay for you to eat? Because you do have a pretty significant heart condition and I would really prefer that you ask. And it wasn't like a cut and dried Absolutely yes or absolutely no. But like you said, the person kind of tells you what they need to hear. I think it would be an excellent idea for you to give some zako and eat During Ramadan.
So Rob Yoni Rosensweig, again, my boss, he told me what he tells people when they have to eat. [00:36:00] Not like in the situation and actually, I think that it's tremendous in its simplicity. He says, you are saving a life. How many people on the holiest day of the year? Can say that they are saving a life by you making sure that you eat.
And you take care of your health. You are keeping the him. Mm-hmm. he says. This is the kind of thing that most people dream of. May I do something so traumatic? He said, and that's what you are doing. He said that that's how he frames it for people. Oh, that's brilliant. I mean, that's the essence of yo Kippur, right?
Like who will live and who will die? Well, if you listen to me now, you'll live, right? You're doing Yeah, but it's more than that. Like you're showing, I mean like this is what you're doing. You are actively doing one of the biggest SVA that mm-hmm. Any [00:37:00] human being can do where you're actively saving someone from dying.
He said, that's what you're doing by eating. He said, it's not that, oh no, you need to eat. He said, by you doing this. This is the highest level of devotion you can show. And there's people who call me year after year after year with diabetes. and it's actually funny, there's one woman that she calls me and it's a running joke with us, and she says, I know what you're gonna tell me.
I just really need to hear it. She's like, I know she said, but I know that if you don't tell me I'm not gonna be able to do it.
Mm-hmm.
those of us who are in the doctor's chair often get questions like that as well, whether it's, I want this test. Because I heard about it,why can't I have it? Why won't you, you know, order that for me. And, you know, happens in the us, happens in Israel, happens in all sorts of countries for different reasons.
Either, you know, it's not covered under the universal healthcare [00:38:00] plan of that particular country, or your particular insurance company in the US won't cover it. Or I don't know how to do that procedure, so I'm not gonna do it for you. And your waiting list to get in to see the one doctor in town that does is, you know, a year long.
So good luck, whatever. But you know, that, or somebody wants a paper sign saying, oh, I get exempted from taking this test in school, and sometimes there's really legitimate reasons to do it. I always tell my students about the 85 15 rule that, you know, 85% of people have some sort of legitimate reason, some more serious than others, but some sort of legitimate reason to be asking you for the thing that they're asking for.
And 15% of people may be looking for some sort of secondary gain, but to quote the old story I would rather, you know, give my money on the street to a hundred Charlottean so that one truly deserving beggar gets his money then to leave that one truly deserving beggar go hungry so that I don't get fleeced by somebody else.
Oh, I totally agree. And I'm also going to say that this situation that I described is an outlier. Not even [00:39:00] filling all the fingers on one hand. If I have to say like the situation of a person calling just to rubber stamp is so rare,
I would rather tell somebody they can do it and it be my mortal soul than tell somebody no. And it turns out that I caused some incalculable harm. the questions like hers are outliers. I get the impression that if somebody's calling you, they really want a serious answer.
Because if they were really trying to get out of something, they would just, answer it for themselves most of the time . That's probably fine. Right? what's sad is that you will get a phone call from somebody who made a decision and then they regret it and they call you and they want you to tell them it was okay.
And it's not the rubber stamping, it's the guilt. And sometimes it's not to worry and sometimes it's a let's move on, you know? And you have to find a way to [00:40:00] say, you did it. It's in the past. We're not looking backwards, we're looking forward. Right. Yeah. So each of these stories has been a woman called about that part of your role, I know you've told me, is that your.
Talking with women because there are questions that it is easier for them to present to you than in the world that you inhabit. That most of the people that they would ask are men. And when I'm working with my students, I talk a lot about equity and representation and something called concordance, which is the shared commonalities between the doctor and the patient.
At least I talked about those things a lot until somebody in a position of power in the US decided those were dirty words, but I still talk about them. So talk to me about that role that you're inhabiting now particularly 'cause again, a lot of just the same people that think of haha as being this very stringent, confining space.
Also, think of the space that you're in as being an all male one, which is obviously not true anymore. No, it really isn't true anymore. There's an [00:41:00] enormous. Amount of women now involved even in the discourse that are affecting changes. there's something called Eden that was started by a woman who was doing her doctoral degree, looked around at all of the different ritual baths in Israel and was like, I don't like what I'm seeing.
And basically it was a grassroots thing that has really changed. And that was a tangent, but it really changed, the ways, you could say it was always the men who were in charge of what was going on in the ritual best. And this is a group where basically if you have a problem and there's something there that you don't like, you can turn to them.
And they will fight the battle for you. More women are getting more involved. Across all of the spheres, including the ultra religious, because, first of all, you're more comfortable going to a woman about a lot of [00:42:00] things. It's hard to talk about your body to somebody who doesn't have your body
About certain issues. In all fairness. it's really hard to talk about menstrual cramps to a man who's gonna sit there and go, oh, yes. especially when a lot of the halakha questions, by definition are incredibly invasively personal.
Yep. Absolutely. you know, I always start with a, I apologize for the incredibly invasive nature of this question, but. it's not that I say it automatically, it's because I understand that I'm asking them to be in
Yeah. I think that's one of the things that I've always considered kind of a real honor of my profession is that people trust me with things that they wouldn't trust anybody with. Sometimes even their life partner. You know, I get the same thing in reverse too, where I have a lot of non-English speaking patients and I'll have an interpreter on the phone.
The patient will be male, the interpreter will be female, and they'll say, doctor, can you hang up the [00:43:00] phone? I was like, okay. And in, very, very rudimentary English will start to explain to me their below the belt problem, because they couldn't share that, even though it's very hard for them to do it in English with, a woman could not share that in their native language with an interpreter that was female.
I totally get that. one time had a fertility specialist that she said that whenever she sees an ultra religious couple sitting across from her, she always makes a point to thank the husband because she said she knows any Yeshiva guy is dying 5 million deaths by a bazillion cuts sitting in a room with his wife and a female fertility specialist.
And he is forcing himself to do it. Mm-hmm. Because he loves his wife and she said so. Yeah. and I get that, and a lot [00:44:00] of women, myself included, we made choices to be extra stringent with ourselves because the idea of turning to a man with any of these questions did a full body ick. Just, I'm telling you, full body, there were so many times when I was just like, no, I'm not asking, right?
Mm-hmm. And more and more rabbis are becoming aware that by having more women involved, right? women are being, more open-minded and less rigid, and they wind up knowing more whereas a rabbi will tell them yes or no, and they're gonna be too embarrassed to ask anything else.
The woman that they ask, they can say, well, can you explain it to me? Mm-hmm. That there's a very big change happening, and I think it's because of the fact that, there are so many more women involved now. Mm-hmm. [00:45:00] So I put a pin in something earlier, but really there's pins all over our earlier conversation.
I wanted to bring this back around to where my audience is coming from. You know, most of the people that I've promoted this podcast to are connected to medicine in some way. And certainly in your role, you encounter a lot of medical and mental health professionals, and I'm sensing there's a lot of lessons in what you and I have already talked about and in what else you've experienced that you could teach us some things about how to conduct our business, how to instruct our patients, how we tailor our advice to their unique circumstances.
Well, that, I dunno, but I do know I now remember what one of the four was. Cool. That I am not a doctor or a therapist . So you provide a lot of halakha guidance, a lot of spiritual guidance to the people who consult you for their personal issues.
Mm-hmm. I get the sense that there's some guidance, especially on how we [00:46:00] communicate our advice, our doctor's orders that we could really learn from you in handling of similarly delicate situations. Okay, so I have frequently told you over the years that you are not a doctor, that you're a healer. And in all of the stories that you tell and the stories that you've shared while we've been doing this podcast, you listen, you pay attention, you are keeping the appropriate distance, but you areempathetic. You do have an emotional investment. You know what I mean by being empathetic means there's an emotional investment, right? you can't say, well, we're completely detached because then, but you do that automatically.
I guess for some doctors, I would say that the same way that, when people turn to us with certain questions, one of the first things we need to ask is, and what does your doctor say? [00:47:00] Right? For example, with birth control, I'm always asked, so what birth control should I take?
And I say that is for your doctor. Yeah. But what do you think what do I think? Yes, I think you need to ask your doctor. Right. that's my opinion. You should ask. That's my opinion. Right. And then I'll tell them, listen, if you wanna ask me afterwards on the scale, where does your birth control fall?
Halachically. Which by the way, that's also something as, when I say a scale, because a condom is permitted in very, very, very specific situations. But it's not this massive, absolutely. Never can never think about it. So I said, then you can call me back and I'll tell you on the scale where it falls,
The medical professionals who are not Jewish and are listening to this, the considerations in Jewish law are very different than, for example, in Catholic religious law, where birth control as a general category of things is generally [00:48:00] not permitted. It is permitted in Judaism just with very different thoughts about which things are preferred, in which circumstances, which I think is maybe beyond the scope of this episode.
Oh, totally agreed, agreed. Hey, listen it was a series of four lectures for us, so, I mean mm-hmm. Yeah. With extra, you know, every year learning other stuff. I would say that the same way that we have to remember that there is frequently a medical component, right? Mm-hmm. And especially on the hotline, there is always a medical component.
A difference between the hotline, I'm gonna say, versus you as a doctor, when you're sitting across from somebody is a hotline, you have fewer clues to go off of. But when you're sitting opposite a human being and you see their body language and you're talking to them, right? You can sometimes tell And there's all these other [00:49:00] clues, how they're dressed, how they speak to you, and that sometimes these issues, they might not be aware of them right there, there might just be this, oh, I can't, but they can't actually verbalize why they might need to sit with, their religious counselor to figure out why it is that they're having an issue with it.
Right. But I would say that that might be the place where, like you said, where the man asked the interpreter to get off the phone where the doctor steps out and lets the religious health professional, Step in to navigate what's going on so that The person can then get the medical treatment that you feel is best for them in a way that they can live with .
and chaplaincy doesn't necessarily answer that, and I say [00:50:00] that with an enormous amount of respect for chaplaincy. Because chaplaincy is so important and so critical. But it doesn't necessarily answer. That particular religious need. This is gonna sound hokey and not mean.
what people will hear it saying, some of my best friends are chaplains. True. But what you do and what they do is different. Right? Yeah. The catchphrase of chaplaincy is the non-anxious presence. Exactly. That the sense of accompanying and sitting with the Pain, the grief, the suffering.
It's not chaplaincy as it's conceived of in the US for sure. And you know, maybe in other countries as well. I don't know it as well in those situations is really about. Presence and relief of suffering. It's not about giving somebody practical religious guidance in the way that you're doing so well in Hebrew.
It actually, the way they describe the two roles is [00:51:00] very, very indicative of the difference. Chaplaincy in Israel is called Voi. Which means spiritual accompaniment, right? Mm-hmm. Whereas what I do is called,
which is supports. Yeah. Yeah. and, spiritual accompaniment can be in any way, like you said, but non-anxious. But they're two separate roles. Okay. This has been a tremendously enlightening conversation. I do wanna make sure everybody knows where to find you. Whether they want to call and ask a question or whether they wanna learn more about the organization.
So we will put in the show notes links to Magley Nish um, and Matan, if they wanna see what because I wear both hats, right? Because I deal so much with women because of Matan and like you said the mental health aspect is later.
But, so I would say Matan. And if people have questions and they wanna email me, that's more than fine. Perfect. We will do all of that. [00:52:00] Alright. Vu and Vu, we'll keep talking. Yes, John. Thank you again.