Dr. Jonathan Weinkle shares a live talk from the Pittsburgh Jewish Book Festival on the dual purpose of the Passover Seder: forging identity with the enslaved Israelites and cultivating real empathy for those still in narrow places. Drawing from his book From Illness to Exodus, he explores four kinds of empathy and whether “fake it till you make it” is enough.id fear, suspicion, and systemic barriers.
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What does it actually mean to see yourself every generation as if you left Egypt?
In this live recording from Congregation Beth Shalom, Dr. Jonathan Weinkle unpacks the central commandment of the Seder and shows how it is designed to do two things at once: build identity with our ancestors and turn that identity into empathy for people still trapped in their own Mitzrayim. He weaves personal stories from medicine, the four types of empathy identified in medical education research, and honest audience conversation about presence, action, and the limits of choice.
The talk ultimately asks whether behavioral empathy, showing up and doing the right thing even when the feeling is not fully there can open the door to deeper connection, and whether remembering our own narrow places is enough to keep us from judging the hard choices others make.
Top 3 Takeaways
About The Show
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."
About the Host
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] This week, I'm bringing you an episode I recorded live on October 18th, 2026, as part of the Pittsburgh Jewish Book Festival at Congregation Beth Shalom, my home synagogue. I've shared material on the podcast before about my book, "From Illness to Exodus," which is also where this talk draws from. I'll share my thoughts about how the Exodus story is meant to create both identity with the enslaved Israelites and empathy for others who are now in the same situation.
Like a real Passover Seder, there are four questions and audience answers, so we arrive together at a deeper understanding of how we develop empathy and whether it's enough to fake it till you make it. It's a Jewish tradition to learn in memory of someone who's died for the elevation of their soul.
This episode drops on October 27th, 2026, eight years to the day since three other synagogues in my neighborhood, sharing one building, were attacked by a murderer and terrorist whose empathy had failed him. Eleven of our friends and neighbors were killed that day, and many more of my friends were badly [00:01:00] injured, traumatized, bereft of loved ones, and forever altered by that event.
You can read my writings on the subject, both from the immediate aftermath of the attack and on other anniversaries, on my blog and in the book. Please take a look when you're done listening. Right now, let's learn in memory of those 11 souls
Most of you will know the phrase that I'm about To quote, but I'm gonna quote it anyway. «בכל דור ודור חייב אדם לראות את עצמו כאילו יצא ממצרים.» In English, in every generation a person is obligated to see themselves as though they went forth from Egypt. So two things about that . One, it is the center text of the Seder, right?
Happens about two-thirds of the way through Maggid. It happens just before dinner time. And if you're listening carefully, it says, ha-adam, a person. So this is our story, right? The Israelites leaving Egypt, leaving enslavement, going out into the desert. But it is, in a sense, everybody's story. This is a story that other cultures look at and recognize as something inspiring, something, foundational to the way they see the world.
And for nothing, this obligation [00:01:00] is every person should learn something from this and see themselves as if they went forth from Egypt. So what does that mean? I'm gonna do this like you would do a regular Seder, which is to say that, number one, I'm gonna ask lots of questions and I'm hoping people will answer them, and number two, I'm gonna start in the middle.
Because if you look at the Seder text, it doesn't go in the order of first we went down to Egypt and then we came back. You start with wine, and then you go to carp- and you, it's all over the place. There's nothing linear about a Seder. So I'm gonna start with chapter 29 of my book and work my way a little bit backwards.
I met a woman, who was a nurse practitioner in the NICU at Children's when I was a resident, and it got to be, midnight, 1:00 AM one night. We had been spending a lot of time trying to stabilize this very tenuous, very small person, so that they could get through the night, and everything's finally done.
And I'm like, that was really rough. I'm really glad you were here." She said, "Thanks. Hey, I wanna show you something." And she points to the V of her [00:02:00] scrub top, and there's a little, tattoo poking out. And she said, "You know what this is?" I said, "No." She said, "I was diagnosed with breast cancer a few years ago, and treated, and I had radiation.
And when I was done, I decided to take the little dots that they made to mark where the radiation had to be aimed and make a full-blown tattoo out of it. And I carry that around to remind me of what I survived." And that's essentially what Jews are doing with the Seder.
We've survived lots of pretty huge things. I gave this talk at some other point, so we're not gonna talk about all the things we've survived. but we survived a pretty huge thing, and we make a yearly commitment, actually a daily or a weekly commitment if you look at all the liturgy, to say, "We're gonna remember the thing that we went through of being enslaved, of being in a narrow place and coming out of it, and we're gonna have this big meal, and we're gonna tell the story, and we're gonna make all sorts of connections to our modern world, and that's what we're gonna do to remember what we went through."
So we don't all have tattoos. That's actually frowned upon in the [00:03:00] Torah, but we have memory, and we have some pretty concrete rituals and we should have behavior. So wanna share a little bit from the book, and then we're gonna chat a little bit. So the way I see it, the Seder is a dual purpose exercise.
On one hand, it's an exercise in identity. Those enslaved people, thousands of years ago, they were us. We descend from them, and without the redemption that would happen to them, we would be slaves. This is in Exodus 13, verses 5 through 8, and it tells the story of the Israelites leaving Egypt, and it tells what we should do to mark the exodus once we enter Israel and settle there.
And the conclusion of the commandment is, "And you will explain to your child on that day it's because of what Hashem did for me when I went free from Egypt." Now, who is this talking to? Is it addressed- Seeing the adults leaving Egypt, all but two of whom are going to die in the desert, spoiler alert, or who are destined to be old when they finally cross into the Promised Land, [00:04:00] their children, or the generation that are born in the desert and are going to be free and enter the land as adults, or is it the children who are yet to be born who are gonna live their entire lives there?
There's a commentary that was written in 18th century Ukraine called the Maaseh Nisim. It was by Rabbi Yaakov Lorberbaum, and he acknowledges this isn't a literal commandment. It's not anchored in history, but it's explained by one word, kiilu, as if. So we're supposed to be behaving as if we came forth from Egypt
There's a reason why we behave as if, and not mamash, and not in fact, right? This is all figurative. Why bother even saying it? There are two passages in the Torah, two four-line passages. One of them is Avadim Hayinu, and the other one is a block of four lines that we read and really discuss in very great depth.
We'll get to one of them in a little bit. Why are we adding yet another [00:05:00] thing to remind us that we went out of Egypt? We've got two texts already that we're doing that with, and it's because we only have one of our two goals fulfilled there. Yes, we're supposed to form identity with those people, but the second goal of development is the development of empathy.
In Deuteronomy 6:23, it suggests that the goal of the whole exercise of the Seder is in order to take us and give us the land promised on oath to our fathers, right? That's an identity goal. We're supposed to identify with the Israelites that went out of Egypt and identify with the people that went into the land.
So say, "That's us. We're meant to be part of this nation. We're meant to live together." But there is another broader goal to the redemption, and so another broader goal to the Passover Seder, and it's this. We say it when we say Shema. It's the very last line, "Who brought you out of the land of Egypt to be your God."
It's Numbers 15:41. This is the one that our insomniac rabbis earlier in the Seder had to be reminded, hey, you're late. You need to [00:06:00] go say this line of the Shema," and all of the rest of it, because their discussion went on so long. And the verse after the Avadim Hayinu passage also says this. It says, "Taking on God's commandments is a goal of the Exodus."
The Israelites, a people that dwells apart, not reckoned upon among the nations, define and separate ourselves by observing laws that don't apply to other people. But in a sense, they do. They're not just peculiar folk ways to keep us separate. These are observances that are meant from the very beginning to be kept in the company of other nations.
It's like the angel tells Avraham after the Akedah, after the near sacrifice of Isaac, "All the nations of the earth will be blessed by your descendants." The presence of our descendants mixed in with the people of the rest of the world is supposed to be a positive for the rest of the world. It's supposed to be the reason God picked Avraham to start this line- And what's the first thing that we do after the exodus?
We [00:07:00] get the Torah. And ... One of the very first things after the big cataclysmic event on Mount Sinai is chapter 22 of Exodus, which says, "Prohibits us from wronging or oppressing a stranger, for you were strangers in the land of Egypt." There is the empathy. 36 times is mentioned in the Torah, at least that's what the Talmud tells us, or maybe it's 46 times the Talmud tells us this also.
different people count different ways. This is how new math got started. And so the point of the covenant isn't just to separate us. The point of the covenant is to benefit all of humanity. The most heavily emphasized consequence of being liberated from Mitzrayim is empathy with, and aid for those who are still there.
So it's easy to understand why American Jews in the '70s held Soviet Jewry Seders to raise awareness for their fellow Jews living under communism. But it also explains the existence of women's Seders that focus participants' attention on domestic violence or restriction of women's [00:08:00] access to education in some countries, or gender inequity in the workplace.
It explains the attempts at each year's Seder to make sense of that year's looming crisis. Every year has a looming crisis. Some years have polycrises.
And what it means to live the lives of our neighbors. COVID-19, the Russian invasion of the Ukraine, the plight of minorities in Darfur, the Uyghurs in China, the Rohingya in Burma under oppressive and violent rulers. It's why there's a Human Rights Haggadah, copyright 2023 by Shlomo Levin, and why a thoroughly Ashkenazi Jew like me owns a copy of the Israeli Black Panther Haggadah, which is entirely focused on the experiences of Moroccan Jewish immigrants to Israel in the '60s and '70s.
And it also explains why our siddurim in 2024 were simultaneously commemorating the attacks of October 7th, 2023, and the literal captivity of many of those victims, [00:09:00] and also at the same time turning our attention to the suffering of people in Gaza. The identity that you form in the first part of the Seder is supposed to pay off in empathy in the second part.
All right What's the most popular number in the Seder? Four. Thank you. I actually thought about saying 40 because today is, on the English calendar, the last time I said this was on the Hebrew calendar, the 40th anniversary of my Bar Mitzvah. and so I was thinking 40 years. But in fact, the most popular number in the Seder is four.
We have four cups. We have four promises that God makes. We have, four questions, of which I will ask some later. Not those four questions, but I will ask at least four questions. Maybe I'll ask five. That's also a thing in the Seder, is it four or five? Rabbi Sacks has a tremendous essay on this that I will not attempt to recreate here.
So in my reading of the medical literature, I was very pleased when I came across [00:10:00] an article from 2012, written in all places Japan, about four kinds of empathy. It works like this. This was a study that was done at Nagoya University Medical School, and it looked at med students, right? Those are the ones with the short coats who don't yet know enough, except maybe enough to be dangerous.
And the residents who are much better educated, working somewhat independently. And they looked at how they felt empathy and how they looked at themselves being empathetic toward their patients There are four kinds. They took this from a framework that was discussed in the psychology literature.
There is behavioral empathy , there is emotive empathy, there is cognitive empathy, and there's moral empathy. So I just gave them in random order. Cognitive empathy is when I understand what that person must be feeling. You get it in your brain. Emotive empathy [00:11:00] is you see what that person is feeling and you start to feel that way too.
You are resonating with them on a particular level
Moral empathy is outrage. I can't believe somebody did something like that to this person. Somebody ought to do something about that. Behavioral empathy is I'm the somebody, I'm gonna do something about this. There are those who will say, and this is the subject of a book called Compassionomics, that what we call compassion is actually behavioral empathy.
It's doing something about it. Empathy is a feeling. Compassion is a behavior. you do compassionate acts for someone. So what do you think they learned when they looked at medical students versus residents in a hospital setting? What kind of empathy did one have versus the other?
So Dan's pointing to behavioral empathy as sort of the marker of the medical establishment. And there are definitely people who would complain that we don't show a lot of empathy. We don't act very [00:12:00] feeling or caring, but we do a lot of stuff. Sometimes I think we do too much stuff.
I've just learned how to do this stuff and I'm going to do. A resident will have had now several years of experience. in actually treating people who are sick and probably has the more empathic point of view . That's a really interesting way of looking at it, and it would've been a great hypothesis.
It turns out that's the reverse of what happened. So the medical students come into this and a lot of them for the first time remembering that medicine is not just a privileged field in the US, but in general around the world because you have to have the stable environment growing up to be able to learn to get to the point of getting into medical school in the first place.
And what they found was that medical students have a very high degree of emotive empathy. they're encountering some of these terrible situations and some of this degree of suffering for the very first time in their lives, and they don't know what to do with it other than, "Oh my, that's so terrible," and [00:13:00] I'm gonna share a cry with this person.
They have more time on their hands 'cause they're usually only responsible for one or two people, and they don't have a lot of skills yet. ... They don't know the system so they don't know where to go for help, and they don't have the permission to order a medicine or, put in a consult for this or that.
They have to go through someone else. The one thing that they have is time, and if they have a second thing it's that they're human beings and they can share that. When they talk to the residents, they said, I can't necessarily spare the emotional energy for every person that comes to me sad.
But I've learned enough about this that I can think my way into cognitive empathy. I know what's going on with these people. I've seen this before. I know what kind of suffering they're experiencing, and I also know what resources I have at my disposal to fix it." So they do actually engage in a lot more behavioral empathy.
now I've done [00:14:00] other readings since. I thought, this is really great. This makes a lot of sense." It turns out that the idea of compassion fatigue, of getting worn out by being too emotionally involved may actually be a myth. It may actually be that letting yourself lean into the feelings is okay, is preferable because when you actually engage with somebody and feel a connection and feel like you're helping them, that's energizing.
You don't walk out of the day feeling completely defeated. You walk out of it feeling like, "I did something worthwhile," as long as you can actually do something about it. And we all know the feeling of frustration, particularly as Jews, Whether we're talking about how people feel about us and we're like, there's really nothing I can do about that, is there?"
That's frustrating. Looking at a system and saying, "There's really no way for me to help somebody," is very frustrating, so there's compassion strain that happens. The Seder is not built to fix that problem. What it is built to do is get us moving in that direction in [00:15:00] the first place
There's one problem. We often encounter people where we don't quite know how to make that connection, how to make that emotional resonance, how to make that behavioral resonance. We have to, as I put it here, fake it till we make it. So I'll read a little bit more, and then we're gonna involve the audience.
So the growth and change of empathetic responses of these Japanese students and residents raises an interesting question. What is real empathy? Is it empathic behavior, the part that the patient sees and responds to? Or is it an inner mental state? Is it a problem if the clinician, quote, "walks the walk" but doesn't, quote, "feel the feel" inside?
In 21st century America, we devalue people who aren't genuine or who are fake, not saying what they mean all the time. And now we see that, we've seen the consequences in our elections in a lot of cases. Is the person exhibiting behavioral empathy fake [00:16:00] if they lack the emotive component? Rabbi Chaim Yosef David Azulai, otherwise known, thank God, as the Chida because his full name is a mouthful to say, in his 18th century commentary, Simchat HaRegel, made a word choice that caught my eye in this section.
He wrote, "Shehayav leharot atsmo," that is obligated to show himself instead of "lir'ot atsmo," to see himself as if he came forth from Egypt. The commentary, Safa Ekhat, which turns out to have been written by the same rabbi, so he's commenting on his own commentary, explains that this means he will get very excited and make preparations as if this night the holiday will be sanctified, and he is willing and ready to leave Egypt.
In the Safa Ekhat, he's describing behavioral empathy, acting in a manner that shows other people that the person making the Seder really means it, that he really believes he's about to be redeemed from enslavement. So I care for a couple of people who have worked as simulated patients. [00:17:00] They were specially trained to play the role of a patient for the purpose of training medical students, nursing students, PA students, some other trainee in the health professions They might practice doing an exam, conducting an interview, or some other skill requiring interacting with a live person whose wellbeing doesn't depend on the outcome of that interaction, and the simulated patients stand in those encounters.
So in my first meeting with one of those people as actually their doctor, we got into some difficult topics, and I gave a brief response to encourage them to continue. "Boy, Doc," they remarked, "you're really knocking that empathetic language out of the park." I was momentarily flustered, but eventually responded, "Sorry, that's actually how I speak.
Is it a problem?" They reassured me that it wasn't, and despite their tone, it was meant as a compliment. They had just heard so many others try and stumble over the words, that hearing them used in the normal flow of conversation was a surprise. Okay, [00:18:00] so now it's your turn. I want you to think of our four archetypes of empathy, because again, Seder four.
What kind of empathy are you best at?
As a reminder, behavioral, cognitive, moral, and emotive
What comes most naturally to you? There are certain situations where I would say behavioral. ... i'm thinking of, when I'm driving and there's somebody asking for money or food- ... I have a whole system that I follow with that, learned from my daughter, Eileen.
And, ... I keep in the dashboard of my car granola bars and dollar bills. So I have a ready plan- ... of what to do. So in that sense, it's behavioral, but I wouldn't say that's the universal way I act You're doing something. You're not necessarily feeling moved every time you roll down the window.
I think I am. I really... And when those people typically say to me, "God bless you"- ... I always thank them and I say, "I [00:19:00] need all the blessings." Which is true
Universally, absolutely. What else? I think it's cognitive. It's most natural to me . I'm a kind of a fixer kind of person . And if someone comes to me or just I encounter someone who's in trouble or whatever- ... my immediate reaction is finding things that I've gone through that I can relate to- and what can I do to help them. so you- So it's not an emotional response it's what can I do to help individual in trouble . And I don't have slides, but the graphic in that article from Japan is exactly that pattern for the residents. they think through it, and there's a big fat arrow pointing from cognitive empathy down to behavioral, right?
That's "I think through it, and once I've processed what they're going through, then that leads me to know what they need." I'm sure. it's a critical job skill for that. Yeah. Yeah.
I would say that it has to be two parts because I would say moral first with behavioral second because it's not [00:20:00] just enraging about something, but then it's making sure that I follow through with an action You're bringing out that element of any of these things can brain the life out of you if you don't have some way of acting upon it.
So absolutely.
And I will, first of all, thank you, 'cause I will say one of the things that inspired me to start working on this book, which we'll talk about in the second part, is how much time I spend working with refugees, right? my practice is very focused on immigrant refugee health, so the experience that they've had in making it to the United States one way or another was...
a thing that I was seeing every day that paralleled my understanding of the Seder, right? So I looked at that and I said, there's just such an obvious connection here." Elsewhere in the chapter that I'm quoting from, I tell the story of naively coming home and saying, I'd love to invite one of these refugee families to our Seder.
it would just bring the message home so much closer." And my wife just turned to me and looked at me blankly. She's like, [00:21:00] "You mean me and my parents?" 'Cause she was born in Moldova in 1974. and I said, "Yeah, like that." And I just walked out of the kitchen- ... and we never discussed it again.
So- I can be an idiot sometimes too.
What kind of empathy, of empathetic behavior do you find helps you the most?
So it could be helpful on its own or in conjunction
So seeing that somebodyis actually acting on your behalf is the most helpful. Okay. yeah, I'd probably say the emotive is most important . To recognizing that somebody understands how I feel and I wouldn't necessarily to act on it but
they need it so much Yeah, and I think, you're pointing to an important issue, which is, and something that definitely happens in the medical establishment. I'll get to that in a minute. But, you go to your spouse or to the friend that you're going out to have a drink with, or, somebody that you call up [00:22:00] on the phone in the evening who's, maybe far away, but they're the ear that you wanna bend when you need something.
You don't necessarily want them to fix everything. You just need somebody to hear you, and maybe to be emotionally resonant. "Oh, that sounds so hard," "I feel terrible," and to talk you through your emotions. Maybe you need them to be outraged for you and just share a good, like, rant.
That could be you. Maybe you need their moral empathy. Maybe you need them to understand, "Oh, that makes sense," just to let you know that you're not totally off base in feeling the way you're feeling. But you don't necessarily want them to fix it, and we run into this problem in medicine all the time.
I have heard it referred to in Latin, 'cause the best way to make something sound really important medically is to give it a Latin name. Furoer therapeuticus , which is the, insane drive to fix everything, and sometimes that's not what people want. Most commonly, Mark mentioned one of the courses that I teach is [00:23:00] end of life, where we can't really fix anything because, also spoiler alert, we're all going to die someday.
we can't fix everything, and sometimes when people are telling us about their suffering as they're getting close to that point, they really do just want us to understand what's going on. It... Because maybe it isn't possible to medicate away all the pain or to get rid of all the nausea or whatever.
Just to feel like somebody is there and caring might be all they need. So having gone through my own cancer scare- ... very recently, surgery three and a half weeks ago I'm here today . Baruch Hashem. Thank you. Baruch Hashem. But, the thing that people would say to me always is, "What can we do?
What can I do to help you?" And I've had three congregations of people come to us with that. And my daughter set up a meal train. And to me, the greatest gift that this community has done for me and my husband , who had his own sinus surgery not [00:24:00] long after that, was to feed us and to not have to lift things out of the oven and cook- just prepare meals for us, and that's really behavioral. And to me, because my cancer scare was really just that- ... it was very short-lived, thank God- And, I didn't have a lot. I'm still, probably in some sort of state of denial- ... at this point, ' cause the diagnosis was just at the end of August , and it's gone.
So- Amazing ... but that was concrete empathy- ... that the community gave to me, and that's, yay. I'm all for it. More than listening to, 'cause I wasn't in pain. I'm not in pain. I'm not in anguish . I'm just needed. Amazing. So I wanna turn then, because these are all fabulous. remember that my patient, who was also a simulated patient, pointed out to me that some people aren't very good at the words.
Is it enough [00:25:00] to say the right thing without feeling it? Or the opposite, to say the wrong thing with the right emotion? You've all been there
Is saying the right thing and not actually having your heart in it good enough? Especially if you're a medical professional. if you're the patient and somebody says all the right words, but the feeling isn't there Okay. You're in a position where you need to hear the Right thing Somehow or other you probably hear the feeling or lack of same in what's being said to you. So just the words alone, nice to hear, but you don't care. And so like the political situation I'm here for you but you're not. Everything you do says otherwise That's the thing.
And- ... yes, I have been paying attention, it's just that I haven't been able... I don't focus necessarily on [00:26:00] one aspect of those four. It's what's the circumstance- ... we're talking about. And then I could give you an answer if I knew what the circumstance was, where if I thought of a- Okay
particular circumstance. You'll have plenty of opportunities to give me answers. It's okay. You don't have to come up with one right now. Yeah. All right. For those who don't know, this is my father. I'll see you tomorrow night. among my experiences as a pastor is that I think the words matter far less-
I have found that there just aren't enough people listening in this world- to each other. And so being in the presence of somebody who can unburden themselves and let all that stuff just much more powerful than trying to offer them words which might just make it I may not help but sometimes just like being , the person to listen which goes to, I guess saying the wrong thing but having the right emotion behind it or, 'cause, if you're not saying anything, you're not ... helping anybody.
you could be saying the wrong thing but with the right emotion. It doesn't really matter. so your point, is that the act of listening, which can be done without saying anything at all, [00:27:00] other than a lot of non-verbal communication to show that one is listening, may be better than either the right or the wrong words in a particular time.
I'm always amazed. Sometimes, I feel like I said absolutely nothing and the person who's talking, that was so helpful ." I'm thinking, "I'm not sure what I did." But I listened, and I was there with them, so several months ago on the podcast, I interviewed your colleague here, Rabbi Tov, Rabbi Kara, and, she described a story which was not a one-off story, but had happened to her several times at the hospital she was working at during the COVID pandemic, of a physician who would walk into her office, kick the door closed behind them, turn towards the bookshelf and just put his head down and probably cry, but he was turned towards the bookshelf and putting his head down so that she wouldn't see that he was crying.
Stop after a couple of minutes, turn around and say, "Thank you so much, Rabbi," and walk out of the office. there is definitely an element of I'm just gonna sit here and be present, and they're gonna do all the work because that's what they [00:28:00] need.
They need to do it not by themselves, not in isolation, but in the presence of another human being. and sometimes the best thing you can do is not interrupt them. yeah, I was thinking of, the instance where someone, walks by and say, "Hi, how are you?" often, I don't think that person really wants to know how you're feeling.
so- I, and I wouldn't go into a lot of detail. But if someone's more sincere- ... about, "How are you feeling today? I know what you went through." ... so that's a different sort of situation. Yeah. So I think eve- that sincerity is important-
as well as the question. And there's a way to convey it with a subtle shift in the tone of voice or maybe a gesture or a, like a gentle touch on the shoulder or something that tells you, "This is that time when you actually can tell me how you're doing." Yeah. But on the flip side, sometimes people, that becomes a little bit of a burden.
speaking of people who are going through a cancer diagnosis or scare. the, [00:29:00] the historian Kate Bowler, who is the professor in the School of Divinity at Duke, has a list of eight things you should really never say to somebody who's going through cancer, and one of them is to walk up to them.
It's like, "No, really, how are you doing?" And do you have any idea how much of a burden it will be for me to repeat exactly how I'm feeling right now? Please don't ask me that. whereas one of the most positive things she says you can say is, "When can I bring you a meal?" so all right, one more question.
I said that this whole exercise is being able to parlay that experience of as if we came forth from Egypt into helping others. when you go to somebody and are putting yourself out there in an empathetic way, what are you drawing on in your own experience that allows you to do that more authentically, more skillfully?
'Cause I'm not naive to think that oh, we're a room full of [00:30:00] people who have never had to put up with any suffering or tragedy or anything like that. I know what we've all been through just by law of averages for sure. I know some of you better than that, so I don't have to guess. But what do you draw on when you are putting yourself out there for others?
Yeah. I think you're trying to help them. or sometimes you look at the guy and maybe you don't really know him well. You say, " Hey, anything I can help you with? Just something like that, and if they said yes, then, or no. And so just a simple statement like that. Sure. What else?
What's the well you dip into? my wife is gonna explain something. I'll be here. Yes. The spouse is always the we can go to if we need to
So you open yourself up to potentially looking the Mirror on yourself and leaving yourself vulnerable. yeah, we do have to expend energy to do that. do I have the reserves in me to be able to be there for someone? That's part of what leads to this myth of compassion fatigue.
[00:31:00] am I gonna drain my own battery in filling up this other person? and it is a little bit like that perpetual motion machine that the physicists tell us we'll never be able to invent, that compassion actually charges our battery if we do it I'm thinking only of... So I had just a, a trivial experience, right?
A lot of my patients are dealing with housing instability and things like that. if anybody ever did any banking in Israel, let's say prior to the turn of the century, right? The turn of the 21st century. you know that the system was a little archaic and very confusing, and there were things that somebody would tell you where, you absolutely had to write your check this way, and then you would write it that way, and somebody was just like, "Masita, what are you doing?
You can't write the check that way, it's not valid." So this happened to me in 1995 when I moved into an apartment, and the landlord called us screaming and storming and threatened to throw us out. that we had an hour to get him a new check or he [00:32:00] was gonna come and evict us. And he didn't mean it.
He was a very short-tempered gentleman with really very little bite. But I really thought that I was gonna be out on the street with my stuff. And so just the fear that I remember from that very short period of an hour and a half was enough to remind me that when my patients are going through housing insecure, like even if we're able to get things straightened out and, I can give them documentation of disability or whatever so that they get an extension on their lease or we can get their gas, the fear of not having any place to live is about the worst thing I've ever experienced So I understand.
That's the well I go to when I'm talking to somebody who's going through that. many of you know we've had some, some pretty bad experiences. Thankfully one of them at least ended up very well. but with illness in our family over the last couple of years, as I was telling Eric, it's one of the reasons why I'm talking about this book that came out last year at this year's book festival.
But it has attuned me very much to other [00:33:00] people's experiences of family illness and of remembering to talk to the caregiver, especially if it's a parent of a child who is ill. but really anybody, somebody who's going through a spouse's illness or a parent's illness, that the caregivers is critical because
I see how burned out the caregivers get and how much of a toll it takes on them. I remember how I felt when everything was over, and that was when I got so deflated I couldn't get out of the easy chair in my living room for two days. So those are my wells that I go to, but I'm curious to know what people lean on when they need to provide empathy for someone and they need to get themselves in that head space to understand what the person's going through.
what do you think about?
What's your, "Oh, I came out of Egypt, I'm going to help this other person come out of their narrow place"? Go ahead, I was a school nurse and, , for elementary school, but we had middle school. And I had a horrible middle school experience myself back in the day . We didn't have people to help us through the process for a whole nine months. And I always said I want to be the person that I needed in [00:34:00] middle school. And they were actually my favorite population of the entire school because I knew what I needed and wasn't given. and wanted to make sure to be able to give that to them You know, I have never thought to make an analogy between Mitzrayim, between the narrow straits and middle school, but it works so well.
you've got this comfortable place of elementary school where everything is, crayons and pictures, and the teachers all love you and whatever, and then high school where you're this independent individual yeah, you might be out in the midbar, you might be out in the desert, but it's okay.
It's fine. you're finding your own way. You're free. you can make decisions. Middle school is awful. It is the worst time of life, and getting through it is really challenging, so I applaud you for digging into your experience and saying, these kids are in the toughest transition of their lives.[00:35:00]
I'm gonna be there for them." That's great. Thank you so much. Okay I wanna get to one other section of the book just briefly. and the reason that I wanna get there is because it's a great example of a place where we often fall down on empathy, which is talking about choices. So there's a passage, one of the first lines in the Torah that talks about the Exodus narrative.
in that four-line section that tells the story, it talks about, Arami oved avi, "My father was a wandering Aramean," and went down into Egypt. And it says about the words went down into Egypt, "" went down into Egypt forced by the word. So ones is duress or force in Hebrew. Anus is somebody who doesn't have a choice.
and if we look at how in the story everybody gets down to Egypt, the first one to go down is Yosef, and [00:36:00] he is definitely anus. The brothers throw him in a pit, the caravan comes by, they sell him into slavery, and he's taken down to Egypt in chains. He does not have a choice about going down to Egypt.
The brothers don't have a choice about following him down because there's a famine, and they're either gonna starve to death in Canaan or they're gonna go down into Egypt and get food. Then they go back up and get Binyamin, also under duress, because if they don't go get him, they're gonna keep Shimon in jail in Egypt, and also he won't give them enough food to sustain the family.
And finally, once the whole plot is revealed, then Yaakov has to come down to Egypt, because how else is he gonna see Yosef? Yosef is the number two guy in Egypt. the prime minister can't just leave town and go back up to Canaan and say, I quit, I'll see you later." They're in the middle of a famine.
He's gotta stay. He's got work to do. So they all come down. And you could say, "Okay, Yaakov had a choice," but did he really have a choice? [00:37:00] He hasn't seen his son in 22 years. He's pretty much given up on life. Now he finds out he's alive? I have to go. I don't wanna go. I don't wanna be in Egypt, I don't wanna die in Egypt, and I'm probably gonna die in Egypt, but I have to go.
And so one of the things that's got me thinking about is, most of the people, like we will often say,what did you expect because you didn't quit smoking?" Or, "What did you expect because, you kept playing soccer on your gimpy knee and now you can't walk?" Or, "What did you expect bec- " And we encourage people to play soccer most of the time, and then they go do it and they get injured.
It's like, what do we want from them? One of the things that I think that as clinicians we need a lot more empathy for, but also just as people in general, think about how many times have you said to someone, if you hadn't done X." And if you step back and think about it like what choice did they really have?
Sometimes people don't have as much choice as we think they do, right? They're choosing between a bad option and a worst option. [00:38:00] They're choosing between two things that are both awful, and they have to make the simplest decision that they possibly can. So I'm wondering, in terms of building empathy, because I think these are the folks that need it the most, is people who have done things that, yes, were harmful to them, but that at the time they did them they just don't have much of a choice, right?
People who choose to work in a profession where there's a pretty good chance that profession is going to shorten their lifespan, right? Somebody who goes to play football because it's the one thing they're good at and then ends up with, chronic traumatic brain injury. Somebody who goes to work in the steel mills because that's what there is, and they're inhaling the soot and the dust and whatever, and also probably, burning themselves on hot metal surfaces and various other things, consuming 6,000 calories a day of not very healthy food.
I learned that when I did the tour of the Frick Mansion. Apparently that's about how much that the steel [00:39:00] workers used to eat. 6,000 calories a day. Yes. In a big canister of stew that was about this big because it was very hearty. Those are the kinds of things that I think we need more empathy for. So the last question I want to ask is what choices have you made in your lifetime, or have you seen other people make, that weren't really choices, they were just the best of a bad set of options?
thinking about some of the things I've done like somebody will say,could you lend me some money?" Or something like that. And it's not a big amount of money. But you gotta ... I'm pissed off at the guy. what do you do? Just giving them some help- that person will be, be grateful that he did this. and, I think there's things I think sometimes you just piss some things away- ... for this guy or like a girl or something. yeah,if someone needs, you see they go to the store and they're $5 off- of how much money. and you're sitting right behind them and you're, you [00:40:00] got a whole bunch of 50s. well- I don't want to make the guy change. Well- So- But, there are things that you can do- ... just come to you automatically- ... and just say, "Oh, I, I can...
Nobody told me about that." Yeah. Just think of what you can do. and you can make the argument, yeah, you know what? This person really didn't have to get themselves into this situation, but I'm just not gonna hold that grudge. I'm gonna do it, and that can be that first step of behavioral empathy.
Even if you're not feeling it inside, later it'll come back around to that. What else? and I see this every day as people making decisions- ... that were based on survival. Any of us could end up in that inmate space. Somebody had one too many drinks before they left the bar, and now they have a DUI,
They... So these are things that- ... it doesn't necessarily make us a bad person. It just is decisions at the [00:41:00] time that may not have been the best decisions, and that is, that's the mindset that I try to meet with my patients on a daily basis. I don't know what you did.
I don't wanna know what you did- Yeah ... but we are here together, and I'm here to help you stay healthy or get healthy while you are here. And that's, again, seeing them as a person- ... more than a patient because the decisions that they made or didn't make, we can't necessarily fix them , but we can work on this moment.
I love that, and I think that's a great place to wrap up. The idea that we make bad choices, that doesn't make us bad people, and that doesn't forfeit whatever right we have to, the empathy and assistance of other people. And I think if we can remember that as individuals, and certainly those of us who are in the helping professions, as you are and as I am, and, some other folks in this room as well, [00:42:00] then I think that is reason enough for people to learn our story, even if it wasn't, their story, and take it to heart.
Thanks so much.
I hope you enjoyed the talk. Special thanks to Isaac Light for working to reconstruct some of the audience sound. If it was still hard to hear, don't blame Isaac, blame the host for not getting the right microphone for the setting. And let's face it, when you're used to having 25 or more people at the Passover Seder like I am, this is kind of authentic.
The people at the other end of the table are really hard to hear. Of course, that's usually because the people in the middle of the table are talking over them and nudging me to move faster so we can eat.
After the talk was over, my rabbi, Seth Adelson, came up to me to talk about the idea of behavioral empathy or compassion when you feel like you don't have much to do for someone. He acknowledged that sometimes he's not sure what he can say or do for someone, and that sometimes people thank him for his help when he feels like he's done nothing at all.
I reminded him of our mutual friend, Rabbi Kara Tav, and the story she told me on episode eleven of this podcast about doctors who would come into her office during the pandemic, kick the door closed and face the bookshelf, presumably to [00:01:00] cry while no one was looking at their faces. Afterwards, they'd turn around, say, "Thanks, Rabbi," and leave the office.
Rabbi Adelson told me that often he leans into another part of the Seder, the part that says, "In every generation, they rise against us to destroy us, but the Holy Blessed One saves them from their hand." I guess the message I lean into is that, well, that may be eventually true in the long view. For those of us sitting at the Seder table or in the exam room or in the pastoral care office or across the table from our distraught best friend, we are the agents of the Holy Blessed One.
We're the ones who, one friend, patient, or loved one at a time, have to save them from whatever hand is coming to destroy them, or at least not let them face that hand alone. And they're not alone. They have you. You, who have been now listening to me talk through healing people with a whole heart and a whole soul for a full year now.
Twenty-five episodes about lament and burnout and spiritual care, about end of life and [00:02:00] trust and living with an addictive disorder. Thank you for being here and hopefully for turning around and being there for others as a result of what we've learned together. I hope you'll keep coming back. In the coming episodes, I'll welcome Professor Brad Buchanan to talk about the role his writing has played in surviving two separate cancer diagnoses and the work he's doing now to serve others going through the same thing.
We'll hear from my new friend, Bryant Richardson, who's founded a company that amazingly teaches healing professionals to do what I've been writing about for the last twelve years. Take big, fuzzy ideas like caring and compassion and operationalize them into real, measurable outcomes that our patients can see and feel.
And because a guy who writes a book about the Seder can't avoid this topic forever, my colleague Daniel Chen will join me to discuss food as medicine in a way that promotes joy rather than abstinence. It's gonna be great. I hope you can join me