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Posted by Dr. Lachlan Forrow October 14, 2013 09:57 AM
While it often seems that the near-miraculous power of modern medicine to extend life has given us new, unprecedented challenges, many of these challenges are not new at all. And I was reminded last week how much wisdom we can find in our faith traditions.
I was asked to lead a conversation last week at Temple Israel in Boston about caring for loved ones (and ourselves) near the end of life. Before I was introduced, my host, Rabbi Ronne Friedman, provided an introduction that included the Talmudic story of second-century Rabbi Judah, the head of the Rabbinic Academy and redactor of the Mishnah, which Rabbi Friedman said "conveys Jewish attitudes with regard to the end stages of life":
When Rabbi Judah haNasi lay dying, the Rabbis decreed a public fast and offered prayers for heavenly mercy. They, furthermore, announced that whoever said that Rabbi Judah was dead would be stabbed with a sword. Rabbi Judah’s handmaid ascended the roof and prayed: ‘The celestials desire [that] Rabbi Judah [join them] but the mortals desire Rabbi Judah [to remain with them]; may it be the will [of God] that the mortals may overpower the immortals (in other words, at first, she joins with those who pray for his life). When, however, she saw how often he resorted to the bathroom, painfully taking off his tefillin and putting them on again, she prayed: ‘May it be the will [of the Almighty] that the immortals may overpower the mortals. As the Rabbis continued to pray incessantly for [heavenly] mercy (their prayers thereby shielding Rabbi Judah from death) she took up a jar and threw it down from the roof to the ground. [For a moment] the astonished rabbis ceased praying, and in the moment that they ceased, the soul of Rabbi Judah departed to its eternal rest.
In this story, Rabbi Friedman explained, "the simple handmaid grasps a truth that eludes the adoring disciples of Rabbi Judah, that is that the preservation of his life at all costs consigns him to an inhumane degree of suffering."
I later heard from a Jewish physician friend two details in a version he had been taught -- the "jar" that the handmaid threw down from the roof was the Rabbi's chamberpot, and it is said that a special place in the hereafter was then reserved for the chambermaid.
As I told the audience at Temple Israel in starting my presentation, this story of the death of a revered leader nearly 1,800 years ago reminds me of realities that take place every day in our own lives. Substitute dedicated "physicians" for the praying "rabbis", and the new powers of medical technology for the ancient powers of prayer. Or substitute praying family members for the praying rabbis, pleading to heavenly powers (or to doctors) to "save" the life of a loved one.
But sometimes all we can "save" the person for is additional suffering. And sometimes it takes someone who can see through all the prayers, who can see past all the heroic medical efforts, someone who can see clearly the concrete realities of the individual, mortal human being and what she or he really needs from us.
For Rabbi Judah, that was his chambermaid. For patients today it is sometimes a family member or friend, sometimes a nurse, sometimes a doctor. It can take deep courage, and deep love, to say "enough".
As we work together in Massachusetts, and across the country, to ensure that everyone, and everyone we love, receives the care we need and deserve in the last phase of life, I am convinced that we can all -- whether we are secular or believers -- find wisdom in our richly-diverse faith traditions. And that wisdom will come not only from past or current religious "leaders", like the eminent rabbis in the story, and not only from moral or religious principles.
Sometimes the greatest wisdom comes from people like the chambermaid.
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About the authorLachlan Forrow, MD is Director of Ethics Programs and Director of Palliative Care Programs at Boston's Beth Israel Deaconess Medical Center and Associate Professor of Medicine at Harvard Medical School. More »
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