Rabbi Avi Weinstein

What physicians once were and what they may not be now.

In Uncategorized on August 25, 2009 at 12:48 pm

I am old enough to remember house calls from my pediatrician, Dr. Pakula who called me “Johnson”, and for some reason, I, as a small child thought this was hysterical. Dr. Pakula was part of our family. He entered rooms that were reserved for those with whom we were most intimate. He was privy to information that was not readily given to many who might be considered good friends. He knew us, he cared about us, and he was considered family. It would have been the most reasonable thing in the world to discuss end of life options with Dr. Pakula, because we trusted him.

Nowadays, avuncular images of the family doctor have been replaced with demonic apparitions of “death panels”, and an innocuous piece of health care legislation that allows reimbursement for counseling becomes an ominous foreshadowing of bureaucrats cajoling the vulnerable and defenseless into dying “early”.
It is too easy to only dismiss this hysteria of “death panels” as ignorant people being stirred up by demagogues, but the deeper fear, I feel is a true one. Anyone over fifty remembers a more personalized medicine that has eroded considerably over the years. Even though the statistics would tell us that we live longer and better than we did fifty years ago, our experience tells us that doctors cared about themselves a bit less and us a bit more. There was a time when they knew us better.
This impression will not show up in statistics, but our quality of life is ascertained by our quality of community. Now, nobody has a “family doctor”, but a “general practitioner”, the practice of which has become the most unattractive option for those entering the medical profession. It doesn’t pay, and there is no time allocated by the insurance companies to develop relationships with patients.
The following Talmudic passage emphasizes the power and the limitation of healing, but more importantly, it underscores the profound impact of genuine concern and empathy.

Rabbi Elazar fell ill, and Rabbi Yochanan went up to him but he was obscured because the house was dark. When Yochanan revealed his arm, light fell from it. When Rabbi Elazar saw this he broke down and cried.

Rabbi Yochanan asked: Why are you crying? If it is because of the Torah you have not learned, isn’t it taught: One will learn much, one will learn littler, but most important is that one direct his heart toward heaven? If it is because of your income, not every individual merits both tables (the table of plenty and the table of Torah). If it is because of children that you have lost, here is the tooth of my tenth son.

He answered: I am crying for this beauty that will be ravaged by dust.

Yochanan responded: This is truly worth your tears.

Both of them then cried together!

After awhile Yochanan asked him: Are these afflictions dear to you?

He answered: Not them, nor their reward.

Then give me your hand. He gave him his hand and helped him stand.

The fear expressed by many is a veiled yearning for the days when the Dr. Pakulas were considered part of the family.
For the complete translation of this piece of Talmud click here.
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  1. Avi,
    I too pine for the old days of family doctors and housecalls, but the reality of now treating more patients and of more specialized medicine has forever changed this. In general, however, medical care is better and people live longer and healthier lives because of this. I work at a university with a very large medical center and many of the physicians there are my friends as well as my own doctors. I can happily report that I feel cared for, listened to, and treated with compassion when I am seen by them as a patient. Their hands have been extended to me and other patients just as our sages did when they healed the sick. American society cannot fulfill its moral and ethical potential when some citizens cannot obtain health care or be covered for all of their ailments or go bankrupt from medical bills.
    Rabbi Joe Topek

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