Thursday, December 14, 2023

Human Flourishing: Judaism, Medicine, and a Life Well-Lived

From the December 16, 2022 issue of the Transformational Times




Human Flourishing: Judaism, Medicine, and a Life Well-Lived


Sarah Root




The Kern Institute believes that human flourishing is central to the health of physicians, caregivers, patients, and society. In this essay, initially published one year ago in the Transformational Times, medical student Sarah Root shares some family stories that highlight her thoughts on faith, flourishing, and the practice of medicine from the perspective of Judaism ...


How can one do the most to help others and uplift the world?

 

Unlike in many religions, Judaism does not generally concern itself with what happens spiritually after death. As a seventeen-year-old reeling from the loss of her grandmother to cancer, this was a surprising comfort to me. From my dad’s eulogy where he reminisced about some of her best traits (the dedication of her life in support of the arts) and her most eye-rolling (her unwavering belief that Melba toast and cream cheese represented a complete breakfast), to the shiva services in which family, friends, and extended community gathered to share anecdotes, quirks, and fond memories (and of course, food), the focus was not on grief. 

That’s not to say that there weren’t tears, but they were intermixed with laughter as we sat there together, eating bagels and lox in celebration of a life well-lived. This emphasis on life is not unique to the Jewish mourning process, but is a central tenet in Jewish philosophy as a whole. Moreso than simple recognition, Judaism holds the preservation of life as one of its highest values. By Jewish law, the pursuit of saving a life supersedes all but four of the 613 mitzvot, or G-d’s commandments, in the Torah. It is this regard that exempts the sick from fasting on Yom Kippur (the Day of Atonement), permits Jews who might go hungry otherwise to break kashrut (the dietary laws), and allows abortions to save the life of the mother. But the simple concept of preserving life is meaningless without a Jewish concept of what it means to live, and perhaps even flourish.

In the Pirkei Avot (teachings by rabbis throughout the ages), Shimon the Righteous coined the idea of al shlosha d’varim, or the three principles on which the world stands: studying Torah, performing avodah, and practicing gemilut hasadim (Pirkei Avot 1:2). To study Torah is to read the fundamental Jewish religious text and learn how to live an honorable life. Historically, avodah referred to sacrificial rites performed in the temple. Throughout the centuries its religious meaning expanded more broadly to worship and divine service, while in modern Hebrew, avodah simply translates to work. Finally, gemilut hasadim are acts of loving kindness, a spiritual calling for Jewish people to help others.

There is interplay between the concept of an individual’s actions in following the al shlosha d’varim and the flourishing of broader society. In Jewish teachings, it is clear that the personal and the community are intrinsically linked concepts, and that one cannot find meaning without the other. From the Torah, we Jews learn the mitzvot and the stories of our people, providing an ethical framework and bringing us closer to our communities, our history, and to G-d. This is the fundamental basis for the Jewish concept of l’dor v’dor, a phrase which translates to “from generation to generation,” and encompasses the sharing of traditions, stories, and values between generations. In participating in l’dor v’dor, we enrich both our own lives and those of our communities by building bonds of love and respect.

In practicing avodah, we Jews find spiritual fulfillment, which may seem personal at first. However, communal worship is a requirement in religious Judaism. For public prayer, a minimum of ten people (historically men) must participate in order for the obligation to be met. 

But I would also like to point out that avodah means more than just worship; it also refers to divine service and work. These two concepts remind me of a story that my rabbi used to tell, in which every week a man would bring a loaf of bread as an offering to G-d and leave it in the ark, where the Torah scrolls are kept. And every week, another man would come pray to G-d, asking for food to feed his family. When he would open the ark, the bread would be there, his prayers answered. When the two discovered each other, both were initially upset; the first because G-d was not receiving his offerings and the second because G-d was not answering him. But their rabbi simply laughed. G-d, he said, was listening to their prayers. By offering the bread, the first man was acting as the hand of G-d to fulfill the prayers of the second.

The story illustrates that divine service is not passive, and that true prayer is not just holy words, but actions that emulate the divine. This understanding is fundamental to the third pillar of al shlosha d’varim: gemilut hasadim, or acts of loving kindness. The scope of this is broad, encompassing anything from caring for the sick, to volunteering at a food bank, to waking up to drive your brother to school at 6:00 AM so he doesn’t have to bike in the rain. Gemilut hasadim is about dedicating your actions to uplifting your community in a way that is personal. 

Gemilut hasadim is notably separate from tzedakah, generally translated as charity, one of the most important mitzvot. It is explicitly commanded in in the Torah to “open your hand to the poor and needy kin in your land” (Deuteronomy 15:11). But in modern translations, tzedakah means more than just charity. The root of the word is tzedek, meaning justice and righteousness. Giving charity can thus be seen as a facet of restoring justice to the world. With this interpretation, tzedakah has extended to not just mean giving money, but also giving time, reiterating the importance of actions in Judaism. This concept underlies Jewish support for many social movements: if we ourselves are to flourish, then we must ensure that everyone can flourish.

The concepts of al shlosha d’varim, l’dor v’dor, and tzedakah come together in turn to form the spiritual foundation for tikkun olam, the Jewish imperative to repair the world. In Kabbalistic Judaism, this moral mandate is explained through the shattering of the vessels, a revision of the creation myth. In this story, when G-d is creating the world, he puts his divine light into several vessels. These vessels were intended to be spread throughout the universe and make it perfect.

But the vessels were unable to contain G-d’s divinity and they shattered, sending sparks far and wide. Tikkun olam, Kabbalistic Judaism states, is the process of finding the sparks and gathering them, by acting as the hands of G-d in helping others. When enough of these sparks are gathered, the vessels can be restored, and the world can once again be made whole. Tikkun olam, in essence, is a directive for how to live a meaningful life. The concept of human flourishing in Judaism then becomes a simple question: how can one do the most to help others and uplift the world?

It is this cultural mindset that encourages many Jews, such as me, to pursue a career in medicine and informs our perspective on providing care. Medical practice inherently encompasses many critical Jewish values, namely an ultimate respect for life and acts of loving kindness. Healthcare workers dedicate their time, on nights, holidays, and weekends, to ensure that the ill can continue to receive life-saving care. Medical education is itself l’dor v’dor, as knowledge, passion, and ritual are passed down from each generation of physician to incoming medical trainees. And the medical field is a community intended to uplift patients, families, and healthcare workers, a direct extension to the communities that we as Jews are morally called to participate in.

The Jewish physicians that I know flourish when their patients flourish, but only so much can be done by the bedside. Thus, the concept of tzedek teaches us that as physicians we have a responsibility to ensure that patients are being treated with justice, both in the clinic and in the broader world. This is ever more important in a society where the cost of care continues to increase, and people are threatened with lack of access. We must strive for tikkun olam, to repair the parts of the system that are broken and advocate on a broader level as a community.

This past Thanksgiving, my grandfather pulled me aside to give me some words of wisdom as a lifelong physician himself. Remember, he said, that medicine is not just a practice, but a privilege. In this, I see a redefinition of the word avodah. Perhaps the distinction between worship, divine service, and mundane work is far smaller than one might initially imagine. When the work is serving others, is that not a form of worship in its own right? I hold all of these Jewish principles close when learning to provide care, when advocating for my patients, and when approaching difficult situations with respect and an appreciation for life. In becoming a medical practitioner, I am laying the groundwork for my own Jewish flourishing.


Sarah Root is an MD/PhD student at the Pritzker School of Medicine at the University of Chicago; she was in her second year of the program when this essay was published in December 2022. She is a graduate of the University of Pennsylvania and is passionate about the intersection of Judaism and ethics. Email: sroot@uchicago.edu

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