Cracking open our hearts

Tradition tells us that the Gates of Repentance stay open until the end of Sukkot. The intensity of Yom Kippur has diminished, but we still remember the hours together, knocking on our hearts, trying to do spiritual CPR, to wake us up to the truth of our lives. On Yom Kippur, we cracked open our hearts to make them softer, to admit our vulnerability, to forgive others and ourselves for not being perfect. We spoke the words of the traditional Vidui, the Confession, which are written in the first-person plural — “We have sinned” — because we are part of a larger community, and we all have responsibility for one another. Confession is the first step in taking off our masks and beginning the work of repairing the hurt we have caused. Vidui comes from the root that means “to reveal.” 

On Yom Kippur at Temple Emanuel of Beverly Hills, we added a new dimension to the Vidui experience. Just before we chanted it collectively, we asked our congregants to write on a card one or two “sins” that had caused them to feel shame in the past year, some action or behavior for which they wanted to do teshuvah (repentance). People took some time in silence to reflect and then to write. Writing it down, even anonymously, wasn’t easy. But many hundreds of congregants did so. Here’s how one congregant, a fourth-generation member of the congregation, described the experience: “The clergy took a huge risk with this innovative prayer ritual. Writing down my personal sins before the Vidui intensified the experience of confession. And then, just before Neilah, as the gates were closing, the sanctuary lights were dimmed, and while congregants came up to the bimah to stand before the open ark, many of those sins were beautifully displayed anonymously on a PowerPoint presentation on a screen for all to see. I sat with my brother and silently read the displayed sins, and then we turned to each other and nonverbally acknowledged whether that one might apply to us. In many ways it was a fitting bookend to tashlich, where we throw ceremonial sins into the Pacific Ocean.” 

Some of the sins were just a word: “pride,” “greed,” “narcissism.” Some were descriptions of behaviors: “holding a grudge,” “being impatient with my children,” “using substances that are not good for me,” “spending recklessly,” “adultery.” Still others evoked a specific story — “the sin of anger held for years against my sister,” “talking about something that is someone’s private business,” “I said some cruel things to my daughter that I never should have said.” Most of the sins were connected to our families — impatience with children and partners, lack of attention or gentleness with older parents, putting too much pressure on children in order that they reflect well on us. Some sins were connected to work — “lying to colleagues,” “contributing to the petty dramas at work,” “not reporting all my income.” Some related to our engagement in the larger world — “that statistics of massacres evoke no sympathy in me,” “averting my eyes when I see a homeless person,” “not giving enough tzedakah even though I could afford to.” 

Seeing all these sins, our sins, revealed on a screen was surprisingly moving. Many people wept. Even in our privileged community, there is so much pain and shame. And we long for forgiveness and the opportunity to right the wrongs we have done and to begin to repair the hurt we have caused. 

Another congregant reflected: “I was particularly moved by the Vidui cards. I heard numerous comments from other congregants about how powerful and transformative this experience was for them, too. This was a great innovation and use of technology to facilitate genuine constructive repentance.” A third reflected, “The effect of seeing my own confession of sin and that of the members of our congregation was profound. I felt on a visceral level a recognition that I had committed many of the offenses that were on the screen and hadn’t acknowledged them before. I know I was not alone in this reaction, as the Vidui has been a topic of conversation at each gathering of temple members I have been with all week, including my break fast, the book club and other social gatherings. It feels that the revelations and examination of our sins will continue on through the year and hopefully trigger necessary attitude and behavioral change.” Still another congregant commented, “Seeing the sin I wrote, my sin, displayed anonymously among other sins of the people around me, was powerful in ways I hadn’t expected. I felt like I had taken off a mask. During the Ashamnu of Neilah, I felt as though my heart had cracked open.” 

We asked congregants and their families at the family service to write their sins as well. I learned later that one 5-year-old who knows his letters asked his mom: “What letters spell ‘Sorry, God’?” 

Sukkot is almost over. It is called Zman Simchateinu, “Season of Our Joy.” What is the nature of that joy? One answer is that it is the joy of knowing what we learned through the hard work of Yom Kippur: Yes, we are imperfect human beings, but we are also forgiven. So we can enter into this New Year believing that change is possible and that we can begin again.

 As Leonard Cohen so powerfully sings: 

“Ring the bells that still can ring

Forget your perfect offering

There is a crack in everything. That’s how the light gets in.”

The gates may be closing, but we have cracked open our hearts and the light came in.

Rabbi Laura Geller is a senior rabbi of Temple Emanuel of Beverly Hills (

Hospitals and community clergy: A match made in Heaven?

I remember the life-and-death confrontation as if it happened yesterday.

An oncologist was trying to deliver painful news to the son of a grievously ill cancer patient. 

“Your mother is actively dying,” the physician said. “I’m not sure if there is a benefit to further aggressive treatment.”

The son shot back: “You must! My rabbi left clear instructions for me to make sure we do everything possible at all costs.” 

The doctor explained that resuscitating the dying woman would only cause her more suffering and would be medically and ethically inappropriate. The son would not listen. He stood up, face to face with the doctor, and said, “You will resuscitate my mother or I will grab your hands and force you to!” 

I recount this story to highlight an all-too-common experience with well-intended clergy members who become involved in medical care, often without fully understanding the implications of their religious or spiritual guidance. This tension was underscored by a fascinating new study in The Journal of the American Medical Association (JAMA). It found that terminally ill patients who frequently turned to their religious communities for spiritual support were more likely to pursue aggressive medical interventions at the end of life regardless of the medical appropriateness of the care. These patients also were more likely to die in an ICU and less likely to receive hospice care. 

On the other hand, the study revealed that end-of-life discussions and the provision of spiritual care by medical teams (including doctors, nurses and chaplains) resulted in less aggressive interventions at the end of life, reducing suffering for patients nearing death.

These results warrant discussion. The study’s authors conjecture that support from clergy members in the community can result in such intense treatment because they may not clearly understand biomedical realities. Well-meaning clergy also may hold firm to a belief in miracles, or focus on the sanctity of life, hope and perseverance even as patients endure the most severe suffering.

Spiritual care providers in hospitals frequently advocate on behalf of the infinite value of the lives of the terminally ill and often defend decisions to pursue treatment that may be called “futile.” Judaism, as I see it, obligates us to do everything possible to prolong life. At the same time, it encourages us — out of respect for the sanctity of human life — not to prolong the dying process for a terminal patient who does not want to suffer. We must keep people alive as long as we can unless it is counterbalanced by extreme pain and suffering, at which point Jewish law permits a compassionate response of allowing (but not causing) the death process to occur with appropriate palliative care. This was the ruling of Rav Moshe Feinstein, widely regarded as a leading 20th century authority on Jewish law. Our challenge is to determine when a patient’s treatment has gone from life prolonging to dying prolonging. These decisions are often further complicated by some distrustful clergy who take an “us versus them” attitude toward medical professionals. 

As a rabbi, I appreciate the incredible importance of hope. It gives people the courage to confront challenging circumstances, and can even alter neurochemistry, significantly aiding the healing process. At the same time, as a chaplain working in a hospital, I see how false expectations and excessive irrational optimism can result in unnecessary suffering, self-blame, and leave people unprepared for adversity. 

This is not to say that less aggressive intervention is always ideal, but it turns out that medical professionals aren’t simply trying to save time and money when they counsel against aggressive treatment at the end of life. We know from many studies that physicians themselves are more likely to avoid aggressive treatment and “heroic measures” before they die than are members of the public.

People who work in hospitals know that CPR is rarely as effective at saving the lives of critically ill patients as may be portrayed on prime-time television, and that it can often be a very traumatic experience that does more harm than good. 

Hospital chaplains are attuned to the complicated medical realities at the end of life and are thus essential partners in the decision-making process for patients who value religious input. 

The delicate balancing act between prolonging life and prolonging dying underscores why people should talk to their families and clergy about their medical wishes at the end of life, and put those wishes in writing by completing advance directives or living wills. The JAMA study highlights the absolute necessity for hospital personnel to reach out to community clergy to better collaborate through open and educational dialogue. That’s what we are hoping to facilitate at my hospital, Cedars-Sinai, in the coming year. As we strive to “choose life,” we recognize that, as Ecclesiastes tells us, “There is a time for everything under the heaven: a time to be born, and a time to die.”