Expired And Inspired

Vibrancy of the Deathbed Confession (Vidui) by Jean B. Berman


Vibrancy of the Deathbed Confession (Vidui), based on Learnings from Gamliel Course 4: Nechama (Comfort) by Jean Berman

Raised in a household with Jewish ethical, social, and intellectual values but little prayer of any kind, all my life I have bristled at prayers that ask the Holy One for favors or repent of sins.

In my 60’s, I find myself being drawn into the heart of Judaism. I identify not as simply a Jewish person but as part of the Jewish people. Part of my journey includes searching for meaning behind the words, including those I react unfavorably to and traditions that repulse me. I am coming to value our tradition more, and I am learning to listen deeply within to catch glimpses of understanding and to open to experiences that seems foreign or antithetical to me.

Vidui

I have always found the concept of vidui challenging. I have come in contact with teachings that have brought some understanding in the moment but little that stayed with me or substantially changed my experience of the Al Cheyt on Yom Kippur. As I began to say daily prayers a few years ago, I picked those that had resonance for me, and Ashamnu was not one I chose. I did not look forward to learning about the deathbed confession (vidui), thinking it was a depressing thing to say at the threshold of moving from the visible world into the invisible one. Having been present at a number of deaths, I have intuitively offered a supportive, silent presence or sang songs that brought comfort. I could not imagine myself encouraging a goses, someone in the process of actively dying, to speak these words.

A Change

My heart opened while reading alternative forms of the vidui authored or collected by Alison Jordan (website https://sites.google.com/site/viduivariations/). Reading language that was meaningful to me, learning that a deathbed vidui can help one to unburden, let go and feel forgiven, my perspective changed. Writing my own deathbed vidui brought me a sense of deep peace and of being gathered into the Beloved.  A daily reciting brings the feel of my death close, and heightens my joy in being alive.

As Judaism has adapted over the ages to be relevant to people where they are, I now have an age-old ritual made new again that blesses me and gives me another meaningful way to bring blessing to those I serve.

Jean Berman speaks and leads workshops on Honor and Comfort: The Jewish Way of Death and Mourning, Care of the Newly Dead – An Inquiry into Intuition and Tradition, and How Death Enhances Life: Heightening our Awareness. She enjoys walks in nature, kayaking and playing ukulele, and lives on Peaks Island, Maine. She is a graduate of the Gamliel Institute, and a Board member of Kavod v’Nichum.

Jean B. Berman

 

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KAVOD v’NICHUM CONFERENCE

Early registration for the 15th North American Chevrah Kadisha and Jewish Cemetery Conference, June 18-20, in San Rafael, California, has been extended for one week to May 8.

Our conference will have intensive workshops on Introduction to Taharah, Infection Control, Communicating about difficult Taharot, Modifying Taharah, Taharah Stories as well as exploring traditional Taharah liturgy, Navigating Taharah Liturgy – A Play, and Taharah liturgy in Maavar Yabbok.

We’ll have an exciting series of workshops on Jewish cemetery issues, including Green Cemeteries, Cremation, Perpetual Care Fund Investments, Record Keeping and Acquiring New Cemetery Property.

What’s different this year is an evolving theme – expanding the work of the Chevrah Kadisha and the Jewish Cemetery by encouraging conversation about end of life plans with the Conversation Project; end of life decision-making with Dr. Jessica Zitter, and communicating about how we die with Dr. Dawn Gross.

There’s much more – see our Preliminary conference program.

Let us know if you are interested in home hospitality.

Consider a Sunday morning pre-conference field trip to Gan Yarok – an environmentally conscious Jewish Green Cemetery.

Sunday afternoon from 2-5 Sam Salkin, Executive Director of Sinai Memorial Chapel, will facilitate an intensive session on starting & managing a community funeral home. Let us know if you are interested in this session. Attendance is by advance reservation only.

Tuesday afternoon after the conference Sinai Memorial Chapel will facilitate a tour of Gan Shalom Cemetery, a Jewish cemetery with an interfaith section. Again, let us know if you are interested – Attendance by advance reservation only.

Register for the conference now. The early rate has been extended for just one week to May 8.

We have negotiated a great hotel rate with Embassy Suites by Hilton. Please don’t wait to make your reservations. We also have home hospitality options. Contact us for information or to request home hospitality. 410-733-3700, info@jewish-funerals.org

Questions? Email info@jewish-funerals.org or call 410-733-3700.

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TASTE OF GAMLIEL

In 2017, Kavod v’Nichum and the Gamliel Institute are again sponsoring a six-part “Taste of Gamliel” webinar series. This year’s topic is From Here to Eternity: Jewish Views on Sickness and Dying.

Each 90 minute session is presented by a different scholar.

The May 21st session is being taught by Rabbi Elliot Dorff, well known author, teacher, and scholar.  

Taste of Gamliel Webinars for this year are scheduled on January 22, February 19, March 19, April 23, May 21, and June 25. The instructors this year are: Dr. Dan Fendel, Rabbi Dayle Friedman, Rabbi Sara Paasche-Orlow, Rabbi Richard Address, Rabbi Elliot Dorff, and Dr. Laurie Zoloth.

This series of Webinar sessions is free, with a suggested minimum donation of $36 for all six sessions. These online sessions begin at 5 PM PDST (GMT-7); 8 PM EDST (GMT-4).

Those registered will be sent the information on how to connect to the sessions, and will also receive information on how to access the recordings of all six sessions.

The link to register is: http://jewish-funerals.givezooks.com/events/taste-of-gamliel-2017.

More info – Call us at 410-733-3700 or email info@jewish-funerals.org.    

Click the link to register and for more information. We’ll send you the directions to join the webinar no less than 12 hours before the session.

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GAMLIEL INSTITUTE COURSES

UPCOMING COURSE

Gamliel Institute will be offering course 2, Chevrah Kadisha: Taharah & Shmirah, online, afternoons/evenings, in the Fall semester starting September 5th, 2017.

CLASSES

The course will meet on twelve Tuesdays (the day will be adjusted in those weeks with Jewish holidays during this course). There will be an orientation session on Monday, September 4th, 2017.  Register or contact us for more information.

REGISTRATION

You can register for any Gamliel Institute course online at jewish-funerals.org/gamreg. A full description of all of the courses is found there.

For more information, visit the Gamliel Institute website, or at the Kavod v’Nichum website. Please contact us for information or assistance. or call 410-733-3700.

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DONATIONS

Donations are always needed and most welcome to support the work of Kavod v’Nichum and the Gamliel Institute, helping us to bring you the conference, offer community trainings, provide scholarships to students, refurbish and update course materials, expand our teaching, support programs such as Taste of Gamliel, provide and add to online resources, encourage and support communities in establishing, training, and improving their Chevrah Kadisha, and assist with many other programs and activities.

You can donate online at http://jewish-funerals.org/gamliel-institute-financial-support or by snail mail to: either Kavod v’Nichum, or to The Gamliel Institute, c/o David Zinner, Executive Director, Kavod v’Nichum, 8112 Sea Water Path, Columbia, MD  21045. Kavod v’Nichum [and the Gamliel Institute] is a recognized and registered 501(c)(3) organizations, and donations may be tax-deductible to the full extent provided by law. Call 410-733-3700 if you have any questions or want to know more about supporting Kavod v’Nichum or the Gamliel Institute.

You can also become a member (Individual or Group) of Kavod v’Nichum to help support our work. Click here (http://www.jewish-funerals.org/money/).

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MORE INFORMATION

If you would like to receive the periodic Kavod v’Nichum Newsletter by email, or be added to the Kavod v’Nichum Chevrah Kadisha & Jewish Cemetery email discussion list, please be in touch and let us know at info@jewish-funerals.org.

You can also be sent an email link to the Expired And Inspired blog each week by sending a message requesting to be added to the distribution list to j.blair@jewish-funerals.org.

Be sure to check out the Kavod V’Nichum website at www.jewish-funerals.org, and for information on the Gamliel Institute and student work in this field also visit the Gamliel.Institute website.

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SUBMISSIONS ALWAYS WELCOME

If you have an idea for an entry you would like to submit to this blog, please be in touch. Email J.blair@jewish-funerals.org. We are always interested in original materials that would be of interest to our readers, relating to the broad topics surrounding the continuum of Jewish preparation, planning, rituals, rites, customs, practices, activities, and celebrations approaching the end of life, at the time of death, during the funeral, in the grief and mourning process, and in comforting those dying and those mourning, as well as the actions and work of those who address those needs, including those serving in Bikkur Cholim, Caring Committees, the Chevrah Kadisha, as Shomrim, funeral providers, in funeral homes and mortuaries, and operators and maintainers of cemeteries.

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Accepting the end


The hospice patient, an innovative leader in his profession, was in his last moments of life. His eyes rolled back into his head, and his breath began to catch in his throat. His devoted wife was not ready for him to go. She climbed up onto his bed, grabbed him by the lapels of his pajamas and shook him, screaming “No! Do not leave me!”

The patient’s gaze returned, and, as his wife later described it, she could see through his eyes into eternity. They held each other’s gaze for several minutes, and then his eyes closed for good. He was gone.

The wife told this story at the patient’s funeral, feeling that it captured something important about her beloved. She was pleased. But our ancient rabbis and commentators, I thought to myself, would have been shocked. For them, this is not the proper way to treat someone as they die.

Judaism is very clear about the precious, holy time of transitioning from this world into the next. Known in medical circles as “actively dying,” it is characterized by raspy breathing, slowing vital signs, and a lack of interest in food and water. It can last from a few hours to several days. 

Judaism has a name for this important stage of life: goses (rhymes with “no less”). As it says in the Talmud (Shabbat 151b), when someone is a goses, they are like a candle whose flame is flickering — if you reach out to touch it, you may put it out. 

So many people today die in hospital rooms, surrounded by beeping machines, yammering televisions, and teams of medical professionals that flood in to administer electric shocks and break bones. This all flies in the face of what Judaism says God wants us to be doing for the dying patient. 

Of course, there are times when modern medical interventions are appropriate to “save” a patient from death, but suffice it to say there are times when it can do no one any good. It is in the latter situation, when the end of life is nigh, that Jewish teachings want caregivers to adopt a very specific attitude: Keep at the forefront of your mind the idea that any action could either hasten or delay death, so it should not be taken. This is a time for self-restraint. Be tender and quiet, and let the death follow its natural trajectory. Let go, so that the patient can as well. 

The rules of goses, and how I suggest the Jewish families I work with observe them (when they are open to them), are as follows:

• Minimize sound. Turn off machines and televisions. Speak quietly. Play only quiet, gentle music or sing sweetly to the patient.

• Minimize touch. Gentle kisses and strokes are fine, as is dabbing the patient’s mouth with a wet sponge to keep it moist. But do not shake, jab, squeeze or move them. Don’t call 911 and rush them to the emergency room, nor rush them home from the hospital (lest they die in the ambulance). Don’t even change their pillow or their diaper — unless you are confident that it is an impediment to comfort and ease that needs to be removed.

• Do nothing bracing. Do not wipe the patient with a wet washcloth or put an ice cube in their mouth. Do not squeeze or pinch them, such as with a blood pressure cuff or an IV needle. It is clear that they are dying; it is not necessary to track each step of it on a medical chart. Hospice nurses should be amenable once you explain that this is a religious preference. But if the patient is in a hospital, it may take stationing someone in the room to negotiate and actively refuse interruptions to the patient’s peace.

• Speak gently. Offer words of reassurance. Do not order the patient not to die, nor to die today. Tell them everything is fine with you, and that they are safe, and that death will be the right thing for them to do, when they are ready to do it. All is well.

I have known people who held on long after they should have died — for months — even though they were being tortured by their health condition. It seemed they were fulfilling a demand, telegraphed to them by their families, not to leave. It’s just not a fair thing to ask.

Dying is not inconceivable or bizarre. We have made it a taboo in our culture, but dying is just as normal and normative as having sex, giving birth or even going to the bathroom. It is something we need to relax and let our bodies do. We need not fear it. It will come when the time is right, and then it will be up to everyone to face it with respect, and let it unfold with grace.

The Talmud (Ketubot 104a) tells the story of Rabbi Judah, who was dying and in pain, but who was so beloved by the community that the rabbis declared a public fast and offered prayers, day and night, to keep him among the living. His housekeeper saw his suffering, however, and interceded. She threw a jar off the roof, and the praying rabbis paused in unison. In the silence, the rabbi died. 

The story is told in praise of the housekeeper. The commotion and pleading of the rabbis was in its own way torture to Rabbi Judah’s soul. It just needed some peace and quiet so it could move on.

The rabbis of old may have had it easy, believing as they did that even reaching out and closing the eyes of a goses could be punished in the afterlife as murder. Today, it takes real bravery to contain one’s inclination to interfere.

Perhaps remembering the rules of goses, and the needs of the soul to return to That From Which We Came, can help give us this strength.

Rabbi Avivah W. Erlick is a board-certified health care chaplain working in home hospice and institutional settings. She owns a referral agency for clergy in private practice (lacommunitychaplaincy.com), and is a provider of creative Jewish after-death ritual (sacred-waters.com). 

Facing mortality at Yom Kippur


Regardless of our race, religion, gender or age, we all have something in common: We’re all going to die.

My friend Eve Elting passed away eight months ago, after she stopped treatment for metastatic breast cancer. At 58, she’d had cancer for 20 years. “I’ve been on 13 different chemotherapy agents,” she told me. “Enough is enough.”

Eve’s decision to die started me thinking about how people view their mortality. What makes us fear death? Why are some people not afraid? What can help us face this natural part of life with more ease?

As an oral historian, I often interview people in the last chapter of their life, either because of age or a terminal illness. I hear stories of their life and experiences, including the impact of family members dying and their own attitude about mortality.

“When I was young I was terrified of dying,” Gladys Sturman, 85, said. “My mother got cancer when she was 50. We were all sitting there crying, and she says, ‘Why are you crying? Kings die. Presidents die. What? Did you think I wasn’t going to die?’ When she said that, it totally lifted my fears.”  

When Dave Schwartz was 100, he said, “There are times when I’m very brave, and I reconcile myself to my demise. I think, it’s a passage; all living things have a beginning and a biological end. I’m looking at things rationally. But there are other times when I have a sense of sadness, a sense of nostalgia, and I have to admit, a sense of fear.”

Discussing end-of-life wishes

Starting in her 70s, my mother, Marcia Goodfriend, was adamant about one thing: “Promise me you won’t let anyone keep me alive with a machine.” She repeated this in letters and on visits and sent my sister and me copies of her Living Will. We knew what Mom wanted before she died, which made our lives easier.

Far too often, these conversations don’t happen. Yes, it’s awkward and it involves admitting that someone is going to die, which is painful. But otherwise, family members are faced with impossible decisions to continue or stop their loved one’s treatment.

“It can be very liberating to have this conversation,” Rabbi Ed Feinstein of Valley Beth Shalom said. He learned he had cancer when he was 39 and, in his 2013 Yom Kippur sermon, he told his congregation, “You need to communicate with your loved ones what you want your final days to be like. What do you need for a reasonable quality of life? When should the fight for your life be carried forward, and what are you willing to endure? And when would it be permitted to say, ‘Enough?’ ” 

Having difficult conversations

“Cancer is an illness of families, and the whole family is suffering terribly,” oncologist Daniel Lieber said. “I think people are afraid the patient won’t be able to handle hearing what their family is feeling and vice versa.  But that is really isolating.”

Lieber’s father, Rabbi David Lieber, died in 2008 from a lung disease. “He faced his mortality with open eyes, which was incredible,” Lieber said. “Many people say, ‘Why me?’ and my father said, ‘Why not me?’ I could say to him, ‘I just can’t believe what it’s going to be like when you’re no longer alive.’ We knew that we could talk to each other that way.”

Renee Marcus’ husband, Richard Marcus, an account manager in the storage and networking computer industry, died from pancreatic cancer at 68. “We talked about everything,” she said, “and that continued during the nine months after his diagnosis.  I thanked him for not dropping dead of a heart attack, so that we had time to talk. I have nothing left that I would have said to him. When I joined a bereavement group, people were envious of me, because they hadn’t talked like that. They thought they’d have the time to do it, but they procrastinated.”

Numerous resources exist to assist people in facing their fears.

Ronnie Kaye, a psychotherapist in West L.A. and herself a cancer survivor, sees many people dealing with mortality. “Each person carries a set of issues related to sickness and mortality,” she said. “No matter what age, I ask, ‘Tell me what scares you?’ It’s opening the dialogue, not knowing where it will lead, but convinced that anything they open up is something we will be able to manage together.”

It’s not unusual for someone facing the end of their life to express anger, Kaye said, and this is especially true with young adults or teenagers. “There is an extra ingredient, because it’s not the right time; there was so much more life to live. In contrast, I often hear from an old person, ‘I’ve had a good life.’ ”

Meditation, or “mindfulness,” is believed to help ease the emotional turmoil of facing illness or mortality. Arash Asher, director of Cancer Survivorship and Rehabilitation at Cedars-Sinai, agrees. “It really is about being self aware and differentiating what our thoughts and feelings are from reality, and having some sense balance in relation to that.” Finding such resources is one of the services offered by Dikla Benzeevi, a patient navigator in Studio City. “I guide them through the journey,” she said. “What’s the most critical thing to do now? What’s the best way to go about the next steps? What can you learn? Where can you get support? I talk about the best approach and help them find resources.”

Counseling both the dying and their family is something Feinstein does often. “Someone came to me when his father was dying. He expected me to have some sort of prayers or mystical rituals to carry out, and I said, ‘Yes, we have them, but it’s more important that you hold his hand and he hears your voice talking about your children and how he’s affected them.’ What we’re tying to do is to re-humanize death. By recognizing that death is what happens to us all, it gives people the courage to help each other through that.”

What might be needed in a family, Rabbi Elie Spitz of Congregation B’nai Israel in Tustin said, is encouragement to be honest about a loved one’s condition. “If I’m with a family that’s withholding that information, I counsel them to share it. The context of last words to someone who’s dying is acknowledging on both sides that the end is near. It’s essential for your relationship and closure that there is honesty and partnership.”

Doctoring

“Doctors are in the business of healing and tend to focus on that rather than acknowledging the end is near,” Spitz said. “That’s where palliative care doctors will say, ‘Here are your options and you might choose to die with less pain by not having heroic measures.’ ”

Lieber agrees. He presents treatment options – the pros and cons – and talks with patients about whether the treatment is worth it. “People are not looking for just the technical. They want to know that you care and will discuss the options and value judgments with them.”  

Kaye recalled a special example of doctoring.  “I was sitting with a patient in the hospital when Dr. Av Bluming came in. The patient said, ‘Am I dying?’ and he said, ‘Yes, you are. What questions do you have for me about that?’ The only thing she wanted to know was, ‘Will it hurt?’ and he said, ’It’s my job to see that it doesn’t.’”  

A word about hospice, or end-of-life palliative care: My mother spent her last years in a board-and-care home. Twice in her last month, they rushed her to the hospital, which was not what she wanted. I discovered that getting Mom into hospice would allow her to stay in her room at the board and care, which was now her “home.” She died there, with my sister and me telling her we loved her and singing her favorite Broadway melodies. 

Faith, God and Yom Kippur

For some, faith can help lessen the fear of dying, but if one believes a terminal illness is a punishment from God, it can be confusing.

“I don’t think God gives us cancer,” Feinstein said. “The disease is the human condition that we live with. To me, God comes into it when a doctor walks into my room at 5 a.m. to make sure I’m OK, and when we live lives of meaning and take care of each other. My faith, when I was diagnosed, focused on the people around me and reminded me of the many blessings in my life.”

The traditional Yom Kippur liturgy suggests that if one is not forgiven by God, he or she might not live another year. This can be frightening for someone with a terminal illness.

“The liturgy comes from a different world,” Feinstein said. “Rabbis have always reinterpreted ancient sources for their contemporary times. I had wrestled with those prayers and, after my diagnosis, I found new meaning in them. I understood why they needed to be reinterpreted when a person is struggling with life and death. The holiday asks you, if you had only 25 hours to live, what would you want to accomplish? What would you want to say?  That’s what Yom Kippur is about.”

Added Spitz, “The wisdom of our tradition is that Rosh Hashanah celebrates the creation of life, and Yom Kippur is the taste of death. The 10 days between the holidays offers a mini life cycle that gives us the perspective from both sides of life … the beginning and the end, leading us to know about the value of our lives.”

Finding meaning

Eve wanted to have a “good death.” She reminisced about her family, her challenges and successes, her friendships and life’s lessons. She expressed gratitude to people she loved, and she forgave both herself and others. She truly modeled finding and creating meaning before dying.

Asher started a program at Cedars-Sinai to increase people’s emotional wellbeing when facing cancer. “Even though one is in this serious situation,” Asher said, “there are still things that they can be grateful for. You can still define your own legacy and find meaning in things that are very important to you. You still have the capacity to love and to laugh.” Asher’s program is called Growing Resiliency and Courage with Cancer, or GRACE.

Benzeevi, the patient navigator, has noticed that a serious diagnosis can inspire positive life changes. “When people receive a metastatic cancer diagnosis, they may experience a major transformation. They let go of toxic relationships and create more nurturing ones. They alter their life style. Their perspective changes; things that used to aggravate them are not as important. Their priorities change. They live life at a more experiential level, with a deeper mindfulness of the moments in their day and week, and of their relationships.”

In February, the neurologist and author Oliver Sacks wrote in The New York Times about his terminal diagnosis. “It is up to me now to choose how to live out the months that remain to me. I have to live in the richest, deepest, most productive way I can.

“I have been a sentient being, a thinking animal, on this beautiful planet, and that in itself has been an enormous privilege and adventure.” 

Ellie Kahn is an oral historian, award-winning documentary filmmaker and founder of Living Legacies Family Histories, www.livinglegaciesfamilyhistories.com, which produces audio and video of oral histories for families and organizations.

Dying we live [1995]


When last I spoke to my teacher, Abraham Joshua Heschel, he asked if he could borrow my kittel. He was not at home in New York but here in California and it was before the High Holidays. “You know,” he explained “the kittel is part of the tachrichim — the shrouds in which the dead are clothed for the funeral. You know on Yom Kippur I face my mortality.” When, more than on Yom Kippur, must we face our mortality?

One must be alive to one's death. Soren Kierkegaard, the 19th century Danish theologian, would tell the story of an absent minded scholar so abstracted from his own life that he half knew that he existed, until one fine morning he awakened to find himself dead. We dare not be so abstract.

You, I, and ours are living older now and equally important we have it in our hands to prolong longevity. We have the powers to extend our lives and the lives of those we love.

In the Garden of Eden the serpent seduced the human being and whispered “On the day that you eat this fruit your eyes shall be opened and you shall be as gods.” We have eaten of the Tree of Knowledge. We have become as gods. And it is revolutionizing our lives. Listen to the radical changes.

The Lord gives, the Lord takes away. But we can give and we can take life. During the services of the first day of Rosh Hashanah, we heard the lament of Hannah the woman angry at her husband, Elkanah, because of her childlessness and embittered toward God because of her barrenness was heard. “I am a woman of sorrowful spirit. I pour out my soul before the Lord. Lord, look upon my plight.”

That was Hanna's cry yesterday. Today, doctors and geneticists have become active partners in the creation of human life. Through artificial insemination, sex pre-selection, host mothers, test tube babies, recombinant DNA technology, Hannah need not despair. Cry no more, Hannah! You are given a child. The first successful laboratory fertilization of a human egg by a human sperm — in vitro fertilization was reported as recently as 1969.

Science has radicalized our idea of ourselves and our prayers. The meaning of liturgy has changed. “How many shall pass away and how many shall be born? Who shall live and who shall die? Who shall be at ease and who shall be afflicted?” Yesterday, the prayer was bothersome to some because it smacked of fatalism. We resented God's decrees. But God has shared His powers with us. More than ever in history we are God's partners.

Who shall live and who shall die is in our hands.

“Who by injection and who by withdrawal of medication? Who by morphine and who by hydration? Who by renal dialysis and who by halting alimentation? Who by omission and who by tubulation?”

We have new power. With power comes choice. That is the mark of modernity: the radical change from Fate to Choice. Yesterday we might say it is all in God's hands. Yesterday we said “es iz bashert” which means “it is sheared”. Today the scissors are handed into our hands. We hold in our hands what existentialism calls a dreadful freedom, a dizzying freedom.

The Greek word for choice is “harein” which means heresy. Yesterday's heresies are today's liberation. Yesterday people quoted the sages: “By dint of force are you born and by dint of force do you die”. Today, we can choose whether to be born, when to be born and when to die. The verses in Deuteronomy reverberate with a different meaning. “I have given you life and death, the blessing and the curse, choose life that you may live, you and your seed.” Choose life. That sounds easy. Life is holy. God is life, the life of the world. Listen to the insistent prayers of these Days of Awe. “Remember us to life. King who loves life and write us in the Book of Life, for Thy sake O God of life.”

So holy is life in our tradition that we are told that if our life in endangered we are mandated to violate any ritual law. To endanger one's life is a graver violation than to transgress a ritual obligation.

Judaism is life intoxicated. It is not just the toast with which we cry out to each other “l'chayim — to life,” but Jewish law goes so far as to prohibit us from testifying against ourselves in a criminal case that may result in corporal or capital punishment because life is not ours to give away. My life is God's and it belongs to God.

Choose life! Did our sages not declare in The Ethics of the Fathers, 4:22,  “One hour in this world is better than the entire world to come.” One hour of repentance and good words is superior to the world to come.

Choose life, even for “chaye shaah” — one hour of life. We read from the Codes of Hilchoth Avelim: “A dying man or woman is like a flickering candle when touched by humans it is snuffed out. Therefore the eyes of the dying are not to be closed. They may not be stirred lest it hastens their death.”

Choose life! So obvious! Yet, in the hospital corridors where sons and daughters, husbands and wives, siblings, congregate: Choosing life is far from self-evident. The doctors have grimly announced that life expectancy is short, treatment is hopeless and aggressive measures will simply prolong a painful and degrading dying process. Before them lies a moribund person in a fetal position, who has gone through endless tests and tortuous treatments. This once beautiful soul, now listless, has lost her language. She has forgotten even the names of things. Her poet, Zelda, writes “How hard to part from the names of things as from the things themselves. Her ears are deaf, her mouth mute, and her face floating on the surface of the silence.” She lives like a bird that cannot fly.

The television set has long been shut off. There is nothing outside that interests her. She stares at the naked four walls without a flicker of recognition. She has become Lot's wife, a silent pillar of salt.

She is locked in an island in which there is not even one dream. Dreamless, she repeats her plea: “I get no pleasure from anything. I give no pleasure to anything. What is there here for you to love?” Her eyes beg, “Do you love me so little that you would force me to live?”

The poet, Rachel spoke her heart:
“My strength gives less and less
Be good to me, be good to me
Be my narrow bridge across a sad abyss, across the sadness of my days
Be good to me, be good to me…be a small light, be a sudden joy, be my daily bread”

I would be good to her. But what is goodness? Fed by a tube through the nose to her stomach, her bladder emptied by a catheter, sometimes vomiting from reflex movements in her throat, half alive, half dead, I can keep her going.

In the United States alone, ten thousand people are kept alive in machines. But this one is no cipher, no statistic. This gnarled, jaundiced body is my own mother. This is the woman who heard my first heartbeat, and her last heartbeat will be in my hand. “God is invisible –but my mother is God's presence.” (Heschel)

The doctors have spoken not once those fateful words “We have done everything we possibly can for her. There is nothing more to be done.” There are no prospects beyond a vegetative state.”

Choose life! I still hear the cries of her suffering organs. Shall I allow the doctor to put another feeding tube into my mother? she who is unable to swallow on her own as a result of the stroke? Now that it is inserted and she is not recovering, dare I have it removed? When is it right to remove a respirator? When is it right to forego renal dialysis or bypass surgery? I am dizzy with semantics: voluntary active euthanasia, passive euthanasia, the right to die, the right to live, heroic measures and the quality of life. What are “heroic measures”? Having contracted bronchial pneumonia, shall I deny her antibiotics? deny her what physicians call the great friend of the terminal patient? When do I ask that the DNR – “DO NOT RESUSCITATE” sign be placed over her door?

Choose life. Dare I, her son, determine what is quality life for her and what is not? Do I exercise over-zealous medicine, practice technological brinkmanship, draw out the process of dying by unduly extended medical intervention?

And to what end? Is it for my satisfaction or hers? That she die a week or a month later — tear off another page in the calendar, but die despondent, deformed, cursing her life?

Choose life. I wonder about the old man, zayde. Would he hesitate? or would he show me the Bible? Deuteronomy 32:39 “See I, even I am He. There is no God but Me. I kill and I make alive, I wound and I heal and there is no one who can deliver out of My hand.”

There are times when I would trade positions with zayde. Take away my dreadful freedom. Free me from my terrible choices. God, you decide — who shall live and who shall die.

The hour is too late. I live at the beginning of the 21st century, at the height of the bio-medical revolution. I have struck a Faustian bargain. I am as god. I am armed with marvelous physicians, with an arsenal of medical weapons, vaccines, insulin, laser beams, and ultra sound scans, radiation and organ transplantation, pace makers and heart-lung machines. I must choose. Not choosing is also a choice.

I can choose to prolong mother's life. Then I remember Karen Ann Quinlan, in a persistent vegetative state. Karen, who lost the cognitive part of her brain, was kept alive by a combination of intravenous feeding, respiration, renal dialysis and artificial heart. Fed through a tube, kept alive throughout the comatose period from April 1975 until her death ten years later. Who shall live and who shall die?

I would surrender my freedom and let God or the doctor or the rabbi choose. But I now see that there are no vicarious agents. This is my own blood and flesh and I myself must make the ultimate decision.

I look long at her in the hopeless twilight, she who has been pronounced terminal she contorted, unresponsive, kept alive only by the scientific genius of awesome machinery. And as I look at her, I see more than her: I see the reflection of my own self. She is the mirror of my soul. In dying, my confidence is shaken, I admit to deep fears and doubts and loneliness. I turn to the comforts of philosophy.

Philosophy is fine in cooler moments — speaking of the soul or eternity. The philosopher Franz Rosenzweig was outraged at the vacuous smile of philosophy when it promised immortality of spirit and denied the dying body. He cried out, “What does philosophy with its chatter about the immortality of the soul know about me, me, me,: the body that wants to remain? The body's judgment is as good as the mind's and the body shrinks from annihilation.”

I turn to the men of faith who, legend has it, are fearless before the Shadow of Death. J.B. Soloveitchik, the man of faith, confesses his irrational fears. “At times I am given over to panic; I am afraid of death. At other times, I am horrified by the thought of becoming, God forbid, incapacitated during my life time. I don't know what to fear, what not to fear: I am utterly confused and ignorant.”

I turn to my mother. Now as I look at my mother, I know that the deep decision refers not only to her life but to my own. What do I want for myself, I who cherish life, I who so ardently believe in the sanctity of life, I who believe in the divine obligation of the doctor to intervene, to cure and to heal? What do I want for my own self?

What do I fear? Is it death I fear, or is it a pitied life? Is it death I fear or a protracted illness? Is it death I fear or that I become a secret object of loathing, a burden on my wife and on my children? In her bed what do I pray for?

What do I want? Do I want to prolong my life by placing machines, impediments upon my dying process? Of course I believe in the “sanctity of life” — What happens to the sanctity of life when it is desecrated by meaningless suffering, embarrassment, humiliation and dehumanizing aspects created by helplessness? It is a mitzvah to prolong life, but is it a mitzvah to prolong dying?

I wonder were others before me not anguished as myself? Did they ever pray for death? their own or others? Am I alone in this conflict between the passion for life and the compassion for the dying?

I read from the 13th century Sefer Hasidim, the Book of the Pious, “One may not prolong the act of dying. If, for example, someone is dying, and nearby a woodcutter insists on chopping wood, therefore disturbing the dying person so that he cannot die, we remove the woodcutter from the vicinity of the dying person. Also, one may not place salt in the mouth of a dying person in order to prevent death from overtaking him.” (Book of Pious, ed. Wistinetzki, p. 100) “We must not cry out at the time when the soul is departing in order to cause the soul to return and bear more pain.” So it appears that one may be silent and not always pray for life.

I recall the wisdom of Ben Sira, in the 3rd century B.C.E., which I sometimes read at funerals “Death is better than a bitter life and eternal rest than a continual sickness.”

Can a believing Jew pray for his own death or for the death of another? I find in the Talmud Ketuboth 104a, a passage in which Judah the Prince is dying. His disciples have decreed a public fast and offered a public prayer to prolong his life. His trusted maid, known for her sagacity and piety, recognizes that Rabbi Judah was approaching his death and that he was in great pain. She runs to the roof and throws a jar from the roof to distract the disciples from praying. This, the Talmud relates approvingly enabled Rabbi Judah's soul to depart in peace.

There are times writes Rabbi Nissim of Gerondi (13th century) that it is commendable to pray for the death of the patient.

I read from the Codes Shulchun Aruch (Yoreh Deah 339): “It is permissible to stop the clattering noises or the pounding of the wood near the patient because the noise delays the soul's departure. It is permitted to remove an impediment to death.”

I look for further guidance in the rabbinic responsa. They are as varied as my own. But what can I reasonably expect of Rabbis who lived long before the bio-medical revolution, before MRI's, EEG's, before catheters and chemotherapies and intubations, who measured death by placing a feather against the nostril? The human condition today is so different from that of older times. Other Rabbis wiser than I that I consult offer so many different interpretations. Once again I recognize that in the end it is I who must choose, even to choose which rabbi to listen to. Even not choosing is to make a choice. It is a monumental truth an existential truth. No one can live for me. No one can die for me. No one can suffer for me. No one can choose for me. I am forced to freedom.

Moral responsibility cannot be placed at the doorstep of God. Ultimately, it is I, not the physician, the attorney or the rabbi who decides. They should be consulted but the ultimate decision — when and what kind of measure to use, whether to make her life longer or to prolong her death, whether to hold on or to let go, all these things depend on me and my family.

People come to my study with life and death questions. I feel for those who come to me, hoping that I can open the book, and find the unequivocal answer. They want authoritarian, unambiguous answers. I cannot give it.

There are no surrogates for me and none for you. No one can tell you even whether to speak the unvarnished truth to the loved one who asks “Tell me do I have cancer?”

Even here the rabbinic responsa are divided. For some, telling the truth is imperative. Does the patient not have the right to know and to act on that knowledge? But for others, the truth should be withheld lest it cause the patient a mental or physical set-back, it must be withheld. I must conjure the disposition of the person, whether the truth will crush her hope in recovery. The world of simple absolutes crumbles. Sometimes a lie is no transgression. We read in the Book of Kings that when the messenger of the King Ben Haddad consulted the prophet, Elisha, the prophet told him: “Tell the King he will surely live.” Then he added “although I know that he will surely die.” There is no universal categorical imperative that one must act lovingly, wisely, personally. For this one must know the patient's heart. One must know the depth of one's own heart.

People come to me in the eleventh hour. There is little time for deliberation. Decisions must be made. They are forced options. The wisdom of the Midrash Ecclesiastes Rabbah 8:8 puts it wryly “None can say to the Angel of Death 'wait till I make up my accounts'.” To you who are in good health, to you who enjoy lucidity: I would plead in the ???? of the ????, “Hayom, hayom, hayom,” not tomorrow. The decisions should not come at the last moment. The decision must be made now while we are alive and clear-headed. Now is the time that the family must open up to each other. Now is no time for squeamish avoidance of the unpleasant. No time for the denial of silence. Now is the time for honest conversation, for real dialogue. Do not procrastinate. Now is the time to draw close to the family!

The family is not simply an economic unit. This is mishpochah, the intimate sacred center of life and death. Now is the time for anticipatory wisdom to learn the heart of the stranger in each other and the stranger in me.

Now is the time for the family to join together and reach agreement.

Do we understand each other, do we understand our wishes and wills? The decision, the forethought must take place now, while our minds are in order, while we have time to weigh consequences. Do not postpone the meeting.

I have witnessed far too many family accusations, recriminations and guilt trail our lives because they do not know the will of the dying. Tragically perverse quarrels swirl around the sibling claims as to who loves papa most, whether the one would “turn off the switch” is callous son or the one who refuses to act is the compassionate daughter. However, the act is done, the scars of guilt remain forever. That is clearly furthest from the will of the dying and assuredly not in the interest of the family.

Now is the time to rehearse for that which is inevitable. More than medicine is involved here, more than technical and technological decisions. We are more than machines. We are fragile human beings. We must not be ignored. The dying fear to be abandoned, fear to be ignored, the dying fear helplessness. They deserve the attention of our love. Now is the time to pay them attention. Listen carefully to the whispers of my philosophy. What is valuable to them? what do they find worth while in living? what do they mean by the sanctity of life, or the quality of life? Listening is a mark of respect. Death belongs to the dying and to those who love them. My death belongs to me. Open my heart to its secret murmurings.

Blessed is scientific research. I praise the miraculous instruments, the sophisticated medical machinery. But machinery must not control us. Because it can breathe for us, make our hearts beat, empty our bladder, keep us technically alive, robotize us, does not mean the invention should be used. If we allow technology to decide for us, we make of machinery an idol, the work of men's hands. It is as the Psalmist wrote and we recite in the Hallel:

“They have mouths, but they speak not
Eyes have they, but they see not
They have ears, but they hear not
Noses have they, but they inhale not
They have hands but they touch not
Feet have they, but they walk not
Neither can they make sounds with their throats
Whoever makes them shall become like them

“Can” does not mean “ought”. Because technology “Can” does not mean that we “Ought”. We must think beyond the machine. We must think in terms of divinely human purpose.

The decision is profoundly personal. It cannot be generalized. Not for everyone living till the last possible breath. There are no absolutes here. Not for everyone life over everything. For some, pain may justify choosing death. For others, Nietzsche's insight reveals: He who has a “why” to live for can suffer any “what” may apply. Some may prefer pain to death, even as in Aeschylus' Agamemnon: “He who learns must suffer. And even in our sleep, pain that cannot forget, falls drop by drop upon the heart, and in our own despair, against our will, comes wisdom to us by the awful grace of God.”

Rabbi Menachem Ha-Meiri would choose to extend life in suffering even for one hour because in that hour he may find time to repent. Franz Rosenzweig, the philosopher, lived eight years with paralysis, and managed to write books.

But they are not us. Facing death, philosophy, theology, values take on existential urgency.

For my own sake and for those I love, I owe it to them to make my desires known. Would I leave my family alone in the dark corridors to speculate about how I would die? If I would not want heroic measures, if I do not want to linger on with paralysis, without speech, or to breathe artificially for years, I must make my decision clear to others. I must have the courage to anticipate because once I am hooked up to life support, no document can readily unhook me. I cannot anticipate every event.

But I must decide in the midst of uncertainty. But uncertain we must choose wisely. Robert Frost summed it up: “True wisdom is the ability to act when it is necessary on the basis of incomplete information.” We cannot demand of the physician or ourselves omniscience. We do not and cannot know the outcome. Still we must choose with the best information at hand and without guilt.

Give me your hand with wisdom. I need from you the art of holding on and letting each other go. Especially letting go. “For holding on comes easily. We do not need to learn it.” (Rilke)

When the shadow of the Angel of Death appears, and like my ancestor, I will wrestle him to the ground, squeeze out of him a new name: Israel “For you have struggled with God and with man and you have prevailed.” But when the messenger of Death cannot be denied, I am prepared to accept the message. I am prepared to accept it not as a defeat but as a summation, not as a punishment but as a conclusion.

I have raised these matters not to disturb your peace but to urge you to take your life into your hands. For facing death, will give us a deeper grasp on life. Once we have settled the future, we can life more freely in the present. There are multiple questions that we have –legal, halachic, moral, medical — and for this reason I have called together a panel of experienced, thoughtful persons to answer your questions and mine, to help you and me make wise and moral decisions. On Sunday, October 15, at 10:00 AM, we will together examine steps that are legally and morally important to execute: a variety of living wills, durable medical power of attorneys, Jewish wills. I want you to be there.

The Talmud talks about a good death and a bad death. There is a healthy way to live and there is a healthy way to deal with death, to see death as part of life and as a friend. In one of the most arresting statements on this subject, the Jewish philosopher, Franz Rosenzweig wrote “Health experiences even death at the right time. It is good friends with him and knows that when he comes he will remove the rigid mask and take the flickering torch from the hands of the frightened, weary, disappointed brother Life. He'll dash it on the ground and extinguish it, and then under skies that flame up for the first time, he'll enfold the swooning one in his arms and only then when life has closed its eloquent lips, he'll open his eternally silent mouth and say 'Do you recognize me? I am your brother.'”

The sage said: “Would you not die? Then die, that you shall live.” We need not die a thousand deaths of ignorance. We need to die and to live with the dignity of courage and wisdom. Living we die. Dying we live. It is given by God into our hands to choose.

Every day and night throughout the High Holydays the tradition singles out one Psalm, Psalm 27. “The Lord is my light and my salvation — whom shall I fear? The Lord is the stronghold of my life — of whom shall I be afraid? Even if my father and mother forsake me, the Lord will take me under His care…I have faith that I shall yet see the goodness of the Lord in the land of the living. Hope in the Lord: Be strong and let your heart take courage. Hope in the Lord.”

L'chayim.

Talking About Dying


From NYTimes.com:

“What should you do if your parent is drawing close to dying but doesn’t want to talk about it?” I asked.

I was sitting in Boulder, Colo., with Rabbi Zalman Schachter-Shalomi, 85. Reb Zalman, as he’s called, founded the Jewish Renewal movement and wrote “From Age-ing to Sage-ing,” a classic book on how to age consciously and well.

Read the full article at NYTimes.com.

Bernie Madoff Reportedly Dying of Cancer


From NYPost.com:

Madoff, who is serving 150 years at a North Carolina federal prison after pleading guilty to swindling more than $65 billion, has been telling fellow inmate he doesn’t have much longer to live.

“He’s been taking about 20 pills a day for his cancer,” one inmate told the newspaper. “He talks about it all the time. He’s not doing very well.”

Read the full story here.

The high cost of dying


A traditional Jewish funeral is simple and not ostentatious good news for people concerned about the high cost of dying. But while Jewish law doesn’t require embalming, elaborate floral displays or 16-gauge metal caskets with tufted crepe interiors, it does require Jews to be buried in the ground. And that costs money.

“You have to be realistic. We happen to live in an area where even a small piece of real estate is expensive,” said Mark Hyman, senior rabbi at Tikvat Jacob in Manhattan Beach, who also serves as chair of the Funeral Practices Committee of the Board of Rabbis of Southern California.

But many Jews don’t want to be realistic when it comes to paying for funerals.

Perhaps it’s denial, a sign of reluctance to accept death, let alone finance it. Never mind that other lifecycle observances b’nai mitzvah and weddings, for instance come with concomitant costs.

Or perhaps it’s a fear of the potential ruses and abuses we’ve heard about in the funeral industry, many of them exposed in Jessica Mitford’s 1964 groundbreaking book titled, “The American Way of Death.”

Today, however, the funeral industry is highly regulated by both the federal and state governments many say as a result of Mitford’s book.

The “Funeral Rule,” stipulating how funeral professionals deal with consumers, was enacted by the Federal Trade Commission (FTC) and put into effect in 1984. This has brought transparency to practices previously shrouded in secrecy; “Funerals: A Consumer’s Guide” is available online.

The Funeral Rule also requires funeral homes to give consumers who appear in person a detailed, printed list of merchandise and services, known as the “general price list.” If requested, a funeral home director must also quote prices over the phone. This allows consumers to more easily and accurately compare prices among funeral homes so they can select only those goods and services they want. Caskets and other items also must be allowed to be purchased from outside sources without incurring a handling fee.

The California Department of Consumer Affairs’ Cemetery and Funeral Bureau’s “Consumer Guide to Funeral & Cemetery Purchase,” spells out state law. Although those laws are applicable to all mortuaries, they do not pertain to cemeteries operated by religious organizations. That booklet, too, is available online.

In Southern California, the Board of Rabbis’ Funeral Practices Committee works with clergy, funeral industry representatives and the Jewish community to set standards, address issues and, as best as possible, nurture “a sacred and positive spirit of cooperation,” according the committee’s mission statement.

To that end, the committee has set a standard honorarium of $500 for unaffiliated families to pay ordained rabbis for officiating at Jewish funerals. Hyman said it is meant to represent the “time, energy and commitment that a rabbi should be giving to a family.”

The committee is also looking into the status and condition of various distressed or closed local Jewish cemeteries, among other priorities.

It’s difficult, if not impossible, to know what funerals generally cost. The national average cost of a Jewish funeral is not available, as the Jewish Funeral Directors of America keeps no records, according to executive director Florence Pressman.

And the national median cost of a funeral in America which according to the National Funeral Directors Association totaled $7,323 in 2006, without including the cost of a plot is not relevant, as it encompasses nontraditional Jewish items, such as embalming, viewing and metal caskets.

In Los Angeles, estimated costs for a traditional Jewish funeral range roughly from $3,500 to $4,500, including the casket but not the plot or the rabbi’s services. The price can be less, with package deals available through some mortuaries. But higher costs can also be easily incurred.

For example, a plain pine casket costs $700 to $900, while some all-wood caskets still considered traditional can exceed $12,000. And a customized nonkosher casket can top $30,000.

As for land, the price for a single plot can range from around $2,000 in some cemeteries to as high as $35,000. And the price of a large estate, depending on the number of spaces allotted, can go as high as a family wishes to spend, commanding as much as half a million dollars.

“It’s location, location, location,” Mount Sinai’s general manager Len Lawrence said.

Despite the familiar real estate refrain, however, it’s worth noting that what you’re buying is the right to inter not actual property. Plot prices do not fluctuate with downturns in the real estate market.

The cost of a plot, by law, also includes a certain percentage mandated for endowment care to ensure cemetery upkeep in perpetuity. That amount for ground plots a minimum of $2.25 a square foot, according to California’s Cemetery & Funeral Bureau, though cemeteries can collect more is monitored by the state, and only its earned interest can be spent on maintenance.

Some cemeteries, such as those owned by Chevra Kadisha Mortuary, are nonendowment care entities.

“Our cemeteries are older and more Orthodox,” said Yossi Manela, a Chevra Kadisha funeral director. “They’re more affordable, but they’re not for everyone.”

A burial vault is another expense that is often questioned. The container, which is usually made of cement and encloses a coffin, is not mandated by California law, but is required by many cemeteries to prevent the ground from settling and forming sinkholes and to facilitate maintenance. “Most cemeteries are referred to as memorial parks and have beautiful grounds. The vault allows for the park-like atmosphere,” said Ira Polisky, Eden’s family service manager.

To save money, some people buy plots from third-party sources. Plots offered for sale can be found in the newspaper classified ads including this newspaper as well as online, on sites like Craigslist and eBay. People sell plots because they decide to move, for example, or divorce and no longer want to share eternity. Or sometimes financial concerns force them to cash out.

Caskets also are sold through online distributors or retail stores. ABC Caskets Factory, for example, located in downtown Los Angeles, is a casket manufacturer and not merely an online store. The company offers same-day delivery to mortuaries within a 30-mile radius, accommodating families who are arranging next-day funerals in accordance with Jewish tradition.

“Our Jewish caskets are all ready. It’s no big deal,” said Isabelle Conzevoy, wife of owner Joey Conzevoy.

Online and retail sellers, however, are not regulated by the same federal and state laws that govern funeral establishments, though they are subject to state and local business laws.

However, a concern was voiced about third-party purchases. “But what do you do if the casket arrives dented or damaged?” asked Moe Goldsman, funeral director and mortuary manager at Sholom Chapels Mortuaries and Sholom Memorial Park.

For the indigent, the Jewish Community Burial Program, offered through Jewish Family Service of Los Angeles, provides a traditional Jewish burial at no cost, with participating Jewish mortuaries and cemeteries donating many of their services. (The toll-free contact number is (887) 275-4537.)

“No one should have to make an un-Jewish and undignified choice because of cost,” Funeral Practices Committee chair Hyman said.

Additionally, some cemeteries, including Hillside and Mount Sinai, do not charge for the burial of a child. “The family has enough tzuris (trouble). They don’t need any more,” Mount Sinai’s Lawrence said.

Still, the fact is, sooner or later, all of us are going to deal with the reality and the expense of death.

“It’s part of our life experience. Death is really another chapter in our life and is to be treated with the utmost sanctity,” Hyman said.



ALTTEXT
Caves of Abraham, Mount Sinai Memorial Park, Simi Valley

Planning Ahead

Rabbis and Jewish community professionals have long trumpeted the advantages of preplanning for end-of-life exigencies.
It’s not always an easy sell.

“We live in psychological denial that we are going to die someday, although we mentally understand,” said Rabbi Elliot Dorff, rector and philosophy professor at American Jewish University, who also serves as halachic consultant at Mount Sinai Memorial Parks and Mortuaries.

“That’s perfectly healthy, but not OK if it prevents us from making preparations for death,” he added.

The Funeral Practices Committee of the Board of Rabbis of Southern California, which acts as a liaison among clergy, families in need and the Jewish funeral industry, takes a strong stance on this issue.

“For parents, [planning ahead] is a gift of love for your family, not just financially, but also spiritually and emotionally,” said Mark Hyman, senior rabbi at Tikvat Jacob in Manhattan Beach and Funeral Practices Committee chair.

Ron Sobol, 54, took action after his mother’s death, soon after which he also received a flyer from Adat Ari El announcing a sale of cemetery plots the synagogue had purchased at Eden Memorial Park.

“When a parent dies, you feel a little bit more mortal,” Sobol said.

Sobol met an Adat Ari El representative at the cemetery, viewed plots in three locations and purchased companion side-by-side plots for himself and his wife, Leah.

“It seemed like the right thing to do,” Sobol said.

For people who want a traditional burial, selecting a cemetery is usually the first step. Choosing a particular plot or crypt, which is a space in a mausoleum or other building, follows.

Those set on Hillside Memorial Park or Mount Sinai Memorial Park’s Hollywood Hills location might not want to drag their feet. In 25 years or more, both expect to be out of room.

“Sold out, not filled,” Mount Sinai general manager Len Lawrence specified.

But the situation isn’t dire.

Mount Sinai opened its 160-acre Simi Valley location in 2002, giving it space for the next two centuries, according to Lawrence. Hillside is actively looking for new property, CEO Mark Friedman reported. And Eden Memorial Park, which was purchased by Service Corporation International in 1985, is “good for 100 years-plus,” said general manager Anthony Lempe.

No national statistics are available concerning the number of Jews who make advance burial preparations, but according to representatives at Mount Sinai, Hillside and Eden, the three largest cemeteries that serve the multidenominational Los Angeles community, it’s a clear majority.

“This is going to happen to all of us, and if you do your thinking and decision making at a time when you can all be open and rational and truly together, you make much better decisions,” Hillside’s Friedman said.

In addition to the plot, preplanning can include selecting the casket and, if desired, a shroud. Plus, certain services, such as taharah (the ritual cleansing) and shmira (guarding the body) can be prearranged. Even flowers can be ordered in advance.

Mortuaries generally take care of the casket and additional services. Certain cemeteries, including Hillside, Mount Sinai and Sholom, have their own mortuaries. Others are independent but work cooperatively with all cemeteries.

Fewer people, however, prepay the mortuary expenses.

“It’s really a personal decision based on a family’s current financial position,” said Helaine Cohen, a certified public accountant.

She explained that families struggling with mortgages, college tuitions and other day-to-day expenses may be better off waiting until the children leave home. Other families, with one or both spouses working, may be better positioned to pay for these expenses when their income is more substantial, before they retire.

Cohen herself admits that she and her husband have not discussed buying plots. “We just turned 50,” she said. “That’s the age to address long-term health insurance.”

But people can make many end-of-life decisions without actually prepaying for them. Most mortuaries, in fact, will

keep these preferences on record. Additionally, writing wills and creating other financial and health care directives are really part of the preplanning process, with some of these documents not subject to delay.

“I frankly think and people look at me cross-eyed when I say this that as soon as a person gets a driver’s license that person should fill out a durable power of attorney of health care,” Dorff said. He believes it’s important that parents know their teenager’s wishes in the rare case of a debilitating accident.

Dorff also recommends that parents, as they get older, write an ethical will, essentially a letter to their children specifying their life values. Additionally, he advises compiling a family history.

But people can’t preplan in a vacuum.

“It’s interesting. We encourage people to preplan, but first you have to do education,” said David Zinner, executive director of Kavod v’Nichum, the national nonprofit organization dedicated to restoring Jewish death and bereavement practices.

Generally, end-of-life education takes place in the synagogue, encompassing a session or two in a Jewish life-cycle curriculum. It’s also a popular sermon topic during the Yom Kippur Yizkor (memorial) service.

Kavod v’Nichum itself sponsors an annual conference on chevra kadisha (a holy society that prepares the body of the deceased for burial) and related topics such as chaplaincy. The organization’s next conference, in June 2009, is targeted for the West Coast, possibly Los Angeles, according to Zinner.

Moe Goldsman, funeral director and mortuary manager at Sholom Chapels Mortuaries and Sholom Memorial Park, holds a seminar annually after the High Holy Days to educate people about preneed. This year it’s scheduled for Oct. 26 at Sportsmen’s Lodge in Studio City.

And Sinai Temple is hosting a one-day seminar on death and dying on Feb. 22, 2009, open to the community. “We hope to help people begin a discussion,” said Terry Wohlberg, co-founder of the synagogue’s chevra kadisha.

A conversation about these issues, whether people actually make advance arrangements or not, can do more than ease future burdens on the survivors. It can have real-time and unexpected benefits for the people themselves.

Producer Cathee Weiss works with individuals who want to create film biographies, sitting down with them to discuss the life lessons they wish to impart to their progeny.

“There’s always reflection on the big values,” Weiss said. “The notion of what we’re going to leave behind makes all of us a little more conscious of living a life of worth, of value, of integrity.”

Obituaries


June Walker, Presidents Conference Chair and Hadassah Leader, Dies at 74

June Walker was in working mode two weeks ago.

On July 21, she presided over a farewell reception for outgoing Israeli U.N. Ambassador Dan Gillerman. Two days later she led a meeting of the Conference of Presidents of Major American Jewish Organizations, which she chairs.

Late in the week, however, tests revealed the cancer she had fought for seven years had advanced too far to allow for a new round of treatment. Walker, of Rockaway, N.J., died Tuesday at 74.

“She was such a remarkable fighter,” said Walker’s rabbi, Amy Joy Small. “She did not let it stop her. She had things to do.”

Walker, a former president of Hadassah, the Women’s Zionist Organization of America, became only the second female to lead the conference last year when she replaced investment banker Harold Tanner as chairperson.

“Leaders of the United States and Israel held her in high regard and respected the person even more than the positions she held,” said Malcolm Hoenlein, the Presidents Conference’s executive vice chairman, in a statement. “They, as we, recognized immediately her integrity, her intelligence and the sincerity of her advocacy. I am personally, as is the conference collectively, devastated by her passing.”

Walker’s nomination in April 2007 as chairperson was something of a departure for the Presidents Conference, the main communal umbrella body on foreign policy, which in recent years has been headed by prominent businessmen.

A respiratory therapist, former college professor and health-care administrator, Walker was a longtime community activist whose involvement with Hadassah began as a teenager.

In June, Walker was awarded an honorary doctorate from the University of Haifa in recognition of her years of work on behalf of Israel, and in particular her devotion to health care in the Jewish state. Walker was one of seven honorees, including a former director of the Mossad intelligence agency and three university professors, but was chosen to deliver remarks on behalf of the group.

“She told me that she was determined she was going to be strong and healthy to get to Haifa and receive this award because it was for her symbolic of her lifetime achievement, something that represented for her a culmination of her accomplishments,” said Small, who accompanied Walker to Israel for the ceremony.

Small recalled that the honorees were to walk across a balcony and down a flight of stairs, a feat that she knew would be challenging for Walker, who was suffering back and leg pain as a result of her disease.

“She held herself with such dignity and such honor you would never have known that she was suffering,” Small recalled. “And she was beaming.”

Later, Small wrote that Walker was “this generation’s Golda Meir” in an article published on the Web site of the Jewish Reconstructionist Federation.

Walker rose through a succession of positions at Hadassah before assuming the presidency in 2003, a post she held for four years. Under her leadership, the organization raised $75 million for a $210 million inpatient tower at its hospital at Ein Kerem, Jerusalem, and completed a $48 million emergency medicine facility in Jerusalem.

She also grew the student body at the Hadassah College of Technology in Jerusalem from 600 to 2,000 students.

“It is with a very heavy heart that we begin to mourn June Walker, a unique leader and a wonderful friend to many,” said Walker’s successor as Hadassah president, Nancy Falchuk. “June once said that Hadassah embodied everything she was interested in: Israel, women’s empowerment, Judaism, education, medicine and Zionism. But June personified values that Hadassah stands for: pride, dedication, and spirit enhanced by her own personal grit.”

Walker is the first Presidents Conference chairperson to die in office. The group says it has no succession plan.

“We’ve never had it,” Hoenlein said, adding that when top officials have become incapacitated in the past, former chairmen have temporarily stepped in.

Walker taught at Passaic County Community College in New Jersey and was the director of inservice education for pulmonary medicine at Columbia-Presbyterian Hospital. She is also a member of the Citizens Committee for Bio-Medical Ethics, the American Lung Association and the Reconstructionist Congregation Beth Hatikvah of Summit, N.J., according to her official Hadassah biography.

She is survived by her husband, Barrett; son, Davi; daughters, Julie Richman and Ellen; and six grandchildren. The funeral was held Aug. 31.

— Ben Harris, Jewish Telegraphic Agency



Oluwaninse Abhay Charan Adeyemi died July 8 at 11. He is survived by his father, Ayodele; mother, Adrienne Liberman; sister, Parama Liberman; and brothers, Manjari and Daniel Liberman. Hillside

Jacob Barad died July 12 at 75. He is survived by his wife, Elizabeth; and sons, David and Glenn. Hillside

Irene Barton died July 15 at 85. She is survived by her sons, Fred and Mark. Hillside

Mervyn Max Becker died July 21 at 78. He is survived by his wife, Yetta; son, Aaron; daughter, Carla; one grandchild; and sister, Elaine. Groman

Lynda Belasco died July 21 at 61. She is survived by her husband, Steven; son, Joshua; and uncle, Irving (Charlotte) Nudell. Malinow and Silverman

Dr. Murray Gill Boobar died July 7 at 85. He is survived by his wife, Helen; and daughters, Robin Lappen and Mindy Cahan. Hillside

Larry Chalfin died July 20 at 68. He is survived by his wife, Vicki; son, Charles; and daughter, Leah Gordon. Hillside

Edward Chersky died July 17 at 83. He is survived by his wife, Evelyn; and sons, Robert, Barry and Stewart. Hillside

Mania Sara Cymer died died July 12 at 97. She is survived by her sons, Harry and Max. Hillside

Ilse Erlanger died July 13 at 97. She is survived by her daughter, Susan (David) Leveton; and grandchildren, Steven Leveton and Stephanie Kinedale. Hillside

Frances Gordon died July 15 at 97. She is survived by her nephew, Peter Spring. Hillside

Dr. Lawrence Gosenfeld died July 19 at 67. He is survived by his friends. Hillside

Victoria Harris died July 21 at 100. She is survived by her sons, Godfrey (Barbara), Micheal and David. Hillside

Philip Kozin died July 20 at 96. He is survived by his daughter, Gail (Stan) Holander; and son Howard. Hillside

Anna Landsberg died July 12 at 92. She is survived by her sons, Abe and Raymond. Hillside

Charles Robert Lever died July 16 at 78. He is survived by his wife, Pamela; and stepson, Mark Neilson. Hillside

Diane Rita Mehlman died July 17 at 75. She is survived by her son, Lon; and daughter, Dina. Hillside

Emily Bell Miller dies July 14 at 93. She is survived by her daughter, Joyce (Stephen) Ranger; and granddaughter, Courtney Ranger. Hillside

Terry Lee Miller died July 12 at 69. She is survived by her daughters, Allison and Julie; four grandchildren; and companion, Norman Lieberman. Hillside

Gerald David Novorr died July 13 at 91. He is survived by his wife, Pearl; son, James; and daughter, JoAnn. Hillside

Bernard Rumack died July 21 at 87. He is survived by his daughter, Robin; and sister, Vella Bass. Hillside

Lillian Schafer died July 13 at 86. She is survived by her daughters, Sue Sanders, Lyn Caron and Elaine Thomassian. Hillside

Rubin Schieren died July 21 at 93. He is survived by his daughter, Phyllis (Ben) Berkley; son, George (Ellen); and seven grandchildren. Malinow and Silverman

Ira Schulman died July 20 at 81. He is survived by his sons, Alan and Russell; daughter, Leslie Mendoza; sisters, Davida Racine and Diane Friend; and partner, Nora Graham. Hillside

Mike Simon died July 10 at 75. He is survived by his wife, Angela; sister, Billie Evenas; and stepdaughter, Patricia Garza.

Harry Talsky died July 17 at 93. He is survived by his children, Leland and Martha. Hillside

Marla Lynn Waldman died July 20 at 51. She is survived by her father, Gerald; mother, Barbara; and brothers, Ron and Craig. Hillside

Hilda Weiner died July 15 at 93. She is survived by her sons, Arnold (Elaine) and Edward (Susan). Hillside

The Dance of Life


On Monday I buried one of my patients.

That is not so unusual given the nature of my work in healing and hospice. When I think about Fred, I am reminded that I work according to the principle of meeting people b’asher hu sham (where they are) as opposed to leading them somewhere, as the image of pastoral care might call up.

Fred was referred to me by his oncologist, who felt that he and his family could benefit from spiritual care — the patient was anxious, needy, demanding and somehow not settling into the reality that he was living with terminal cancer.

I was told to speak with his ex-wife and son first, as the patient would probably not welcome my call. I arranged a meeting with her, and she spoke of the difficulty of finding a balance for all three family members with the patient being so unhappy and demanding.

She described him as very bright; a college professor who didn’t trust most people and though they had divorced, they had remained amiable in the raising of their son. I later came to learn that Fred was born in France, an only child whose parents sent him to a convent to hide him from the Nazis. That was his early life.

I asked her what gave him pleasure or joy in life, and she didn’t hesitate for a moment: salsa dancing.

Bingo — I knew he would not hang up on me.

Fred and I shared several things in common: Cancer and salsa dancing.

I called him after my meeting with his ex-wife and asked him if he wanted to meet with me.

He said “no thank you,” he wasn’t feeling well. When I explained that was the usual condition of people that I meet with, he still declined. I then mentioned that I was a salsa dancer, and he took my number and said he would call.

Several weeks later, Fred called and asked to meet me. We arranged to have coffee at a neutral place; he was still a bit suspicious. I found him sitting, waiting for me, wearing a wig to cover his chemo baldness. My hair at this point had grown out and looked like a poodle’s.

We had an easy conversation; he talked about the numerous rounds of chemotherapy, the clinical trials, how the current one seemed to be working, and how he was getting a bit more energy and could see the road to recovery. We talked about our dancing history, same clubs, same people; we’d probably passed each other on the dance floor once upon a time.

I shared with him that my last dance was on my birthday a year and a half before, the day I was diagnosed with breast cancer. Technically, I had one quickie after that, in front of the PET scanner with a technician who had missed my veins three times before the scan and was making it up to me by showing me a fancy dip.

Fred suggested we might go dancing some time. I thought about boundaries, and client/clergy relationships, and realized that if this was the one thing that gave this man joy, who was I to step on his toes?

Besides, hadn’t I heard a colleague of mine — a hospital chaplain, herself a breast cancer survivor — tell me that, on a counseling visit with a pre-op mastectomy patient, she found herself, despite being armed with psalms and healing prayers, pulling her shirt up over her head to show this young woman her own reconstructed breast? B’asher hu sham.

Fred and I met at the club, both of us nervous about how rusty we were; how we had to face the fact that we were no longer the energetic, young dancers we had been in the past.

One of us had a wig and the other new curls, but we hit the dance floor, managing to make it through an evening of dance, with long breaks for club soda and to wipe the sweat from our brows. We vowed at the end of the evening to return and to keep practicing.

I spoke to Fred several days before he died. He didn’t want to be on hospice, didn’t want to think about dying — or to let me visit him in the hospital — but he said he thought that he had danced his last dance.

I was honored to have shared it with him — b’asher hu sham.

Rabbi Carla Howard is the founder/executive director of the Jewish Healing and Hospice Center of Los Angeles. She can be reached at Rabbihoward@jewishhealingcenterla.org.

Final lesson


In this week’s Torah portion, Vayechi, we have the most intimate description of a deathbed scene and the most elaborate description of a le’vayah (funeral)
contained in the Torah.

As I read through this portion in preparation for writing this column, I found myself struggling for a theme. I quieted my mind for a moment and found myself immersed in memories — memories of the dying, of funerals, of people working through grief. Like all congregational clergy, I have attended to the dying and their families. It is one of the holiest things I do, or, more precisely, one of things I do that makes me most conscious of the Holy.

It’s an aspect of a rabbi’s life that, I believe, is key to all of us, but one that we don’t talk about much, even to each other. I feel in some ways that a dying man helped make me a rabbi.

I was a rabbinical student at the Los Angeles campus of Hebrew Union College-Jewish Institute of Religion when I first reported to my second part-time student pulpit in Boise, Idaho, in September 1982. Linda, the synagogue president’s wife, picked me up from the airport and after a bit of chitchat asked me if I was willing to work hard. I said that I was and told her a bit about myself, to which she responded, “Well, maybe you’ll do.” She told me that there was a dying man, and she felt he needed to talk to a rabbi.

I had no idea what rabbis or anyone said to someone who is dying. It was just before Rosh Hashanah, and I thought maybe he would want to hear the shofar, so I brought it along with my prayer book.

When we got to the hospital, Linda took a seat in the waiting room, and I walked into the dying man’s room. He was having trouble breathing and looked angry. He said, “What’s that in your hand?” I told him it was a shofar, and I asked him if he wanted to hear it. He told me that if I wanted to be helpful, I could throw my shofar and my prayer book out the window and bring him a gun so he could put himself out of his misery.

I could feel that I had been play-acting at being a rabbi, doing what I thought a rabbi should do. I wasn’t real. I caught my breath, and my bearings returned.

I put the shofar and the siddur on an empty bed, pulled up a chair next to him and said, “I don’t have a gun, and I don’t know that I would give it to you if I had one, but tell me why you want one.”

He told me of his excruciating pain in taking each breath. He told me of a wasted life, of the bitterness in his family. He just wanted out.

I told him, “I want you to tell me what went wrong, what you would do differently.”

I did not ask that only as therapy, I am a bit ashamed to say; I asked for me. I suddenly knew that one of the ways I might die would be like this, in a hospital bed, in pain. Would I think of a life wasted? Would I be filled with bitterness? I wanted him to teach me.

Each word was spoken in pain, but he insisted on speaking. I filled in words for him, and eventually pulled out a notepad and started writing things down. He spoke in grief about his children and their discord. I asked him what he would want to tell them, what legacy he wanted to give them. I told him, “This is your final goal — help us live better lives.”

He grew so tired that I knew it was time to leave the room. I told Linda how it went. I could see her eyes laugh when I told her about asking him about the shofar. When I finished, she said, “You’ve got some work cut out for you here.”

I flew into Boise once a month for a few days each time. I visited with the man in the remaining few months of his life, and I spoke to his family. I helped him compose what I later learned was called an ethical will, a way of passing his values on to his family.

Linda and her husband, Alan, guided me carefully through the entire process, up through his death, which occurred when I was in Los Angeles; a lay leader officiated at the funeral. I felt the dying man’s family was transformed by his work, a transformation I hope was lasting.

I took the lessons he taught both to me and his children to heart. I became a witness to a family story, a story of love and bitterness and folly, and a final redemption. I realized that every family, every person has such a story, a fully textured life of hopes and dreams, of joy and heroism and tragedy, and we hope, of redemption.

Every life is like a book of the Torah, filled with laws and lessons, wisdom, drama and destiny. I realized something of my role as one who works with the dying and their families — if I can, to draw out a teaching, a legacy, for those left to grieve, and for me.

And as we attend to the dying, grieve with their families, draw out lessons and legacies, we strengthen them, and we are strengthened.

This column originally appeared in The Journal on Jan. 9, 2004.

Mordecai Finley is the rabbi of Ohr HaTorah congregation, as well as provost and professor of liturgy and mysticism at the Academy for Jewish Religion, California Campus.

Laugh at Death the Buchwald Way


Art Buchwald is living and dying in a Washington, D.C., hospice. If you don’t know his story, you could be forgiven for thinking this is a very sad time for the 80-year-old Jewish columnist.

Just the opposite, Buchwald says. “I am,” he announces, “having the time of my life.”

His family and friends, along with the political and artistic glitterati, are coming by to shmooze, reminisce and bring his favorite foods. He mentions that he likes corned beef sandwiches; the next day guests bring in 10.

He continues to write his column for the Washington Post and 50 other papers, but now the topics, still with his characteristic humor, are often about death, the hospice and making your own end-of-life decisions. Many people write to thank him for giving them alternatives to consider.

Here’s the story. Suffering from kidney disease, he entered a Washington, D.C., hospice in February after deciding that he didn’t want to prolong his life by having dialysis five hours a day, three days a week. He had already had his leg amputated for other reasons and he figured now: “I had two decisions. Continue dialysis, and that’s boring to do three times a week, and I don’t know where that’s going, or I can just enjoy life and see where it takes me.”

Life had already taken him, beginning at age 3, to two orphanages after his mother was institutionalized with mental illness from which she never recovered. Young Art ran away at age 17 in 1942 to join the Marines. After the war, he attended college and edited the campus magazine, but didn’t graduate because the school discovered his lack of a high school diploma.

So he went to Paris where a small job at the Herald Tribune morphed into a humor column, which in 1962 he took to Washington. During his heyday, he was writing three columns a week, syndicated in 700 papers.

His shtick was taking serious political and social issues and turning them into humor, which as we know, for whatever genetic, social or historic reasons, has always been a strong Jewish trait. Think Lenny Bruce, Mort Sahl and a 100 others. In Buchwald’s day, he was better known than Al Franken and Jon Stewart are today.

Through it all, he never lost his sense of his place in the whole story, which most of the time was outside laughing in.

“Just when you think there’s nothing to write about, Nixon says, ‘I am not a crook,'” Buchwald once wrote. “Jimmy Carter says, ‘I have lusted after women in my heart.’ President Reagan says, ‘I have just taken a urinalysis test, and I am not on dope.’ You can’t make up anything anymore. The world itself is a satire. All you’re doing is recording it.”

When President Eisenhower’s press secretary, James Hagerty, took a Buchwald column seriously and called it “unadulterated rot,” Buchwald responded with indignation: “He’s wrong. I write adulterated rot.”

Buchwald has undoubtedly earned a place in my pantheon of personal heroes, men and women whose actions in the face of impending death seem to me both inspiring and heroic: Hubert Humphrey, tennis great Arthur Ashe, professor Morrie Schwartz of “Tuesdays With Morrie,” Christopher and Dana Reeve, Lenny Zakim, to name a few.

Talk about dying with dignity. Their deaths may have come too early and been too hard, but not one of them ever lost his heart or soul or kindness, nor stopped performing good deeds in this world. Nor did they kvetch, complain, blame. Buchwald fits in well.

Should there ever — sometime, somewhere — be a meeting of these greats, along with all our friends and family members who have inspired us in life and in death, you can bet Buchwald will be there, too. And you can bet he’ll regale them all with how he beat the doctors’ forecasts of his survival by hundreds of percents, just as he regales us now when asked about the afterlife.

“I have no idea where I’m going but here’s the real question: What am I doing here in the first place?” Buchwald says, part humor columnist, part rabbi. “It’s what you do on earth and the good deeds you do on earth that are important.”

Shalom u’lehitraot, Art.

This article originally appeared in The Forward (dblevy@columnist.com

 

In Death, Still Not Parting


 

I am 33,000 feet above ground en-route to LaGuardia, accompanying my father to his brother’s funeral. I am expecting the coming days to be very difficult for my father, but not in the way you would expect. You see, my father and his recently deceased brother had not spoken in 20 years. My uncle resisted all of my efforts at reconciling them in his final two weeks, before his long battle with cancer ended his life earlier than my father had ever envisioned.

How often do we let feuds linger on believing that we have so much more time left on this earth? Sometimes, as in the case with my father and uncle, small resentments and lifestyle differences continue to simmer beneath the surface until family members stop speaking. And the longer family members go without speaking, the larger the rift becomes.

As we awaited the plane at the Delta terminal, I asked my dad what exactly happened between them. He thought long and hard.

“We had the usual sibling jealousies, we had completely different life perspectives and values and we didn’t see eye to eye,” he said. “I never liked his wife and told him so. But is that a reason to refuse my visit, a conversation, reconciliation in his final dying days? I never stole from him, I never was inappropriate with his wife.”

“I wanted badly to have a last conversation with my brother. To find out what it was all about. I guess now I’ll never know,” my father said sadly.

My father had recently written his brother a letter, but my uncle had told me he’d prefer to leave things the way they were.

I am bracing for more than chilly weather in New York. I know about the chilly reception awaiting my father. My aunt, with whom I am on good terms, wants me to tell my father about what to expect. I will not: it is too ostracizing and, in my opinion, just plain mean.

But father’s other living brother, doesn’t think so, so he decided to forewarn my father of what was ahead. Basically, my father is the only immediate family member not allowed in the limousine headed to the funeral or the cemetery. My father has to find his own transportation. At the funeral ceremony, he has to sit apart from his mother, brother and my uncle’s descendants and cannot walk in the procession. He is also not welcome in their home for the shiva.

My uncle’s surviving family says that these were my uncle’s dying wishes, and they were honoring them.

Talk about getting the last word in.

What is the point of dying with these type of instructions? My uncle went on to another world, but not before doling out the final insult to my father. At what expense are we willing to sever family ties, perhaps forever? In the case of my father and his brother, it seems that the animosity my uncle felt toward my father was not even buried with him.

There are many life lessons to be learned from this unfortunate situation:

• Don’t insult someone’s spouse lest it ultimately cause a tension between you and them;

• Don’t wait so long to reconcile differences, even a big blowout between family members;

• Refrain from tossing and alternating insulting gestures like a ping-pong ball;

• Be gracious and forgive everyone before dying.

• The most important less of all, though, is that holding on to resentment and anger really eats a person up, psychologically and physically. Some medical experts even go so far as to say that it can bring on illness and hasten death. We are all familiar with the over-used adage, “life is too short,” but life, unfortunately, can be shorter than we expect. Once a person is gone, it’s too late to bury the proverbial hatchet.

I’ve come to realize in the past few days why God commands us to judge people favorably. It’s really not for their benefit, but for ours. The Torah instructs us to help our enemy before our friend, so that we won’t have an enemy anymore. The Book of Psalms provides a profound message: “Who is the person who is looking to live?” it asks. The answer King David provides: the one who loves days to see good things happen. And his specific instructions for living well: watch what you say and seek peace.

In my uncle’s passing, I have learned that it’s best to say your piece and then make peace with the past before time has passed too far.

Any other alternative is just a dead end.

Soriya Daniels is a freelance writer based out of Philadelphia.

 

The Answer Is Love


Excerpt from “More Money Than God: Living a Rich Life Without Losing Your Soul,” by Steven Z. Leder

A few years ago, I was called to see an extremely famous and wealthy movie director. He was a friend of a friend, and he was in the hospital. We were strangers, this dying old man and I. Entering his room, I noticed amid the monitors, tubes, and fluorescent lights of the sterile ICU, there was only one solitary breath of humanity tacked up on the wall — one small black-and-white photograph, some sixty years old, of a young couple in their twenties holding hands on a park bench.

I entered the room, glanced at the photograph, and then focused on the balding, white-bearded man behind the oxygen mask. His name was John. With a curl of his hand hanging limply off the side of the bed, he motioned me toward him, removed his oxygen mask, and tried to speak. Too weak, he replaced the mask, closed his eyes, rested, and tried again. Again and again he tried. A whisper. A mumble. “John, I can’t understand you,” I told him, “but I’m not leaving until I do. So, rest and we’ll try again in a few minutes.”

Finally, pulling me gently down over the bed, John pressed his dry lips against my ear and mumbled a simple question: “What is it all for?”

Suspended in a moment both eternal and brief, there we were. The dying seeking an answer, the answer of answers, while holding a stranger’s hand; a stranger who was supposed to know. My eyes darted to the little black and white picture, then back to John, laboring for breath. And with Zen-like clarity that surprised me, I uttered a response as simple as his question. “It’s to love and be loved,” I told him. “They understood that,” I added, pointing to the picture.

“You’re right,” John whispered as he closed his eyes and drifted off to sleep. In a way, I felt sorry for John. With all of his success, he was dying alone, asking a stranger what life was really about. I believe what I told him. A life well lived is filled with love given and received, the ebb and flow of time and generosity.

No matter what our net worth, all of us can become rich with family, caring, and laughter. We can all invest in and achieve the wealth of friendship. We can all spend less time counting our money and more time counting our blessings. We can all lead richer lives, ever more grateful simply to love and be loved.

For more information, please contact Stephanie Adams at
(310) 260-9400 or go to stephanie@bonusbooks.com .

Opinions Conflict on Ending Life Support


The Florida case of a woman on life support for 13 years has put issues of how we die and when and how doctors and others should intervene on the front page. Whatever the courts say about that case, however, will only apply to federal and Florida law.

What would Jewish law say about such a case? That question is important because the issues raised in that case confront Jews often as they care for their parents, spouse and other loved ones and as they contemplate their own dying process.

The basic Jewish principle about these matters is clear: We are, on the one hand, not allowed to hasten the dying process, but on the other, we are not supposed to prolong it either.

Until just a few decades ago, it was easy to adhere to that prescription, because there was little, if anything, that doctors or anyone else could do to prolong or reverse the dying process. Now, however, we are faced with the old Kantian problem: specifically, as Kant pointed out, as soon as one can do something, then one has to ask whether one should.

Our ancestors, of course, could never have contemplated these new powers that we have. As a result, we cannot just look up the answer as if we were looking up a recipe in a cookbook. We, instead, must use judgment in applying Jewish laws, principles and sensibilities to the new situation.

When we examine the tradition, we find that there is a strong imperative to save life and health when we can, but there is also a clear recognition that we are not immortal, that Adam and Eve could not eat from the Tree of Life and that, in the words of Kohelet (Ecclesiastes), "There is a time to be born and a time to die."

Medieval Jewish sources also announce that we must do what is in the best interests of the patient, and while they assumed that that always meant trying to save the patient’s life, in our own day, when that can mean years in a coma supported by machines, that is not always as clear.

Most Jewish authorities from all movements would agree that we may and, in some cases, should remove machines or medications that are not curing the patient, whether dying or earlier in life, for every medical intervention has side effects and both emotional and financial costs.

Rabbis differ, however, regarding artificial nutrition and hydration. Some — for example, Conservative Rabbi Avram Reisner and Orthodox Rabbi Moshe Tendler — understand them to be the equivalent of food and liquids, for they function to nourish the patient. These rabbis assert that if a person cannot eat normally, we need not insert feeding tubes but may rather let nature take its course. If we do insert feeding tubes, however, we may not remove them.

I, however, maintain, as I did in a ruling approved by the Conservative movement’s Committee on Jewish Law and Standards, that artificial nutrition and hydration should be classified as medicine. That is because it does not come into the body in the usual way food does and thus lacks all the qualities associated with food, such as taste and varying temperatures and textures. Furthermore, one of the natural features of the dying process is that the person stops eating, and so by using tubes, we are effectively force-feeding a patient and thus prolonging the dying process.

Thus when Jews face these issues, they should think carefully about whether they should permit feeding tubes to be inserted into their loved one in the first place. If they do and the patient does not recover, they may, in my view, take the tubes out and let the person die a natural death, making sure that comfort care is administered.

In such cases, it is not the person removing the feeding tubes or the one who authorizes that who is killing the person; the underlying disease is. And they should do this as soon as it becomes clear that nothing can be done to bring the person back to independent functioning — long before the 13 years that it has taken the Florida courts to resolve this issue.

That is not only the wisest way to spend our limited health care dollars; it is also the most humane and theologically correct way to acknowledge that God has made us mortal.


Rabbi Elliot N. Dorff, rector and distinguished professor of philosophy at the University of Judaism, is the author of "Matters of Life and Death: A Jewish Approach to Modern Medical Ethics" (Jewish Publication Society, 1998).

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