Dr. George Berci: Beyond the scope

Those who know Dr. George Berci describe him as a visionary, and it’s not just because the world-renowned surgeon pioneered the techniques that serve as the foundation for endoscopic procedures that have changed the field.

At 92, the Holocaust survivor is still contributing to medical advancements as the senior director of minimally invasive surgery research at Cedars-Sinai Medical Center.

“The techniques he developed have had a profound impact on a generation of surgeons,” said Dr. Bruce Gewertz, chair of the department of surgery at Cedars-Sinai. “He is a towering figure in our profession.”

Endoscopy is a procedure that allows doctors to view the inside of the body using a tiny camera attached to a thin, long tube. It can be used for diagnostic purposes or, when used in surgery, allow for smaller incisions that allow for a faster recovery and fewer side effects.

As an innovator in endoscopy techniques and technologies since the 1950s, Berci’s work not only led to new visualization techniques, instrument minimizing and high-definition cameras, but also took him to 40 academic institutions around the world where he taught surgeons and continued to improve the imaging and viewing capabilities of endoscopes.

His first love, though, was music. Originally from Szeged, Hungary, Berci moved with his family to Austria in 1922 when his father was hired as the assistant conductor of the Vienna Philharmonic Orchestra. As a child, he learned to play the violin and by 10 he was playing concertos.

In 1936, his family returned to Hungary to escape from the rising anti-Semitism in Vienna, although discrimination continued to be prevalent. In 1942, at the age of 21, Berci was taken to a forced labor camp, where he spent the next two years. Later, he was transferred to Poland to unload explosives. 

“There were people in my age group who were sick. For instance there were a couple of epileptic boys. Some of the wardens didn’t believe they were sick and put them out in the snow; they died there,” Berci said. “At that time, life didn’t mean very much because we saw how many of our friends were killed. Therefore you became very fatalistic.” 

After narrowly avoiding being sent to a concentration camp — Berci said the train car he was on was abandoned by guards — he eventually was reunited with his mother and began working with the Hungarian underground. At the war’s close, he returned to Szeged in search of food and with the hope of studying music at the academy.

“I understood music,” Berci said. “Having a Jewish mother, she told me that under no condition will you be a conductor — you will be a doctor.”

In 1945, he was accepted into medical school in Szeged, graduating summa cum laude, and his interests emerged in the areas of experimental surgery and instrumentation. Following the failed 1956 Hungarian Revolution, Berci immigrated to Australia on a Rockefeller Fellowship. 

“There are more kangaroos there than people,” said Berci, who in 1957 was the first foreign physician accepted as a surgeon and a teacher. “I didn’t speak a word of English, and they gave me six months to learn the lingo to teach medical students.”

He worked on the challenges of surgery visualization, and during a visit to London, met with inventor Harold Hopkins, who was working on a separate approach to the subject. Berci then introduced Hopkins to Karl Storz, founder of the eponymous company known for manufacturing medical instruments, to help make their optical advances come to fruition.

And while most people still didn’t own a television, Berci published a paper in 1961 called “Medicine and Television,” and started recording surgery. 

In the 1970s, Cedars-Sinai had an understanding for the needed specialization for endoscopy, and Berci — who arrived there in 1968 as a visiting professor — joined the faculty as director of the multi-disciplinary surgical endoscopy unit. 

Over the years, Berci has written more than 10 books, 200 scientific papers and produced more than 40 teaching films.

Recognizing that surgical training was poor, he set up teaching and guidelines as a founding member and past president of the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES), which aims to improve the quality of patient care, principally in gastrointestinal and endoscopic surgery. 

“We have to change our educational system,” Berci said. “We are over-technical — we don’t ask the patient how he feels and should take time to examine the patient more closely.”

Today, SAGES has created the George Berci Lifetime Achievement Award in Endoscopic Surgery, its highest honor. They debuted a documentary film about Berci’s life and innovations at the annual SAGES conference this past April in Baltimore.  

“It’s just a riveting story all the way through,” said Dr. Michael Brunt, president elect of SAGES and director of Berci’s film. 

“The film is really about a man who was so resourceful at every turn and who went through many trials and difficulties, yet he persisted,” he said.  “Somehow he managed to survive when it was not easy and became one of the great surgeons and innovators.”

Last year, Berci also received recognition in Budapest where he was awarded an honorary doctorate from Semmelweis University and a building in his name.

Berci, who continues to sleep with a yellow pad by his bedside in case he wakes up with an idea, still thinks he would have been a superb conductor. 

“I still love music, and this is one aspect that I don’t forgive my mother.”

Shavuot 5768: Midrash love

When I think of Torah, the first thing that comes to mind is a divine, rigorous system of laws that guides an ethical and holy way of life.

The last thing I think about is whimsy and romance.

Yet, over the past few weeks, as part of the B’nai David-Judea Congregation, I have indulged in a poetic and literary aspect of Torah that has moved me in an unusual way.

It’s called the midrash.

Midrash is a mysterious part of the rabbinical literature. It comes in many forms, but the major idea is to seek a better understanding of scripture through stories, homilies, parables, poetry, word play and so on.

Midrash is an integral part of the haggadah tradition of Jewish learning, which emphasizes narrative and philosophical commentaries, rather than strict talmudic and legal analysis.

In the yeshiva world, midrash and haggadah are the granolas of Torah learning — not taken as seriously as the meat and potatoes of Talmud. They’re seen as being too wishy-washy, too flaky and open to wide interpretation. The law is grounded, the midrash and haggadah are “out there.”

Well, a few weeks ago, I stumbled on a piece of “out there” midrash that has moved me to no end. Last Shabbat, I brought this midrash to B’nai David’s monthly “Nosh ‘n Drosh” class and shared it with a small group of shul members. Here’s the gist of the midrash (Song of Songs Rabbah):

A husband and a wife go to a well-known rabbi to get a divorce. They have been married for 10 years and do not have any children. Since they observe Jewish law, the man must marry another woman to fulfill the commandment to be fruitful and multiply.

The rabbi sends the couple away and tells them to make a “holiday” for one night. Since they were united in celebration, he explains, they must separate the same way.

The couple follows the rabbi’s instructions. During their private celebration, the husband, now a little inebriated and in a festive mood, tells his wife that she can have anything she wants from the house and bring it to her father’s house.

While he is sleeping, she orders the servants to pick him up and transport him in his bed to her father’s house.

He awakes at midnight and says: “My beloved, where am I?”

She says to him: “In my father’s house.”

He says: “What am I doing in your father’s house?”

She says: “Is that not what you said to me last night, ‘Anything you desire in my house, take it and go to your father’s house’? There is nothing I desire more in the world than you.”

They went back to the rabbi and he prayed over them and they had children.

The more I reflected on this midrash, the more it moved me. The couple was so obsessed with their obligation to “be fruitful and multiply” that they forgot how much they loved each other. The rabbi (in the actual midrash, it is the famous Shimon Bar Yochai, author of the Zohar), by sending them away for a one-night “holiday” — even though the law called for a divorce — liberated them just enough from their obligations that they could rekindle and rediscover their love for each other.

The rabbi could have given them a blessing for children at the beginning, but he wanted to test their love. He knew how important it was for children to have parents who love each other. When he saw how much the husband and wife wanted to be together, he saw they were worthy of the blessing.

For me, the midrash also spoke to a romantic notion of purity in relationships: The idea that “I want to be with you because I want to be with you.”

We don’t need to create something to want to be with each other.

I could have gone to any number of Torah classes on love and relationships and not absorbed as much spiritual nourishment as I did from this one little midrash. The quirky love story drew me in. It disarmed me. It didn’t preach to me or tell me what to do. It worked on my imagination and made it take off.

Even more, it made me marvel at our tradition.

How remarkable that a religion that is literally inundated with laws and codes of behavior can find the time for literature and parable?

How extraordinary that the same rabbis who pontificated endlessly in the Talmud on the minutiae of this law or that law, would find the mental and emotional space to explore the poetic and philosophical unknown?

When comparing the world of law (halacha) to the midrashic world of stories and philosophy (haggadah), the great Jewish poet Haim Bialik wrote: “Halacha wears a frown, aggadah a smile. The one is pedantic, severe, unbending — all justice; the other is accommodating, lenient, pliable — all mercy. The one is concerned with the shell, with the body, with actions; the other with the kernel, with the soul, with intentions. On one side there is petrified observance, duty, subjection; on the other perpetual rejuvenation, liberty, free volition.”

Lest you think Bialik favored one over the other, he concludes: “Halacha and aggadah are two things which are really one, two sides of a single shield. Aggadah is the plaintive voice of the heart’s yearning as it wings its way to its haven; halacha is the resting place, where for a moment the yearning is satisfied and stilled.”

Some days, the voice of the heart’s yearning is the one we hear the loudest.

David Suissa, an advertising executive, is founder of OLAM magazine and Meals4Israel.com. He can be reached at dsuissa@olam.org.

Doing the Dirty Work

Rabbi Safra roasted the meat. Raba salted the fish.

According to the Talmud, this is what these two great sages did every Friday afternoon, in preparation for Shabbat. The Talmud regards this information as noteworthy because, although both sages certainly had others in their households who could have done this work, they insisted on doing it themselves. “It is greater to do the mitzvah with one’s own hands than to delegate it to others” was the motto by which Rabbi Safra and Raba lived. And they apparently applied this motto without discrimination. It pertained to messy or smelly mitzvot just as it did to mitzvot that did not get one’s hands and clothing dirty. A mitzvah is a mitzvah.

I remember reading journalist Ari Goldman’s book, “Finding God at Harvard.” He recounts, at one point, an oft-repeated request that his mother would make during the years of his childhood: “Do a mitzvah Ari, and take out the garbage.” Goldman notes with joy and wonder the way that we elevate the most mundane, physically dirty activity to the level of sacred act.

This important perspective on the irrelevance of esthetic pleasantness to the performance of mitzvah is critical to our religious vision. It is the premise that inspires the wonderful “Mitzvah Days,” sponsored by synagogues and federations everywhere, which include cleaning up polluted beaches and scraping graffiti off the walls of playgrounds. It is the understanding that animated some of my all-time favorite people to go out every single Saturday night on the “midnight run” — a tour of several New York City subway terminals, at which they distributed sandwiches, blankets and conversation to the city’s homeless.

I suspect that the source of this idea is to be found in the portion we read this Shabbat. It begins with the command to clear the ashes off the altar at the beginning of each Temple workday. “And the kohen shall don his linen garments and remove the ashes which the fire had produced, and he shall place them next to the altar.” After he’s done that, he is to remove them from the Temple altogether. This must have been a messy job. Yet the Torah ordains that it must specifically be done by a kohen, and by a kohen who must specifically wear white clothing, to boot. It seems an unavoidable conclusion that the Torah was here going out of it way to establish this point — that mitzvah and esthetic pleasantness having little to do with each other.

It is interesting to note that the daily clearing of the ashes became a highly prized assignment within the world of the Temple. The Mishna attests to the competition that attended the privilege of performing this task. The Torah succeeded in implanting its ethic. We should not be surprised about how strongly the Torah and Talmud make this point. After all, the world is not such a clean, sweet-smelling place. If we’re going to succeed at all in “fixing” it, we have to get dirty and understand that getting dirty is a mitzvah.

Like most counter-intuitive religious insights, this one, too, requires daily reinforcement. Let me suggest something that I intend to try, and perhaps you’d like to try, too. With a little reflection, I bet I could compose a kavannah (statement of religious purpose) that I could recite before doing the family’s laundry, or before washing the dinner dishes. Are these not tasks through which I express love for my family, and gratitude to God for having blessed me with them? Couldn’t a similar kavannah be composed for the act of changing a diaper? Surely, one could be recited before kashering the oven for Passover.

If our tradition has it right, these daily reinforcements could change the way we see the world. They could help us to see mitzvot everywhere we look. They could help us to look out each day, and to not see a world that’s a big mess, but to see a world that is waiting for a few more people to roll up their sleeves and get dirty.

Yosef Kanefsky is rabbi at B’nai David Judea in Los Angeles.