October 17, 2019

The shofar saves a rabbi’s life: a case study

My patient, an esteemed rabbi, underwent major abdominal surgery lasting several hours. Within one day postoperatively, he was instructed to blow into a mechanical device to help prevent respiratory complications. 

Pulmonary problems are not uncommon after surgery, and they include pneumonia, atelectasis, respiratory failure, prolonged mechanical ventilation, pneumothorax, acute respiratory distress syndrome (ARDS), pleural effusion and pulmonary embolus.

Atelectasis (collapse of part or all of the lung) is perhaps the most common, particularly in those patients with neuromuscular or chest wall disease. Because atelectasis in some patients appears to be due to repeated small inspirations, deeper breaths may be helpful. Incentive spirometers encourage expansion of the lungs as much as possible above spontaneous breathing — these have proved to be beneficial in controlled studies.

The dilemma

The rebbe blew and blew into the spirometer, but his profound weakness precluded successful deep respiratory excursions. Several doctors and nurses hovered over this frail, gentle, brilliant scholar but could not coax him into breathing deeply. As his attempts increased in frequency, his frustrations grew, as he knew failure could possibly transform into pneumonia or atelectasis, with their attendant consequences. More important, Rosh Hashanah and Yom Kippur were a few days away, and he was emphatic about not missing these High Holy Days; he never missed blowing the shofar during the Days of Awe.

I spoke to the rebbe. He shared his concerns, his fears, his hopes, but focused on his love for all humanity. He conveyed his dream immediately prior to surgery, when he “stood in court and was being judged.” He argued that he is merciful — that he is a good person. Because he is merciful, he wants to help others. He wants to “stay alive to continue to do good things.”

In this same dream, he is moved to another room, surrounded by books — thousands of books — that help convey the word of God. (This array of books is exactly a replica of every room in his house.) He continues to teach: 

“In Genesis, God blows breath in man.” 

“He gives him the ‘soul of life.’ ” 

“Life is ‘God blowing in and out of man.’ ”

“I have the answer,” he cried out. 

“The answer to what?” I asked.

The solution

“It is Rosh Hashanah!” he bellowed. “I need a shofar. Bring me a shofar!”

He put the shofar to his lips and the wailing sound permeated the hospital corridors. His respirations deepened: Full expansion of his lungs was successful. This new “breathing apparatus” may have saved his life. “How do you have the strength?” I asked. 

He replied, “The shofar is blowing itself.” 

Days later, he walked unaided to shul. He stood on the bimah, almost glowing, and he blew the shofar better than anyone could imagine. He felt strong. He felt connected to God.

The physical shofar is nothing more than the hollow horn of a ram. When the breath of a human being is blown through it, however, it undergoes a transformation. It becomes a living embodiment of the heart and emotion of the human being expressing the Divine Self, its sense is pulsing within, crying out to its Maker.

The shofar has an aura of awe and holiness about it. Its blasts can shatter hearts of stone and wash away layers of complacency. Its call is capable of bringing us back to places inside ourselves, impenetrable by any other means. The Baal Shem Tov taught that the shofar is an emotional, intuitive way of gaining access to the deepest recesses of our heart and of divine experiential knowledge. Its blast — a wordless sound — speaks to the heart in a way all the greatest words and insights cannot approach.

Dr. Norman Lavin is a clinical professor of endocrinology and director of endocrinology education at UCLA Medical School. He writes the Jewish Diseases blog at