My Worst Enemy’s Shiva

I found this today and felt it was quite important to share as a whole.  People have enough trouble paying a shiva visit in general.  How much more so when we think we need to visit someone we are in conflict with.  I am somewhat concerned by the Q and A here.  While I agree with the author’s response and strategies for visiting and how to visit, I would have started with a simpler question;  why do you feel the need to visit in the first place?  Is it out a sense of reconciliation, or a sense that the fighting was a mistake to begin with?  Or do you merely feel the need to fulfill the commandment of comforting the bereaved?  Nevertheless, consider the answer Hammerman offers for it does provide us a real sense of the appropriate timing and means of visiting while limiting the potential for fighting. 

Q. The mother of my worst enemy just died and I’m not sure whether to visit during Shiva. In truth, I sincerely see this as a chance to reconcile (we haven’t spoken in about five years but have a lot of friends in common). My only concern is that he would misinterpret the reason for the visit and kick me out of the house. I really don’t want to cause him any discomfort. What should I do?

A. Do you think this would be the first time that two people at a shiva had unresolved issues?  It happens all the time, usually involving people from the deceased’s family who are barely on speaking terms. I’ve seen amazing moments of reconciliation happen during the period of grieving. When someone says “over my dead body,” sometimes that’s precisely the most likely location for enemies to reunite, as happened to  Isaac and Ishmael when they buried Abraham.

So go.

But I add this disclaimer: If you poisoned his Akita or stole his birthright, I might hold off until the time is right. Jacob’s journey back to Esau was paved with gifts and trepidation. It took decades before each party was ready. In any event, if you do go to the Shiva, I’d avoid visiting during peak periods, when the mourner might feel you are simply making an appearance for show. If the guy shows signs of being uncomfortable with your presence, or worse, begins to make a scene, I’d make a hasty exit and not take it personally.  The rabbis explained that the second Temple was destroyed because of the resentment of a person humiliated in public by his worst enemy. Don’t let that happen to you. It’s also OK to wait until after shiva, when you might call and meet for coffee in a quite spot. Or maybe the best strategy would be to write a heartfelt letter.

I believe that all conflicts have an expiration date. Even the Hatfields and McCoys signed a truce just a few years ago. If you could reconcile with your worst enemy and become a true pursuer of peace, echoing the words of Psalm 34:15, you will make the world a better place. And an enormous weight will be taken off your shoulders.


What’s More Important to You, Quality or Quantity of Life?

Rev. Dr. Martha R. Jacobs: What’s More Important to You, Quality or Quantity of Life?.

I have been following with interest the story of Desmond Watson, an 87-year-old who has advanced dementia and has been in the hospital in Canada for 14 months. He was admitted to the hospital in January 2010 with pneumonia. His wife of 69 years told doctors that he would want to keep living as long as possible. As a Roman Catholic, she says that he “would have wanted to be given every chance at life despite any suffering he may be enduring.”

“Desmond is suffering without any prospect of long-term improvement,” said one of Mr. Watson’s doctors. This doctor is quoted as saying: “Prolonging life and living are two totally different things … being kept alive in this way, I can’t imagine anybody would wish this … Mrs. Watson is entitled to her opinion but we need to be satisfied for ourselves that we’re doing the right thing … (We’re) not satisfied.”

In Ontario, they have a Consent and Capacity Board (CCB) that reviews cases like Mr. Watson’s. (“The CCB’s mission is the fair and accessible adjudication of consent and capacity issues, balancing the rights of vulnerable individuals with public safety.”) The CCB ruled that because Mrs. Watson (and her two daughters) expressed what she said were her husband’s beliefs, the hospital is required to continue treatment. Unfortunately, none of those caring for Mr. Watson ever asked him what his beliefs and values were even though the Consent and Capacity Board weighs the patients’ beliefs and values in their decisions.

Some of the questions that families have struggled with in situations such as this are: What is “living”? And is this a quality of life that would be acceptable to the patient? As the hospital’s doctor said, “prolonging life and living are two totally different things.”

I mentioned in my last posting that we need to determine for ourselves what our “bottom line” is. The question becomes: When is enough, enough?

And while money should not play a part in the decisions people make, we should at least be aware of the costs to our health system. For example, “Medicare, the health insurance program for the elderly, spends nearly 30 percent of its budget on beneficiaries in their final year of life. Slightly more than half of Medicare dollars are spent on patients who die within two months. Forty percent of Medicare dollars cover care for people in the last month.” This is amazing considering that when asked, most people say that they would prefer to die at home and not in a hospital. And yet, 56 percent die in a hospital and 19 percent in nursing homes. (Read more.)

What is more important to you: quality of life or quantity of life? And where do your religious beliefs come into this consideration?

I am presenting the entire post above so nobody will accuse me of bias by only quoting what I agree with.  Rev. Jacobs presents a story about a religious Catholic family that has a deep belief which is being questioned by the medical establishment, thus setting up an argument about whether their belief is antithetical to good medical care.  Unfortunately, we live in a society today which is beginning to downgrade patient autonomy, even with the increased advocacy for advanced directives and living wills.

If we examine the story closely, we will also see something else which is ethically challenging.  The doctor seems to be weighing his sense of non-maleficence, his desire not to do harm, to be greater than the autonomy of the husband and his health care advocate, his wife.  This is challenging because we want our doctors to act in our best interests as we perceive them to be (which is influenced by our culture, ethnicity and religious beliefs).  A doctor should be comfortable enough to know when the right thing to do is to step away when morally and ethically opposed to a form of treatment or non-treatment, but the doctor must also recognize the patient’s autonomy.

As a chaplain, the role in such a situation would begin by investigating with the family the source of their wishes.  Often, this might entail speaking with their clergy in addition to the health care proxy.  By ascertaining the specifics of their wishes and what is driving their wishes, a chaplain will be better able to provide clarity for all those involved, as in the patient/family and the doctor.  I have often found that many requests start of a place of emotional denial rather than from a place of religious and moral conviction.  This is not to say a person can’t be both in denial and yet feel very strongly about their spiritual and religious beliefs.  Rather, often times the family is struggling with the fundamental challenge of losing a loved one and are looking for something to grasp onto.

To deal with Rev. Jacob’s question of quality vs. quantity and how religious beliefs would play a role in that discussion, I would say both are important ideally. The question of quality vs. quantity of life is completely predicated on religious belief.  If we believe the human being to be a sacred being, both in mind and in body, then we encounter a true paradox.  For most of us, the thought of living without being able to interact as we do during our formative years is frightening.  Yet, even for those who believe in life after death, there is a base fear of life ending prematurely, no matter how old one gets.  Every religion struggles with this question.  There is no right answer to this question, and again, one’s beliefs will be influenced by one’s cultural, spiritual and ethnic background.

(crosspost here)

Kenneth J. Doka, M.Div., Ph.D.: Helping Children Spiritually Cope with Dying and Death

Kenneth J. Doka, M.Div., Ph.D.: Helping Children Spiritually Cope with Dying and Death.

I recently had an opportunity to teach a Hebrew school class of 12 yr old children about death and Hospice.  I was amazed at how much these children knew about those two subjects.  Many of them had a grandparent or older relative cared for by a Hospice.  We discussed aspects of spirituality in relationship to death, including near death experiences and how the Bible looks at life and death.  In the piece I am linking to, Doka discusses how younger children can have a concept of death and how we should teach children about life.

As children encounter illness, loss and grief — whether their own or someone close to them — they seek to understand those events and to make sense of their experiences. This inevitably is a spiritual process as they turn to their beliefs, faith narratives, rituals and practices. They may not yet have the cognitive capacity to reach conclusions, yet they yearn for an explanation of events that are sometimes difficult, if not impossible, for even adults to answer. Their questions may show innocence and naiveté. For example, when her maternal grandmother died, my 3-year-old granddaughter took comfort from the belief that even though her grandmother was no longer physically present on earth, she would watch over her from heaven. However, this led to a very practical concern: Would her grandmother be able to see her on the toilet — a potent issue as she was becoming toilet trained? We reassured her that her Grandma would not look at her in these very private moments.

Children as young as 2 or 3 years old are trying to make sense of their world, and inevitably they are encountering their spirituality. Illness, grief and loss are often part of their worlds as well, so their spiritual development helps shape how they grapple with issues for which they want a concrete explanation. Often it is these questions — Why did grandma have to die? Why is there illness? What happens to you after you die? — that spur a child’s interest in spiritual questions and explanations…

Everyone has some set of spiritual beliefs even if they do not accept theism, or the practice of incorporating a belief in a higher power or God. It is important to share those spiritual beliefs with your child as well. For example, a parent might not believe in heaven, reincarnation or any form of afterlife, but that parent may still take comfort in the memories that he or she has of a person or find solace in a sense of pride based in the legacy of a deceased individual. Such memories and legacies can be remembered and celebrated.

It is also important to take care in presenting romantic explanations rooted in spirituality to a child, because children often interpret such stories literally. I once counseled a 7-year old boy who was acting out after the death of his friend — a death due to a car accident that this boy witnessed. He had been told that his friend was good and that God wanted him to be angel in heaven. This surviving child wanted to make it clear to the Deity that he would not be good material for any prospective angel. The romantic stories we may weave may do more harm than good. It is best to simply and honestly share your own spirituality with a questioning child.

Young children can have a concept of death, even if they don’t fully understand its permanence at such a young age.  We do a service to their intellectual and spiritual growth by not hiding this part of life from them.  Keep in mind that even if we don’t talk to kids, death is all around.  Between hearing about celebrity deaths and reading the stories in the Bible, which include death, it is something that can’t be avoided.  At the same time, we must learn how to be honest about death and dying in a way that doesn’t create falsities or situations as described in the last paragraph quoted above.  I find a good resource to be When Families Grieve, a video put out by Sesame Street.

(cross post at Stein Hospice blog)

First Yahrzeit Shiur for my Brother-in-law

The following is the Yahrzeit Shiur I delivered last night in memory of my wife’s brother. 

יארצייט שיעור ראש חודש אלול 5770

ר’ זוין in his מועדים בהלכה,[1] points out that when it comes to the month of אלול, the majority of דרשות about the month are based on אגדה as opposed to הלכה.  As an example, how do we know that אלול is considered the month of preparation for ראש השנה?  We know that אלול is the month of preparation because it is the sixth month, and all sixes are preparations for the seventh, which represents שבת, as it says והיה ביום הששי והכינו את אשר יביאו, but on the sixth day when they apportion what they have brought in (שמות ט”ז: ה). In this case, the sixth month, אלול, is the preparation for the seventh month, תשרי, which contains שבת שבתון, יום כיפור.  The month of אלול is the time we work towards being able to stand before G-d in judgment on ראש השנה.  ר’ זוין continues by saying that אלול also contains areas of halachic consideration that help define the essence of the month, as the month of G-d’s presence being at its most accessible. 

ר’ זוין continues by expounding upon the following הלכה that occurs certain years with regard to ראש חודש אלול.  Throughout the year, when ראש חודש falls out on Sunday, we have the custom of skipping the prescribed הפטרה for the פרשה and instead we read the הפטרה of מחר חודש.  However, for ראש חודש אלול, this is not so clear cut for we also have the מנהג of reading from the הפטורות known as the שבעה דנחמתא, the seven הפטרות of comfort, which we read to find comfort after the harrowing experience of תשעה באב.  There is a מחלוקת between the מרדכי and תוספות regarding which of these two מנהגים take precedence.  According to the מרדכי, the custom was to skip the הפטרה of ראה, עניה סערה לא נחמה, for the הפטרה of מחר חודש because מחר חודש is Talmudic while the שבעה דנחמתא is non-Talmudic, found in the פסיקתא (a non-Talmudic rabbinic work of the same time period).  תוספות disagree, for the שבעה דנחמתא are to be said as they result from having the ג’ דפורענותא, the 3 הפטרות of suffering, which are said during the three weeks leading up תשעה באב.  As such, these הפטרות take precedence over מחר חודש.  The same rule applies for פרשת שקלים and פרשת החודש, in which the special הפטרות for those פרשיות take precedence over מחר חודש, although for these two הפטרות, the פסק is not as challenging for פרשת שקלים and פרשת החודש are also to be found in the גמרא as opposed to other non-Talmudic works from the same time. The רמ”א[2] in the ש”ע states that the הלכה follows תוספות.

However, if ראש חודש אלול is שבת, the מרדכי presents two opinions with regard to whether we read the הפטרה for ראש חודש or the הפטרה for ראה.  This מחלוקת is then found in the differing customs of אשכנז and ספרד, in which the ספרדים read the הפטרה for ראה, while מנהג אשכנז, as taught by the רמ”א, is to read the הפטרה for ראש חודש.  While הפטרת ראש חודש, like מחר חודש, is discussed in the גמרא, it would appear at first as the מחלוקת would follow the same logic as the previously stated מחלוקת, namely whether the הלכה follows the גמרא qua גמרא or that the הלכה would follow the פסיקתא because the theme of the day shouldn’t change.  However, since the הפטרה for ראש חודש relates to the theme of this time period, finding comfort for the tragedies of our history, it falls into the broader category of נחמה, and hence, for בני אשכנז, is read on שבת ראש חודש אלול.  As an interesting aside to this, it is the custom to still read the הפטרה of עניה סערה two weeks later, as part of the הפטרה for פרשת כי תצא.

Why does ר’ זוין connect these two points, discussing אלול as the month of preparation and also as a time of continuing נחמה.   ר’ זוין’s reason for connecting the idea of אלול being the month of preparation with the question of what is read when ערב ראש חודש אלול or ראש חודש אלול and שבת coincide is to highlight the uniqueness of אלול in that the month encompasses two ideas, one based on looking backward and one looking forward.  Facing backwards, אלול is the month of comfort, the continuation of the comforting days of מנחם אב, the days after the 9th of אב, the day on which we mourn for all the Jewish communities’ tragedies.   After תשעה באב, we begin picking ourselves up through G-d’s words of comfort.  This is a challenging task, taking seven weeks, for we struggle to truly accept that G-d is comforting us.  We need a complete cycle of time, seen in the notion of seven being a complete week, a שבת.  The same holds true for שבעה, for it takes a complete cycle, a seven, to begin coming to grips with the reality of a tragedy.    

During אלול, G-d is close by, providing us comfort and promising חסד, kindness. Yet we must also recognize that אלול is the time of חשבון הנפש, investigating ourselves to see what can be improved in preparation for ראש השנה.  This preparation is not from a place of love of G-d, but rather from fear, for we try to prepare to face G-d and show why we should be judged favorably for the coming year.  Therefore, we can conclude from the duality of the month of אלול that finding comfort must come through our own actions, not just the words of others.  It is not enough to hear the words, נחמו נחמו עמי, comfort, comfort my nation, but we must find a way to bridge the chasm created by the tragedy that has occurred. 

The bridge is built by תשובה.  When we refer to תשובה, we are referring not to the notion of penance, but rather to the literal definition, namely returning.[3]  When אלול begins, we, who will be awakened by the sounding of the שופר, must begin returning to G-d.  We find ourselves having become distanced from G-d throughout the year, as the highs of ר”ה and יום כיפור are in the distant past.  But, as the בעל שם טוב taught, the King is now in the field, ready to be encountered.   

The תשובה of אלול is most manifest through the מנהג of reciting לדוד ה’ אורי from the beginning of אלול through שמיני עצרת.  In this chapter from תהילים, דוד beseeches G-d for protection and to be allowed to dwell in G-d’s midst.  As time moves further from tragedy, a different perspective begins to arise.  On תשעה באב, at the conclusion of our reading the terrifying laments of ירמיהו, the book of איכה, we repeat the second to last verse השיבנו ה’ אליך ונשובה, חדש ימינו כקדם, Take us back, G-d, to yourself, and let us come back, Renew our days as of old (5:21).  We cry out to G-d to remove the tragedy that occurred from our midst, for while we must face tragedy head on, we also need to recognize the future possibility of comfort.  The same is also paralleled in שבעה, for in the midst of mourning, the mourners are constantly offered words of comfort upon leave taking, המקום ינחם, May G-d comfort you.  While those words can sound shallow at the time, they are said as a means to looking towards the future, when comfort can be found. 

Coming back to לדוד ה’ אורי, its appropriate that we do not recite this Psalm until אלול and not immediately after תשעה באב, because we are not ready yet to ask G-d to be allowed to dwell in His midst.  We need to integrate the loss first.  Just like in שבעה there are different הלכות regarding visiting do the first 3 days and the remaining 4 days, so too, it is only after the completion of the month of אב, the first three weeks after תשעה באב, that we can begin to truly look back to G-d to not forsake us and to give us the hope that we will have the strength to endure. 

Once we ask this of G-d, we must confront the other aspect of finding comfort, the need to change and search for the lessons of a tragedy.  While it is not appropriate for people to offer reasons for why something happened, it is the natural human reaction to tragedy that we want to know why.  For example, חז”ל taught that if the בית המקדש is not built in one’s lifetime, then it is considered as if the בית המקדש was destroyed during one’s lifetime.  Why are we unable to rebuild the Temple?  That is the challenging question, to which I am not in a position to even offer a sliver of an answer.  The only statement I can make is that if it wasn’t built, we must continue to work towards that goal, for something continues to be lacking.  And we reach that goal through תשובה, returning to G-d, working on ways to come closer to G-d. 

As we gather here today to face the first anniversary of our collective tragedy, we reflect back upon the past year.  Grieving the loss of a loved one is not just about allowing time to pass and thinking back about the person’s life.  Grieving is about the actions we take to begin integrating into our lives the chasm that has been created by the loss.  We have tried to accept the harsh reality that is our loss, and we have looked for ways to rise up from the loss.  In the most basic sense, this is through the study of משניות, which many participated in during the year.  We do things that merit the soul of the deceased.  The study of משניות also represents a form of action.  We integrate this loss, as hard as that is, by not sitting idly by, continuing with our routines, but rather by taking upon ourselves actions that require us to do more than we usually would. 

And as with all losses, the loss of a dear person leaves us looking to find comfort in strange places.  For me, a comfort I can offer was one I witnessed at the end of שבעה.  When escorting ברוך’s soul out of the house, I recall that the day was gray.  It was a cloudy early morning at the end of August.  Yet, when I looked up to the sky, I saw a sliver of blue, a clearing of the gray, a ray of hope in the midst of tragedy.  As we enter אלול, we should collectively find comfort during this period of נחמה, leading us to rekindling our relationship with G-d as we get closer to ראש השנה and יום כיפור.  May we find that the work we have done and the work we will do be a source of comfort for ourselves and this community as we commemorate the first יארצייט.

[1] מועדים בהלכה כרך ב’

[2] אורח חיים תכ”ה: ב

[3] See Torah Studies by Rabbi Jonathan Sacks, פרשת האזינו.  This work is an adaptation of talks by ר’ מנחם מנדל שניאורסון זצ”ל.

Paul Griffiths on the dual nature of death and dying

As a Hospice chaplain, I often consider the challenging question of when enough is enough.  Yet I am also left wondering about the continuous want of living.  In a recent post, Paul Griffiths presents a Catholic take on death.  Below are my comments just posted on The Book of Doctrines and Opinions.

I think people are ready to hear these thoughts of Paul Griffiths and in the current cultural climate of debating health care spending, perhaps his words are crucial.  We need to always remember that it is a tricky balance between embracing life and embracing death. We all want to live as long as possible, but wish and hope that our current physical lives are qualitatively good as well. 

In terms of a Jewish art of dying, I think we are challenged to reexplore the texts you make mention of in your post.  Most Jewish people are unfamiliar with works like Maavar Yaaboq and of those who are familiar, there is still the challenge of incorporating a 16th century mystical death journey into our 21st century consciousness. 

Having said that, working in the field of chaplaincy, it is the works of our mystics that often get lost and when it comes time to people dying, there is little that can be said about the journey of the soul for most were never even brought up to believe in an afterlife.  I think we need people to bring to the forefront these issues in the Jewish community for it gives people a hope for something more than life itself.  Sure, much of the descriptions of a Jewish afterlife include punishment and suffering along the way, but I think even that people would be willing to hear.  I cannot begin to count the number of times I have heard from Jewish people who are dying “do we believe in an afterlife?”  My favorite of those was the words of one surviving family member who said, “I envy Catholics for they have an afterlife.”  It is very disheartening.   

Talking about Dying According to Reb Zalman

There is a wonderful piece based on a conversation had with Reb Zalman Schachter Shalomi published on a NYT’s blog entitled Talking about Dying.  In this piece he discusses the question of approaching a loved one during his/her later years and talking about what it means to die.  He argues that we should be cautious with the need to talk about death and dying with those in the “December years”, for underlying our need to ask the elder about dying is a seemingly selfish desire.  We have to remember that the goal isn’t to satisfy our own curiousities but to be present to someone and give that person the opportunity to share the experience with us.

Grieving in the 21st century

Two recent pieces came across my desk about the use of modern technology as a forum for grieving.  The first is a blog post entitled “Facebook after Death.” In this piece, the author laments and grieves her son’s death and how having his facebook page still available has given her a different outlet for grieving.  She finds comfort in seeing how his friends continue to acknowledge his life even after death. 

The other piece is from Newsweek back in February “RIP on Facebook.”  The author gives a recap on how facebook is used as a virtual tombstone, allowign people to talk to the deceased without having to go to the gravesite. 

Both pieces extol the power of the internet in our lives.  In grief counseling, the first rule is that all people grieve differently.  It would be interesting to see if use of technology helps or hinders the grief process.  Any takers for such a research endeavor?