31 Dec DO YOU HAVE 8 MINUTES?

In his book, “The Anatomy
of Hope: How People Prevail
in the Face of Illness,” Dr.
Jerome Groopman shares the
following story:
Barbara received
another three courses of
chemotherapy, but the tumor
seemed to shrug off the drugs. The deposits
grew in her liver and in her bones. She lost
weight and spent most of the time in bed. After
the last cycle of chemotherapy, I admitted her
to the hospital with a high fever. Antibiotics
stemmed an early bacterial infection.
As Barbara slowly recovered from the
infection, I told myself knew of no drugs,
either standard or experimental, that stood a
real chance of ameliorating her condition. The
time had come for me to tell her.
I chose to visit in the early evening, when the
hubbub of the hospital had settled down, so
there would be less chance of distraction and
interruption. Barbara greeted me warmly, as
she always did. I moved a chair close to the
bedside and grasped her hand. She returned
the gesture, but it had little force. After we
chatted for a short time about several articles
in the day’s newspaper, I began to break the
bad news.
“Barbara, we’ve known each other for well
over a year, and we’ve been honest with
each other every step of the way.” Briefly,
her lips trembled, and then she regained her

composure. Her eyes told me she knew what I
was about to say.
“I know of no medicines that I can give at this
point to help you.”
We sat in heavy silence.
Barbara shook her head. “No, Jerry,” she said.
“You do have something to give. You have the
medicine of friendship.”
I shared this story recently at the Chemed
Medical Ethics Florida Summit in an effort
to encourage medical practitioners to see
their work as much more than a profession or
source of income, but rather as a remarkable
platform and opportunity to do chesed, to the
share the medicine of friendship on a daily
basis.
Indeed, according to Halacha, doctors are
not even permitted to be paid for treating
or healing patients. The Gemara (Bechoros
29a) rules that one may not be compensated
for performing a mitzvah. Hashem says,
in essence, “Just as I share Torah and heal
people without compensation, so too those
who emulate Me must provide those services
at no cost.”
So how do doctors, educators, or rabbis
Halachically charge or receive payment? Our
rabbis rule that it is permissible to collect a fee,
not for the healing or teaching, but for schar
batala, the time spent on the noble activity
that could have been used to earn a different
income instead. Or they are paid for schar

tircha, compensation for the trouble or effort
exerted. Alternatively, for schar halicha, the
travel expense incurred.
While Halacha provides a legal mechanism
to be paid, medical providers should still be
mindful that the renumeration is not coming
for their healing and treatment, which must
remain sacred acts of chesed, gestures of
lovingkindness.
Following my presentation, one of the
participants, a gastroenterologist, shared
with me the following story: When he was
in in 40’s, he developed regional migratory
osteoporosis, a rare condition where a person
experiences severe, excruciating, migrating
joint pain. A flare-up would hit, last eight
to nine months, and then go away. There is
no treatment for the condition and during an
episode it is nearly impossible to find relief.
He had suffered for nine years on and off
from the condition and one time found
himself going through a bout. The pain was
so severe and his joints so compromised that
he could only get around with crutches. “It
was motzei Yom Kippur,” he told me. “I
was in unbearable pain, truly suffering. We
were supposed to go to Israel for Sukkos and
I could barely get around. After breaking the
fast, I went up to my bedroom and just cried. I
was so low, depressed, frustrated, angry, and I
called out to Hashem asking Him, why would
you give me this rare condition? Why would
you put me through such pain? What are you
trying to tell me?”
Just then, a Gemara (Bava Metzia 85a)
he had previously learned popped into his
head. Rebbe Yehuda HaNasi, the great
direct descendant of Dovid HaMelech and
the editor of the Mishna, was minding his
own business when a calf that was being
led to slaughter came running toward him
to hide. The calf nuzzled inside Rebbe’s
robe and began to weep in fear. Instead of
protecting or comforting the calf, Rebbe
scolded it and said, “This is why you were
created, go back to your owner.” He then
sent it on its way to meet its demise.
At that moment, it was decided in Heaven
that since Rebbe hadn’t shown compassion
toward the calf, he wasn’t worthy of
compassion and would suffer great pain.
Beginning then, Rebbe suffered six years
of kidney stones and seven years of scurvy.
The pain was so intense, the Talmud relates,
that Rebbe’s scream could be heard by the
sailors out at sea.
One day, Rebbe’s maid was sweeping the
house when she encountered young weasels.
She was disposing of them when Rebbe
said to her, “Let them be, after all, the pasuk
says, v’rachamav al kol ma’asav, Hashem
has mercy on all of His creations.” At
that moment, it was determined in Heaven
that since Rebbe was compassionate, he
would receive compassion and his suffering
ceased.
The doctor shared with me that it occurred
to him, maybe his suffering from this rare
disorder was meant to teach him to have
more compassion for his patients. He
realized that night that for his whole career,

he had practiced very clinically, impersonally,
quickly going from patient to patient,
expediting their visits as quickly as possible.
That night, in his bedroom, he wiped away
the tears and felt Hashem had answered his
question, He gave this physician insight into
his suffering and he knew what he had to do
differently.
The very next morning, someone stopped him
in shul and asked for his help with a GI issue
he was having. Instead of blowing him off
or answering on one foot, he sat down with
the person, looked him directly in the eye,
listened to his issues, felt empathy for his
situation, and recommended a remedy.
Almost immediately, his own pain began to
dissipate and disappear. He returned to his
practice a transformed man, intentionally
connecting with and feeling sympathy for
those in his care, not just seeing them as a
patient but as a person. He healed not only
from that particular episode of regional
migratory osteoporosis, but the condition
went away entirely and never came back
again.
He finished the story by suggesting that maybe
this is what Dovid HaMelech means in the
pasuk (Tehillim 94:12): Ashrei ha’gever asher
teyasrenu Kah u’mitorasecha selamdenu,
“Happy is the man whom You discipline with
yissurin, with suffering, the man You teach
from your Torah.” He had looked in the Torah
to make sense of his situation and he walked
away having learned a lesson that changed his
life.
Early this year, a study was published in
the Journal of General Internal Medicine
showing that meeting a patient’s eye level
while talking about their diagnosis or care
make a huge difference. Making the effort
to sit in the office or hospital when speaking
with a sitting patient, being on the same level
and looking them in the eye, brought about a
better outcome and helped patients recover
quicker and better.
A recent study showed that all it takes is eight
minutes with a caring friend to significantly
decrease anxiety, depression, and loneliness.
Eight minutes of a conversation, visit, or even
text exchange.
You don’t need a medical license or the
ability to prescribe to dispense the medicine
of friendship. You simply have to care, to
literally or metaphorically get to someone
else’s eye level for eight minutes, look them
in the face, make them feel seen, and care to
show the kindness of companionship.