Sunday, March 30, 2008

On the Red Sea, SARS and Fear

The Jewish Week, April 25, 2003

In what is arguably his funniest movie, “Love and Death,” Woody Allen plays a Russian caught up in the Napoleonic invasion of his country. Amidst the philosophical banter that produces much of the film’s humor, Allen’s very Jewish outlook shines through in what some would label his pragmatism, but others would call cowardice:

“And so I walk through the valley of the shadow of death. Actually, make that "I run through the valley of the shadow of death" -- in order to get OUT of the valley of the shadow of death more quickly, you see.”

Contrast that with the image of courage depicted in the legend regarding the crossing of the Red Sea, an event that will be commemorated on the seventh day of Passover. It’s a remarkable Midrash, because it goes against all the stereotypes about the “daring” Moses and recalcitrant Israelites that we’ve been fed. In this tale, the tribes are vying for the honor of being the first to plunge into the still-raging sea, while Moses is standing off to the side immersed in panicked prayer, acting more like a Woody Allen than a Charlton Heston. Here Moses is the sniveler, until God finally chides him saying, “My beloved are on the verge of drowning in the sea and you’re babbling on with lengthy prayers.” Nachson the son of Amminadav springs forward into the sea and gets very, very wet, while Moses, in a state of near paralysis, begs God to tell him what to do. Finally, God responds (and here I paraphrase), “Dummy! Stop praying, tell the people to move forward, and pick up your rod.” He does, the sea splits, and the rest is history.

Woody Allen’s ambivalence about risk-taking has been mocked as a relic of our centuries-old, Diaspora-conditioned negative self-image, something that was supposedly rendered obsolete by the creation of Israel. The modern Sabra has indeed fostered a new image of Jewish heroism, but Judaism remains as it always was, somewhere between Woody Allen and Ari Ben Canaan, traversing the Valley when necessary, but traversing it briskly. Ours is not a kamikaze religion. Even Moses had his moments of paralysis.

So a Jewish medical practitioner comes to me and asks what our tradition would tell him about a doctor treating a patient with SARS. This virus is truly scary because so much about it is still unknown, although that is changing quickly. But what is known is that SARS is deadly and extremely contagious. Unlike AIDS, it can be transmitted without intimate contact; unlike West Nile, it can’t be traced to infected parasites, and unlike Ebola, it’s not confined to some remote jungle. It’s right here, or soon will be, threatening to turn your local mall into that Valley of the Shadow of Death.

Think about it: when people take the “risk” of traveling to Israel, they may get flak from loved ones before they go, but once they return they are embraced and celebrated for their courage as folks crowd around to hear their tales. But if you take a trip to Hong Kong these days, no red carpet will greet you on your return. It might be best not to return, in fact. If you do, you’ll be greeted like an outcast, quarantined, shunned, feared even by your closest family – avoided like the plague.

Eventually the panic will subside as the medical community gets a handle on SARS, but for the time being, the answer I gave was not at all clear-cut. Maimonides and others long ago codified the obligation of a physician to heal, but when a patient has a contagious disease, the obligation to save one’s own life can take precedence. If the risk is very small (sofek sakanah) the doctor is obligated to heal, and if it is great s/he is not. Interestingly, according to Dr. Fred Rosner, an expert on these matters, when a doctor treats a patient despite high risks, the act is considered a “pious one” (midat hasidut) by some Halachic authorities and folly (chasid shoteh) by others. The Babylonian Talmud opines that one is not obligated to endanger one’s life even if the risk is small, in order to save the life of another. In contrast, the Jerusalem Talmud states that one should take that risk. It’s interesting that the Talmud written in the Diaspora conveys the more cautious, Woody Allen-like approach, while the Jerusalem Talmud speaks in the macho tongue of an Israeli cab driver. The dialectic between the two Talmuds reflects a dialogue that has been ongoing in Jewish circles through the centuries.

In “Love and Death,” Allen is challenged to a duel. He replies, “I can't do anything to the death, doctor's orders. I have an ulcer and dying is one of the worst things for it.”

It’s OK for Jews to be afraid. It’s OK to place personal safety – and, by extension, obligations to one’s family – above a higher cause, such as a physician’s oath or national objective. In biblical times, an Israelite who was afraid to fight in a (non-obligatory) war was sent home without censure. “Just go,” the officer would say. “Enjoy your new wife, new home or freshly planted vineyard! It’s OK!”

We have nothing to fear of fear itself.

Which is why I am in such awe of those who have placed it all on the line these past few weeks, whether in the hospitals with SARS victims or on the front lines of Iraq. A Jew isn’t doing these things out of a religious obligation, but out of pure love of country and humanity, and the hope of freeing others from the fears that enslave them. Like Nachshon at the Red Sea, they have taken the plunge for all of us.

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