tag:blogger.com,1999:blog-12970718.post6951308202226041855..comments2024-03-18T03:40:39.185-04:00Comments on The Curious Jew: Medical Ethics: How To Be an Orthodox Jewish Physician in a Secular WorldChanahttp://www.blogger.com/profile/17655144434904957767noreply@blogger.comBlogger15125tag:blogger.com,1999:blog-12970718.post-31728972277729555342012-04-18T12:32:22.387-04:002012-04-18T12:32:22.387-04:00I know it's an old post, but in case anyone li...I know it's an old post, but in case anyone like myself has just stumbled upon this page.....my wife is completing clinical rotations as a medical student here in Eretz Yisroel. While we dealt with many objections, we had properly tzanu (we're not talking about silly pencil skirts either, calf to floor length, wide enough to flow, and scrub pants under during surgery or stockings during other rotations , and properly professional scrub skirts. For some hospitals we had xxxL scrub pants altered, and other times we were able to contact the hospital's uniform provider and buy a few meters of the same fabric to make proper skirts. <br /><br />Yes it was an uphill battle every time, and US rotations and residency probably won't be easier, but as Rav Dr. Avraham said, if you want to be a doctor, the goal is to be a FRUM doctor. <br /><br />We don't get challenges and nisyanos we can't handle, if you want to know what to do, "The shchina rests in the daled amos of halacha" (Devine presence rests in your own personal 'four-square' of following Jewish Law).Shmuelnoreply@blogger.comtag:blogger.com,1999:blog-12970718.post-44907926912314692892007-12-31T00:06:00.000-05:002007-12-31T00:06:00.000-05:00Happy birthday, Chana!And thank you for these grea...Happy birthday, Chana!<BR/><BR/>And thank you for these great notes.Charlie Hallhttps://www.blogger.com/profile/17667135360784254574noreply@blogger.comtag:blogger.com,1999:blog-12970718.post-62496720962045267032007-12-30T15:18:00.000-05:002007-12-30T15:18:00.000-05:00I cannot trust the halakhic authority of someone w...I cannot trust the halakhic authority of someone who states as a medical fact that most diabetics cheat.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-12970718.post-6461529111234248732007-12-28T12:05:00.000-05:002007-12-28T12:05:00.000-05:00Dr. Avraham's point is not that we don't need frum...Dr. Avraham's point is not that we don't need frum doctors. We certainly do. But he is pretty adamant that we need <B>frum</B> doctors - not those who are <I>moreh heter</I> to themselves, but those who follow halakhah meticulously.<BR/>The answer is NOT for frum Jews to stop becoming doctors. Rather, Dr. Avraham has tried repeatedly to try to get national Jewish organizations involved in pushing for shomer shabbos residencies.<BR/>All the rabbonim "in charge" of all of these organizations agree - from R. Hershel Schachter, R. Yisrael Belsky, the OU administration to R. Perlow (Novominsker Rebbe), R. Shmuel Kaminetsky and more.<BR/>For whatever reason (feel free to speculate without violating any issurim), the organizations have not come through.<BR/>Any suggestions?Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-12970718.post-49394328571794774552007-12-28T09:55:00.000-05:002007-12-28T09:55:00.000-05:00All these religious nutjob rabbis really need to c...All these religious nutjob rabbis really need to cool it with the criticism of frum doctors. I am not a doctor myself, but I definitely recognize the importance of having frum doctors within a community. Pikuach nefesh doesn’t exist in a vacuum. One needs to train in order to be in the position to save lives. I have no problem saying that these rabbis are straight up fools for possibly discouraging talented individuals from becoming doctors. They are causing more harm than good, just to feed into their insatiable religious zealotry. <BR/><BR/>Although there may be exceptions, 95% of residence/doctors need to be mechalel shabbos for non-life saving purposes. But at the end of the day, it allows them to do more good and help more jews than any of these rabbis can ever dream of.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-12970718.post-78368599577067133982007-12-28T09:54:00.000-05:002007-12-28T09:54:00.000-05:00David, apology accepted.May a peaceful Sabbat...David,<BR/> apology accepted.<BR/><BR/>May a peaceful Sabbath be upon you!Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-12970718.post-12437862424160888352007-12-28T00:42:00.000-05:002007-12-28T00:42:00.000-05:00To Anonymous,I sincerely apologize for how my rema...To Anonymous,<BR/><BR/>I sincerely apologize for how my remarks sounded. I was responding to what, I and others, saw as an inappropriate brash tone in your initial remarks.<BR/>I am both happy that we were incorrect in reading your initial piece and somewhat embarrassed to have not been more generous in being dan le-kaf zekhut. It is something that I must continue to work on.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-12970718.post-10126244992851416312007-12-27T21:20:00.000-05:002007-12-27T21:20:00.000-05:00David,While I do wish to retain my anonymity on li...David,<BR/><BR/>While I do wish to retain my anonymity on line, I will be happy to tell you who I am offline if that is what you wish. I have notified Chana who I am; you can follow up with her if you wish to contact me. I am an RN and a CDE, with many years of maternal child experience. <BR/><BR/>1. “Dr. Avraham never indicated that there is never any reason to examine both breasts of a woman simultaneously.”<BR/><BR/>Here is a quote from Chana’s write-up: “You have to look at both breasts to see if they are symmetrical or not- standing on right-hand side of the patient so you examine the right breast. Give me one good reason why the left breast has to be left bare while you examine the right breast.”<BR/><BR/>I have done these exams; it is very difficult to check for asymmetry without exposing both breasts at the same time. <BR/><BR/>2. “Let's just assume for a moment that Dr. Avraham knows many diabetics and has treated hundreds if not thousands of such patients. This is experience, you are free to disagree.” <BR/><BR/>Thank you, but as a CDE, I also have treated thousands of such patients. And yes, I have seen cases where eating a ‘normal’ meal for all or part of shabbos can lead to pikuach nefesh situations. I know of two elderly Jewish patients who entered DKA after having a ‘normal’ meal at a hospital. (I can explain offline if you wish to know the specifics.) The ‘normal’ meal spiked their blood sugars up tremendously. Do you agree that DKA is a pikuach nefesh situation? <BR/><BR/>3. “Did you not write dietary orders? Ever sign any documents? Did that treat a patient? Ever log in to a computer? Type anything on a computer? Fill out an accident report?” <BR/><BR/>Not sure why this is relevant, but I never did any of these things on shabbos during my training or on the job. I once did have to switch jobs to avoid getting into some difficult halakhic situations.<BR/><BR/>Perhaps I wasn’t clear; my point in speaking about GIFTED HEALERS was to question the doctor’s opinion that everyone who can sit and learn go into Kollel rather than pursue a healthcare career. I believe everyone has a gift that is unique to them that should be developed. Doctors are not exempt from learning and can also grow into Talmidei Chachamim. <BR/><BR/>“Oh, and being a "GIFTED HEALER" does not grant you any dispensation.”<BR/><BR/>I truly find your sarcasm unnecessary and unbefitting a God fearing Jew or a doctor.<BR/><BR/>4. "About a man being an OB/Gyn: I guess R. Neuwirth is just being a lot more realistic than you are. I think anybody reading this, would agree. Everybody has a yetzer hara, regardless of what they write anonymously on comments to a blog".<BR/><BR/>Most doctors I worked with in the past with are professionals. I believe they are not sexually stimulated when working with female patients who are somewhat exposed. We'll have to agree to disagree.<BR/><BR/>5. "I happen to believe that it's OK to wear scrubs if one is a female RN." “Good, next time I have a halakhic shailah I will ask an anonymous commenter to a Jewish blog. This is patently ridiculous.<BR/>Nobody said a girl should wear such a long skirt that it causes problems”<BR/><BR/>As a maternal/child RN who worked in a low income area, I was constantly exposed to body fluids possibly contaminated with HIV/Hep B viruses. Many of my patients were high school dropouts on drugs. Rabbi Gedaliah Dov Schwartz, the head of the CRC Beis Din gave me the psak that I could wear scrubs. See http://www.crcweb.org/community/asktherav.html if you don't know of Rabbi Schwartz.<BR/><BR/>Again, I find your comment condescending and inappropriate. I hope you are more sensitive to your patients, nurses and colleagues.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-12970718.post-6767716481490752162007-12-27T19:50:00.000-05:002007-12-27T19:50:00.000-05:00To Psychotoddler:I don't know what you mean by: "F...To Psychotoddler:<BR/>I don't know what you mean by: "First, it's necessary if you want to be able to practice the other six days of the week, unless you're one of the lucky few who can finagle it otherwise."<BR/>Do you mean that if you don't work on Shabbos than practically you will not have a job for the other six days? It sounds like that is what you mean.<BR/>If that is true, then there are plenty of jobs for the other six days - outside of medicine. <BR/>There is <B>absolutely</B> no heter to work on Shabbos so that you can keep you job the other six days. There are many jobs out there, you need not pick this one.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-12970718.post-80204362283356802752007-12-27T16:47:00.000-05:002007-12-27T16:47:00.000-05:00As an orthodox nurse in a metropolitan pediatric h...As an orthodox nurse in a metropolitan pediatric hospital I would like to address the issue of dress.<BR/><BR/>Many ambulatory clinics allow street clothes. Others require scrub attire, but you must purchase, and launder your own. In this situation, I see no difference between street clothes and scrubs, since they both come from my closet and go in my machine. It is purely for the way the office personnel look. Most floor nurses also have to wear their own scrubs, except in the ICU. I have several scrub skirts and white skirts that are knee length that I wear to work, and I always wear full stockings or hose. <BR/><BR/>I am the only nurse in this hospital that wears a white skirt. It went out with the advent of penicillin. Still there is something to be said for sticking to your principals.<BR/><BR/>In the one clinic where I sedate babies and get spit and gagged on constantly I do wear a topper over my scrubs for exactly the reasons stated. <BR/><BR/>When I teach CPR I also wear a skirt, although a little longer. The getting down on the floor is tricky, but as long as they let you wear a skirt, I do.<BR/><BR/>I think I would feel ridiculous walking around in short sleeves and pants and a sheitl.Mrs. Balabustahttps://www.blogger.com/profile/08917736008706230616noreply@blogger.comtag:blogger.com,1999:blog-12970718.post-70521805859245263622007-12-27T15:55:00.000-05:002007-12-27T15:55:00.000-05:00I wish I had time to write a proper response to th...I wish I had time to write a proper response to this. I own Rabbi Abraham's book (in English) and find it useful for some things.<BR/><BR/>I think that we agree that it's really not possible to be on call on shabbos and parse each and every action to see if it fits within halacha or to do shinuyim. It's just not practical and leads to poor patient care. I also agree that there is quite a bit that has to be done on shabbos that is far from the category of pikuach nefesh. I can certainly verify this to be true. Again, you cannot parse these things, because while you are busy screening calls, you can miss something very important.<BR/><BR/>His solution, if I get the nub of your gist, is either not to take call on shabbos (even if this means you can't be a doctor after all) or hire a goy to do your bidding. <BR/><BR/>I can tell you that the latter is not financially feasible for most of us involved in primary care. It is common for specialists and surgeons, though, to have PAs or Nurses do all their documentation. But the system is not set up for primary care in this country for that to be viable.<BR/><BR/>As for finding shomer shabbos positions. Good luck. I was fortunate enough to go to Einstein where you don't have to take shabbos call, and afterwards I made a shomer shabbos residency for myself in the Midwest.<BR/><BR/>While that solved many problems, it created others. Foremost is that it doesn't prepare you for the real world, where you may find that many places will not want to hire you if you refuse to work on shabbos. And while you're going from practice to practice and being shown the door in each, be aware of the tremendous chillul Hashem that you may be generating, not only with the non-Jews you interview with, but certainly with the non-Observant Jews who will now have yet another reason to be hostile to Orthodox Jews in general.<BR/><BR/>Finally, and I really don't have time to express this well now, I don't think there is such a thing as taking a time-out from being a doctor. Even when I was in a shomer shabbos position, I worked on shabbos all the time. My office was the shul, or my house, or the rabbi's house, and people were CONSTANTLY asking me to be mechallel shabbos to do things for them. An antibiotic for this guy. Look in this one's mouth. Do some first aide for my kid who fell off the couch. In fact, the first time I drove on shabbos, it was to take a fellow shul member to the hospital. It was Rosh Hashana, in fact.<BR/><BR/>So if you're a doctor, you're always a doctor, there's no escaping it. And I think there is a value to having a frum doctor who takes care of people on shabbos. Many reasons. First, it's necessary if you want to be able to practice the other six days of the week, unless you're one of the lucky few who can finagle it otherwise. Second, because your patients deserve a full time doctor. They need to feel confident in you and your abilities, and shouldn't be afraid to call you when they are really sick. You're no good to them if you're "occupado" when they really need you. And finally, because it sends a message to the medical community, to non-observant doctors, and to the world in general, when they see a guy with a yarmulke taking care of the sick on shabbos. <BR/><BR/>It says, here is a religion where they care about life, so much so, that they are willing to put aside their most sacred rituals to save one. It is a tremendous kiddush hashem.<BR/><BR/>I agree with his other comments regarding tznius and the unique role of visibly orthodox doctor in the hospital and clinics. Consciously or otherwise, I do try to incorporate those behaviours into my own practice, whether it's the way I address nurses or assistants, or the care I give to ensure confidentiality and privacy to my patients, or the time I take to listen to them. I try to make them feel that they are important to me, and that I care about them, and that my goal is to make them feel better. All the more so because I have that black beanie on my head.PsychoToddlerhttps://www.blogger.com/profile/00874353280798371891noreply@blogger.comtag:blogger.com,1999:blog-12970718.post-18046413386597185352007-12-27T13:04:00.000-05:002007-12-27T13:04:00.000-05:00It is difficult to respond to somebody not willing...It is difficult to respond to somebody not willing to give his or her name to their comments, but a response is certainly in order to the first Anonymous's remarks.<BR/><BR/>It might be helpful to listen to the actual recording (Chana could perhaps link to it when it goes up) before you come to incorrect conclusions.<BR/><BR/>1. Dr. Avraham never indicated that there is never any reason to examine both breasts of a woman simultaneously. It was explicitly stated that after a doctor examines a women for assymetry, there is often no need for a women to be <B>unnecessarily</B> exposed for the rest of the exam. This was clear and your remarks are unecessary.<BR/><BR/>2. Let's just assume for a moment that Dr. Avraham knows many diabeteics and has treated hundreds if not thousands of such patients. This is is experience, you are free to disagree. Moreover, in his <B>professional medical opinion</B> (you are free to disagree) that eating a normal meal for all or part of Shabbat will not create pikuach nefesh. You can argue medically, but since we don't really know who you are, I find no reason to trust you over him.<BR/><BR/>3. "Yes,it's much harder to be a shomer shabbat Jew in a NON- shomer shabbat medical/nursing programs. However,some of us are GIFTED HEALERS and it's possible to go through the programs and not violate the laws of shabbat(I'm a living proof of that as are many others)."<BR/>Did you not write dietary orders? Ever sign any documents? Did that treat a patient? Ever log in to a computer? Type anything on a computer? Fill out an accident report? <BR/>Dr. Avraham quoted R. Auerbach and R. Neuwirth that no patient ever benefited directly in any way from any of these actions. Therefore, R. Auerbach concluded that these actions are <B>absolutely</B> prohibited on Shabbat. R. Hershel Schachter paskins similarly, and I have never heard anybody of stature disagree.<BR/>Oh, and being a "GIFTED HEALER" does not grant you any dispensation.<BR/><BR/>4. About a man being an OB/Gyn: I guess R. Neuwirth is just being a lot more realistic than you are. I think anybody reading this, would agree. Everybody has a yetzer hara, regardless of what they write anonymously on comments to a blog.<BR/><BR/>5. "I happen to believe that it's OK to wear scrubs if one is a female RN." Good, next time I have a halakhic shailah I will ask an anonymous commenter to a Jewish blog. This is patently ridiculous.<BR/>Nobody said a girl should wear such a long skirt that it causes problems - in fact, Dr. Avraham didn't actually address this point. I know of many girls who are just as makpid about tzeniut as they are about their patient's health. They manage just fine.<BR/>"many Rabbis are willing to grant a female RN a psak allowing wearing of the scrubs these days. Why not take it and protect oneself from harm?" Many 'rabbis' are willing to say you don't have to keep Shabbos at all, or kashrut or taharat hamishpachah for that matter. <BR/>Dr. Avraham limited his remarks to Orthodox doctors, assuming that they are consulting Orthodox physicians. He thought that went unsaid.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-12970718.post-2129729816747555662007-12-27T10:22:00.000-05:002007-12-27T10:22:00.000-05:00I find this extrmely problematic. Don't know wher...I find this extrmely problematic. Don't know where to begin but...<BR/><BR/>The scrubs = problematic issue for women. I think it is even more problematic to wear a floor sweeping skirt and run the risk of injuring yourself and your patients.<BR/><BR/>Context wise: I am a certified EMT who also works in a medical setting. Had a very "interesting" discussion with an instructor who was shocked that I identify as Orthodox because I wear scrub/EMT pants to training and ER work. She apparently had had arguments with Orthodox women EMTs who insisted on wearing skirts on the ambulances (leaping on and off with oxygen tanks and risks of getting caught in equipment and such). She ended up telling them to get off.<BR/><BR/>I don't understand how some chumrot can be allowed to override one's safety or the safety of one's patients.<BR/><BR/>Agreed with anonymous on all other points.rivkayaelhttps://www.blogger.com/profile/06509357690398313014noreply@blogger.comtag:blogger.com,1999:blog-12970718.post-51417508570237406472007-12-27T01:32:00.000-05:002007-12-27T01:32:00.000-05:00Anonymous,Rock on! I agree with every single one o...Anonymous,<BR/><BR/>Rock on! I agree with every single one of your points. You are my hero.Chanahttps://www.blogger.com/profile/17655144434904957767noreply@blogger.comtag:blogger.com,1999:blog-12970718.post-91636846487790072822007-12-27T01:01:00.000-05:002007-12-27T01:01:00.000-05:00As an Orthodox (board certified)healthcare profess...As an Orthodox (board certified)healthcare professional I found certain concepts presented in this lecture questionable. For example, there are situations when a physician must look at a woman's both breasts at the same time in order to observe the degree of marked assymetry. Pushing the concept of examining one breast while the other one is covered (and erroniously basing it on tzniut) doesn't work in this case. <BR/><BR/>I also was surprised by the doctor's approach to diabetics. I find it condescending and inappropriate to assume a diabetic cheats and that a diet order can therefore wait. The implementation of the concept of DO NO HARM to the patient must be a # 1 PRIORITY at all times and it doesn't matter whether a person is a medical student,intern,resident and etc.<BR/><BR/>If a man decides to be an MD-he should be allowed to follow his dreams. There is no reason to belittle people's ability and state that a man is allowed to become a doctor since he is not able to study Torah "16 hours/day". To each his own. Yes,it's much harder to be a shomer shabbat Jew in a NON- shomer shabbat medical/nursing programs. However,some of us are GIFTED HEALERS and it's possible to go through the programs and not violate the laws of shabbat(I'm a living proof of that as are many others).<BR/><BR/>As far as a man who wishes to become an OB/GYN specialist..... It's being suggested in this lecture that it's better if this man is married. But why? Because there is a chance that he will not be able to control his urges? Why assume the negative? Can't one be responsible and accountable for his own behavior?<BR/><BR/><BR/> I happen to believe that it's OK to wear scrubs if one is a female RN. Better scrubs than being exposed to body fluids contaminated with AIDS/Hep B and etc. It's so much easier to change soiled scrubs than a skirt,a blouse,pantyhose and etc. Besides,many Rabbis are willing to grant a female RN a psak allowing wearing of the scrubs these days. Why not take it and protect oneself from harm?<BR/><BR/>Last but not least-those of you who wish to read a truly fantastic manual that deals with medicine and hilchot shabbat-please locate a book titled HALAKHA and MEDICINE(A physician's hospital manual/hilchot shabbat) by Binyomin Sokol,M.D.(Regensberg Institute publishers/Jerusalem). You will find the content rather useful and refreshing.Anonymousnoreply@blogger.com