By Dennis Rosen, M.D. / New York Times Blog
“Doctor, is it O.K. for our rabbi to visit my father?”
I was an intern on call in one of the internal medicine wards in an Israeli hospital just south of Tel Aviv. The first day of the Jewish holiday of Sukkot had just ended, and the ward was beginning to fill up with visitors who had been unable to drive until after sunset.
Looking up from what I was doing, I saw the son of one of my patients standing at the counter of the nursing station. He and I had already spoken several times that day about his 75-year-old father, who had been admitted the night before because of a stroke.
The father’s CT scan from the night before had been unremarkable, not unusual in patients whose strokes are caused by an interruption of blood flow to portions of the brain. I had explained this to the son, as well as what to expect over the next few days as his father would undergo further testing and then discharge to a rehabilitation facility. I told him that it was impossible at this early stage to predict how much function his father might recover, and cautioned against giving him anything to eat or drink until we were certain that his ability to swallow had not been affected. All of the son’s questions had been very appropriate and focused.
“Of course,” I responded, smiling and a little surprised that he had asked my permission. No one else had that evening.
Thanking me, he turned around towards the main door of the ward, located just beyond behind the nurses’ station. Bowing to the rabbi who was just out of sight, the son addressed him in the third person: “Please, may the honorable rabbi enter.” After kissing the rabbi’s hand, he straightened up and led the guest to his father’s room.
I followed them down the hall with my eyes. It was only as they were about to enter the room that I noticed that the rabbi was carrying a white chicken in his arms. Although quiet, the chicken was very much alive.
Amazed, I stood up and followed them into the room. Inside, there were perhaps 20 people, the men standing in a tight circle around my patient’s bed, the women sitting off to the side. The rabbi, who I suspected would be visiting other patients that evening, had already begun to chant the prayer for the recovery of the sick, one that I recognized. Totally new for me, however, was the role of the chicken. Clasped snugly in the rabbi’s hands, the bird was being waved in tight circles about 12 inches above the patient’s head as the prayer was being chanted. I was familiar with the practice of kaparot, in which observant Jews swing a live chicken over their heads on the day before Yom Kippur to symbolize the casting away of sin. I had never, however, seen or heard of this being done as part of a Jewish healing ceremony.
My patient’s eyes were partially closed, but the rest of the men by the bedside were fully engaged in ritual. Swaying back and forth, some chanted along with the rabbi. Only one person seemed to notice me as I entered the room. He glanced at me in a stern way, as if warning me not to interfere. I stayed there for a minute until one of the nurses called me away to see another patient.
A couple days later, I asked the son about the ritual I had witnessed. They were members of the local Persian-Jewish community, he explained, and this particular way of reciting the prayer for the sick — with the chicken — was their custom. Be’ezrat hashem (with God’s help), his father would make a full recovery.
I was very impressed by how deftly the son was able to maneuver between two very different belief systems explaining his father’s disease and paths towards possible recovery: biomedical and religious. As evidenced from our repeated discussions about tests and treatment plans for his father, he clearly understood — and valued — what modern medicine could offer. And yet, his belief in Divine mercy and intercession was unshakeable.
In her book “The Spirit Catches You and You Fall Down,” Anne Fadiman describes the collision between two radically different belief systems, shamanism and biomedicine, held by the parents of a Hmong girl suffering from epilepsy and the physicians caring for her. The pushback the parents encountered from the medical team when they tried to incorporate shamanistic healing into their daughter’s treatment plan led them to reject biomedicine altogether, with tragic consequences.
Although it hadn’t occurred to me to disrupt the unfamiliar ceremony with the chicken — mostly because I was so astonished by it — I probably would have been within my rights to do so: bringing live poultry into an inpatient ward is risky from an infection-control perspective, after all.
I’m glad that I didn’t. Doing so would have prevented my patient and his caregivers from accessing the healing potential that their religious beliefs provided them, and likely would have provoked antagonism towards — or the outright rejection of — the biomedicine that I represented. And that would have been detrimental to my patient, who so clearly needed the powers of both in order to heal.
Although nearly 19 years have passed since that October evening, hardly a month goes by in which I do not find myself reflecting on this patient, and the chicken. This invariably occurs because of an interaction I’m having with another patient or family with deeply held beliefs that need not only to be recognized and respected, but also integrated into the therapeutic approach in order for treatment to succeed. It is a lesson that has served me well, and which has helped me to serve so many others over the years.