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April 20, 2014 / 20 Nisan, 5774
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Sh’mor Al Nafshecha – Watch Over Your Life

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The Torah admonishes each Jew to ‘take care of yourself,’ to do what’s necessary to stay alive and well. Obviously this means to do life enhancing actions like eating and sleeping properly, taking precautions like putting on a seat belt when in a car, and not taking unnecessary risks, like jaywalking across a busy street or walking on a ledge 40 stories high. Most importantly, one needs to get medical attention when sick or injured.

Having said that, when going to a doctor, especially for a more serious illness or injury, or if you are hospitalized – it is a necessity to educate yourself, to the best of your ability, about your particular illness. Unfortunately, the hefkerut that I wrote about in my previous column – the casual, apathetic attitude towards service that is so rampant in today’s consumer society – has infiltrated the health (as well as legal) professions. It is incumbent on every person to guard his life.

In some instances, hefkerut is the result of being in the care of a “kidult” - a doctor, nurse, lab technician, whose immature personality – not intelligence - prevents him from being competent and meticulous. Kidults tend to be arrogant and have feelings of superiority (to mask their
feelings of inferiority, and a need to be in control). Doctors who are “kidults” may be educationally brilliant, but their conceit may stop them from consulting with other doctors who could give them a valuable insight into your medical situation.

“Kidults” tend to be narcissistic – they are focused on themselves, and may not bother to go that “extra mile” to make sure their orders have been carried out, or look into the medical literature regarding your particular disease. And because of overt pride, or narcissistic self-love that precludes being able to be thoughtful, caring and compassionate, or because of the need to be in complete control, or because the insatiable desire to be admired and praised, your medical care may be seriously compromised.

Some professional hefkerut is unavoidable – because of understaffing, your doctor or nurse may be juggling so many other patients that you somehow fall into the cracks and crucial diagnostic tests were never ordered, the results went un-noticed, a medication was not given, or proper follow-up not done. I personally know people who have experienced such mistakes, and I’m sure my readers do as well. Whatever the reason – incompetence, a lack of care, or genuine error - the life threatening outcome is the same.

When you’re on an airplane with 100 other passengers, you can be pretty confident that the pilot is focused on just this one flight. He will make sure that all the necessary buttons are pushed and all the right levers are pulled and the correct weather and geographical maps are looked at. He is focused on the one job and has no distractions from the task of getting his 100 passengers to their mutual destination.

Let’s say, however, that each passenger was in his/ her own capsule and that the pilot was flying each of these capsules by remote control from his office. Each of the mini-planes carrying just the individual is going somewhere else. Some of them have a long distance ride, some are going for a short haul, all are headed in various directions. Some of the destinations
are more complicated to get to, some quite easy. The pilot has to keep an eye on dozens of capsules at the same time.

I would imagine that before you boarded your individual flight capsule, you would make it your business to know as much as you could about where you were headed, the workings of the airplane, what levers need to be pulled, and when. Thus, when on your journey, you could see if your pilot was doing what he was supposed to be doing, and you could ask him questions about the route and remind him about certain procedures.

A doctor is like a pilot trying to make sure dozens of his “passengers” who are travelling in their unique “capsules” arrive safely to their destinations. However, due to the logistics of monitoring dozens of people, entailing the remembering of hundreds of details to ensure a successful “journey to recovery,” or due to sheer hefkerut, mistakes or omissions happen.

To protect you or a loved one who is ill from medical mishaps – all the more tragic because they were avoidable - try to learn as much as you can about the particular problem so that you can ask your doctor astute questions. When medical personnel see that they are not dealing with an am ha’aretz, but with someone who has a decent grasp of the situation, they will more likely be more conscientious.

You can educate yourself by going on the internet - typing in the name of the problem, for example, diabetes, on a search engine such as www.google.com. You will get a whole menu of related topics to look at, such as symptoms of the disease, diets for diabetics, support groups where you can exchange information and experiences, resources for finding out who is
tops in this specific field, etc. There is a wealth of information, written in language the average non-medical person can understand, for you to peruse and educate yourself with.

Another helpful thing to do is to enlist the aid of a relative, friend or neighbor who is a physician and with whom you have a close relationship, and ask him/her to be the family spokesperson. If the doctor in charge knows that another doctor is monitoring the situation, that will also be a good motivator for his being extra meticulous about the patient’s care.

Another tactic is to ‘humanize’ the patient.

My mother (Leah bat Zisel) is currently in the intensive care unit of a Toronto hospital and we have photos on her IV pole and bedpost of her rejoicing at family weddings. In these photos, she looks even more radiant and beautiful than usual. We want the medical staff to see who she really is, and not view her as just a sickly old person. No doubt that looking at family pictures also gives chizuk to the patients to recover and return to their lives.

I can’t emphasize how important it is for there to be a steady stream of visitors to the patient. When the nurses, technicians, doctors, hospital staff see that “the stroke in bed #9″ is not just a sick body, but a person who is important to many people, that he/she has a family and friends and a community behind them, they are likely to be more attentive.

Those patients who lie alone hour after hour, day after day, are often overlooked by the overworked, understaffed or uncaring kidult medical personnel, their attitude being, no one cares about “the renal failure in bed #7″ - so why should we go out of our way?

Know that the value of chesed of the selfless members of Bikur Cholim cannot be measured on this earth – that on Yom Ha’din, the merit of those who visit the sick will reach up to Hashem’s throne itself.

Take an active stance on your care or your loved ones as much as possible - don’t be a passive participant. Ask the nurse what medications are being administered and when, so that you can check if the dose was given on time. Ask what the beeping noises are, what looks like a normal drip - lots of drops or very slow ones; what the numbers mean on the screen – what is normal and what isn’t, so if there is a change, you can alert the nurse.

Don’t be afraid to ask – the squeaky wheel gets the oil. And if the doctor is not reasonably accessible – then consider getting another doctor to take over - one who will address your concerns instead of resenting them and putting you on the defensive.

And without question the best course of action – daven to the Ultimate Healer for a refuah sheleima for you, your beloved one, for Klal Yisrael and for Moshiach to come speedily and remove all our tzoros. Amen.

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