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The Music in My Operating Room
Parshat Mishpatim 5780

An operating room can be a pretty tense and chaotic place, which is why it is no surprise that about 70% of surgeons prefer to have music playing while they operate. Already in the early 1900’s, a Pennsylvania surgeon wrote of the benefits of bringing a phonograph into the room, but that was before anesthesia and the primary purpose was to “calm and distract the patient from the horror of the situation.” Thankfully, we live in an entirely different world, where the patient is most often blissfully unaware of what is happening in the operating theater around him, but music still features prominently in most surgical procedures.

In a recent study published in The BMJ (one of the leading medical journals that most people have never heard of because it’s not called JAMA or Lancet), 80% of operating room staff claimed that music helps the cooperation between team members, lowers anxiety levels, improves efficiency, and may even improve the surgeons’ task focus. The accepted practice is that the lead surgeon picks the playlist, and most frequently classical music is the genre picked. This seems like a good thing; I doubt many people would want to be operated on to the sounds of gansta’ rap or heavy metal.

But this week, for the first time in recorded history, the music being played in the operating room was being played by the person being operated on! Dagmar Turner, a fifty-three year old British woman, who had been playing violin since she was ten years old, had to undergo surgery to remove a slow-growing tumor in her brain. Dagmar plays in the Isle of Wight Symphony and discovered the tumor after undergoing a seizure in middle of a performance. She knew that she needed the surgery to remove the tumor, but she was very concerned that while operating the doctors might remove excess brain tissue causing her to lose the ability to play, which is one of her greatest joys. This concern was exacerbated by the location of the tumor, in the right frontal lobe, right next to an area of the brain that controls fine motor movements of the left hand!

The surgeon, Dr Keyoumars Ashkan or King’s College Hospital in London, himself a dedicated pianist, came up with a novel plan. They would fully anesthetize Dagmar while they opened her skull, and then wake her when they started poking around in her brain. She would still be anesthetized to the point where she wouldn’t feel pain, but she would be awake enough to interact and play an instrument. She would begin to play her violin, and before making any incisions the doctor would carefully probe the area and see if it affected her playing.

The surgery went without a hitch. Dagmar, eyes closed, breathing tube in her nose, and skull partially removed, played her violin beautifully while the team of doctors worked to remove the tumor. The surgery was a success, the surgeons were able to remove over 90% of the tumor, especially all the aggressive areas, and Dagmar can still play the violin! She retuned home three days after the surgery, but not before expressing her deep gratitude to the hospital staff for saving her ability to play music, “her passion since she was ten years old!”

The ability to play music while undergoing brain surgery is something that would not have been possible at any point in history until the advent of anesthesia and modern medicine, which is in its own right worthy of wonder, praise and blessings to the Good Lord Above. It is hard to comprehend how much death was caused by medicine and its well-meaning practitioners, from doctors who delivered babies directly after dissecting corpses without even washing their hands, to doctors who literally bled their patients to death, thinking they were draining the “bad humors,“ to doctors who performed trepanation, the boring of holes in the skull, as the cure-all for almost any ailment. But Baruch Hashem, we have seen modern science progress so far to the point where we can have a woman play violin while in middle of surgery! The Talmud teaches us that when we see the wise of the nations of the world, we are supposed make a blessing, praising Hashem for “giving of His wisdom to [those made of] flesh and blood.” We understand that all of mankind’s wisdom is a gift given to Him be G-d, from a DNA perspective there is very little that separates us from the orangutan, but we are performing surgery in state of the art hospitals, while the orangutan still hasn’t figured out how to make a sandwich. Seeing Dagmar’s surgery would definitely be cause for making that blessing.

But this story also reminded me of another concept. The Talmud (Berachos, 5A) speaks about “Yissurim shel Ahava,” afflictions of love, which are difficulties that a person encounters that are sent to him out of love by G-d because G-d is trying to make him into a greater person. There is a famous phrase, “Ships are safest in the harbor, but that is not what ships are made for.” Mankind is here to toil and grow, to become great people. When we face challenges and overcome them, when we face difficult situations and fight through them, we come out bigger and stronger people. So there are times that G-d sends challenges to a person, not as a punishment but as a growth opportunity.

But how do we know if a particular difficulty is of the Yissurim Shel Ahava, the Afflictions of Love category? The Talmud asks this question, and records a few different answers offered by two Talmudic Sages, Rabbi Yaakov bar Idi, and Rabbi Acha bar Chanina. One says that afflictions can only be considered afflictions of love if they do not impede a person’s ability to study Torah, and the other says that they can only be considered affliction of love if they do not impede a person’s ability to pray. But both answers follow the same theme; as long as you can make music through your difficulties, they are difficulties of love, difficulties that you can grow from. If they shut down your ability to make music, they are can’t be difficulties of love because they are turning off your most beautiful form of expression.

We all go through difficult periods of our life, but if we can just hang on to our fiddles and keep playing beautiful music right through those difficult times, we will later recognize that those difficult times were a process that excised all the worst in us, and left us much healthier human beings, and we were able to play right through them. If we can still smile at others and support others when we feel like our support is non-existent, if we can be a ray of light to others when we feel like we don’t have any rays in our life, when we can be honest and good, kind and loving, filled with faith and sanctity, despite being buffeted by so many waves, if we can play music through the surgery, we will surely be playing powerful music that will give joy and hope to others for many years to come!

 

Parsha Dvar Torah

This week’s Parsha is the first Parsha to detail many of the civil and criminal laws that are an integral part of the Torah. Examples of laws found in this week’s parsha are those dealing with stolen items, property damage, murder, integrity of the judicial system, and the responsibility of guardians.

The commentators ask what connection there is between this week’s Parsha and the end of last week’s Parsha, which dealt with the altar in the temple and tabernacle. They explain that the juxtaposition is supposed to teach us that the Sanhedrin, the Supreme Jewish Court, should convene in close proximity to the altar. In practice, the Sanhedrin met in a chamber on Temple Mount, called The Chamber of Palhedrin. What is the connection between those two – why did G-d make these two ideas adjacent in the Torah, and why does He hint to us that the Sanhedrin should be near the altar?

One explanation of this juxtaposition is that the Torah is directing us to a fundamental duality of Jewish life, civic responsibility and service of G-d. Although it may seem that one is a religious matter and the other is not, Judaism sees both as primary expressions of what it means to be a Jew. A person who focuses only on service of G-d or on his civic responsibility will not be develop his full Jewish potential. Being very pious in the House of Worship, but then going to the boardroom and committing fraud, tax evasion, or other white collar crimes, is not an acceptable form of Judaism. Neither is being scrupulous in business, paying taxes on time, never stealing a penny from anyone, but then ignoring G-d, or not having any relationship with Him.

A recent colossal financial scandal that rocked the Jewish world underscores this point. While the main perpetrator may have given large sums of charity, and volunteered his time to sit on the boards of many non-profits, his professed piety clearly did not translate into his business practices. He was a person who would have been happy to see the court far from the Temple, so that he could maintain his religious actions without having his conscience assaulted by the paragon of jurisprudence being located next to the altar. But our Sages teach us that the very first question we get asked when we come before the Heavenly Court after passing to the Next World, is “Did you conduct your business affairs faithfully?” There is no split between the altar and the court.

Unfortunately, our world also suffers greatly from a lack of appreciation for the other side of this message. Many people confuse being a good Jew with being a good citizen. They feel that as long as they are honest in business, pay their taxes, keep their lawn mowed and sidewalks shoveled, they are being all they can be as Jews. But in truth, that might make them a good American, but Judaism is a much richer experience than that, one that includes a relationship with the Divine; one that includes prayer, Torah study, mitzvos, and spirituality. Right next to the zenith of civic propriety was the altar – the place where mankind related to Hashem.

There is an analogy often used to understand this concept. Imagine a person who achieves extraordinary success. He becomes a world renowned surgeon saving people’s lives daily, and then turns to research and discovers the cure to a particularly resistant strain of cancer. He flies all over the world presenting his findings and freely dispensing his cures. There is one thing however that separates him from most people. He has no relationship whatsoever with his parents, despite the fact that his parents took good care of him as a child, showered him with love and attention, and worked hard to ensure that he would have numerous avenues to develop his skills and faculties. In Judaism, this person would be the person who does everything right from a civic standpoint yet has no relationship with G-d, no personal altar.

The Holy Temple in Jerusalem was meant to be a model that showed Jews the way to make a temple within themselves. Indeed the wording for the commandment to make a Tabernacle indicates this, “And they shall make for me a Tabernacle and I will dwell within them. (Exodus 25:8)” Just as the Temple had the civic courts of justice and the altar next to each other indicating their equal importance, so to we should make our civic justice and our relationship with G-d into equal components of the temples we build within us!

 

Parsha Summary

This Parsha is where we begin to learn about the Jewish system of law. The first verse starts with a fundamental, namely that a Jew cannot take his legal issues to a non-Jewish court even if he knows they will give the same verdict as the Jewish court. We believe that when a Jewish judge sits in trial, he receives Divine assistance, which aids him in adjudicating properly. A non-Jew in a secular court doesn’t have that added benefit, therefore the Torah commands us to bring our issues before a Jewish court.

The first laws dealt with in this portion are those of the Jewish servant, someone who stole and didn’t have the money to return the stolen goods, who the court then sold so he could pay the victim of his thievery. The Sages tell us, “Anyone who buys a servant is acquiring a master for himself.” According to Jewish law, not only does the master need to take care of the servant’s wife and kids (who are not working for him), but if there is only one pillow in the house it must be given to the servant. The goal of the servitude is to rehabilitate the criminal by having him be around his master for a number of years and see how fair and upright he is. (Having once been beaten by a gang of thugs fresh out of prison, I believe that anything would probably be better at rehabilitating miscreants than our current prison system!)

There are so many laws in this week’s Parsha that I will only list some of them. After the laws pertaining to servants, the Torah deals with: murder – intentional and unintentional, kidnapping, striking or cursing of parents, and damages for bodily harm to others caused by a person, his property, or his animal. It teaches us how to deal with the stealing of livestock or other goods, the right to self defense, the different types of legal guardians, and the laws of a seducer, sorcerer, or people who engage in bestiality. G-d warns us to be extra sensitive to widows, orphans, and converts, warns us against charging interest for loans, and reminds us of the importance of upholding the integrity of the judicial system.

Next, we get back to some general mitzvos as G-d commands us here regarding the laws of Shmitah (leaving the land fallow on the 7th year), the laws of Shabbos, and the laws of the three major festivals, Pesach, Shavuot, and Succos. After that G-d promises us that He will watch over us, and get us settled into the Holy Land swiftly and safely, without disease or lost battles.

The last part of the Parsha goes back to the narrative of the Jews at Sinai. We are told that the Jews, upon being asked if they wanted the Torah, replied, “Na’aseh V’Nishma,” meaning we will do and we will listen. This was the Jewish people’s way of showing their complete faith in G-d. They were so certain that G-d would only give them mitzvot which were good for them that they accepted them even before hearing them all. Even today, we can still express the idea behind Na’aseh V’Nishma by doing the mitzvot we don’t yet understand as beneficial or just. When we do them anyway, we show that we do even what we don’t fully “hear” (understand). That’s all Folks!

Quote of the Week: All know the way, few actually walk it. ~ G. Yelnats

Random Fact of the Week: The Library of Congress has 327 miles of bookshelves.

Funny Line of the Week: A burrito is a just sleeping bag for ground beef.

Have a Feisty Shabbos,

R’ Leiby Burnham

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