Thursday, July 16, 2009

Saving lives in shul

I’ll never forget it.

It was my first year in Allentown, Shabbat Chol haMoed Succot. An elderly gentleman was called up to the Torah for the third aliyah. He made the opening berachah, and we read the powerful words of that reading (Sh’mot 33:20-23):

And HaShem said to Moshe, “You cannot see My Face, for no man may see me and survive.”
And HaShem said additionally to Moshe, “Here is a place with Me; you will stand on this rock. When My glory passes, I will place you in the cleft in the rock, and I will shield you with My Hand until I have passed. And I will remove My Hand, and you will see My aftermath, but My Face will not be seen.”

The gentleman then recited the closing berachah, thanking Gd for giving us the Torah of truth – and then he died.

I didn’t know he was dead. He collapsed, and I caught him (I think). We laid him out on the bimah, and doctors rushed over to apply CPR and use our AED (automated external defibrillator), while an ambulance was called. The shul said tehillim, and eventually he was moved out and taken to the hospital. We continued davening; we found out later that he had passed away.

That was the first time I was faced with someone needing serious medical attention in shul, but it was by no means the last. Over the years we’ve had several people faint or have seizures, during davening or shul meals or just general use of the building, and I’ve learned a few lessons from the experiences. They may be obvious to everyone, but I'll post them here just in case.

1) A shul must have an AED and an oxygen tank, and people must be trained to use them.
Our shul had an AED before I arrived, thanks to the prescience of the membership. It’s a good thing; the AED has saved at least one life, and the oxygen has been used to treat many more.

2) If someone needs medical attention, keep the davening going, whether with tehillim or simply by continuing the normal davening.
This is somewhat counterintuitive, because it feels crass to go on with musaf while someone is fighting for his life. It certainly is difficult to maintain concentration, and the minyan may need to move to a different room in order to avoid disturbing the rescuers. Nonetheless, this is valuable for several reasons:
First, davening for someone always helps them.
Second, davening provides friends with something they can do.
Third, it helps for crowd control; having a hundred people mobbing the rescuers and keeping air from the patient is counterproductive, to say the least.

3) The rabbi does not need to be in the middle of the action.
I am CPR-trained and AED-trained, and, like many rabbis, I always want to be in the middle, doing something to help in the most concrete way possible. However, that isn’t necessarily the best place for the rabbi; finding another way to contribute may help others do likewise.

One other thought: We often encourage frail and recently-hospitalized people to come to shul, whether directly ("I look forward to seeing you in shul when you come out of the hospital") or indirectly ("We miss having you around.") This may not be the best tack.

Of course, people joke that because of our large number of doctors, and because we have equipment and experience, our shul is the safest place in town to pass out. There’s a lot of truth to it, certainly for someone who otherwise might have passed out at home, with no one else around. But, at the same time, the walk to shul might be the small exertion that puts someone at risk. Better to stay home and stay safe, daven to HaShem on Shabbat in private and join with the community during the week.


  1. For those of you not familiar with the Rambam, Hil. Shabbos Perek 2, pay particular attention to Halacha 3:

    א דחויה היא שבת, אצל סכנת נפשות, כשאר כל המצוות; לפיכך חולה שיש בו סכנה--עושין לו כל צרכיו בשבת, על פי רופא אומן של אותו מקום. ספק שהוא צריך לחלל עליו את השבת, ספק שאינו צריך, וכן אם אמר רופא לחלל עליו את השבת, ורופא אחר אומר אינו צריך--מחללין עליו את השבת: שספק נפשות, דוחה את השבת.

    ב אמדוהו ביום השבת שהוא צריך לכך וכך שמונה ימים--אין אומרים נמתין עד הערב, כדי שלא לחלל עליו שתי שבתות; אלא מתחילין מהיום שהוא שבת, ומחללין עליו אפילו מאה שבתות: כל זמן שהוא צריך ויש בו סכנה או ספק סכנה, מחללין--מדליקין לו את הנר, ומכבין מלפניו את הנר, ושוחטין לו, ואופין ומבשלין, ומחימין לו חמין בין להשקותו בין לרחיצת גופו. כללו של דבר: שבת לגבי חולה שיש בו סכנה--הרי היא כחול, לכל הדברים שהוא צריך להן.

    ג כשעושים דברים אלו, אין עושין אותן לא על ידי גויים, ולא על ידי קטנים, ולא על ידי עבדים, ולא על ידי נשים--כדי שלא תהא שבת קלה בעיניהם; אלא על ידי גדולי ישראל וחכמיהם. ואין מורין לנשים לעשות דברים אלו. ואסור להתמהמה בחילול שבת, לחולה שיש בו סכנה, שנאמר "אשר יעשה אותם האדם וחי בהם" (ויקרא יח,ה), ולא שימות בהם. הא למדת, שאין משפטי התורה נקמה בעולם, אלא רחמים וחסד ושלום בעולם. ואלו המינים שאומרים שזה חילול ואסור, עליהן הכתוב אומר "וגם אני נתתי להם, חוקים לא טובים; ומשפטים--לא יחיו, בהם" (יחזקאל כ,כה).

    When someone had a heart attack right at the end of Adon Olam one Shabbbos, an MD started CPR and I immediately called an ambulance and took down the chains of our parking lot to allow the ambulance to come right to the door.

    Another Rosh Hashana, a lady semi-fainted during the Rabbi's speech. He immediately had his son (who is holding in these halachos and has been moser nefesh in the past for cholim on Shabbos) run & call an ambulance. The Rav lost the audience for his speech, but he did the right thing.

  2. Indeed, Talmid; I took it as a given, but it's always worth spelling that out. Thanks.

  3. I would add one more thing based on personal experience. There should be some accessible juice, soda and/or cookies for diabetics. I live close to shul, and this past Rosh Hashana I had to run home to get these things for someone who had just tested very low.

  4. Good point, Staying Afloat. Odd you had to run home for it, though; every shul I've ever known has had food around because of kids' snacks and because of the kiddush.