“Asher Yotzar”: A Lesson in Medicine
In this column, we dive into the rich history of Jewish Life, the precursor to Jewish Action. Published by the OU from the 1940s through the 1970s, Jewish Life offers a unique window into the vibrant evolution of American Jewish life during the 20th century.
The true story below appeared in the November-December 1970 issue of Jewish Life.
My chief, Dr. Dagradi, was there to see if something could yet be done. Father Sullivan was there to administer the last rites. I was then a resident physician at the Veterans Administration Hospital in Long Beach, California, assigned to the GI (gastro-intestinal) ward. We were standing at the bedside of a man in his early thirties. The alcohol he had consumed for years was finally taking its toll. It was killing him now. He was bleeding to death. He had bleeding esophageal varices. (Those are veins in the gullet that become enlarged and then engorged with blood that has bypassed the diseased cirrhotic liver.)
In an attempt to stop the bleeding, a Sengstaken tube had been passed into the esophagus and the stomach to compress the veins. In hospital for one week, the patient had already received a goodly number of units of whole blood, but it was coming out the rectum faster than it was flowing into the veins. He was receiving transfusions via both arms simultaneously, but his blood pressure had dropped to 60 systolic. In medical terms, he was in shock, in addition to being in hepatic coma. Prognosis: very poor.
The nurse, a “special” assigned to him, was going efficiently and silently about her work, moving with quiet dignity. The stench of the partially digested blood was unbearable. At least it was for me. A colleague had once told me it was the worst smell in the world. He was right. It looks like black jelly (my apologies to all black-jelly eaters) and the sulfides make it smell like a thousand stink bombs rolled into one.
She changed the bed linen—all too often, it seemed to me. Because every time she uncovered the stuff, an even more powerful wave of sheer stench invaded my nostrils. I looked at the nurse, at Father Sullivan, and at Dr. Dagradi at the other side of the bed. Their noses were not wrinkled; there were no frowns, no grimaces. Judging by the expression on their faces, you would have thought they were standing in a field of blooming lilacs. Jealously, I tried to unscrew the muscles in my face to present a picture of serene nonchalance—and commanded my nose to stop sending me messages.
But more consuming than this terrible odor was the sudden air of defeat in the room. You fight and fight to save a man’s life, and then as abruptly as the end of a summer storm, the battle is over. And more peculiar yet, this feeling of defeat was sensed by all of us at the same time. As if a bugle had suddenly sounded retreat. And what was the bugle call but the quiet, calm verbal exchange between doctor and nurse, superfluous really, but necessary only as a signal to “cease and desist.”
Dr. Dagradi: “He’s still bleeding, isn’t he?”
Nurse (looking him straight in the eye): “Yes, he is, Doctor.”
Dr. Dagradi (gently): “We can’t keep up, can we?”
Nurse (glancing at the patient with an expression of sympathy and compassion—it was a silent good-bye. Aloud and simply): “No, we can’t, Doctor.”
Finis. That did it. It was over.
Finished the life we tried so desperately to save. It hurt. And it is now that defeat turns to sorrow. Judging by appearances, nothing has changed. The patient is still alive, the Sengstaken tube is still in place, he is still being transfused. But in those few seconds of conversation between doctor and nurse, all has changed. We are already mourning the patient’s death. His family is in the hallway, totally unaware of the drama that has just transpired.
You fight and fight to save a man’s life, and then as abruptly as the end of a summer storm, the battle is over.
As if to prove that the patient is still as alive as a miracle might make him, the nurse changes the linen as carefully as before, wipes away the beads of perspiration as she applies a slightly moist cool towel to his brow.
What does one think of at a time like this? Heaven and Hell? The Lord and His Universe? Reward and Punishment? Sinners and their sins versus saints and their moments of salvation? I looked at the man on the bed. Why was he dying? And all I could think of was that small vein, open, and spilling out that precious red life fluid.
At that instant, of all things, I thought of the Hebrew blessing, “Asher Yotzar.”
“You know,” I said to Dr. Dagradi and Father Sullivan, “we Jews have blessings for almost everything. We are always thanking G-d for something. When we eat bread, drink schnapps, see lightning or a rainbow, hear thunder—for each of these there is a special blessing. There is even a blessing recited after performing a physiological function in the bathroom.”
“You’re kidding,” laughed Dr. Dagradi.
“No, I’m not kidding. I’m reminded of it now because it is applicable now. It is a blessing called in Hebrew ‘Asher Yotzar,’ which means ‘Who created.’ A good many Jewish people don’t even know it exists. The scholars appreciate it. Stated simply, what is closed must stay closed—and what is open must stay open. If what is open becomes closed, or what is closed becomes open, you are in trouble.”
“I see what you mean—the vein that should have stayed closed was open.”
The following day I brought a siddur to the hospital and showed them the English translation: “Blessed art Thou, O Lord, our G-d, King of the universe, Who created man with wisdom, and fashioned in him organs with orifices and cylinders. It is apparent and known before Thy glorious throne that if one of the closed cylinders becomes open, or if one of the orifices becomes closed, it would be impossible to exist and stand in Thy presence. Blessed art Thou O Lord, Who heals all flesh and does wonderful things.”
When my chief read this, he said: “That is beautiful. That’s principle! So much anatomy and physiology contained in so few words.”
Father Sullivan also had just one word for it: “Beautiful.”
As I walked away, the words of Devorim 4:6 rang in my ears: “And you shall keep them, and perform them, for it (the Torah) is your knowledge and your wisdom in the eyes of the nations.”
In 1943, Nathan M. Bernstein was spiritual leader of the Lincoln Park Jewish Center in Yonkers, New York. Then, moved by a long-cherished purpose, Rabbi Bernstein left his pulpit, attended medical school in Switzerland, and became Dr. Nathan M. Bernstein, M.D.