Last month, I visited my internist for a routine appointment. He is young, very bright, and attentive. When my then-doctor retired a year ago, I hired him to take over my care because I was impressed by his aliveness—he was totally present, on top of things and he listened, really listened, which I know that you will agree is a crucial trait in a physician. In this appointment, though, my impression was that there was something different in his speech, and in his body language. He was leaning back and just didn’t seem the same. After my part in the appointment was done, I said, “So how are things going with you, how is your career?” He looked at me and responded, “I don’t know, things are a lot harder. I was talking with my wife the other day (she’s also a doctor) wondering about our lives, our life paths.” This from someone only five years in practice.
I asked him if he had a dream of what he would rather be doing and he answered yes but it would take a lot more study and it was a completely different career.
I relayed this incident to a good friend of mine, a physician retired for over a decade, and he said, “Tell me something else — if you ask any of the doctors at Cedars, I’m guessing about 80% would tell you they’re burnt out.” What is it about physicians that create such a high statistical rate of burn out? I know that in order to do their job many feel they have to distance themselves emotionally from the work and I think that’s a key issue, the fragmentation. That creates a low to more serious level of ongoing anxiety and that anxiety covers over the clarity of purpose that we need in order to derive meaning and a sense of wholeness from our work.
In his recently published book, Unwinding Anxiety, psychiatrist/researcher Judson Brewer discusses the culmination of a 5-year study at Brown University, spotlighting the burnout culture of physicians and healthcare providers in general. Even Before Covid (universally and euphemistically now referred to as “BC”) we’d all heard of stories, which, whether you are a physician yourself or not, you can relate to — the feeling of wanting to throw up your hands or throw in the towel. The pressures of dealing with incredibly difficult situations and the common response of disengaging, causes fragmentation. Is it any wonder that statistics report that 50 to 80% of doctors, and many others, experience burnout in their work? This burnout is the result of ongoing levels of unaddressed anxiety.
What do we do with feelings ranging from mild unease to downright dis-ease? When we feel completely fragmented inside, how do we cultivate a sense of Chochmat Lev, a wise-heartedness that can lead to a sense of wholeness allowing us to be fully present? What do we do to take care of ourselves so that we can serve in the way that we were placed here on this Earth to serve? What does our tradition have to offer on this?
The Ishbitzer Rebbe teaches that when it is written
חיזוק – -ברא בראשית ברא אלהים
the word “Barah” is an expression of the concept of Chizuk, that is to say just as a structure has reinforcements, there is an underlying foundation of chizuk. In this case, it is the foundation of the World, Heaven and Earth. Further, Heaven and earth is considered to be a metaphor for the human soul, including our mind and heart. We too are created with the foundational element of chizuk.
He also reminds us of the prophet Isaiah’s words that “the world was not created for chaos, it was created to be settled.” He derives this from the verse: So says God, Creator of the Heavens. [Is. 45:18.] God does not mean for a person to live in internal chaos. Settled implies ease and quiet of mind.
In this time of year, when we have commemorated the birth of the universe, we look to the Creation narrative and turn it around and around to learn from it. In verses 3 and 5 of Bereshit we are told of the creation of light – Yehi Ohr, Vayehi Ohr. First, a spiritual light, the light from Hashem, glowing throughout the universe and through each of us. And in the second, referring to the light of the sun, day – the separation of light from dark, the creation of day and night.
The Sefat Emet also teaches that the Book of Life is within each of us – that HaShem writes “CHAYIM!!!” on the tablets that are within us. Our job is to keep the schmutz away—the transgressions, the distractions, the guilt and the worries, so that we can be the best people that we can be while we are here. When we are out of touch with who we are, we cannot find our inner answers and are plagued by doubt, worry, and uncertainty. The Sefat Emet teaches that at this time of year, we do an accounting and just like the Shofar image the sound calls us to wake up and be present. Nachmonides defines Teshuvah as a great return– Return Again to what we are, Return Again to who we are. This is not a once a year process, but a daily practice.
Orah L’ Hayim offers that just as the Shofar, we are to consider ourselves as a mere trumpet and to understand that the good that we do and that we have comes from God. Arthur Green adds this: that God created and continues to create the world out of love. When we stop trying to compete with that love and accept that we are an echo of it, we will feel that spirit blowing through us.
We have just commemorated Rosh Hashanah. The fact is that, although the first day of the year is known as Rosh Hashanah, the Torah does not call it by this name but uses an entirely different one, Yom Teru’ah — the day of blowing. The blowing of the shofar is meant to jolt us out of our apathy, our ruts, and cause us to engage in the soul-searching needed to allow us to emerge worthy of going into the next year. Indeed, the very word “shofar” has the same root letters as “shipur“, which means “to improve”. It is as if the shofar is calling to us, “Improve yourself!”
In Exodus 34, we read of the 13 Attributes. There is a commentary that states that God caused the Israelites to sin with the Golden Calf incident so that the 13 Attributes would be written down for all future generations, to help us when we transgress. It was a message for all time that our ancestors were not perfect, and we should not expect to be perfect, but we can continue to redirect ourselves again and again, by looking at these attributes to model and guide us as to how we live our lives. This ties in with the concept that Teshuvah is a way of reshaping oneself for the better, so that we can then truly be wholehearted as we undertake the repairing of ourselves and of the world—Tikkun Olam.
It occurred to me that we can utilize a gift that Hashem had given to the Israelites following the sin of the golden calf. Just like any teacher of children knows, if there’s one behavior that needs to switch, it can’t be done in a void. You have to redirect by substituting another behavior. Our children, grandchildren, and even the children who live inside each of us, at times all need to be redirected.
We do that through God’s great gift … the Mishkan, a project where people could come together to create in community and then carry with them as they journeyed on their way. We too can use the Mishkan as we journey through our lives.
The Mishkan was the first great egalitarian project, a precursor to another egalitarian project— our Library Minyan — For the Mishkan, all could come and contribute and work to create something extraordinary, not for any Pharaoh, but for the Israelites themselves, and for God.
The Menorah reminds us that each of us is created B’tselem Elohim and that the light that was created in the story of Creation lives on within each of us.
The incense altar, emitting a beautiful fragrance, helps us to remember that our actions are to leave behind a Re’ach Nichoach. Tough to do when we are stressed, but therein lies the real work.
The Mizbeach (altar) is the ever-present reminder of what our korbanot are today. And the utilization of our gifts and our acts of lovingkindness so that we can partner with Hashem to be of service and to continue the creation of this world.
And…the Ark. With both sets of Tablets — the whole and the broken. Just as with the broken Torah, we take with us our on our journeys what is whole and what is broken. We carry the jagged edges of what is broken with us, which may tell us exactly what we need to face and address in our lives. I encourage each of us, myself included, not to shy away from those jagged edges. They may point us to our most profound opportunities for growth.
The antidote to fragmentation, however, going toward who we truly are is the only way we can achieve a sense of wholeheartedness. Rabbi Dov Ber Pinson, in his book, Reclaiming The Self, describes Teshuva as returning to the person we were meant to be. This implies that there is a point of origin, and that point is one’s deepest self. He quotes Ezekiel 1:1 “And I was in the midst of exile.” We do have the capacity to take ourselves out of our own inner exile to once again realign ourselves.
So during those times that we need to redirect, to pull ourselves away from the unease and dis-ease that could escalate to downright fragmentation, let’s look to the first verses of Bereishit and the gift of the Mishkan to help turn us into a place of love, kindness, and at-oneness. ECHAD! Within ourselves, with our families, with our community, with the world, and with Hashem.
BEREISHIT BARA ELOHIM … CHIZUK! SHABBAT SHALOM