Coping with Despair: Reflections on a Hospital Experience

We gather in shul on Rosh Hashanah for complex and complicated reasons: it’s the Jewish thing to do, we like to meet with friends after the summer hiatus, perhaps to pray to God, perhaps to listen for God’s answer.

Most of all, it is a time for heshbon hanefesh, for taking account of our souls, for baring our hearts. Today I would like to share from my heart, from my experience.

Crossing the Half-Marathon Mark 2015So, here goes a hard sermon – it has been a difficult year for me. Last year, I spoke about the challenges I faced, and how I overcame them and ran the Boston Marathon; it was a talk that was filled with hope, filled with optimism.

But this year, I stand before you a little different. My experiences, particularly of personal illness, have shaken me, humbled me, and, I hope, have deepened my understanding of myself and have helped me, with God’s help, to deepen and strengthen my connections to all of you and to God.

tara-brach“May my suffering serve to awaken compassion.” (Tara Brach)

But first, from the bottom of my heart, I thank you, all of you, for the wonderful gift of this spring semester. I am so grateful to Rabbi Fel, our entire staff, and our lay leaders for carrying the workload while I was away.

Despite the downtime spent healing from GI surgeries, your gift of this sabbatical provided me many wonderful experiences: spending more quality time with family and friends, researching prayer at Brandeis,brandeis-seal participating in a spirituality conference, attending the Wexner Alumni Institute, serving as a rabbi-in-residence at Camp Ramah Darom for Pesah, and at Camp Ramah in the Rockies at the beginning of the summer, as well as organizing and helping to lead a trip to Germany for twelve Boston rabbis as guests of the German government. But the most transformative moments occurred not during the Sabbatical.


* * *

A mentsh trakht un Got lakht” – A human being plans and God laughs.

This morning, as we celebrate the birthday of the universe, we read about the futility of planning. Sarah and Abraham planned on children, but she was unable to conceive. This caused her deep, visceral pain. She had come to believe that God’s plan and her own dreams were one and the same.

But the years passed without children. Then, when conception is no longer physically possible, God tells her that she will conceive. And how does Sarah respond? She laughs. She laughs to herself.

And we can feel that lifetime of disappointment in her laughter. This is what she has wanted more than anything else in the world, and now her life is almost over – how else is she to react? God, in response, expresses anger at Sarah’s disbelief and lack of gratitude, yet God still remembers her.

And the child is named after that initial, spontaneous response – “laughter – Yitzhak.” That burst of laughter suffused with bitterness and absurdity has been transformed into a new life that is welcomed into the world with overwhelming joy.

* * *

It was during the last week of August, when I was full of energy and excited to be back at work that everything stopped. I could feel an intestinal blockage coming on again. It was completely unexpected – I was having a lovely day with our staff – learning about email efficiency techniques, filming our fun Rosh Hashanah video, and having lunch, when I felt an intense pain.

I did not immediately panic. This type of pain was familiar, and sometimes fleeting, so I returned to my office to relax with a cup of hot tea and tried to return a few calls. When that didn’t work, I went home and took a warm bath – sometimes these things just disappear. But by this time it was an effort to remain positive and I started to recite for the prayer for the body, the Asher Yatzar which acknowledges how fragile and vulnerable we are.

I also called my acupuncturist.

Back in January, I began to see an acupuncturist – that has been a helpful part of my healing. I called for an urgent appointment and was seen immediately. It helped a bit and I thought that – maybe – maybe my body had reset itself. I convinced myself that I was better, yet within a couple of hours of getting home, I was too sick to go to our board meeting; the pain became so great that Sharon drove me straight to the ER.

That ushered in the start of nine really difficult days.

* * *

During my sabbatical, the focus of my reading and research shifted to exploring the intersection between Eastern Medicine and Jewish spirituality.

when-things-fall-apart-coverPema Chodron, a Buddhist teacher, reminds us in her book, When Things Fall Apart, that: “Things are always in transition, if we could only realize it….Sticking with that uncertainty, getting the knack of relaxing in the midst of chaos, learning not to panic…this is the spiritual path.”

Except for perhaps entering a prison, entering a modern hospital in crisis, is the ultimate example of surrendering control in the midst of chaos, literally stripping off your identity, removing your wallet and clothing, finding yourself naked except for a flimsy gown, completely exposed and vulnerable.

I took Chodron’s words to heart and quickly embraced the strategy of surrender. With Sharon as my advocate, I gave myself permission to let go. To try to relax and not struggle as the nasogastric tube was painfully inserted up my nose and down my throat. To surrender to the non-stop hiccuping I developed. To accept the rhythms of hospital procedure. To trust in my body’s ability to heal and wait for the blockage to resolve.

A mentsh trakht un Got lakht” – A human being plans and God laughs.

Despite acceptance, meditation, and a hopeful outlook, early the next morning, the surgeon on call stated matter-of-factly, “You look like you need surgery.”

“What?!? I just had surgery five months ago. I can’t have another surgery!!”

I bargained for a little more time. But a few days later, the time had run out – the reality of the situation was that I couldn’t eat, the blockage was still intact, all other approaches had failed, and there was no choice. Another surgery was needed to cut through an adhesion, scar tissue from the previous surgery, that was causing the blockage.

I was alone in my hospital room when the surgeons entered, to inform me that I needed to make a decision. The choice was that she could operate on me that evening or her colleague could perform the surgery the next morning. There was really no other option.

In retrospect, it was not that big a decision, but at the time, suffering and in pain, I was completely overwhelmed.


Sharon had left to pick up the kids, but when I tried to update her over the phone she could barely hear me – I still had the nasogastric tube down my throat and horrible hiccups. She said she would drop the kids at home and drive right to the hospital.

I had never felt more alone in my life. I was never more afraid. Is this my life? Surgery after surgery with a bit of living in between?

I was becoming such a burden to everyone. I always viewed myself as strong, as someone who took care of others, but now I was the one who needed care. When would I be able to return to the work? I was so embarrassed to be sick again. To have another email sent out to you, my congregation, whom I care about so deeply. You had granted me this beautiful gift of a sabbatical, but instead of being back at work renewed, I was in the hospital again. I felt immense shame. I felt so exposed.

And then there was the guilt I felt toward my family. I was becoming such a burden to Sharon, Talya, Ari, and Matan. We had so many plans for the last week of summer and for Labor Day weekend. And then, I would miss their first week of school. How many times would Sharon continue to feel torn between being with me and being with the kids? How many more times would my children have to visit me in the hospital?

I was lying in bed with all of these thoughts swimming around in my head, confronting mortality in a way I had not before, not sure of what to do. I decided to have the surgery the next morning – at the very least, the surgical team would be starting the day and not ending it.

But the fear remained. Would it be successful?

When the surgeons left, the tears fell freely. Despite that release, I still felt scared and vulnerable. No matter how many people we have in our lives, underneath it all, there is the knowledge that we are ultimately alone. That nobody else can live our lives for us.

I remember when Sharon discussed her long labor birthing Talya, and the moment when she realized that no matter how much support she had, it was ultimately up to her to push the baby out. No one could do that for her. How she wasn’t sure that she had the strength. That there was one moment when she despaired.

the-courage-to-create-coverRollo May, the existential psychologist and minister who spent 18 months in a sanatorium for tuberculosis, writes in his book, The Courage to Create, that “courage is not the absence of despair; it is, rather, the capacity to move ahead in spite of despair.”

That moment, alone in the hospital, anticipating surgery the next morning, I despaired.

* * *

What do we do when we despair, when we feel we have lost hope? We can try to run away from it. Often, that is what we do when we are afraid. We do something else. When we are afraid to be alone with our thoughts, we fill our days with activities and appointments, with things to do. We turn to substances. We disconnect.

But instead, we may try truly to enter that space of fear and not run away from it, to let it be.

That is what I tried. I just tried to breathe. I prayed quietly for strength. I cried. I let the emotions carry me and let myself feel them. I did not try to make them go away, for that would not be real, nor honest, nor truly helpful. I tried to simply acknowledge my feelings, especially the fear, the fear of death, the fear of weakness, the fear of disability, the fear of being alone.

And that gentle compassion I was able to bring to those emotions, to those parts of myself, created some lightening, some ease, some softening.

In the words of the Adon Olam which I recite every night: “Into God’s hand, I place my soul, soon I will sleep and then [hopefully] wake up; when I sleep, as when I wake, God is with me, I have no fear – Be’yado afkeed ruhi b’eit ishan v’a’ee’ra v’im ruhi g’vee’ati Adonai lee v’lo ee’ra.”

* * *

The surgery was deemed successful and after another nasogastric tube, a slowly restarting GI tract and six more days of horrible hiccuping, I was able to go home – still hiccuping, but home.

This process of despairing, of being alone, and then breathing into that pain and feeling a lessening of the pain, of feeling God’s presence in that hospital room, felt transformative.

Since returning, I have experienced new insights. I walk with a lighter load and a softer step. I am meditating more, taking walks and paying more attention to my breath – breathing in kindness and breathing out calmness and peace.

* * *

While today may be a day of strong breaths, the sound of the Shofar comes to mind, a breath that surprises us and wakes us up to the task of self-transformation and repentance, it is all about the breath.

And it all builds until Yom Kippur, when the High Priest would recite God’s ineffable name, which some believe sounded like a breath coming in and going out.

Breathing in and breathing out. Sometimes it is breathing in our anxiety, sadness, anger, the negative feelings, and then letting them go. Other times it is taking in compassion and love from the world, and then returning it into the world. Taking in the love and then breathing it out.

That is a core experience of being a human being – the ability to take in love and then bring it back into the world.

That is what parents and children learn how to do. Parents pour love into the child and the child takes in that blessing, eventually learning how to return that love to the parents and to others.

This is not a simple process. One needs to learn how to perform tzimtzum, contracting one’s self to become aware of others and then to figure out how to share one’s love with others.

Learning to truly love ourselves and others is what transforms us into an adult, an achievement that is challenging, and a skill that we must work to perfect throughout our lives. Our tradition wanted to emphasize this and, thus, built it into the very fabric of our spiritual lives. Two millennia ago, our rabbis embedded this process into the Sh’ma and its blessings. Right before the Sh’ma, there is a blessing called: ahavah rabbah that speaks of the great love that God has for us – God created the universe and therefore, all of us!

So, the liturgy reminds us of the great love that God pours into the universe and we acknowledge it, we take it all in and then, we pause, by saying the Barukh Shem line silently on all days except on Yom Kippur.

We meditate for a moment in quiet.

And then, we declare loudly, joyfully, powerfully: V’Ahavta et Adonai Eloheikha – that we love God! We have taken the love in and now, we are ready to reciprocate it – to bring the love back to God and the universe.

For that is what the entire world is. Initiating the Universe, God creates with an act of love and, eventually, human beings evolve who have the sensitivity and subtlety to take that love in and then project it back – to the world, to God.

And so each morning as we start our day and as we conclude it at night, we practice. We practice letting love in – not always easy. We accept the kindness. We accept this grace. We take in goodness. Feeling how it makes us both acknowledge our humility and appreciate our blessings.

And then we practice, sharing it. Bringing the love back out.

And we practice and we practice.

Every time we daven (pray), every time we wake up, every time we go to sleep, we need to try to feel and let that love into our hearts and then, if and when we are ready, try to verbalize that love, bringing it to God, to the world, to others.

Every day, we are invited to this ritual. Breathe in the love and breathe it out.

It seems deceptively easy; but it’s not.

And one of the keys is the pause – the barukh shem line – the silent line. Give that some time; take the time to take it in, to truly feel it and to be held by it.

* * *

radical-acceptance-coverOne of the books that I found most helpful during this year was Radical Acceptance: Embracing Your Life With the Heart of the Buddha by Tara Brach.

She writes: “When we feel separate and alone, we long to be held like a child in the compassionate heart of an all-loving mother, [or] a merciful and accepting father.” (p. 208)

That echoes the language of our own liturgy found in the prayers surrounding the sounding of the shofar – rahameinu keraheim av al banim – we call upon God to be compassionate, like a father has compassion for his children.

And the word for compassionate, rahameinu comes from rehem, meaning womb – may God become like a mother holding Her children.

Once we feel held and loved, we can allow ourselves to feel joy, laughter, and love, even in difficult times. This can be truly healing – especially during times of trouble.

After he knew that he was going to die from tuberculosis, Rabbi Nahman of Bratslav, the great mystic and Hasidic master, said: “Only by means of joy can a person lead his mind to where he wants, and thus settle his mind. Joy represents the world of freedom, as in ‘for in joy you will go forth.’ It is by means of joy that a person becomes free and goes forth from exile.”

Sometimes, it is not easy to feel that joy. But it is only by breathing in and feeling the rawness of our pain, our fear, our anxiety, that we can breathe out compassion, peace, and connection.

* * *

“Human beings plan and God laughs”

Our rabbis in the Midrash taught that in addition to the Universe being born today, Yitzhak, Isaac, was conceived on Rosh Hashanah. And he was born in the spring on the first day of Pesah. On the day of Isaac’s birth…all creation rejoiced: the earth, the heavens, the sun, the moon, and the stars.

The rabbis were teaching us that new life is full of possibilities for the entire world. And today, it all begins – on Rosh Hashanah, we imagine the birth of ourselves, of our new selves, the selves we are becoming. Today, we imagine a new way of being in the world, we aspire to new patterns of living and new possibilities for ourselves and others.

And we do it – with a measure of both trepidation and joy.

We do it by moving away from defensiveness, guardedness, mocking, laughter born of pain – towards the laughter of renewal and pure joy.
May hearing Sarah’s laughter in today’s reading remind us that even amidst all our challenges and sadness and suffering, we can allow ourselves to experience the compassion, the love, the joy, and the laughter that can heal the world.

Shanah tovah – may it be a year of goodness, a year of health and prosperity, a year of compassion and a year of peace for us and the world and let us say: Amen.

About the Author
For the past seventeen years, David Lerner has served as the spiritual leader of Temple Emunah in historic Lexington, MA, where he is now the senior rabbi. He has served as the president of the Massachusetts Board of Rabbis and the Lexington Interfaith Clergy Association. He is one of the founders of Community Hevra Kadisha of Greater Boston, and Emunat HaLev: The Meditation and Mindfulness Institute of Temple Emunah. A graduate of Columbia College and ordained by the Jewish Theological Seminary where he was a Wexner Graduate Fellow, Rabbi Lerner brings to his community a unique blend of warmth, outreach, energetic teaching, intellectual rigor and caring for all ages.