When I started my medical practice in 1986, my plan was to work until old age, caring for multiple generations of patients. It was not meant to be. Due to illness, I am now retired.
This is not how or why I planned on ending my career, and I greatly regret that I did not get to say goodbye to you. Each of you has a place in my heart, and I am writing you to tell you how grateful I am that I got to be your pediatrician. I am also writing you this letter to share with you some things we didn’t get to talk about between your shots and your sore throats. There is a lot I have learned in my time on earth, much of it from you and your parents, about love, faith, freedom, work, and hope. I hope you will read this. Here goes…
In Hebrew, the word for “love” shares the same root as the word for “give”. I can’t think of any more appropriate word association.
The purest form of love, the ultimate giving without expectation of any return, is the love that parents have for their children. Witnessing this love has been the best part of practicing pediatrics. It has been the inspiration that gave me the strength to make it through long nights on call and busy days in the office.
I believe that none of you have any idea how much your parents so dearly love you. It would be overwhelming. It would paralyze you with gratitude and indebtedness. Much of the strength that it took to work as a solo pediatrician for a quarter a century, allowing me to see you grow up, came from the inspiration I got from watching your parents’ devotion to you. The “power of love” is most evident in parenting, not in romantic involvement.
As for sex, it is a whole different dimension than love. Love does not equal sex. One of your generation’s most damaging misconceptions is that there is such a thing as “casual sex”. It does not exist. The depictions of sex and relationships that you have spent your life seeing on television and in movies have no basis in reality. The joy of a long term, committed relationship cannot be accurately depicted on a two dimensional screen. In short-term, temporary relationships, medically speaking, sex has emotional, physical, and infectious disease consequences that can be devastating.
Note I said “medically speaking” here. It is only the medical aspects of sex that I address with you. One of the biggest barriers in human relationships, the highest of walls that we build between us, is the defensiveness and hurt that comes when any of us feel judged. I have no right whatsoever to judge anyone.
Another barrier to peaceful human relationships is unkind speech. One misconception that has caused your generation much suffering is the idea that it is always good to “speak your mind” and share your thoughts. Un-filtered speech can have unfortunate consequences for human relationships, and once uttered, words cannot be “un-said.” A famous rabbi once said that when he was young, he admired clever people, but that as he aged, he admired kind people.
Unkind speech, and judgmental attitudes, are poison to human relationships.In my faith, there is a blessing for just about everything. G-d is to be addressed in all circumstances. The blessing over a tragedy is that we acknowledge G-d, “the One True Judge.” I have pondered this blessing all too many times, in the most ultimate of tragedies, when I have lost precious patients. What I take from it is that even in the most dire of times, we are to let G-d do the judging. So with no judgment intended, please be aware that medically, “casual” sex can be really harmful for both your emotional and physical health. Not everyone your age is sexually active. If you choose to be, please always remember that sex can be really, really dangerous.
Many people have suggested that my illness should make me doubt the existence of G‑d. These innuendos were my initial motivation to write you this letter. Faith and suffering, throughout human history, have never been mutually exclusive. If I have a legacy, let it be affirmation, not doubt. With all my heart, soul, and intellect I believe in an all powerful, all knowing, all merciful, and yet invisible G-d.
Through the many medical procedures I’ve had over the past several years, I have never felt abandoned, but rather accompanied by G-d. This experience has strengthened, not weakened, my faith.
Just because G-d is invisible doesn’t mean He’s absent. It is said that G-d is not everywhere, but rather only where He is invited and allowed into our hearts and lives. In nature, many of the greatest powers around us are also invisible. Oxygen, sound waves, wind, and electrical energy cannot be seen. So it is with G-d. Why G-d is invisible is an issue to be pondered. On one level, an obviously present G-d would be overwhelming, like looking straight into the sun. On another level, while G-d’s overt presence would certainly get us to behave, in doing so it would take away our free will. Our free will is what allows us to implement our ethics, and elevate our lives, differentiating us from animals.
Yet another perplexing dimension of faith is that being “G-d-fearing” is considered a positive trait. We are told in the Bible to fear G-d. Paralyzing fear is not good, but caution and “healthy fear” in anticipating bad outcomes is a positive force.
Closely related to fear is guilt, another dimension shunned by my generation. The anticipation of guilt is a powerful deterrent in preventing us from committing transgressions. One of my favorite sayings is “He who marries for money, earns it.” The bottom line is that when we compromise, we end up suffering. Knowing and anticipating this would make for a lot less heartache and regret in this world.
While fear and guilt are unpopular and unpleasant concepts, you will not parent effectively or safely without using these tools. “Fearless” and “guiltless” don’t make for children who behave. Likewise, they are a part of living faith.
In a quarter century of practicing pediatrics, I have seen both great joy and unspeakable heartache. Some of the precious patients I have lost were taken by illness, after weeks and months of suffering. Others were taken in accidents, in a heartbeat. Some families treasure and remember, confident their children are in a Better Place. Others are bitter. Some turn away from G-d, in anger. But this also affirms G‑d’s existence. To be angry with something is in itself an acknowledgement that it is real.
The absence of that Creator is impossible for me to accept. Could the complexities of nature and life have been an accident? When we see a finely made jacket, would any of us believe it assembled itself by chance, without a tailor? When we see a beautiful painting, does it seem likely that the paint was blindly thrown on the canvas? When we read a book, do we think the letters were pounded out randomly? Do high rise buildings arise from glass and steel simply heaped up?
And these concepts only address the rearranging of existing materials. Even those who believe in the evolutionary change of natural systems are left needing to explain where the building blocks came from to begin with. There is a story of a man who challenges G-d, claiming that humans, too, can make life from mud. The man fills a bucket with dirt, but is stopped by G-d. “What a minute,” He says. “Make your own mud.” The truth is, we can’t even make our own mud.
All this brings me to why I often call you all Angels. The reason I call all of you Angels is because you are. “Angel” is my generic term for the G‑dliness in each of you. Every person is made by G-d with an element of the Divine in them. G‑dliness in humans is the sacred spark of life that differentiates us from inanimate material. The brighter light that separates our souls from animal souls is the power of speech, intellectual thought, and free will.
By definition, exercising free will involves making choices. To wield our will, there must exist options, both good and bad. We are not inherently good, but rather we have the G-d given potential to be good after we fight off other inclinations and options. Our job is to choose life, and put our gifts to good use.
My mental image of life is that we are guests of a Hidden Host. We are here as long as G‑d wants us to be. We cannot understand G‑d or His ways, because if we understood Him, this would make us intellectual equals with Him, which is of course impossible.
If you interpret my suffering and illness as proof of an absence of G‑d, then you have taken away from me my greatest legacy. If you remember anything about me, please let it be that I believed with all my heart, soul, and intellect in an all powerful, merciful, and loving G‑d Whose ways we can never fully understand.
Our free will is what distinguishes us from animals. Our culture celebrates and values freedom. We have freedom of speech and freedom of the press. Our first battle cry was Patrick Henry’s “Give me liberty or give me death.” Our Civil War was fought to free all Americans. Our most celebrated national holiday is Independence Day.
The opposite of independence is dependence. It takes away our autonomy and freedom. It is quicksand. And it surrounds us. Dependence in our culture takes many forms. There is chemical dependency to drugs and alcohol. There are also addictions to tobacco, gambling, sex, internet use, and dieting in the form of eating disorders. All these avenues lead to trouble.
Some people may have a genetic predisposition to addiction. They have many family members suffering with dependencies. But just by virtue of your age as adolescents and young adults, you also have an extreme vulnerability to falling prey to addictions. There is a physical, biological basis to this. Another contributor to the development of addictions is simple boredom, and the temptation to fill that void with excitement in the form of addictable activities. Although it will seem like painful, slow motion compared to what you are used to, consider celebrating “boredom” and trying a day a week without TV or any electronic media. Every faith has a Sabbath. Try observing it. Read, eat with family, and take some time to rest and reflect.
And while you are still in your addictable, teenage and young adult years, please always remember that alcohol, marijuana, all “recreational” drugs, sex, pornography, and gambling are all highly addictable. They ruin lives and marriages, they devastate families, and they break parents’ hearts. Please use your freedom to make safe and wise choices.
Freud defined mental health as the ability to “love and work”. As for work, I consider all honest work inherently meaningful if the proceeds are used for good purpose, like supporting a family and giving some to charity. There is a story of two bricklayers who worked side by side for many years. One says “I hate these bricks. They are heavy and all I get when I’m done with one project is more bricks to lay on the next job.” His partner says “I love these bricks. Laying them feeds my family and provides for education for my children. Some of the bricks allow me to donate to charity.” Same job, same bricks, whole different perspective.
Your generation may find many jobs frustrating. You have been conditioned by the speed of technology to expect relatively fast gratification. The slow satisfaction of gardening might seem unfathomable to you. The slowest satisfaction of all is that which comes from parenting. Though sometimes it seems like you grew up in a heartbeat, in reality your parents put in many long and agonizing nights for you. There is an old Yiddish saying that “the days are long but the years are short.” Your parents toiled many long days, and nights, on your behalf.
Outside our families, there is also the collective work we do as a generation. We are supposed to leave the world better off than when we got it. This is no easy task, and often conflicting with this is the hardest work of all–raising children and taking care of a family. One of the greatest ironies of our lives as parents is that the task involved often obscures our idealism. The things our children dislike us parents for are often choices we made on their behalf. Was I wrong not to set up my practice in a higher need community? I chose to practice close to home, partially out of my home, so I could be physically close to my children when they were small. Should I have done more charity work? I chose to be with my children.
There are many parents in my practice who donate time and money to charities. I am proud to know them, and to see them in the newspapers almost every time I open one up. When parents in my practice are featured in newspaper articles, however, I often barely recognize them in the accompanying pictures. I usually saw your parents after sleepless nights, after they had been awake for hours and hours with ill children. They were physically and emotionally exhausted and worried, always for your well being. They did whatever it took to get you better. The tireless, devoted parenting I got to see your parents provide was the inspiration that fueled my ability to practice medicine all these years.
I heard once of a Rabbi who greatly offended an audience he was speaking to. Questions were asked about the Rabbi’s wife’s work. He felt she was being insulted. It was being implied that it was not impressive that the Rabbi’s wife did not have a wage-earning career as a “professional”. The Rabbi swayed the crowd’s opinion when he explained that his wife ran a home for “unwanted children”. This satisfied those present, and gave them a new respect for the woman. At the reception after the lecture it was divulged that the “unwanted children” were the couples’ own, and people were angry. Yet from the rest of the world’s perspective, the Rabbi was accurate. No one loves our children as much as we do. No one wants them as passionately as we do.
No one has ever loved you as much as your parents do. And it wasn’t just “lip service”. No one has put “their money where their mouth is” more than the parents in my practice, who tried their absolute best to make you happy, safe, and healthy. They worked at parenting, putting their heart and soul into it. There may be things your generation will do differently, but you will not beat your parents on effort. Please know and remember how much your parents loved you. I was there. I had the privilege of seeing it. It gave me inspiration and memories that I will always cherish. Please know that the greatest of all work is parenting, and that your parents did it with unspeakably great love and devotion.
Here is what I hope for you:
I wish you good emotional, physical, and spiritual health
I wish you enduring love, and meaningful work
I wish you families and children of your own to invest that love in
I wish you faith, and the clarity, serenity, and strength that come with it
I wish you peace
Please make peace with your childhood and your parents, and find an appreciation for them. Those parents of yours love you more than you know. I know, because I was there. I cherish the memory of it, as much as anything else in my life.
Many of you and your parents have been incredibly supportive of me throughout my long illness. I am often asked what people can do for me. My family, our beloved Central Avenue Synagogue, and a really great medical team take care of all my physical needs. Our synagogue even brings us meals and food every single week. Here are some things you can do, though, that would give me great comfort:
Take care of yourself, and your parents
Give charity and think of me
Leave me a legacy of faith in G‑d, kindness, love, and hope
With much love, and with endless hope, and with gratitude for having had you and your parents in my life, please take care.
P.S. And if you can, always have a cat. You all know how much I love cats. I have been fostering cats recently for the Tree House Animal Shelter, in Chicago, and it has given me some really happy moments. Adopt cats from a shelter, not just cute kittens, but older cats who have less chance of getting a home. Utterly indulge them, and enjoy the appreciation they will show you.