Weekly D'var

Shemos 
Irwin Benuck
January 18, 2025

Imagine an action movie.  Two surgeons are operating furiously on a condemned but innocent patient to quickly save his life in a harsh autocratic country.  They complete the operation just in the nick of time and the patient is safely removed.  However, the two surgeons are discovered and brought before the authority.  If you want to know how it ends, the movie doesn’t exist but a similar scenario took place 4000 years ago in this week’s sedra, Shemos.  We learn that the midwives, Shifrah and Puah, disobeyed Pharoah’s edict of killing male Jewish babies and used the excuse to Pharoah that Hebrew women are experts at birthing their own babies and deliver quickly before they even arrive unlike the Egyptian women.   This is probably the first reported case of civil disobedience and for their courage, they were greatly rewarded.  This passage about the midwives played a monumental role in my life that encouraged me and probably many other Jewish doctors and healthcare providers to go into medicine.  It not only reflects on medical skillsets and knowledge that is necessary but also the moral compass and ethical decision-making physicians must make to ensure they are doing the best for their patients.  Whenever I have a tough decision to make, I only think to myself, “what would Shifrah and Puah do.”  

The Torah is replete of many examples of not only Jewish ethics but also observations and commandments which are pertinent to not only the study of medicine but the treatment of our patients.   One early observation example, as we recently read in Vayishlach, following the violation of Dinah by Shechem, the daughter of Jacob and Leah. Shechem wanted to marry her and merge his nation with Israel.  An agreement was brought forth to have all the males of the city circumcised.  On the “third day” when they were in pain, two of Jacob’s son, Simeon and Levi who were Dinah’s brothers, slew all the recently circumcised males.  Medicine has long known that the third post-operative day is considered the most painful.  We teach the complications after the first day of an operation is wind, meaning respiratory, day 2 is water, meaning hydration, and day 3 is wound meaning pain and infection.  

Although the laws of Kashruth, are not meant necessarily for health benefits, in fact by not eating meat from certain animals like the pig which we know carry many parasites like ascaris, roundworm, and Trichinella, will eliminate these illnesses. Likewise, shellfish and fish without scales like catfish which are bottom feeders, are not considered healthy.  Even mixing milk and meat can increase cholesterol consumption, something I certainly know a little about.  There are further laws in the Torah focusing on isolation, quarantine, and cleanliness, which certainly has health benefits.  What other religion is commanded to wash hands and say a blessing before eating?

We know all too well of the pogroms against Jewish communities that took place during the 14th century Black Plagues.  During this time, the number of deaths among Jews were less than that of the general population.  Jews were scapegoated as antisemitism was spreading wildly in Europe, something that we are now again witnessing all over the world, as the Jews were accused falsely of poisoning wells.  In reality, their better hygiene, sanitation, and being quarantine in ghettos, contributed to their better survival.  Actually, this bubonic plague was caused by the organism Yersinia pestis which was spread by fleas.  

The Torah and Jewish medical ethics have contributed significantly to the world.  We are all familiar with the Halakha concept related to Pikuach Nefesh.  Other commandments may be broken to save another life as well as yourself.  This is written in Parsha Achrei in the book of Vayikra which states:  

וּשְׁמַרְתֶּ֤ם אֶת־חֻקֹּתַי֙ וְאֶת־מִשְׁפָּטַ֔י אֲשֶׁ֨ר יַעֲשֶׂ֥ה אֹתָ֛ם הָאָדָ֖ם וָחַ֣י בָּהֶ֑ם אֲנִ֖י יְהֹוָֽה׃ {ס}        

You shall keep My laws and My rules, by the pursuit of which human beings shall live: I am יהוה.

Rabbi Akiva interprets this passage man shall live and not die.  Human life takes precedence over anything else.  Keep Shabbat but to save a life, even laws pertaining to Shabbat may be broken.  In Fred Rosen’s publication, Jewish Bioethics, he states that there is an order how Pikuach Nefesh should be carried out, the most qualified must help first unless seconds’ count.  (I could not help by marvel last Shabbos when we had a medical incident here in shul, that two neurologists, an orthopedic surgeon, and a cardiologist handled the situation, while 4 pediatricians stood in waiting.) Also, one needs to sustain him or herself if kosher food is not available as the victims had to endure during the holocaust or pork derived insulin can be used for diabetes.  Similarly, IDF soldiers are given dispensation to fight on Shabbat.  During the Maccabean wars, the Maccabees were allowed to fight on Shabbos so not to allow their enemies to go on the offense.  We all know too well how our enemies purposely attack on Jewish holidays as we have witnessed with the 1973 Yom Kippur war and of course most recently on October 7th which was both Shabbot and Simchas Torah.  

Another ethical concept in Talmud Sanhedrin is also widely quoted, “Whoever saves a single life is considered by scripture to have saved the world.”

No wonder the field of medicine was so popular for many centuries among Jews. It was also portable, which was important as when Jews were expelled from a community, they could set up a practice in another community as all they needed was what was in their head and the skillsets they learned.  Medicine has truly become the fabric of Jewish people which is so much part of our culture and DNA.  It is no wonder that 61 Jews have won the Nobel prize in medicine and Jews have won 22% of all Nobel prizes, a people who are less than 0.2 % of the world’s population.  

I would like to spend the remaining time introducing you to some of my favorite Jewish doctors and scientists.  The first is the German Jew, Dr. Paul Ehrlich, who won the Nobel prize in 1908 for his work in chemotherapy, immunology, and infectious disease and discovered the drug, neosalvarsan or compound 606.  This was called a magic bullet because it had a specific delivery system to kill the spirochete responsible for Syphilis using an arsenic compound.  Not only was this a cure but was far more effective and less toxic than the use of mercury which had been used for centuries.  Germany was far different during Ehrlich’s time where he received a first-class education, became an eminent faculty member at the University of Berlin and received no less than 81 honorary memberships throughout the world, as well as countless awards.  A street was named for him in Frankfurt, Paul Ehrlichstrasse, which was renamed in the 1930’s because he was a Jew.  

If we fast forward a couple decades later in Germany, we find Dr. Ernst Chang a scientist.  For him being a German Jew was quite dangerous and in 1933 he fled to England and was invited to continue his research with Dr. Howard Florey who was also studying lysosomal breakdown of bacterial walls.  One of the substances they were investigating was penicillin which was discovered 10 years earlier by Dr. Alexander Flemings by accident.  The utility of this as an antimicrobial agent changed the world and just in time for WW2 resulting in the saving of countless lives.  It also replace neosalvarsan as a cure for syphilis.  In 1945 the trio was award the Nobel Prize in medicine.  Both Fleming and Florey were knighted in England but not Cheng.

While Cheng was having a difficult time in German, a Polish pediatrician by the name of Dr. Janusz Korczak, was beginning to have difficulties with the rise of antisemitism in Poland.  Prior he was known as the Benjamin Spock of his time appearing on weekly radio broadcasts and a writer of children’s books and topics related to children.  He directed a Jewish orphanage where each child had responsibilities.  He called it a Children’s Republic, the idea coming from visiting kibbutzim in Palestine in the 1930s, with his desire to make every child a productive citizen.  The orphanage was moved into the Warsaw Ghetto and because of Korczak’s influence it was able to survive until the Nazi’s decided to liquidate the orphanage and the ghetto.  Korczak was literally given a “Get Out of the Warsaw Ghetto Free Card,” which he declined.  The day of the evacuation of the orphanage, Korczak calmed the children telling them they were going into the country on a picnic.  He led the children to the waiting trains where they were taken to Treblinka and all were exterminated.  The original orphanage still stands in Warsaw and is used.  Across the street in the Jewish cemetery is a statue of Korczak caring a child while holding hands with another as other children followed.  

Of course we have our Salk and Sabin for polio, who refused a patent because the entire world should benefit, and Landsteiner for discovering blood groups, and Waksman for the discovery of streptomycin to treat TB, and even Krebs who made all of us doctors sitting here today confused and annoyed with his Krebs’ cycle and how many ATP were actually generated, just to name a few, but probably the next Nobel Prize in medicine will go to Dr. Daniel Joshua Drucker, a Canadian Endocrinologist, who worked on the GLP 1 agonist and how they help satiate appetite, whose parents were holocaust survivors.  How many more potential contributors were lost as well as their potential progeny to the arts, humanities, technology, and science.  

I just recently learned that the inventor of the shopping cart was an Oklahoman Jew named Sevryn Goldman who put four wheels on a chair, a basket on the seat, and another attached to the legs of the chair so his customers can purchase greater quantities in one shopping session.  Yes, the world would be different without Jews. The quality and quantity of life would be so poor and those who survived would be living in caves.  Shabbat Sholom.