Reacting to the Morgue

July 10th, 2018 Posted by Ask the Rabbi 37 comments

Dear Rabbi and Susan,

This year I became a med student. Therefore, with anatomy lessons I go to the morgue. It’s a great way to learn, however, I can’t help but feel rather uncomfortable.

That got me thinking – Is it an appropriate way to learn?

God bless you.

With kind regards,

Julie

Dear Julie,

First of all, congratulations on getting into medical school. That is quite an accomplishment.

As you go through school and residency and embark on a medical career, you are going to be called upon to do many things that will make you uncomfortable. Not only will you dissect cadavers but, among other things, you will be cutting into living people and be exposed to intimate and hidden parts of people’s bodies. You will be surrounded by people in deep emotional trauma. You will sometimes make mistakes that have the most serious consequences as well as blessedly do just the right thing at the right time with amazing results.

In order to be effective, it can be helpful to remember that you are in the process of fulfilling your God-given mission to heal.  “…I am the Lord your Healer” (Exodus 15:26)  Just as He heals us, so should we emulate Him and also become healers.  You know that you will need to learn to act professionally and overcome your feelings. That doesn’t mean to cauterize your feelings but it means to control them.  The danger is that you can do that so well that you end up slightly  dehumanizing  yourself in order to do what needs to be done.

So, we are happy to hear that being in the morgue makes you feel uncomfortable, because it reflects an understanding of the awesomeness of life and death and the responsibility you are taking on yourself by training to be a tool of God’s healing.  Medicine needs to be a calling, not a job. Part of that calling is entering a “zone” where you can work effectively despite the nature of what you are doing.

We encourage you to precede every shift with a prayer acknowledging your partnership with the Almighty and asking for His support. You might also choose, like some other amazing doctors we know, to make a ‘spiritual’ demarcation after working with a cadaver (or losing a patient) by filling a cup of water and deliberately pouring it over each hand three times. Water is the universal symbol of life and this would mark an acknowledgment of what you just experienced and a return to a life-giving environment as you continue your day.

You also need a large human support system. That should include those who have been in your shoes and who have managed to combine medical professionalism with a well-adjusted human life. It will also be important to have people you can lean on for physical, emotional and spiritual support.

If all this sounds like an immense undertaking, that is because it is. You are not choosing an easy path in life, but you are choosing one with immense opportunities to help God’s other children. Take care to keep yourself healthy and well as you do so.

Wishing you success,

Rabbi Daniel and Susan Lapin

 

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37 comments

David Altschuler says:

Your call for a support system after an intense medical situation is interesting. In the 80s or 90s there was a passenger airplane catastrophe over Compton, CA. Policemen and firemen were picking up body parts for days. A year later some psychologists tried to understand why far more policemen were traumatized and went on disability or resigned than firemen who did so. The conclusion reached (leaving aside suspicion of abusing the disability program) was that firemen went back to the station and got support from their colleagues. Policemen went home and had to choke back the trauma to spare their families, resulting in lengthier and inadequate adjustment.
FWIW.

Susan Lapin says:

What is FWIW, David?

Pat Coon says:

For Way It’s Worth

Catherine says:

FWIW = For What It’s Worth, Susan.

Camden Ross says:

FWIW is an acronym which means “For What It’s Worth”. It usually accompanies a phrase said when you are giving someone a piece of information and you are not certain if that information is useful, helpful, or important.

Hope this helps clarify this abbreviation.

Rabbi Daniel Lapin says:

Thanks Camden!
YAMK
Cordially
RDL

PS: (You Are Most Kind)
PPS: (Rabbi Daniel Lapin)

When Samuel was old he set his sons to rule Israel but they were corrupt. Israel brought this to Samuel and then asked for king. This grieved Samuel but God said it Him who Israel had rejected. How does ancient Jewish wisdom explain what went wrong with seemingly justified request in the face of incompetent sons of Samuel

CK says:

For What It’s Worth.
Cheers.

Michael Weaver says:

Texting has brought us many (annoying) acronyms:
FWIW = For What Its Worth
IMO = In My Opinion
BFF = Best Friend Forever
LOL = Laugh Out Loud
IDK = I Don’t Know
BTW = By The Way

Rabbi Daniel Lapin says:

Thank you Michael–
GB
Cordially
RDL

PS: (God bless)
PPS: (Rabbi Daniel Lapin)

Sara Groat says:

For What It’s Worth

Rabbi Daniel Lapin says:

Yes, David,
I remember it well. It was actually over Cerritos a couple of miles east of Compton in summer 1986 and wiped out about 80 lives. I didn’t know about the firemen/police discrepancy but I do know that sending in therapists and counselors to talk to children who’ve witnessed trauma postpones their return to normality rather than helps it. Talking and talking and rehashing one’s feelings over and over again is not, as is fondly believed, a helpful cathartic. It’s a damaging indulgence. It’s counterintuitive as we might well assume that letting someone talk about what they experienced would be helpful but it actually isn’t. But having someone, either a colleague or someone at home who gets what you went through is helpful. We discovered a lot in the aftermath of 9-11 back in 2001.
All very interesting. And very sad.
Cordially
RDL

Bijan Zahir says:

What if you are a Cohen? Can you still go to the morgue?

Susan Lapin says:

Bijan, you ask about a Cohen – a Jew descended from the priestly line of Aaron. Any Cohen needs to have a Rabbi closely guiding him.

Rabbi Daniel Lapin says:

Dear Bijan–
A huge question and in general, the answer is a definitive “No”. You are obviously knowledgeable.
Cordially
RDL

A.J. Hoffman says:

An Idea: As I read this, I recalled in Eccles. 7, which is called Khohelet, of going to the house of mourning, as part of getting wisdom. So similarly ,You’ll get to see value of your task, in addition to anatomical instruction,etc.

Rabbi Daniel Lapin says:

Yes, A.J.
Your quote is correct and so is your conclusion. There is certainly wisdom to be derived there.
Cordially
RDL

A.J. Hoffman says:

Once Again. The seeing of why you do your task is reinforced as important, and this by the viewing of those no longer with us.

James says:

There is a natural foreboding that hinders cutting on a human body, and all medical personnel must face and overcome it. I have heard that certain surgeons even learn to enjoy the process, clearly an ‘acquired taste.’ Yet there is no better way to discover awe and respect for our bodies as God’s awesome creations, than to dissect human specimens, preferably necropsy of the dead before vivisection of the living. It is a common practice in my family, in fact, to leave one’s body to medical science, an unselfish way to advance the cause of medical science, practice and expertise.

Susan Lapin says:

Interesting as always, James.

Rabbi Daniel Lapin says:

Dear James,
The steps we suggested were partly to avoid the really unhealthy development of a doctor beginning to enjoy the parts of his practice that normally would be viewed as morbid. Nobody should ever start enjoying the many painful but necessary actions such as executing murderers, disciplining children, shooting enemy soldiers, or operating on patients. Obviously they’re not comparable, the point is that we must take spiritual steps sometimes to allow us to do tough things without corroding our souls.
Cordially
RDL

Vallerie Fletcher says:

Dear Rabbi Daniel Lapin and Susan,
Interesting about not immersing in disturbing situations and not indulging with the recalling of it through intensive counseling and I notice that people I know in my circle who do potentially disturbing work do not dwell on what they do and seem better adjusted this way! For one small example, my hair dresser goes to the morgue to do her client’s hair. It is a personal way of serving her loyal clientele. She is a gracious lady and even though she is somewhat sensitive, she is always willing to do this. She does not talk about the emotional part of it. Our Father and Creator has many ways of making sure that we survive psychologically and one of them is called “denial” and is viewed by Secular individuals as being pathological … but as you have noted, I agree, it is indeed, intuitive! Thanks again for the wisdom,
With Continued Appreciation,
Val

Susan Lapin says:

Val, you are right that studies show that too much dwelling on disturbing or crisis situations does not help mental health. However, a certain amount of sharing rather than repressing feelings does. Like everything, it is a balance. The woman you speak about who tends to the hair of clients is taking care of the dead in an honorable way. That she does so privately and cherishes her actions privately is appropriate. She is performing a service for the dead person and that should not be traumatic in the least (moving, emotional, but not traumatic). That is completely different from cutting into a dead body – using it, in effect, for another purpose, as our medical student is doing.

Rabbi Daniel Lapin says:

Dear Val–
I am thinking of making next week’s podcast about this topic of how wrongheaded is the general belief that being a therapist or counselor often means listening to your client whine about his parents for hundreds and hundreds of hours. And getting paid handsomely for doing so.
Cordially
RDL

Mark says:

What a wise answer to a thoughtful and important question.

Rabbi Daniel Lapin says:

Thank you Mark,
Susan and I do not take credit for that wisdom, as you know. We are merely privileged transmitters of ancient Jewish wisdom and we appreciate the trust people place in us by asking us these many real-life questions.
Cordially
RDL

Susan Lapin says:

Thanks for all the FWIW help, y’all!

Jim cockrum says:

NP
haha

Rabbi Daniel Lapin says:

Ha ha, No problem!

Jim Cockrum says:

I’ve heard you reference the damage that can be done by endlessly exploring your feelings in counseling and I agree based on spiritual instinct as a Bible based believer, but I’d love to hear you address this on a show or podcast if it’s not already available. I’d love to hear the spiritual precedent behind this truth.

And on an unrelated note…

As children age and move out of the house what are the benchmarks of a healthy transition? My wife and I find ourselves in this season with our oldest children and would value the insight you have on this topic.

Rabbi Daniel Lapin says:

Dear Jim–
Both your questions deserve comprehensive answers; the full story of the heresy of being cured by incessant talking, digging into the past of your parental potty training, and wallowing in victimology as well as healthy transitioning to empty nests. Could we ask you please, Jim, to submit them as two separate questions to our Ask the Rabbi page and we will immediately put them on the list for quick responses. Too many people are impacted by these matters to answer them insubstantively with less than they deserve.
Cordially
RDL

Kevin says:

As a hospital chaplain dealing with those who are suffering from trauma, cancer, and other traumatic events and chronic illnesses, I disagree both personally and professionally regarding processing these traumatic events. I could cite dozens of studies, as well as my clinical residency training and twelve years as a professional grief counselor, that it is indeed helpful to individuals and groups to find someone with skills to help them process their feelings about traumatic events. I’m quite puzzled and slightly troubled by comments suggestion otherwise. Spiritual expertise is one thing, while psychological expertise another. Professional clergy should exercise caution when giving psychological advice unless they have the training and credentials to do so.

Susan Lapin says:

Kevin, it’s possible I missed some comments, but I think there may be a misunderstanding. The studies that were spoken about were with survivors of traumatic incidents (for example, children who were involved with school shootings) who were encouraged to relive and relive the incidents over and over. That is entirely different from processing the incident by speaking with someone competent. I’m sure your training and experience are invaluable. At the same time, we don’t think a medical student working with cadavers in the morgue is a “traumatic event” that needs a professional grief counselor and the same is true for many other disturbing incidents in all our lives. You are correct that clergy come across many things for which they may not have training as well as many things for which their counseling is invaluable and precludes needing other help. Competent clergy, like competent doctors and I dare say therapists know when something is outside their scope of expertise.

Kevin says:

Yes. It’s possible I misheard. Looks like we agree after all! 🙂

Susan Lapin says:

Glad you raised your concern, Kevin.

Evy Stamoolis says:

Seeing the original question, I remembered a fascinating article in the Johns Hopkins alumni magazine, “First-Year Medical Students Still Rely on Cadavers to Learn Anatomy.” The students describe how they honored the person they studied in a number of ways. It is worth reading to the end. I agree that approaching this work (and every work actually) in partnership with the Almighty is the way to live. We see His image in every person.
https://hub.jhu.edu/magazine/2016/winter/cadavers-anatomy-medical-school/

Susan Lapin says:

Evy, thank you for sharing this. We are going to (very unusually) leave the link for those who are interested.

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