Di-verse Verse

Di-verse Verse

Di-verse Verse

I’ve learned the verse lo ta’amod al dam re’echa, Leviticus 19:16, countless times.  The English translation I was always taught was, “Do not stand idle while your neighbor’s blood is shed.”  Don’t be a bystander – be an upstander.  Or, as I once quipped, a stand-by-her.

So I was surprised this afternoon when, in the space of looking at this verse for maybe 5 minutes and digging into the translations and commentaries, I was suddenly looking at a new interpretation I had not considered before.

Let’s start with the original, “Don’t stand idle.”  The direct, pshat (simple) translation is, “Don’t stand on the blood of your neighbor.”  The “idle” was always implied, and multiple commentators use this interpretation.  And in our current pandemic, the message seems clear – you have a role to play in keeping other people alive.  Play it!  Don’t just keep going about your business.  But I’d go a step further: there is a Talmudic precept shtika k’hoda’ah domeh: silence is assent.  When someone else is failing to do their part, call it to their attention. 

It is uncomfortable to be “that guy” in the hospital or at my office pestering people not to pull their masks down.  I’m sure it’s more uncomfortable if those people hold national elected office.  But calling out people in higher positions is how hospitals got handwashing to be de rigeur – when the culture allowed custodial staff to tell the chief of orthopedic surgery that she had forgotten hand hygiene when she left a patient’s room, infection rates dropped.  The stakes here are even higher.

It’s not necessary to shame the person to call them out; in fact, the very next verse in Leviticus says, “reprove your kinsman but incur no guilt because of him.”  In other words, do it in a way that does not publicly embarrass him or cause him shame.  So, for instance, perhaps not on social media by name….

But today I noticed that the translation I was reading didn’t say, “don’t stand idle.”  It said, “Do not profit by the blood of your kinsman.”  Turns out one of the Aramaic translators, Onkelos, used the words “lo takum,” for don’t stand.  Ta’amod has the connotation of standing in one place.  Takum has the connotation of getting up or rising.  “Don’t rise on the blood of your kinsman” – don’t build yourself up through the blood of another.

There is growing unrest in the healthcare world.  The COVID 19 pandemic has only exposed the rest of the world to what those of us inside already knew – as Danielle Ofri observed in the New York Times last summer, “(the professional ethic of doctors and nurses) holds the entire enterprise together.  If doctors and nurses clocked out when their paid hours were finished, the effect on patients would be calamitous.”  So when scarce resources run short, the system falls back on the one unlimited commodity it has: the good will of healthcare professionals to do the right thing, no matter the cost.

And the cost is often the ultimate one.  A year ago Ofri highlighted physician and nurse burnout and suicide as that ultimate cost; to that we can now add the hundreds-and-counting healthcare workers who have died of coronavirus related disease in the last few months.  Working endless hours, exposed to heartbreaking scenes out of Camus’ The Plague, and inadequately protected with PPE, my colleagues continue to fight the good fight.  If they are the Marines, I am a supply clerk by comparison, doing primary care telehealth with a grilled cheese sandwich, a spaceheater, and my family close at hand. 

Yet these Marines work for organizations with huge administrative staffs, sometimes outnumbering doctors 10:1, and many of those at the top of the pyramid getting 8-figure salaries.  Is it a stretch to say that when they provide inadequate protective equipment, or threaten to punish or fire clinicians for speaking out about that lack of equipment, they are rising on the blood of their kinsmen?  Is it a stretch to say the same of the companies employing the supply chain workers that have kept the rest of us non-coronavirus-infected folks alive during the quarantine while exposing themselves to the virus in warehouses, meat-packing plants, and grocery stores?

Which brings me to a third, and final interpretation of the verse.  Two other Aramaic (Targum Jonathan and Targum Jerusalem) translations go in still another direction: they translate lo ta’amod, don’t stand, as la tishtok idma d’chavr’cha bizman d’at y’da k’shot b’dina – do not be silent about your neighbor’s blood at whatever time in judgment you know the truth.  They are referring to a time when a person stands falsely accused – a function of the slanderous gossip forbidden in the first half of the verse, which says, lo telech rachil b’amecha, do not go about as a talebearer (some say a spy collecting gossip) among your people.

In other times, I realize, I have employed this interpretation even when I did not know it. I go to bat for patients who have been labeled as disruptive, drug-seeking, “impossible,” in order to get others to see them through my eyes – justifiably upset, struggling with coexisting addiction and genuine pain, trying to get to a kind of better they don’t realize does not exist because we aren’t able to provide it for them. Without that advocacy people can be cut off from care altogether, as I was reminded yesterday as I cleaned up some old records from someone who had, in fact, been shut out of an entire specialty due to the false accusation of one powerful physician.

Again the principle applies, shtika k’hoda’ah domeh.  Silence is assent.  Whether it’s, oh, I don’t know, someone whose reputation is deliberately being destroyed for speaking out about poor working conditions, or false accusations at one ethnic group or another for originating or spreading the virus, or even people simply spreading false information that has the potential to be deadly by virtue of misleading them, don’t remain silent.  We are all hanging in judgment here, our health, our lives, and the future of our societies and communities very much dependent on what the person standing next to us (hopefully not idly, and not on our blood) decides to do.

Dr. Jonathan Weinkle

Dr. Jonathan Weinkle is an experienced primary care physician seeking to fix our broken healthcare system by returning the focus to the relationship between human beings. His new book, Healing People, Not Patients, gathers together ancient wisdom, medical science, and the experiences of one doctor to draw a portrait of a partnership—a medical covenant—not just between doctor and patient, but also including receptionist, nurse, transporter, and radiology technician.

Healers Who Listen would love to listen to what you have to say, too.

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