Golden Guilt

Golden Guilt

Golden Guilt

Fill in the blank in this popular saying:

“Silence is _________.”

I would wager that if you are of my parents’ generation, an early Boomer or older, you answered “golden.”  The adage conjures images of whispering in libraries and children being seen, but not heard.  My children’s generation and the one immediately preceding it, the millennial and post-millennial cohorts, answered “assent.”  They disdain silence, because it is the posture of those who sit on the sidelines while racism, sexual assault, environmental destruction and economic exploitation proceed unchecked.  One generation’s gold is another’s guilt.

I am in my late forties, a Gen-Xer stuck in the sandwich between these two generations, paralyzed into involuntary silence by not knowing what to say, how to say it or whether anyone wants to hear what I have to say to begin with.  I feel golden and guilty all at once.

We’re having a medical moment in this country, and as a physician with a very modest platform to speak from, there is much I could say.  Medical expert witnesses spent the past month on center stage in our country’s ongoing drama about race and policing, and I approached my CPR recertification at the exact moment that the mainstream media were discussing how a person ends up in PEA (pulseless electrical activity).  That drama spills over into our clinical lives as well, as many of my colleagues walk a tightrope between promoting restorative, anti-racist actions in their medical practice and alienating staff who don’t yet see how they could be contributing to the problem.  Speak, or be silent – and in speaking, say what?

At this same medical moment, the world is torn between hope and fear as the second year of the COVID 19 pandemic drags on.  Vaccinations have proven more successful than we had a right to hope, yet fearmongering and resistance to any caution persist in some quarters, while in others legitimate small fears – breakthrough infections, rare but real side effects, and persistent use of precautions that are no longer, or were never needed – loom larger than necessary and muddy the message.  What tone do we adopt, one of hope and reassurance or of uncompromising vigilance?  As the US teeters between the polar opposites of Israel, with its systematic lifting of restrictions amid plummeting infection and fatality rates, and India, with its smoking funeral pyres aptly symbolizing the wildfire spread of the virus as vaccination fails to keep pace, the cost of saying the wrong thing, or the right thing in the wrong way, could be enormous.

In my Jewish life, I am having a Vayikra moment.  The middle book of the Torah, often referred to as the Torat Kohanim or Priestly Code, is laced with lessons on speaking and being silent.  In Vayikra 10:3, after the deaths of Aaron’s sons Nadav and Avihu we read, vayidom Aharon, “and Aaron was silent,” using the word vayidom instead of vayishtok.  The root sh-t-k conveys a person ceasing to speak; d-o-m implies complete stillness, like the paradoxical kol dm’amah, “still, silent voice,” that speaks to Eliyahu.  His silence speaks volumes, about his faith in God’s justice, his internal state of shock and his sense of responsibility to his office over and above his personal ties to his family.   Later in the book, in this week’s parasha of Emor, we learn that the opportunity for a Kohen Gadol like Aaron to mourn his personal losses is severely limited.  His silence is the price of his golden robes.[i]

Silence in Vayikra also serves the Golden Rule, expressed here as veahavta l’re’acha kamocha, “Love your neighbor as yourself.”[ii]   Rabbi Jonathan Sacks z”l presents this verse in context as immediately following the prohibitions on seeking revenge and bearing grudges, both acts which often manifest in words.[iii]  By not speaking vengeful or grudging words, one creates an environment in which one is able to love a neighbor as dearly as oneself.  Similarly, the same portion of Torah contains the prohibition not to go about as a talebearer among one’s people, meaning not to gossip,[iv] and not to curse the deaf.[v]  I remember reading a text several years ago based on the work of the Chofetz Chaim about the rules of speech, and wondering if there was anything at all I could say.

Yet these same chapters also compel certain kinds of speech.  Immediately prior to the counsel against taking revenge and bearing grudges, we learn, “Do not stand by the blood of your neighbor . . . you shall rebuke your neighbor.”  When another is in danger, or another is either about to sin or has already done so, we are forbidden to be silent.  And indeed, the phrase, “silence is assent,” is as much a slogan of venerable Jewish tradition as it is of the woke 21st century.  In the Talmud, the phrase shtika k’hoda’ah damia, “Silence is agreement,” appears multiple times to reflect that a person given the opportunity to refute a claim who does not do so is tacitly agreeing to that claim.  The principle is so powerful that it even allows for a court case to be decided on the testimony of a single witness (normally two witnesses who do not contradict one another are required) provided the accused does not offer any objection to the testimony. [vi]

Power corrupts, however.  Silence may not be golden in these cases, but the Torah does warn that in rebuking, “do not incur guilt.”  Constructive criticism is an art[vii] which is MIA in the age of social media.  The “call out,” the act of drawing attention to a person’s racist or sexist words or behavior, may seem like a necessary act, a form of what tradition calls lashon hara l’toelet (evil speech for a purpose) to fulfill the obligation “not to stand by the blood of your neighbor.”  Yet it is so often carried out by strangers, in the public sphere, with little or no knowledge of the context of the words, and often by people who are learning of the act second-hand from someone else’s call out.  How much more powerful the direct appeal to that individual, through direct messaging, a phone call, or an email, with a constructive solution rather than the aim of destroying their career.

The oncologist Vinay Prasad has been a frequent lightning rod throughout the pandemic, in part because his opinions on the handling of COVID19 have not fit neatly into either of the two political camps that have arisen around the issue.  In a recent op-ed, however, he turned his attention to the damage social media has done during the course of the pandemic, and specifically highlighted an online tirade against him that was shocking not for what it said, but for who said it: another scientist whom he knew personally and with whom he had engaged in friendly discussion and social activities over the years.  Prasad would have welcomed a direct appeal from this colleague to reconsider his opinion, something which in the end did happen because Prasad reached out to the other person to let him know how hurt he was.  He may not realize it, but Prasad was echoing centuries-old rabbinic understanding that a public rebuke incurs guilt, while a private one can be a golden opportunity.[viii]

At the same time, the verse warns, in the ellipsis between not standing by and rebuking, “Do not hate your brother in your heart.”  Refraining from speaking one’s objections and criticisms causes those feelings to fester, in a way that hardens, eventually, into hatred and vilification of the person, even when they are, in fact, your brother, other close relative, or erstwhile friend.  A patient explained it to me this way the other day: when you bottle up every bit of anger and negative emotion, and never let it out, eventually the bottle breaks and it all explodes outward in ways we can’t control.  We may incur guilt if we rebuke someone in the wrong way, but we may incur even more if we don’t do anything.

Consider what you may have said, whether in your heart or into the air to no one in particular, over the past year, about people you purport to love: “These tyrants want to take away my freedom.”  “These selfish bastards don’t care how many lives they cost just so they don’t have to wear a mask.”  “These idiots don’t understand the vaccine is the only way out of this pandemic.”  “These doctors are all corporate shills trying to inject me with microchips.”

Guilty, as charged.

There’s been a lot of discussion this year about freedom of speech, but after considering speech and silence in this way I have to conclude that while the American government should not be restricting our speech, we are not morally free to say whatever we want.  Speech, and its absence, both have real consequences, some of them deadly.  The new week opens with questions about whether Dr. David Fowler’s words, both in the Derek Chauvin trial and in other cases, may have endangered lives.[ix]  I open the week wondering whether my silence on social media has meant that my careful voice on vaccination, what risk-management strategies we still need, and how to serve those enduring the pandemic in other countries has been absent – and that my silence is assent.

This happens to me from time to time, but it has to stop.  The bottle has to stop filling, then exploding, then filling again in vicious cycles, taking me from complete silence to torrents of words in response to whomever happens to pop up on my social media notifications.  It is true that some of my best healing happens when I sit silently and wait for the words to come, for a person to share their story and feel better for it, as that patient did last week.  But when the story ends, words of healing are called for, and I am supposed to be an expert in knowing what those are.  In private as in public, if we are to heal these wounds, we all need to get better at knowing which silences and which words are gold, and which are only gilt.


[i] See Ellen Frankel, The Five Books of Miriam, Harper San Francisco, 1996, p. 185, for discussion of the reasons and ramifications of these laws.  See also earlier in the book, pp. 159-160, for how Frankel imagines Aaron’s wife, Elisheva, felt about Aaron’s silence after the death of their sons.

[ii] Vayikra 19:18

[iii] Sacks, “The Logic of Love,” Covenant and Conversation – Leviticus: The Book of Holiness.  New Milford, CT: Maggid Books, 2015, p. 303. 

[iv] Vayikra 19:16.

[v] Vayikra 19:14.

[vi] Bavli Yevamot 87b

[vii] https://www.sefaria.org/sheets/16957?lang=bi for sources on the details of delivering an ethical rebuke.

[viii] https://www.medpagetoday.com/blogs/vinay-prasad/92200

[ix] https://www.medpagetoday.com/publichealthpolicy/generalprofessionalissues/92164

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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