Sit With It

Sit With It

Sit With It

Don’t take away hope. 

Ask any doctor practicing today and they will either tell you that they live by these words, or that one of their mentors told them this when training them.  No matter how bad the news, no matter how grave the outlook, no matter how dismal the prognosis, don’t take away hope.  Leave the patient and their loved ones something to cling to.

It’s unnecessary advice, really.  When I deliver a life-threatening diagnosis, I have an irresistible urge to follow immediately by saying, “But we have excellent treatment for this now,” or “Some people survive for quite a long time with this disease.”  When I see a concerning lab result I feel compelled to include the phrase, “It could be nothing,” in my explanation of what it might mean.  When I lay eyes on a festering wound, I fight the need to lead with, “I’ve seen worse.”

I’m writing this on the last hour of the Tisha B’Av fast, 25 hours without food, water, bathing, intimacy, perfumes or leather shoes meant to commemorate everything bad that has ever befallen the Jews.  Imagine that Pearl Harbor, the 9/11 attacks, the Kennedy assassination and the Challenger all happened on one date and you’ll be a fraction of the way to understanding the despair associated with this day.  As such it is a day that gives very different advice.

Sit with it.

We start the fast sitting on the ground, in the dark save for individual candles, chanting the mournful trope of the book of Eicha (Lamentations).  The imagery is gruesome, the emotions raw, and we are counseled not to even greet one another as the service ends, let alone chit-chat during the service.  Nothing is allowed to disturb the dread and sadness we are meant to feel.

Sit with it.

If it pleases you, call it “holding space.”  It’s a word from the therapy field, a word my chaplain friends use all the time.  When things are awful, fight the urge to chase them away immediately with hope.  Fight the urge to do anything at all.  Hold space.

Sit with it.

I’ve spent nearly my entire tenure as a writer, these last four years, trying to respond to a series of tragedies, most notably the Tree of Life terror attack and the enormity of the COVID-19 pandemic, with hope.  At the outset of the pandemic I felt like it was my personal charge to keep up morale and cheerlead people into doing their share.  So in the midst of the pandemic all that despair I pushed aside nearly consumed me, to the point where friends were reading my writing and calling me concerned for my well-being.

I didn’t sit with it.  The night before the shooting I was in synagogue, and I had latched onto the line Rav lach shevet b’emek habacha – “you have sat too long in the vale of tears.”  Getting unlatched from it, admitting that my optimism and hopefulness were unearned, was soul-crushing.

It is certainly possible to sit too long in the vale of tears.  It can be just as damaging never to sit there at all.  To return to work immediately after the death of a loved one.  To barrel ahead to discussing treatment as soon as the diagnosis bomb has been dropped.  To put on a smile and pretend the trauma never happened.

Dealing with all of us optimistic healers, and with chin-up, keep-calm-and-stand-up-to-cancer family and friends, can also be damaging.  All of the “at leasts,” all of the “you’re a fighters,” all of the “so-and-so beat this, you can too” doesn’t leave space for the shock, pain, and sadness of the event which is actually terrible.

And so, Tisha B’Av comes to teach us to sit with it.  Lower yourself to the ground, wallow in the tears, don’t even attempt to feel better, or try to make anyone else feel better.  It’s supposed to feel awful, and you should dwell in that for a while.  The therapeutic equivalent, the “holding space,” is the silence we can maintain as the “wave” washes over the patient – sometimes again and again.  I care for a woman who, in addition to her own complex heart disease and diabetes, has children living abroad whom she cannot currently visit, and a husband dying of cancer.  She comes to every visit wearing a broad smile, but bursts unpredictably into tears once or twice each appointment.  It may last 30 seconds, or five minutes, but we halt when it does.  Then the wave dissipates on the shore, and we can resume.

The “wave” of Tisha B’Av rises at nightfall, crests in the morning, and crashes in early afternoon.  The first “normal” act we are supposed to engage in, while still fasting, is putting on the tallit (the prayer shawl) and tefillin (if I say it means phylacteries, would that make it any clearer?  Here’s a link to a photo and an explanation) before the afternoon service and resuming greetings.  As I put my tallit on this afternoon, I enveloped myself completely for a minute and held it tightly around my body, my face and head covered to the outside world.  It was a Divine hug, comfort without words, an acknowledgement that the wave of sadness was receding, and we could begin to speak of “what’s next?” again. 

Even Tisha B’Av embeds hope in the despair.  The Messiah is supposed to be born on this day; the readings for the afternoon speak of forgiveness, of rebirth and rebuilding, of acceptance for the outsider and legacy for the childless.  But none of that would be possible if we didn’t sit with it first.

Psalm 30, the psalm of dedicating a new structure, contains the well-known line, Ba’erev yalin bekhi, v’laboker rinah.  “Tears may linger for the night, but joy comes with dawn.”  Devotees of The West Wing may remember President Bartlet using that line in a speech mourning the loss of victims of a terror attack on a college campus: “Joy cometh in the morning.”  But the first half of the line is necessary for the second.  Tears must linger for the night, or we will find our joy fleeting, disturbed by unresolved grief, unsettled memories, unwept tears.  We must linger in the tears, sit in their valley.  In the morning, we can get up, wrap ourselves in a comforting embrace, and find words again to hope.

First we have to sit with it. 

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.

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