"From the Narrow Place I Called to You." The Passover Seder as a Model for Healing
Jonathan Weinkle, MD, FAAP, FACP, University of Pittsburgh SOM
In his essay, “Judaism as an Exodus Religion,” Rabbi Yitz Greenberg explains that by being in bondage in Mitzrayim (Egypt)the Israelites were in a state that God never intended human beings to endure. Slavery is not the natural condition of humanity. The Exodus from Egypt, in turn, is proof that when humanity suffers, God hears, and God cares, and God acts. In 1990, Greenberg traveled to India with a group of other Jewish leaders to meet with the Dalai Lama and his community of Tibetan exiles. Among them was Rabbi Zalman Schachter-Shalomi, founder of the Jewish Renewal movement. Reb Zalman suggested to the Dalai Lama that retelling of the Exodus narrative during the yearly Passover seder is essential to Jewish survival and proposed that to ensure their own survival as a people, the Tibetan exile community needed its own seder. They needed to prevent successive generations of their descendants, growing up without memories of Tibet, without knowledge of a world where the People’s Republic of China did not control their fate, from drifting away from their connection to their holy place and its holy traditions.
The Hebrew for Egypt, Mitzrayim, means “in dire straits” – stuck in a narrow (tzar) place from which escape seems impossible. Illness is its own sort of Mitzrayim, and the healing arts help people to leave that space. Pediatric oncologist and palliative care physician Elisha Waldman calls his memoir of treating children with cancer at Hadassah Hospital in Jerusalem This Narrow Space for just this reason.
The problem with being in that narrow space is that it creates an eternal present of suffering. Bessel van der Kolk, psychiatrist and author of The Body Keeps the Score, maintains that trauma survivors do not remember traumatic events so much as relive them constantly. In the reliving, the events are experienced as fragments, and appear unasked for when they are triggered by events outside the person’s body and beyond their control. The Haggadah (the text from which a Passover seder is conducted) asks participants to feel as if they, too, were once slaves in Egypt. The person living with trauma, or in the throes of illness, feels as if they are still in Egypt. A seder is a way of ritualizing memory, and in so doing, can be a way of moving experiences of brokenness from the realm of the eternal present to the space of the contextualized past. At the same time, a seder is a way of fostering identity and empathy in those who never directly experienced brokenness with those who still experience it. It seeks to ensure that those who have been fortunate do not become disengaged from those less fortunate. Psychiatrist Elliot Mishler brought the sociological concept of Lifeworld to bear on medicine, contending that the Lifeworld, the milieu in which patients live from day to day, is fundamentally different from the world of medicine. The world of medicine speaks in a different language, favors different priorities, harbors different expectations and employs different techniques than the Lifeworld, to the point of deliberately blocking out data from the Lifeworld. Consequently, the medical enterprise suppresses and fragments the patient and provides inhumane, ineffective care.
A healers’ seder, scripted in a healers’ Haggadah, has the potential to bridge the gap between these worlds, just as the traditional seder bridges the gap between the enslaved Israelites in ancient Egypt and modern Jews in some of history’s most affluent societies. Just as the seder has been adapted over millenia to launch discussions of feminism, Tibetan exile, being Jewish in America, or making sense of the Holocaust, it can be adapted to rededicate the covenant between healer and patient.
Faculty: The workshop will be run by a full-time primary care physician with thirteen years’ experience in a community health center, working with patients of myriad religions, ethnicities, and socioeconomic backgrounds, including many who have suffered tremendous trauma. They are a clinician-educator for two separate universities, including as medical director of a clinical training program, teaches an interdisciplinary undergraduate class entitled “Death and the Health Professions,” and advise a major non-profit foundation on projects in end-of-life and medical education. They have won awards for excellence in clinical precepting on two separate occasions, as well as awards for outstanding primary care in a community health center in their state, for excellence in medical care for refugees in that state and for outstanding primary care in any setting in their county.
Based on their experiences the instructor has written a book, published in September 2018, tracing how the Jewish belief that human beings are created in God’s image can be made concrete in each phase of the clinical encounter: listening, speaking, questioning, non-verbal skills, and interacting with colleagues while shepherding an ill person through a large, impersonal health system. They are currently at work on a commentary on the traditional Passover Haggadah for professionals in the healing arts, using the Exodus narrative as a window into more intentional healing work.
Workshop: The workshop will demonstrate the potential of a healers’ seder to inform individual healers’ practice of their profession through increased empathy, self-awareness, and identification with the Lifeworld goals of the people they care for.
he format will be a traditional chavruta, or dyad, setup in which the instructor frames a discussion with a brief segments lecture, then proceeds to deeper discussion between the participants who are separated into dyads called chavruta (fellowships). The dyads will receive texts to discuss and questions to frame the discussion, and engage in writing exercises that draw out specific ideas in the text. Insights gained in chavruta will be shared with the whole workshop. The lecture portion of the workshop will cover:
•The tradition of Passover seder and the rich variety of Haggadah texts published over the ages •The Lifeworld concept and its clash with medicine as it is practiced today •The structure of the seder - the simanim (“signposts”) that mark the fourteen distinct sections of the seder as it proceeds from sanctifying the day, to inviting the participants in, to retelling the story of the Exodus, to discussing and consuming symbolic foods, to singing songs of praise, to a final plea for ultimate redemption. •The basics of the Exodus narrative •The tradition of detailed interpretation and spinning of midrash (homiletic interpretations) late into the night The chavruta portions of the workshop will include the following: 1.The invitation to seder a.Text: Ha Lachma Anya (“This is the bread of poverty”) b.Discussion: What are some of the symbols of illness in our time? How do you feel about the analogy of illness as a “narrow place” or “dire straits?” Who do we “invite” to this ritual as one who is “needy” or one who is “hungry?” Where are we now, and where do we hope to be next year? 2.The story of the Exodus a.Texts: Deuteronomy 26:5-8 and “d’var Torah (brief word of Torah interpretation)” on those verses by David May on the occasion of his Bar Mitzvah, September 5, 2020 b.Discussion: write the story of a healing experience in four lines – from the perspective of the healer and the perspective of the patient. Read it as a whole, from 10,000 feet. Now re-read it word by word and tell us what is hidden in each of these words. 3.Ritual foods a.Texts: Rabban Gamliel (text on the three essential foods of the seder) and Korekh (the Hillel Sandwich) b.A snack! c.Discussion: what role does food play in illness, illness narratives, and healing? 4.Praise and Pleading a.Texts: selections from Hallel (Psalms 113-118) i.Psalm 114 - Triumph ii.Psalm 118 – Despair, Resilience, Unbridled Joy b.Discussion: What do these psalms offer us and our patients in terms of context for the emotions that well up during the process of illness, healing, and loss? The concluding discussion with the group will follow from questions and comments that arise along the way, and move toward a final question: how do we incorporate intentional rituals like this into our regular practice, and toward what end? The seder ends with a hope of a return to a rebuilt Jerusalem, symbolizing an end to wandering and brokenness. What do we hope to return to because of refocusing and rededicating ourselves?
The Hebrew for Egypt, Mitzrayim, means “in dire straits” – stuck in a narrow (tzar) place from which escape seems impossible. Illness is its own sort of Mitzrayim, and the healing arts help people to leave that space. Pediatric oncologist and palliative care physician Elisha Waldman calls his memoir of treating children with cancer at Hadassah Hospital in Jerusalem This Narrow Space for just this reason.
The problem with being in that narrow space is that it creates an eternal present of suffering. Bessel van der Kolk, psychiatrist and author of The Body Keeps the Score, maintains that trauma survivors do not remember traumatic events so much as relive them constantly. In the reliving, the events are experienced as fragments, and appear unasked for when they are triggered by events outside the person’s body and beyond their control. The Haggadah (the text from which a Passover seder is conducted) asks participants to feel as if they, too, were once slaves in Egypt. The person living with trauma, or in the throes of illness, feels as if they are still in Egypt. A seder is a way of ritualizing memory, and in so doing, can be a way of moving experiences of brokenness from the realm of the eternal present to the space of the contextualized past. At the same time, a seder is a way of fostering identity and empathy in those who never directly experienced brokenness with those who still experience it. It seeks to ensure that those who have been fortunate do not become disengaged from those less fortunate. Psychiatrist Elliot Mishler brought the sociological concept of Lifeworld to bear on medicine, contending that the Lifeworld, the milieu in which patients live from day to day, is fundamentally different from the world of medicine. The world of medicine speaks in a different language, favors different priorities, harbors different expectations and employs different techniques than the Lifeworld, to the point of deliberately blocking out data from the Lifeworld. Consequently, the medical enterprise suppresses and fragments the patient and provides inhumane, ineffective care.
A healers’ seder, scripted in a healers’ Haggadah, has the potential to bridge the gap between these worlds, just as the traditional seder bridges the gap between the enslaved Israelites in ancient Egypt and modern Jews in some of history’s most affluent societies. Just as the seder has been adapted over millenia to launch discussions of feminism, Tibetan exile, being Jewish in America, or making sense of the Holocaust, it can be adapted to rededicate the covenant between healer and patient.
Faculty: The workshop will be run by a full-time primary care physician with thirteen years’ experience in a community health center, working with patients of myriad religions, ethnicities, and socioeconomic backgrounds, including many who have suffered tremendous trauma. They are a clinician-educator for two separate universities, including as medical director of a clinical training program, teaches an interdisciplinary undergraduate class entitled “Death and the Health Professions,” and advise a major non-profit foundation on projects in end-of-life and medical education. They have won awards for excellence in clinical precepting on two separate occasions, as well as awards for outstanding primary care in a community health center in their state, for excellence in medical care for refugees in that state and for outstanding primary care in any setting in their county.
Based on their experiences the instructor has written a book, published in September 2018, tracing how the Jewish belief that human beings are created in God’s image can be made concrete in each phase of the clinical encounter: listening, speaking, questioning, non-verbal skills, and interacting with colleagues while shepherding an ill person through a large, impersonal health system. They are currently at work on a commentary on the traditional Passover Haggadah for professionals in the healing arts, using the Exodus narrative as a window into more intentional healing work.
Workshop: The workshop will demonstrate the potential of a healers’ seder to inform individual healers’ practice of their profession through increased empathy, self-awareness, and identification with the Lifeworld goals of the people they care for.
he format will be a traditional chavruta, or dyad, setup in which the instructor frames a discussion with a brief segments lecture, then proceeds to deeper discussion between the participants who are separated into dyads called chavruta (fellowships). The dyads will receive texts to discuss and questions to frame the discussion, and engage in writing exercises that draw out specific ideas in the text. Insights gained in chavruta will be shared with the whole workshop. The lecture portion of the workshop will cover:
•The tradition of Passover seder and the rich variety of Haggadah texts published over the ages •The Lifeworld concept and its clash with medicine as it is practiced today •The structure of the seder - the simanim (“signposts”) that mark the fourteen distinct sections of the seder as it proceeds from sanctifying the day, to inviting the participants in, to retelling the story of the Exodus, to discussing and consuming symbolic foods, to singing songs of praise, to a final plea for ultimate redemption. •The basics of the Exodus narrative •The tradition of detailed interpretation and spinning of midrash (homiletic interpretations) late into the night The chavruta portions of the workshop will include the following: 1.The invitation to seder a.Text: Ha Lachma Anya (“This is the bread of poverty”) b.Discussion: What are some of the symbols of illness in our time? How do you feel about the analogy of illness as a “narrow place” or “dire straits?” Who do we “invite” to this ritual as one who is “needy” or one who is “hungry?” Where are we now, and where do we hope to be next year? 2.The story of the Exodus a.Texts: Deuteronomy 26:5-8 and “d’var Torah (brief word of Torah interpretation)” on those verses by David May on the occasion of his Bar Mitzvah, September 5, 2020 b.Discussion: write the story of a healing experience in four lines – from the perspective of the healer and the perspective of the patient. Read it as a whole, from 10,000 feet. Now re-read it word by word and tell us what is hidden in each of these words. 3.Ritual foods a.Texts: Rabban Gamliel (text on the three essential foods of the seder) and Korekh (the Hillel Sandwich) b.A snack! c.Discussion: what role does food play in illness, illness narratives, and healing? 4.Praise and Pleading a.Texts: selections from Hallel (Psalms 113-118) i.Psalm 114 - Triumph ii.Psalm 118 – Despair, Resilience, Unbridled Joy b.Discussion: What do these psalms offer us and our patients in terms of context for the emotions that well up during the process of illness, healing, and loss? The concluding discussion with the group will follow from questions and comments that arise along the way, and move toward a final question: how do we incorporate intentional rituals like this into our regular practice, and toward what end? The seder ends with a hope of a return to a rebuilt Jerusalem, symbolizing an end to wandering and brokenness. What do we hope to return to because of refocusing and rededicating ourselves?