Each sect of Judaism has its own way of observing the Jewish Day of Atonement, Yom Kippur, but there is at least one custom observed across the board: fasting.
As members of the Baltimore Jewish community spend the day in synagogue with empty stomachs beginning the night of Oct. 3, some observing the holiday won’t be able to take part in the ritual.
“I have Stage 3 kidney failure,” said Pikesville resident Mike Solomon. “They don’t want me not drinking or eating, because the kidneys could shut down.”
While Solomon said his condition is stabilized and that he is not on dialysis anymore, he and his doctors would like to keep it that way.
Solomon’s condition is just one of many that exempts him from fasting, according to rabbis and physicians.
“In Judaism life always takes priority over anything else,” said Rabbi Mitchell Ackerson, director of pastoral care and chaplaincy at LifeBridge Health. “If fasting is going to get you sicker, then you shouldn’t be fasting.”
Dr. Elliot Rothschild, an internist at Pikesville’s Baltimore Suburban Health, said patients who can’t fast include those who are frail, have heart conditions, take medications that require food, some diabetics and those with acute conditions such as pneumonia that could worsen from fasting.
“I tell somebody not to fast if I think it will destabilize their condition, particularly someone who is frail,” Rothschild said.
Perfectly healthy people, such as some pregnant women, don’t fast either.
“It’s just generally not a good idea,” said Daniela Levine, an expectant mother. “You don’t want to deprive the growing fetus of nutrients.”
Levine, who is modern Orthodox, still plans to celebrate the holiday and said she will miss fasting.
“It gives you a chance for introspection, it gives you a chance to really think about all the things you’ve really done over the past year,” she said. “Although difficult, I think it takes away that little bit of pleasure you get from eating, and it gives you a chance to really think about all the things that Yom Kippur is about.”
Owings Mills resident Dennis Duell said he last fasted about 10 years ago. He and his wife both have medical issues that prevent them from fasting.
“That’s what happens when you get into your golden years,” he said.
He takes medicine for his rheumatoid arthritis that requires food. And although they can’t fast, Duell sees the value in the tradition. He explained it as a way of connecting to past generations and their hardships.
“We didn’t suffer as other people suffered prior to us, so [fasting is] really little compared to what other people went through before us,” he said. “It’s an important thing because it’s symbolic.”
Rothschild said some patients do fight him on not fasting but joked that it’s no different than any other time he gives them instructions. Some, he added, can fast with precaution and consume small snacks and drinks. For those who fight him, he cites a story a rabbi at his synagogue, Suburban Orthodox Congregation, told about a man whose wife told the rabbi he wasn’t following doctors’ orders to not fast.
“The rabbi visits him [and says], ‘I just want to let you know I won’t be able to give you an aliyah in shul anymore,’” Rothschild said. “The rabbi says, ‘You have decided to practice a different religion. The law is you have to eat.’”
Rabbi Ackerson has dealt with similar situations. Although those admitted to the hospital generally understand why they can’t fast, there’s one population that sometimes has trouble with the notion of not taking part in the ritual.
“It takes more effort in terms of that emotional side, particularly with some of my very elderly Holocaust survivors,” he said.
“They’ll say, ‘I fasted in Auschwitz and now you want me to eat?’ That’s a very different situation.”
So what does a rabbi say to that?
“For most, it was their deep faith, that’s what allowed them to make it through,” he said. “We tell them, ‘That deep faith is what tells you to make your life a priority.’”
At the end of day, even though it means missing out on a lifelong practice, Solomon said there really isn’t another option.
“It’s just one of those things where you have to go by what the doctors and the rabbi says,” he said.
Questions about fasting should be directed to one’s Rabbi and physician and should not be answered on the basis of this article. For example, not all medicines that are to be taken with food absolutely need to be taken with food. And a medicine that needs to be taken with food once a day can be taken just before the fast and just after the fast. Additionally, pregnant women have always fasted unless there was a specific issue that prevented it, and there is no evidence for any harm to the fetus on that basis.
I appreciate Mr. Shapiro’s comments. At our old shul in Richmond (with an aging population) we noted a large number of members who 1) had multiple medical problems on multiple medications and 2) stubbornly insisted on fasting. Predictably on Yom Kippur afternoon, people started hitting the floor. Chaos ensued, as 500 people each took it upon themselves to call 911 and dozens of members with medical training surrounded the fallen each trying to take charge.
What we learned from this was to do the following:
1) Arrange a schedule of “on call” providers among the membership to reduce the chaos
2) Widely publicize the existence of the Emergency Squad, asking everyone else to stand down and let them do the work in case of emergency
3) Having emergency stands around the building with sweets (for fasting diabetics) and drink (for those who became dehydrated)
4) For weeks before the holy day (and multiple times during the day) the Rabbi would remind all present that our goal was to send our prayers to the Heavenly Throne, not to deliver them in person.
We did reduce the incidence of medical incidents with this system, as well as reducing secondary problems such as overwhelming the Emergency Response system by having too many people call for the same emergency. I would note that many synagogues, especially those with large and/or aging membership should consider adopting a similar system