Hillel’s Approach to the Anniversary of 10/7/23

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PSYCHIATRIC VIEWS ON THE DAILY NEWS

“There is always an easy solution to every human problem - neat, plausible, and wrong.” - H.L. Mencken

Some years back, when neither our Rabbi nor I could recall my Hebrew name, he offered to give me another. After a couple of other tries, he came up with Hillel. I readily agreed and felt honored, though intimidated by being associated in this way to this great Jewish sage from the turn of the common era. I reassured myself by noticing that the name Hillel had similarities to my real birth first name, Hillard, for which I have long used the “H” as the designation for my professional name.

Probably the most famous saying of Hillel is from the Pirke Avot, and it is one that I often fall back upon for general guidance. It consists of 3 questions:

“If I am not for myself, who will be?

If I am only for myself, what am I?

If not now, when?”

Even if these questions seem rhetorical, I think there are answers to them in The Principles of Medical Ethics, with Annotations Especially Applicable to Psychiatry, although the order is changed. The Preamble states that “a physician must recognize responsibility to patients first and foremost, as well as to society, to other health professionals, and to self.”¹

Actually, when we think about our current epidemic of physician burnout, which is connected to decreased quality of care, our personal well-being may well need to be put first as Hillel did.

We also realize that we always need to be on call, or have a substitute, for patient needs. In that sense, when is always “now” for us.

In terms of a major conflict like the war in the Mideast and continuing over 1 year later, I think Hillel’s principles can be adapted to groups, too. Every population involved in this war has to be concerned with themselves. But if only concerned for themselves, adequate compassion, curiosity, and compromise seem out of reach. Some concern for the well-being of the others seems requisite for a lasting peace, even when the other is a real enemy. Such concern surely occurred in helping Germany after World War II.

There is a well-known Jewish saying, repeated in the Quran, and discussed in the October 31, 2016, Mosaic article by Philologos titled “The Origin of the Precept ‘Whoever Saves a Life Saves the World’”,² that whoever saves 1 life, it is as if all humanity is saved. Hence, the anguishing Hillelian dialectical dilemma of considering all the lives lost in this war.

A new book of 10/7 stories about individuals in Israel just came out.³ In the Afterward, Joshua Cohen wrote:

“It is possible to read this book and finish it with a desire for revenge, and it is equally possible to read this book and finish it with a renewed commitment to peace. I have read this book multiple times, in multiple languages, and have had both responses.”

Perhaps a corresponding book of stories about Palestinians during the war will also be published.

In interfaith discussions with colleagues recently, it seems that we psychiatrists have had similar responses to the war, as presented in Monday’s column. We psychiatrists of different faiths and cultures will probably agree about the need to be concerned about the extraordinary levels of major trauma that is taking—and will take—its toll on most all the citizens and military on all sides, if not also secondarily adversely affecting ourselves and others downstream. Utmost care has to be associated with processing this trauma so that it does not traumatize or retraumatize the recipient, but does solidify their concern for recovering.

Thankfully, the anniversary passed without a major escalation, though in the continuing back and forth between self and other, Israel claimed to kill another Hezbollah leader, and Hamas and Hezbollah fired rockets into Israel and toward Tel Aviv.

We in psychiatry know the complexity and uncertainty that can occur in patient care and funding limitations. Over this next year, it seems like we are ethically required to do what we mental health professionals can to produce more peace on all levels, from ourselves on up to internationally.

Dr Moffic is an award-winning psychiatrist who specialized in the cultural and ethical aspects of psychiatry and is now in retirement and retirement as a private pro bono community psychiatrist. A prolific writer and speaker, he has done a weekday column titled “Psychiatric Views on the Daily News” and a weekly video, “Psychiatry & Society,” since the COVID-19 pandemic emerged. He was chosen to receive the 2024 Abraham Halpern Humanitarian Award from the American Association for Social Psychiatry. Previously, he received the Administrative Award in 2016 from the American Psychiatric Association, the one-time designation of being a Hero of Public Psychiatry from the Speaker of the Assembly of the APA in 2002, and the Exemplary Psychiatrist Award from the National Alliance for the Mentally Ill in 1991. He is an advocate and activist for mental health issues related to climate instability, physician burnout, and xenophobia. He is now editing the final book in a 4-volume series on religions and psychiatry for Springer: Islamophobia, anti-Semitism, Christianity, and now The Eastern Religions, and Spirituality. He serves on the Editorial Board of Psychiatric Times.

References

1. The Principles of Medical Ethics, with Annotations Especially Applicable to Psychiatry. American Psychaitric Association. 2013. Accessed October 8, 2024. https://www.psychiatry.org/getmedia/3fe5eae9-3df9-4561-a070-84a009c6c4a6/2013-APA-Principles-of-Medical-Ethics.pdf

2. Philologos. The origin of the precept ‘whoever saves a life saves the world.’ Mosaic Magazine. October 31, 2016. Accessed October 8, 2024. https://mosaicmagazine.com/observation/history-ideas/2016/10/the-origins-of-the-precept-whoever-saves-a-life-saves-the-world/

3. Yaron L. 10/7: 100 Human Stories. St. Martin’s Press; 2024.