מתי לסרב לניתוח?

00:01 Speaker 1 This is the Yiddish year, and today we have in front of us, I think my best s- my best source sheet ever. This is a good source sheet. So, uh, if you are listening to this and don't have a copy of it, you can ask me for it. I'll send it to you. It is a list of pretty much every letter I could find, um, that discusses the Rebbe's position on surgery, on whether people should get surgery, when to get it, when not to get it, uh, what time of day to, or what time of year to schedule it for. It's, uh, it's all over the place. A lot of people write to the Rebbe asking should they get surgery or not. We have one from our year. That's what we're basing this on. This is a-- from the year Taf Shin Lamed Gimel. The letter is Yud Tav Tav Lamed Beis and Chelek Chaf Ches. And the Rebbe writes the following. Based on what you wrote to me, tests. They haven't finished all the testing. So a mother's writing to the Rebbe, I believe. A mother's writing to the Rebbe saying that her daughter, they wanna do surgery on her because she's, uh, too short and maybe too thin. I think she's not gaining weight, and she's also too small. They wanna do some kind of surgery. I don't know what kind of surgery that would be, but some kind of surgery. I don't know, to stretch her or whatever. And in any case,

01:00 Speaker 1 they write to the Rebbe and say they, uh, that they want a berakhah for the surgery. So the Rebbe said, "First of all, they haven't finished all the tests yet, so I don't know what we're talking about. Second of all, ." Since everything about her seems to be fine besides her height and her weight, she's not gaining weight, she's not growing taller, but otherwise, they're not finding any other problems with her. It'd be best if you could find a doctor who would find a way to treat her without doing any sort of surgery.

01:26 Speaker 2 Are they talking about putting in a G-tube?

01:28 Speaker 1 I have no idea. I have no idea.

01:31 Speaker 2 This is part of the parsha that I'm going through with my own daughter, is that they wanna put in a, a tube through her stomach because she's-- the feeding issues, things like that, and I'm re-resistant to it.

01:40 Speaker 1 Wow.

01:40 Speaker 2 Um-

01:41 Speaker 1 This letter might be for you.

01:43 Speaker 2 No, I know. That's what I've been, uh, pushing off knowing that that's why we're going to, that's why we went to Cincinnati and that's why we're going to CHOP because of that reason.

01:57 Speaker 1 It's best to find a doctor who will treat this without surgery. Especially since it's been going on for a while already. There's no reason to rush right now, but you have a camp and this girl can go to camp with a relaxed, uh, with a relaxed demeanor. And then the Rebbe's, uh, the Rebbe's signature. I'm sorry. I have a door I need to close. So just a moment. That said, and this first letter read, I do wanna give what I meant to make an intro to this entire class, which is that every time we do the Rebbe on medicine, we need to keep in mind that the Rebbe on medicine is very tailored. There really aren't klalim. There are a couple klalim. I think we found a klal here, a general rule. But with everything regarding the Rebbe, um, there are very few general rules regarding medicine because people will write to the Rebbe saying, "Do I need this surgery?" And the Rebbe will say yes to one and no to the other. The only general rules we have by medicine that are, that are really strong is, um, is consulting multiple specialists, consulting a, uh, a rofe yadid, a rofe momkha. Other than that, it's, it's hard to draw straight lines. However, I do think that we'll find when we look at these letters, the Rebbe is generally anti-surgery. And because the Rebbe is generally anti-surgery, first of all, I'm kind of, uh, I'm spitting in the, uh, I'm sp- I'm spitting in the

03:09 Speaker 1 place that feeds me. I, uh, I, uh, my, I, I, I, owe, I owe my education and comfort in life to, uh, to, to, to surgical procedures, and my father listens to these shiurim, so I think my anti-surgery shiur might not be his favorite. So let's open with a couple pro-surgery letters. There's a few letters that the Rebbe tells people that they absolutely do need surgery, lest we think that the Rebbe always says avoid surgery. We have a letter here from the year Taf Shin Chaf. This is letter Zion. Lamed Daled's on your screen. And the Rebbe writes to a woman saying, "Of course, you have to get surgery. That's what the doctor said." said, "You requested that I put this letter ahead of the line because it's urgent, and I have, and here's what I'm writing to you." The permission is given for doctors to do their curing. Excuse me. This also includes this means that they have the ability to do things This nituach, this surgery should cause an immediate healing. and she should return to her prior strength or prior health. a bunch of berakhahs. et cetera, et cetera. So what the Rebbe is saying in this letter is the doctors told you you need surgery. Doctors have permission to heal, and they also are given an ability from God to heal. And so if the doctor says you need surgery, you need surgery. The surgery will go well. You'll recover, and you'll go back to your regular health, and may you

04:35 Speaker 1 live a good life. So sometimes if somebody writes to the Rebbe and says, "I want surgery," and the Rebbe says, "Listen to your doctor." That definitely does happen. I will also note over here is a, uh, letter in Yiddish that is also to a woman from per the berakhah of Shalom Klal. The letter is Ches Tav Kuf Mem Zayin. It was written in the year Taf Shin Chaf Gimel, and here somebody writes to the Rebbe saying that they're trying to decide between radiation and surgery for Rachmana Liuitzlan cancer, and they're trying to figure out whether they should do radiation or surgery. They've been given both options, and the Rebbe says, desp-- the Rebbe doesn't say this. I'm adding this. Despite the fact that the Rebbe isn't always a big fan of surgery, now the Rebbe's talking, the Rebbe says that he prefers surgery to radiation, and the reason why he preser-- prefers surgery to radiation, he spells out in this letter at some length. He says that, um, he says that once you've, of course, gotten the consent of Rabbonim who normally, who normally you'll poskin on these issues, you can't really predict the outcomes of radiation for sure. You never know exactly what's happened with radiation. You don't know whether you've gotten, whether you've gotten the job done. I don't know how true this is nowadays. This might have been much more true in Chaf Gimel. Um, but the Rebbe's concern that a person can do that, a doctor can do s- can do

05:36 Speaker 1 radiation and not know for sure whether the cancer is gone. It's easier to know that the tumor's completely been removed when you're, when you're literally removing it. So he says, uh, "Obviously, I want you to, as in all cases, talk to two specialists, also talk to a Rav." Uh, but the Rebbe, when it comes down to surgery versus radiation, seems to prefer surgery over radiation, and he says here, this isn't just for this person. He makes this a klal, a klal that is dependent on the situation at the time. I think it's possible that nowadays we have a pretty good idea of how well radiation works, but what do I know? Uh, people can write in, people can call in and tell me. In any event, the Rebbe is saying that, uh, that he definitely presu-- prefers procedures where you know that the goal was met over procedures with ambiguous outcomes. In his time and in his place, that was surgery over radiation. Returning to our list down here, though, we have a lot of letters where the Rebbe says that he's not a big fan of surgery, and a lot of these letters are written in general terms, not to individuals. I tried not to include any letters where the Rebbe says, "You don't need surgery," and try to stick only with letters where the Rebbe explains his shitah about why he doesn't usually suggest surgery. So we have this letter over here. This is from the year Taf Shin Chaf Alef Yeah, this

06:40 Speaker 1 is the right one? Yep. This is letter Zion Taf Kuf Gimmel, and it's a long letter. We're just gonna take a look at this middle over here. He says, uh, "You wrote to me about different opinions from your doctors and what they should do." The Rebbe says, "Yadua. It's well-known. So that's a big klal." The Rebbe says when it comes to surgery, it should be well-known that when it comes to surgery, if we're not sure whether they need it or not, don't get it. So if a doctor tells you they're not sure that they need surgery, the Rebbe says, "There's a klal. Yadua. If there's any doubt , whatever surgery it is, it's always better to not get the surgery unless they are certain you need it. And God will provide healing." So first of all, I think this is safe to say as a general rule, given the way the Rebbe's writing the phrase, if we're not sure whether we need surgery, we shouldn't do it. Surgery should come only when we're quite sure that we need it. Okay, this other letter is over here. And this is another big klal you see in a lot of the Rebbe's letters. This from the year Taf Shin Yud Tes. The letter is Hey Taf Taf Kaf Samech. And here the Rebbe says, "You need to consult with other people before you get surgery." So, when it comes to all , notice the lashenus that we're picking here. Any kind of surgery. That means anything irreversible.

07:51 Speaker 1 So he's qualifying. He's saying that this is, uh, this is-- I, i-- There are certain surgeries where you can't reverse what you've done. For example, radical surgeries, you remove a good deal of tissue, you sometimes an entire organ or an entire part of the body. You don't get that back or an amputation. These are things that are irrev-irreversible surgeries. When it comes to irreversible surgeries, the Rebbe has a rule, and that is . You have to a-ask, you have to ask experts in the field. Notice that he always says experts in the field and frequently uses the word specialist. I think a lot of us misunderstand this. We think that if we're going to have a procedure done, we should go talk to some doctor who's a, a rofeh, a rofeh yadid, who's not necessarily a mumcheh in that specialty. Uh, while the Rebbe does want us consulting rofeh yadid, he also insists that we get multiple opinions from the specialist. That doesn't mean that a specialist in one field said that the person needs surgery, and now I'm going to a specialist in a different field, and they say that they don't. It needs to be experts in that field. Okay, so they have to ask expert, experts in that field. At the very least two, and it would be best if it was three. This is the Rebbe-- this is a rule from the Rebbe. I believe this is a hirah that people have to keep, that if they want to get a

08:52 Speaker 1 surgery that is or have somebody in their family unfortunately get a surgery that is irreversible, they must first get at least one second opinion and ideally two second opinions, a total of three opinions on the matter. I'm sure that your, uh, father-in-law or mother-in-law, I guess father-in-law in this case, won't be, um, won't be makpid about this. Because according to the Torah itself, there's a special power to the opinion of two or three people that is not in play when you have the opinion of only one person. So he's saying this isn't a medical thing, this is a Torah thing. This applies to every aspect of life. You should be getting second opinions, but obviously applies most pressingly when it comes to medical conditions, especially irreversible procedures. the Rebbe says this is logical that you should get a second and third opinion. The person at the end of the day is only human, they are a creation, and sh-shuu and, uh, you end up getting s-- there's salvation through much counsel. Okay, the Rebbe says, "I'm writing back to you, and everything should go completely well." So the Rebbe's not a fan of surgery. He says when in doubt to avoid it, uh, is definitely the way that we do things if we're not sure that we need it. He wants you to consult with two to three specialists, and it-- although he's in favor of surgery in specific cases where it sounds like there aren't a lot of other options, and although he's in

10:09 Speaker 1 favor of surgery over radiation, you certainly see some reticence here. We have a letter that as far as I know was only ever printed in English, so I'm scrolling down to the bottom of our page here to show it to you. And this is where the Rebbe talks about how he is also in general against radical surgery. Radical surgery does not mean surgery that wears sunglasses. It's not cool surgery. I think that's a funny joke. You can take it or leave it. A radical surgery also does not just mean that it is very severe. It's a medical term. Radical surgery frequently means removing an entire p-- an entire, uh, an entire organ. Um, sometimes it just means removing a very large amount of tissue and all of the surrounding area. What it means literally is when they do ra-- when people do radical cancer surgery, which is as far as I know the main way that it's used, is that they don't just take out the tumor, they also take out all of the tissue surrounding the tumor, less than just in case the tumor has leaked into the surrounding tissues. So, uh, these are very serious surgeries when there's a radical prostatectomy, that's, uh, of course, the field that my family comes from. That's my family business. They remove the whole prostate. Radical usually means they're removing an entire thing. So of course, this would be in the category of irreversible surgeries because when you remove something, it doesn't come back. So the Rebbe

11:08 Speaker 1 says on nine other fifty-seven thirty-- thirty-nine, he's acknowledging receipt of the letter and says, "You asked the Rebbe about this." The Rebbe says, "In general, I am not in favor of radical treatment if there is any possibility in treating a patient in some other way." So it's not that he's not in favor of it ever. If that's the only possibility on the table, go for it. But if there's any other possibility, the Rebbe wants radical treatment to be a final, a, a, a final line, that that's only what you do when there are no other options. Says also, "I need to add that it's customary among Jews that whenever there is a difference of opinion among doctors about the urgency of an operation or whether or not to operate, it should be treated as any other question in Jewish law, and therefore, there needs to be spoken, uh, it needs to be, uh, discussed with a competent rav," which is just interesting to me. He's saying to talk to a rav about the procedure. I don't think he's saying what he said in the prior letter, you consult multiple doctors. I think he's saying to talk to a rav when there's a safek about the procedure. Just interesting. Um, and then he says, "Don't forget that God's the one who does all of the healing." So the Rebbe's not a fan, excuse me, clearing my throat, of radical procedures. Another kind of surgery the Rebbe is not a fan of is new procedures. The Rebbe

12:07 Speaker 1 does not like new things. This is also the case with vaccines, but it was misused during the COVID pandemic, uh, to mean that the Rebbe would not be a fan of a vaccine that had been around for a year or two. As far as I can tell, when the Rebbe says that he doesn't like new procedures, it means procedures that have only been out a few weeks. The vaccine letters that he wrote where he said that a vaccine was too new to use, that vaccine had only been used for a couple of weeks at the time that he wrote that letter, and he said that we-- "I want a few months to go by before we use it." So just to note that when the Rebbe doesn't like new procedures, he means like months new, not, uh, not, not things that are new-

12:35 Speaker 2 Sorry-

12:35 Speaker 1 They've been around for a year.

12:36 Speaker 2 Sorry to interrupt.

12:37 Speaker 1 Yeah.

12:37 Speaker 2 But don't mean to, to sidetrack the whole thing. Interesting what you said about the vaccines, though by the polio one, when the new polio came out, the Rebbe said to actually use that one because it was less risk with that one than with the oral polio. Just as a side thing

12:49 Speaker 1 That's true. That's true. Um, I would like to do-- I have a Shear prepared on this that I've given another context of just the Rebbe's tshuvahs on vaccines. Um, people really got it wrong. People-- every time I've spoken to anybody about the Rebbe's shitas on vaccines, uh, besides Mendy Levertov, who knows them pretty well, um, no-- most people are very wrong about the Rebbe's position on vaccines. He's, he's, he's brought-- he almost, almost totally pro, um, with a certain amount of caution that isn't necessarily applicable nowadays because a lot of that time passes automatically. I mean, we are sidetracking, but, uh, when the Rebbe says certain vaccines shouldn't be used until they've been on the market for a month or two, you usually can't get them till they've been on the market for a month or two. In any event, um, absolutely true what Mendy said about the polio vaccine. Okay, when it comes to new procedures, however, new surgical procedures, the Rebbe is not happy with them in general. The Rebbe says that the surgery that you are suggesting, this is printed in the Likutei Sichos, tell you more about that later, that, uh, the surgery this person is suggesting, it is, um, it is a very complex surgery. It's a surgery that, uh, they're not exactly sure how to do it yet. It's very new. So the Rebbe says, uh, they're not sure how the outcomes look. They're not sure what the side effects are going to be. And because of all of

13:51 Speaker 1 that, he's not interested in having this surgery right now. He says that, "L'chen be'yom ha'matzav m'khem emet lo nigle ha'shom." As long as things don't begin to decline, we should wait for, uh, wait for other treatments to, uh, for other treatments to appear and avoid a new procedure. So the Rebbe also doesn't seem to like very new, very cutting-edge surgeries unless there is, of course, no other option, which is another footnote to this entire thing. Footnote number one, of course, was that not all of these letters are applicable to everybody, and footnote number two is that when there are no choices, we always do surgery, obviously. But the Rebbe's saying that when there's a choice, he usually doesn't like-- he usually is not a fan of surgery, I think is fair to say. How about the timing? How about timing of surgery? Uh, I mentioned a second ago Likutei Sichos and said I'd tell you more on this in a moment. What's really interesting is in the hisafus in the back of a lot of volumes of Likutei Sichos, they put together a series of letters that are almost like our Igrish Shulam, where the, where the, the editors took a topic and had multiple ma'yas from the Rebbe, the excerpts taken from the letters, and they're in the back in the hisafus sections of several volumes of the Likutei Sichos. Some of them are just out of this world. There is one of them that's edited by the Rebbe that is a, uh, that

14:50 Speaker 1 is a frequently asked questions. It's an FAQ on mitzvah tefillin. People saying, "Can you really put tefillin on people who are dirty? Can you put tefillin on somebody, uh... Shouldn't we be prioritizing from?" It's like there's a whole, like, FAQ in the back of Likutei Sichos that the Rebbe edited questions and answers. In the back of volume thirty-six, if you've never looked at it before, open it up and take a look. You'll be amazed. In the back of volume thirty-six, it is a ton of answers from the Rebbe on medical issues. It's a whole collation of the Rebbe's take on medical issues whenever they felt very general. So a lot of this comes from back there. I wanna talk for a minute about the timing of surgery. We have down here, I think I brought the actual sheets for you. I did. The Rebbe does not-- this is shayach to, uh, Inyanim DeYoma. The Rebbe doesn't want people to get surgery during the three weeks if possible, or during the nine days if possible, uh, as we're about to see in these letters. Of course, if there is an urgent need or somebody's in terrible pain, which is, I think, also an urgent need, there's a lot of room for leniency here. But we're talking here mainly about elective surgeries. So if we're talking about elective surgeries, don't schedule them for this time of year. I think you might have guessed that, but let's read it. He says, uh, "Im idri et yemei ka'anal yaaseh

15:50 Speaker 1 ken be'shas ted mitzlachas." This is again the Rebbe Shita. If another doctor agrees, go ahead and get the surgery. "Kamuvah mateh be'chedish Elul v'loim Menachem Av." Would do best if you got it in Elul and not in Menachem Av. Somebody asked me a question recently that they had a court case coming up, and they asked me, um, should they, uh, should they, should they do it in, in Av or should they do it in Elul? And their concern was that Av is a time of, uh, is a time of tragedy, but Elul is a time of judgment. There-- as far as I know, there's no such inyan like that. Although Elul is a time of judgment, it's also a time of good fortune. It's a time of very positive judgment. So, uh, I gave them the answer, of course, that it was much better to push it to Elul and that everything would be fine then. Just to let you know, the Rebbe's saying here about surgery too, that it's best to do surgery in Elul, that Elul is a time of divine-

16:29 Speaker 2 I think I once, I think I once asked and I was told that after Tu B'Av is totally fine.

16:33 Speaker 1 It is. It is, as we're, as we're going to see. Um-

16:36 Speaker 2 Oh, sorry.

16:37 Speaker 1 "Mateh be'chedish Elul v'loim Menachem Av." He goes, ideally, anything after the fifteenth is considered a positive time, but the Rebbe always prefers Elul over the second half of Menachem Av. Um, and that is actually the answer I gave this person regarding the court case. I told him anytime after the fifteenth was fine, but actually, Elul is preferable to after Menachem Av. Even after the fifteenth, Elul is a very special time. We schedule weddings then. Elul is a time of, uh, of divine favor. "V'chalifen lo yehi shabbos kodesh kim kar le'tzidlas hashvuah." The Rebbe says also not on Friday. Doesn't want surgery scheduled on Friday, and he wants it at the beginning of the week, so not really Thursday either. We're gonna see this a little more in a second. In this letter down here, "Niskavel michtav" from Yom Chaf Sivan. It's my birthday. "Ve'item shih kirbeh sadatsanal." Let's see, and I'm gonna read it then. "Negeh letipul refui" regarding the treatment you're looking for, "yaaseh kedasah chiddah ba'akupan sh'neidrei v'mumchim." Okay, the same thing. We have to remember v'mumchim. This is the part I want. "V'chalifen lo iben ha'meitzarim." See, the Rebbe says not ben ha'meitzarim, so that's not during the nine days. That's all three weeks. The Rebbe seems to not want you to do surgery either during the ni-- during the three weeks, of course, if avoidable. Um, so what do we have here? We have not during the three weeks, not during the nine days, and also not on Friday. There's a

17:41 Speaker 1 letter over here. I think it's my last one up here on the screen, hopefully. Yep. The Rebbe writes in this letter, this is letter from Tuchin Chav, Zion Shin, Ayin Hey, and he says, "Generally speaking, you need to use at least a second opinion. Get at least a second opinion from a doctor. Make sure that they all agree before you do the surgery." When it comes to the timing, though, the Rebbe says, "Negeh le'azman. Yemei amshavi yesh lichas achri ha'matishi." At the very least, push it off to after Tisha B'Av, so at the very least from the tenth onward. So that's not even from the fifteenth. He says anything after the ninth day at the very least. "V'chalav kavaliteva," but the further you can push it off, the better. Id- I assume all the way until Elul. "Vi maray beidichek bedafkes hashav." If the doctor really tells you you need to have it right now, "har las izzeh kedem Shabbos Chazon." At least not Shabbos Shavuot Shachabai. So Shavuot Shachabai is a Halakhic term you're probably familiar with. The, the stri-- the, uh, stringencies of the nine days are much more strict in the week that Tisha B'Av falls on. So the Rebbe's telling him at least after Shabbos Chazon, because then you'll be in the, uh, i-- I mean, sorry, at least before Shabbos Chazon, because then you'll be in the nine days, but not in the strictest part of the nine days. But it looks like unless things are really serious, even if

18:43 Speaker 1 the doctor's pushing, the Rebbe really doesn't want surgeries on Shavuot Shachabai. Um, obviously, that doesn't apply to real emergencies, but, you know, we're, we're seeing levels of strictness here The Rebbe has a super long letter, a super long sicha/letter that we're not going to do today. I'm just gonna tell you kind of the maskana of it. If you can find it and look at the sichas, volume-- I put Roman numerals. I hate when I do that. Volume sixteen, page five eighteen. It goes until page five twenty-one, where there's sort of a sikham at the bottom, where the Rebbe has a very long teshuvah, where he explains at length why he thinks that it is not just not a bad-- good idea, but literally aser, literally aser to schedule a procedure of any kind that will require any sort of stay in the hospital for a Friday. He gives multiple reasons for this in Halakha. Of course, this doesn't apply to emergencies, but if it's not an emergency, it sounds like that we're not allowed to schedule a s-- a, a medical procedure for a Friday. And the Rebbe says, if possible, he doesn't even think it should be scheduled for a Thursday or a Wednesday, that all medical procedures should be scheduled for Sunday, Monday, and Tuesday entirely for Hillul Shabbos reasons. It's a long teshuvah. Love to do an independent shiur on it sometime. I gave you the source, so you can look it up. But also it looks like we want first half

19:45 Speaker 1 of the week. So if we were to summarize everything that we've learned about surgery today, what it would be is that in some cases, the Rebbe is clearly pro-surgery. That is, that the doctors all agree the surgery needs to be done. He then tells the writer, "Trust in Hashem. Do what the doctor is saying. Get the for the Rebbe. Don't be afraid of surgery. Surgery itself is not bad, is not evil when everybody decides that it's the right thing to do, and it sure beats the pants off radiation," right? However, when in doubt, . If we're not sure whether the surgery is necessary, it's best not to do it. Before we get a surgery, we need to consult with at least one other specialist in that field, and ideally three specialists in that field before deciding to get a surgery. The Rebbe generally says that he wants to avoid radical treatments unless there are no other options, and he also wants to generally avoid new treatments unless there are no other options because we don't know how their outcomes work yet. When it comes to timing surgery, the Rebbe does not want surgery-- I mean, look, let's start from the best-case scenario. Ideally, cut out the entire three weeks completely and, uh, and don't-- Ideally, cut out, uh, cut out the la-- the shivas haB'tamuz through the entire month of Av would be the Rebbe's favorite outcome. It would be either do it in the beginning of Tamuz or do it in Elul. If necessary,

20:48 Speaker 1 we can do it any time in Av after the ninth. If necessary, we can do it during the three weeks, but not during the nine days, and if necessary, before Shabbos Chazon, but not before Shacharis. Much more importantly and much more practically, I think, though, is a possibility of Hillul Shabbos that the Rebbe raises in his letters and sichas regarding going into the-- scheduling a surgery for Friday. The Rebbe doesn't want it done at all unless it's absolutely unavoidable, and maybe even not on Thursday or Wednesday, as early in the week as possible to avoid any possibility of Hillul Shabbos. That's everything.

21:22 Speaker 3 I have a lot to say. I've been-

21:24 Speaker 1 Go ahead

21:24 Speaker 3 ... I've been, I've been, I've been pent up. No, but I've, I've three, three, three key things that I wanted to comment on. Number one-

21:29 Speaker 1 That's why you're taking notes.

21:31 Speaker 3 Y-Y-Yeah. Number-- 'cause I don't wanna interrupt. But I want-- my, my one-- number one is you mentioned the concept of radiation today, right? And how, you know, things are different today than they maybe were in, in, in, you know, in, in the, in the, in the forties and fift-- in the fifties and early sixties or mid-sixties when the Rebbe's writing it. So, like, I, I know that a lot of times people come up with this concept that when a, when a woman is pregnant, that the Rebbe was against taking sonograms. Now, it's very possible, and, and I always thought to myself that that's because at that time, sonograms were either done differently or the technology or the knowledge of what the effects could or can be on the fetus was different. And versus today, where it's something that is so routine, perhaps the Rebbe's opinion would be different. Can we even take such a direction when it comes to, to things from the Rebbe, or if the Rebbe said in nineteen-- in nineteen fifty-three that sonograms were, were not-- shouldn't be done, so now in, in, in, in twenty twenty-three, we're not gonna do sonograms either?

22:22 Speaker 1 My rule, which isn't necessarily the universally accepted rule, but it's mine, is that if the Rebbe gives a reason for something in medicine, then if the reason doesn't exist anymore, then we don't say-- we don't take into account the Rebbe's concern about it anymore. Meaning, if the Rebbe says, "I'm always against this," and doesn't say the reason, then he's always against this, and we don't have a reason. But if the Rebbe says, "I'm against this procedure because it has this sort of risk to it," and, uh... Or a, a very practical example, I'll give you a real practical, is that, uh, regarding ultrasounds. Um, one of the things that the Rebbe says in s-- regarding some ultrasounds is that, uh, and regarding a lot of tests like it, is that it's a test that has no practical outcome. If you find something, you can't do anything about it. So in the Rebbe's time, if they found certain things in the ultrasounds, they literally couldn't do anything about it. The baby would come out with that problem, and they just knew about it. The only option really was abortion, is if they saw real horrible things, they could talk about aborting, which the Rebbe was not in favor of, obviously. So the Rebbe said there's no point to the procedure. Why would I do a procedure that has no point? That's not really true anymore. Nowadays, the, uh, twenty-week anatomy scan is able to detect things that can be-- where we can actually treat them before

23:27 Speaker 1 the baby is born. In some cases, they can even do these really innovative surgeries on the woman in utero and fix the baby before it comes out. That didn't exist when the Rebbe was writing or talking about ultrasounds, so I think it doesn't make sense to superimpose the Rebbe's perspective on a treatment that has no purpose onto something that now has purpose. So my, my, my general klal is that if the, uh, general klal. My klal is that if the Rebbe gives a reason for something and we know the reason isn't the case anymore, then it's not effect-- then it's not in effect anymore when it comes to medicine.

23:53 Speaker 3 Okay. So that's a great answer. I appreciate that. Second thing is, I'm gonna-- I just have three things. Second thing is about kidney donation. When the Rebbe talks about here radical surgery, there's today such a tremendous move of people removing a kidney for a Chesed purpose, where it would seem, based on these letters, that the Rebbe would not be in favor of a radical surgery, even for a Chesed purpose, unl-- you know, because it's something that you're actually removing a complete body part, and people do have complications from it or could possibly have complications from it. What do you think?

24:20 Speaker 1 That's a very strong diuk. And I think as you know, 'cause we've hagraned about this before, I have several other reasons why I'm not in favor of the, of the movement to, uh, to-- for everybody to give away their kidneys willy-nilly. Uh, I think that most of the poskim who pasken that it's mutar are unaware of the actual risks, 'cause they'll say things in their teshuvahs along the lines of, "There's basically no risk to this procedure, therefore it's mutar." And if that's what they're saying, that it's mutar because they think there's no risk, then I'm here to tell you that they're wrong. So, um, obviously, the argument back would be in a case of saving somebody else's life, maybe there's more leniency. The Rebbe's talking here about, uh, about, about, um, I don't know. Uh, if it's radical, I guess it's also to save your life. It's-- I think you're making a strong point, and you're preaching to the choir. I'm, I'm, I'm already biased in this direction, and I think you may have given me more ammunition. But yeah, the Rebbe is saying that he doesn't want surgery done if at all avoidable. And, uh, I think it's quite avoidable.

25:07 Speaker 3 And then my final comment before Perez jumps in, 'cause I know that he also would like to make some comments. This is his field and his area. I just wanted to make one last comment, is you, you say that is judgment. Why are you saying Elul is judgment versus Elul being Melaveh Malka? If anything, Mel- Elul is a zaman, is a zaman of rachamin and El- and Melaveh Malka is not a yemei hadin, it's yemei rachamin, but it's not yemei hadin. Why would you say Elul is judgment?

25:28 Speaker 1 I didn't say Elul was judgment. The person who called me asked because they understand Elul to be judgment, is this a problem? I agree with you. Elul is not a time of judgment. Well, it's, it's a time of judgment, but it's a time of, uh, it's a time of that good kind of judgment. You know, the Hatanu Lefanecha sung like a Sephardi, uh, if you get the reference. It's, it's, it's a time of-

25:46 Speaker 3 Okay. Thank you.

25:48 Speaker 1 It's a time of positive judgment. So, uh, it's a... And, and the rebbe says it's actually a good time to schedule dangerous procedures. So I think, uh, Kol Shekein a court case. Parrots? No? You just looked like you wanted to say something. Mandy, you got anything? And Parrots got his banana. Mandy, our, our, uh, our community- Yeah?

26:09 Speaker 4 You covered most things that I was gonna say. Um, no, but again, the, the procedures during the nine days, obviously, you know, I had a situation myself once. You know, you have to do certain ti- certain things at certain times, and if there's no less bracha, then you do it.

26:24 Speaker 1 Yes.

26:24 Speaker 4 But obviously, you don't want to. Um, the whole donation thing, that's a whole separate... I've spoken to people about that in the past. Uh, that's a whole separate shiur. I think-

26:35 Speaker 1 It absolutely is.

26:38 Speaker 4 Oh, and regarding the ultrasounds, um, the, again, like you said, if it has anything that's pertinent to now versus, you know, aborting, like the alpha fetal protein test, you know, we don't-- I don't agree with, because again, we're not gonna abort based off those kind of results. So why do those tests? But the ultrasounds, like you said, sometimes we could find things that could be fixed early, um, in utero and sometimes, uh... Yeah, but just dumb scanning, like for, for, for gender and things like that is not, is not necessarily the right thing.

27:10 Speaker 5 Yeah, but then you have, uh, you know, these young Hasidish couples that get married, and they get pregnant, and they know that the rebbe said, and, and they end up having complications later because they didn't, uh- They weren't, uh, enlightened in the r- in, you know, that they should be taking sonograms along the way when needed.

27:36 Speaker 1 It's very unfortunate. I don't remember if we talked about this before, but ACOG, which is the main organization for, uh, gynecol- gynecology and obstetrics, they recommend one ultrasound during pregnancy in an, in a pregnancy without complications. They recommend the 20-week, and they say everything else is elective because parents like to see their babies.

27:51 Speaker 5 Right. But-

27:52 Speaker 1 So to me that, uh, it seems to me that, uh, the Hasidim should all be getting that one. And, uh-

27:55 Speaker 5 But when you, when you have doctors, you know, you know, arguing with their patients and trying to tell them, "You're, you're-- What are you doing?" And they're like, "Nope, we're not doing it," you know?

28:09 Speaker 1 Yeah, I haven't made any friends by telling the doctors every time that ACOG says that the kid only needs one.