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Dr. Stephen Goldman
Dr. Stephen Goldman

With A Terminal Illness, What Do You Pray For This Yontef?

a reflection by Dr. Stephen Goldman

L’shanah haba’ah b’Yerushalyim!

These words end the final closing service every Yom Kippur. Our fasting (maybe) and praying are finished. We have just completed 10 of the most important days on our calendar. We do this, hopefully, every year. Each year we pray to be inscribed in the Book of Life for another year and ask forgiveness for a multitude of sins.

Dr. Stephen Goldman

Dr. Stephen Goldman

But, what if you knew you had a good chance of not being around for the next yontef? Not metaphorically, but what if you had been diagnosed with an illness that may indeed take your life in less than a year? Would the words of your prayers then have a different meaning, or any meaning at all?

I am speaking about this concept because I am one of those people. Shortly after last Yom Kippur, I was diagnosed with a form of ALS that does not give me a long lifespan. It has robbed me of my speech, my ability to swallow, of my trumpet playing, of blowing shofar at shul, and forced me into early retirement. I see my body slowly withering away as the disease takes its toll. Yes, there is a great new medication that slows down the progression of the disease, and there is some amazing research going on, especially in Israel, that may offer a cure.

But the reality is this: I, like many other people, have a terminal illness. I pray that I will have more time with my family and friends. And I began to wonder how, being acutely aware of my mortality, to approach a holiday centered on teshuvah, [literally “a turning” and often translated as repentance] as we read a litany of prayers asking for forgiveness.

So, we can hear from God, salachti, you are forgiven.

The meaning of these prayers, however, start to shift when you realize you may be speaking them for the last time. You begin to wonder what are you praying for? Not why you are praying, but do these familiar words now mean the same as before? We pray for forgiveness from our sins, to work toward teshuvah. To become a better person, to not miss the mark as often as we have in the past.

And we pray to be inscribed again in the Book of Life for another year.

Time really is short. I am coming to the end of mine. Do these words even hold any value to me? Not from bitterness, but from a sense of wonder: What if we all knew that our time is growing short? What would our focus be in prayer? More time? Asking for insight? Less pain?

And, to me, most importantly, what should we ask forgiveness from.

Al Chet … grant us forgiveness from … The list in every prayer book is the same, and some congregations even add their own take, a modern Al Chet. Listed alphabetically in Hebrew, it contains a litany of major and minor transgressions between people and between people and God. They cover every topic imaginable, from lewdness to disrespect for parents and teachers to doing various forms of evil. In Orthodox Yom Kippur services, it is recited 10 times. All of it is about the stupidities and vanities and arrogance of human beings, to make us realize what we need to correct to become a holier person.

What if you had been diagnosed with an illness that may indeed take your life in less than a year? Would the words of your prayers then have a different meaning, or any meaning at all?
­— Stephen Goldman

All the Al Chet prayers are about behaviors and intentions. Those are important, but what is not included is how we take so many things for granted. Life. Longevity. Family. Friends. Health. Every year, we pray the same prayers, never really stopping to think: “What if this is the last time I say these words?” We don’t take the time to really think about the importance of the words we recite and to ponder their importance or lack of importance to us.

And the Days of Atonement become a blur, a way to mark another year that has passed; another set of family meals. The words and intention and fasting are designed to open our hearts and minds to God and others, to pull us from our everyday petty needs, wants and egos to try to become better people. To achieve teshuvah.

Yet, when faced with death, one’s focus tends to be on fewer, more important things. Family. Friends. Making amends with others. Reaching out to God for help, understanding and, yes, forgiveness for yourself and from others.

Psalm 90:2 asks God to “teach us to number our days so that we may achieve a heart of wisdom.” All of us should know that our days are numbered. When you are dying, the numbers come into greater focus and the focus shifts. Life becomes about connections between you and people important to you and between you and God. You become acutely aware that time is finite, that your time is limited to do things you want to do. That your time is limited to be fully alive, to appreciate the world and universe around you. That you must open up your heart in ways you have not, to work toward that elusive heart of wisdom.

But what do I, like others in this situation, now hope to atone for? To paraphrase one of the four questions of Pesach: Why are these days of atonement different from others?

My head spins with questions … and ultimately turns.

Read Petite Essays On Mortality from writers who are connected to the Jewish Hospice and Chaplaincy Network.

Teshuvah … to turn.
A difficult metaphor.

And I think that I begin to understand.  The word “turn” can be used as a verb, an action word or as a descriptor such as the word turning, an adverb. Taking that one step further, either use of the word implies a change of direction. Turning takes time. It can happen in a split second when you hear something loud coming from behind you, or it can take hours or days, like a large ship turning at sea.

Or it can take a lifetime.

I finally understand that turning is a process, not an end point.

First, you must recognize the need to turn. Something stirs, wakes up inside you and asks you to be still and listen. It does not matter what prompts you to listen.  What matters is that whatever prompted you, you take the time to listen.  Perhaps it is a simple change that needs to be done or it can be a life-altering event. It may be a gentle nudge or a shout from the rooftop. Just listen.

What if we all knew our time was growing short? What would our focus be in prayer?
— Stephen Goldman

Second, there is the intent to turn. You have listened, and now are deciding how and when to act. The intent is to build a process and gather the energy to start to change direction. Maybe you decide to reach out to someone to correct an old wrong. Perhaps you begin to meditate or seek counseling to decide your course of action.

Third is the actual process of starting to turn. Like intent, this can happen quickly or it can take months or even years. The important part is that the process has begun.

In our demanding, goal-driven society, we are tempted to think that everything has an ending, that we have to achieve specific goals or else we fail. God, however, does not demand we achieve perfection and does not require that we even complete the process. But God begs, pleads and demands that we try. That we try to open our hearts, to understand that we should learn to number our days, to come to love and respect our fellow humans, and come to learn and respect God, the source of all life.

If teshuvah is indeed a process, and part of it is asking forgiveness at the end of our lives, what should we ask forgiveness from? On this Yom Kippur, as I realize my days are numbered, as I pursue the never-ending process of teshuvah, the ritual of the Al Chet makes me stop and think and listen in a different way. To things that are truly, deeply important. To goals that allow us to achieve a heart of wisdom, to open our hearts to God and others around us.

In other words, what do we really want forgiveness from?

For the sin of pushing You away when
I need you the most.
And for the sin of thinking that you have abandoned me.

For the sin of not looking in my partner’s
eyes and telling that person how much
I love him or her.
And for the sin of not reaching out for my partner’s hand.

For the sin of missing the beauty of the world and the universe because I am too distracted.
And for the sin of taking for granted the gift
of all life, including my own.

For the sin of wasting precious time that
is given to me.
And for the sin of thinking when I
was younger and healthier that I would l
live forever.

For the sin of only giving, but not receiving.
And for the sin of only receiving,
but not giving.

For the sin of not reaching out to
friends and family.
And for the sin of rebuffing their efforts.
For all these, God of pardon, pardon us,
forgive us, atone for us.

For the sin of thinking I cannot make
a difference.
And for the sin of acting like I cannot
make a difference.

For the sin of not truly, deeply listening
to my children and my spouse or partner when I am tired and wrapped up
in my own problems.
And for the sin of thinking that my input was not important.

For the sin of thinking I have to be perfect.
And for the sin of not trying my hardest.

For the sin of not listening to the sounds
around me,
And for the sin of acting like the sounds from my mouth are all that is important
to be heard.

For the sin of closing my heart to
the needs of others.
And for the sin of closing my heart to You.

For the sin of thinking I am alone.
And for the sin of acting like I am.
For all these, God of pardon, pardon us,
forgive us, atone for us.

To me, at this Yom Kippur, in addition to the classic words of Al Chet, these words will be upon my heart, upon my soul and upon my lips. I know that others, like me, who are facing the end of their lives may add or subtract to these prayers.  That is good, for all prayer is personal as well as communal.

And so, at yontef this year, look around you. Reach out to those who are quietly living life as best they can. Tears at Yom Kippur services are not just for those who we know are ill or who have passed into memory. Sometimes tears are for ourselves, for what we fear we will face in the year ahead. Tears for who and what we will leave behind. Tears that we will be forgotten in the headlong rush of time.

Tears from the struggle of trying to find new meaning and relevance to a service that has been so familiar but now is seemingly different when our days are numbered.

This Yom Kippur, let us pray for a good year, a sweet year with our family and friends. Let us pray that no matter what circumstances we may face, we will remember that teshuvah, like life itself, is a journey. And let us pray that when our time comes to leave this good Earth, we will fall gently into God’s loving arms and hear:

“Welcome home. You did well. Salachti. You are forgiven.”

Stephen Goldman, 60, and his wife, Deborah, reside in Novi. He recently retired from his medical practice in Novi where he specialized in osteopathic manipulative medicine and sports medicine. He is the author of many medical articles and essays. 

Read Tears on the Window, one of Stephen Goldman’s 1989 short stories.

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