אמצעי מניעה לאחר לידה (אי ספיקת כליות מילדות)
שלום אני בגיל 24 לאחר לידה רביעית . יש לי אי ספיקת כליות על רקע רפלוקס מילדות והקראיאטינין נע סביב 2.5 – 2.8 . אני
I am twenty-nine years old, single, and living at home. I am as religiously observant as I can be and as I know. I have a Gemara havruta five times a week and I try to learn and to absorb as much Torah as much as time and ability permit. I am a medical doctor, specializing in radiology in South Africa. I have completed two out of four years of my training. Training here is limited and almost substandard due to a lack of magnetic resonance imaging (MRI), which is very important, and a general lack of structured training and supervision (we have no department head) due to the general trend of emigration from South Africa for a variety of reasons (e.g., crime, uncertainty, etc.). The Jewish community is getting smaller!
My priorities, in order, are to get married and to complete my training.
I have a job offer in Birmingham (approximately seventy miles from London), England, starting this October after Sukkot. The radiology department there appears quite academic and efficient. They have training in MRI and have sufficient supervision. The course is five years long, during which one develops specific areas of interest. I would continue my training without losing any time there—that is, having completed two years of training in South Africa, I would enter into the third year.
I have no family in the U.K. but do have some in Paris, which is not too far away.
I would like to accept this post as I think that it would be good for my personal growth out of the home, and as well as for my training. However, Birmingham has only a small Jewish community and only two Orthodox shuls. The community consists of some local people and the students that attend Birmingham University. This means that there are not many eligible women, so I would only stay there for about six months, until I pass my final exams, which I could write in March of 1999. Once I’m already in England it will be much easier to get a job in another city like London or Manchester—these being places with larger Jewish communities.
The after-hours calls in the U.K. fall on Shabbos (this is the case in any city in the U.K.). Every month I would be on call one Friday and one Saturday. I have tried to arrange it so that I will not be on call on Shabbos but it is not possible on an organizational level to make such exceptions for me and not for other people. I would, however, be entitled to swap a call on a personal level on my own accord. The doctors that I spoke to there appeared to be quite flexible but I do not really know how flexible and for how long, or if they would accept money to do my calls. In South Africa I never have to do calls on Shabbos or Yom Tov; it is so arranged and is acceptable to all parties involved. If I resign from my job in South Africa, the chances of getting it again are low.
Can I go to Birmingham, where the training is better, the long-term future is brighter (as opposed to the future of South Africa), and—once I move to a larger Jewish community—there are more eligible girls, even though there is a chance that I will have to work on Shabbos?
Do I require a halakhic ruling or can I decide for myself (i.e., go and try to arrange things myself)? Do you think I should perhaps pose this question to someone else?
Firstly, we do not believe that you will advance on a personal level in Birmingham. The frum community is, as you yourself write, very small and we wonder whether you will even find a suitable havruta.
Secondly, and most importantly, you will undoubtedly have to be mehalel shabbat in Birmingham and you may not knowingly put yourself in a situation where this is what will happen, even if this means remaining in South Africa, where your specialization will suffer.
You should make efforts to find a job in Manchester, London, or Newcastle (near Gateshead) where there are very active communities and frum physicians and where you can be certain to swap Shabbat with gentiles or pay for a gentile stand-in and do extra weekday duties to show your sincerity.
I also spoke to Rabbi Y. Y. Neuwirth, the author of Shemirat Shabbat ke-Hilkhata, who heard the same pesaq from the late Rabbi Shlomo Zalman Auerbach.
How about making aliya, in spite of all the difficulties?
With all good wishes,
Prof. Avraham S. Avraham, M.D., F.R.C.P.
Rabbi Mordechai Halperin, M.D.
The following paragraphs were excerpted from Practical Medical Halacha (second ed.), Fred Rosner and Moshe D. Tendler, eds., p. 150 (p. 116 in first ed.).
Subject: Training in hospitals without Sabbath obligations.
Question: Is a physician obligated to seek training, employment or attending physician status at a hospital where there is a minimum or no conflict between hospital policy and Sabbath observance? Should a house officer seek training at an inferior quality hospital where he is “guaranteed” not to have to work on the Sabbath or should he seek training in a hospital where training and overall patient care is far superior, but where there may be interference with the Sabbath spirit but not with the observance of halachic restrictions? Must one compromise one’s medical education in order to simplify Sabbath and kashrut observance?
Answer: A physician must seek association with the most reputable and prestigious hospital possible to ensure excellent training and continuing education.
Comment: Jewish law requires that the physician acquire maximum skill and competence to practice his chosen profession. Therefore, he should forego the personal comfort and convenience of training in a hospital that is sympathetic to his religious needs in favor of the hospital that will provide him with the best possible training, provided that he is certain of his fortitude in maintaining all halachic requirements, despite the less favorable environment.
If the superior training is to be acquired at the price of Sabbath desecration even of rabbinic ordinances only, the student-physician must forego the educational advantages of the prestigious hospital. It is important to emphasize that residents in non-“shomer shabbos” programs have often found themselves under great stress from hospital administrations and mentors who are un- sympathetic to their religious convictions. Open discussion with the training hospital administration must be initiated before accepting such an appointment.
שלום אני בגיל 24 לאחר לידה רביעית . יש לי אי ספיקת כליות על רקע רפלוקס מילדות והקראיאטינין נע סביב 2.5 – 2.8 . אני
thank you very much- B"H my sister in law picked up the phone for me last week in Bayit V'gan. One question that remained unanswered
הרב ד"ר שלום רב. אני מטופלת (לאור וירוס הרפס) בזובירקס 800 מ"ג *5 פעמים ביום למשך שבוע ימים. בנוסף נוטלת כדור לכאבים ומשחה להרגעה. כדור
