Rosh Hashanah 2011: The Unwashed Poor

By | October 3, 2011

Poverty comes in all shapes and sizes. Sometimes it evokes a natural feeling of sympathy, while other times...

In the previous blog we looked at a little girl, a fairly sympathetic figure, but we know, at least in normal times many of the poor amongst us are not so sympathetic. Studies of poverty going back at least as far as the 1950s and 60s show a strong correlation with IQ. This in turn correlates strongly with the individual’s history of making chronically poor choices in their lives. Many have severe psychiatric problems, but are noncompliant with the medical regimens that might ameliorate the effects of their disease. And then there are the alcoholics and the drug addicted among us.

It is easy to feel sorry for the little girl from the last blog but what about the cigarette smoking hobo pictured above. Perhaps we should look at one of the later Hebrew Prophets, missing from the Old Testament, but possessed of a Canon all his own.

5:46 For if you love those who love you, what reward have you? Do not even the publicans the same?

5:47 And if you salute your brothers only, what do you more than others? Do not even the publicans so?


It is hardest to help those who will not or cannot help themselves, but we are not absolved of the obligation to try. A concrete example may be helpful. I see a great many patients who suffer from chronic pain and also the complications of prescription drug addiction. Am I justified in turning these people away because one of their problems is condemned by society?

Our prophet from Nazareth admonishes:

7:1 Judge not, that you be not judged.


But I prefer to say only that it is my job to treat the patients, not to judge them. The other is someone else’s job. So treat them, we do. We try not to give them the drugs that they abuse and there usually are other ways. When I have no choice but to prescribe narcotics, I do so only for short periods of time and in very small amounts. The patients are warned that if they do not take the medication as directed or seek more pills from other providers, I will cut them off. I never feel quite as good about treating these difficult patients as I do the more sympathetic and compliant ones, but I accept it as part of my job and try to make the best of it.

L’Shanah Tovah! Happy New Year!

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