last wishes

I recently finished reading Atul Gawande’s new book, BeingMortal: Medicine and What Matters in the End, and I loved it, just like I loved all his other books.  He is a great writer with great insight.  In this book he explores ways of caring for the elderly without robbing them of their freedom and sense of purpose – something being shuttered in a typical nursing home all too often does.  He tackles hard questions like whether hospice care and palliative care is sometimes a better solution than a medical intervention.  When has medicine reached its limit, who decides, and how?  He forthrightly admits that as a doctor, he and most other doctors don’t like to have these type conversations, but having them can lead to better care for patients.  The book is not just discussion in the abstract, as he demonstrates by recounting how he and his father dealt with these very issues during his father’s final illness.

I was thinking about the book as I reviewed the beginning of Parshas VaYechi and a diyuk of the Netziv caught my eye.  “Vayikrevu y’mei Yisrael la’mus…” The name Yisrael is used usually in connection with the spiritual side of Ya’akov’s personality; the name Ya’akov is connected with the mundane.  When Ya’akov called Yosef to make arrangements for his death and burial, he was not yet sick or decrepit.  It was Yisrael, the soul of Ya’akov, that felt that his days were numbered, even though he was otherwise still in good health.  He sensed, perhaps in ruach hakodesh, perhaps knowing that he was close to reaching a milestone age relative to his parents and grandparents, that the end would not be that much further off.  So he dealt with it – while he was still “of sound mind and body,” to use a cliché.  He made his wishes known to his children and had what must have been a very difficult conversation with Yosef.