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 medical experience. B claims: “It is not my turn now. The patients in   his daughter who had suffered a miscarriage. He asked the admin-
 my unit need me and I do not have the strength nor the time to treat   istrator to wake up the expert physician (who sleeps in the hospital
 the seriously ill patient, as well as my own patients. Tomorrow morn-  and is awakened to deal with difficult cases) in order to perform a D
 ing, I am scheduled to continue working, and if I take this serious   & C (dilation and curettage) on his daughter. At that time, there was
 patient now I will not be able to sleep during the night and will be less   a good physician in the hospital who could also perform the D & C,
 productive tomorrow.”  but this person wanted the expert physician do it. Was it right to heed
           his request?
 Is it his halachic obligation to accept the patient, or are his claims
 justified? Since the hospital relies on interns, the care they provide
 is considered okay. Perhaps the veteran resident should devote his   1   AnsweR
 energies to the patients who came first?
           Logically, hospital procedure dictates that if a good physician is pres-
           ent on site, we reserve the more expert physician for difficult cases. At
 1   Question 2  the moment, the expert is sleeping so that he should have the strength
           to perform if truly necessary. Therefore, one should not awaken him,
 In the orthopedic specialty unit there is an orthopedic surgeon who   even though an important and honored man is requesting it. One
 specializes in surgery of the hand. He was told by the Director of the   should not comply with the request at the expense of the public.
 department that any patient who has a surgical hand problem would   Even if the man who made the request were a Torah scholar, whom
 be referred to him. The expert hand surgeon claims that patients   we are obligated to honor, it would still not be proper to awaken the
 should be referred to the care of the orthopedist in line at the time.   expert. As explained in Tractate Kesubos (105b), Rav Nachman in-
 If someone with a hand-problem lands up by him, that is his luck.   terrupted a case involving an orphan in order to deal with a case of
 If not, and he wants to be treated by the expert hand surgeon, then   the “relative of Rav Anan” since the positive precept of “Honor the
 he should pay a separate fee. The other physicians in the department   Torah” takes precedence to that of judging cases in the order that
 are all orthopedists who can provide reasonable treatment, but this   they arrive. We also find in Hilchos Tzedakah (Yoreh De’ah #251:9)
 physician is a greater expert on the palm of the hand.  that when public charity funds are limited, a Torah scholar who is a
           mamzer comes before a Kohen Gadol who is an ignoramus. In other
 1.  Can the director obligate this orthopedic surgeon to accept all   words, the obligation to respect Torah scholars often dictates halacha.
 patients needing hand surgery, even though this will increase   Even so, we should not wake the expert physician upon the request
 his work load, which will require him to work additional hours   of a Torah scholar. When the physician is sleeping, he is exempt from
 that he would prefer to dedicate to his private clinic, where he   honoring the Torah. Also, the administrator has no right to change
 can earn much more money?  hospital procedure for a Torah scholar, and certainly not for any other
           honored person.
 2.  In the above case, is the Director of the department obligated to
 compensate this physician more than the other physicians?
               1    AnsweR to Question 2
 3.  Is the physician’s request in line with halacha, in the event that
 people are not prepared to compensate him separately?  Concerning the question about the expert orthopedist who refuses




 192   1  Medical-HalacHic Responsa of Rav ZilbeRstein  Division of Work in Hospital  2   197
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