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is not in danger to take it. According to the Yad Avraham, it is
                    permitted.
                  3.  If a chametz medication was created on Pesach itself, an external
                    ointment can be permitted. If the medication has to be swal-
                    lowed, and the patient is not in danger, one should be strin-                             DESECRATION OF SHABBOS
                    gent. For a dangerously ill patient, it is preferable that a gentile       96
                                                                                                              TO PREVENT A FAR-
                    prepare the medication, or that it be prepared differently than                           FETCHED CONCERN OF
                    usual.                                                                                    PIKUACH NEFESH







                                                                                                   1    Question


                                                                                               With Hashem’s help, I completed my specialization in internal med-
                                                                                               icine. I live in Rechovot, a 45-minute walk (at a brisk pace) to Kaplan
                                                                                               Hospital. As a medical resident, I would leave my house on Shabbos
                                                                                               an hour before the time I was scheduled to be in the hospital for my
                                                                                               shift and walk there and back.
                                                                                                  Today, as a specialist on call, there are several possibilities for how
                                                                                               I will need to carry out my duties on Shabbos:

                                                                                                  1.  A planned visit to the hospital on Shabbos morning.
                                                                                                  2.  Consultation by telephone, which may be urgent or not urgent,
                                                                                                    and at times requires several follow up phone calls.
                                                                                                  3.  Urgent consultation. For example, when there are two or more
                                                                                                    seriously ill patients in the emergency room, or during resusci-
                                                                                                    tation in a department where the person on duty is an intern or
                                                                                                    a new resident, they alert the internal medicine expert who is on
                                                                                                    call to come to the hospital.

                                                                                                  4. In a non-internal medicine unit: Every second Shabbos our de-
                                                                                                    partment is on call. It is protocol in our hospital that the inter-
                                                                                                    nists who are present in the hospital do not answer calls for help
                                                                                                    from other units, except if they have no choice, in urgent cases,
                                                                                                    and only if their own unit is quiet. For example, if a woman




        216              1  Medical-HalacHic Responsa of Rav ZilbeRstein                       a Far-fetched Concern of Pikuach Nefesh  2                      237
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