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WRITING
105
PRESCRIPTIONS AND
USING INSTRUMENTS
ON SHABBOS IN AN
OPHTHALMOLOGY
DEPARTMENT
1 Questions Shabbos in an OphthalMology DepaRtMent
I wish to ask a number of questions relating to my work in the oph-
thalmology department in the hospital on Shabbos:
1. It is an international law that a physician is obligated to record
his instructions regarding medication and treatment in the pa-
tient’s chart. The nurses carry out the instructions according to
what is written in the charts. It is forbidden for a nurse to give
medication without a physician’s order and signature.
What should a physician do on Shabbos when he gives orders to
administer medications to patients with eye ailments in order
to save them from danger to their lives? For example, patients
hospitalized after surgery for cataracts, retina, or for glaucoma,
receive drops and compresses and capsules according to their
needs, to prevent infection, to balance the pressure, and to min-
imize the level of reaction in the eye. Is it permissible for the
physician to write?
It is well known that there is an oculo-cardiac reflex: when stress
or pressure is put on the eye or the extra-ocular muscles of the
eye are pulled, this can slow down the heartbeat (bradycardia).
296 1 Medical-HalacHic Responsa of Rav ZilbeRstein
danger? Even if the danger will be after several years, we permit it
now. As the Gemara states in Yoma (84b): “…not only a possibility [of
danger] on this Shabbos but also a possibility [of danger] on another
Shabbos.” Obviously, this is not limited to Shabbos, but applies even to
endangered immediately is not proof of anything.
a number of years later. Therefore, the fact that the children were not
We can add to this the words of the Gemara in Shabbos (145b):
Rav Chiya bar Abba said to Rav Assi: Why are the birds in Baby-
lonia fatter than those in the land of Israel? …because they were not
exiled, as it says: “Moav has been at ease since his youth and he has
settled on his lees, he has never gone into captivity” (Yirmiyahu 48:11).
By contrast, birds in the land of Israel were exiled, as it is written:
“From the birds of the sky to the beasts, they have fled and gone”
(Yirmiyahu 9:9).
Although Rav Chiya lived about six hundred years after the Bab-
ylonian exile, the influence of the exile still expressed itself in the
offspring of the birds. Likewise, the after-effect of pain in the eyes
augmented by the pain of the circumcision is liable to express itself
after many years. In a similar vein, there are Rabbanim who have in-
structed people to write the words “may Hashem revenge his blood”
on the tombstones of Holocaust survivors, since the suffering they
endured certainly left its mark and hastened their death.
Therefore, the answer to the question – why do we not circumcise
the baby immediately considering that medicine has proven that
there is no harm to performing the circumcision – is that our Sages,
with their holy eyes, were able to see that there is a remote possibility
that the baby will be harmed, and perhaps it will only be expressed
years later. Therefore, we are obligated to give the baby seven days of
rehabilitation.
These are the words of the greatest of Torah scholars, the Ram-
bam (Mishnah Commentary, Shabbos 19:19): “And they said “until he
recovers,” meaning, until he is completely healed from his illness, and
the healing process is complete, and after the fever has subsided, he
must wait another seven full days, and these are the days of ritual
purity. Then he can be circumcised.” The Rambam adds that just as
Circumcision with an Eye Infection 2 285