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 it is possible that after some time the baby will suffer if he is circum-  gated to arrange the payment in advance so that he will not have
 cised him during the seven days following his illness. So, too, in our   to desecrate Yom Tov in order to pay the driver.
 case, it is possible that after some time a heart ailment will develop   5.  A gentile driver – In places where a gentile driver is available,
 because of the retinal detachment, since our Sages have determined   one should not use a Jewish driver.
 that the eye depends on the heart, which is the king of all the organs.
 According to the Divrei Malkiel, one has to reckon with the possi-  6. Eiruv Techumin – If a patient knows in advance that he will
 #
 bility that retinal detachment will cause danger and if not now, per-  need to travel outside the techum on Yom Tov or Shabbos, he is
 haps after some time. Perhaps it is permitted for Jewish physicians to   obligated to place eiruvei techumin in place in advance.
 perform the surgery in such cases, where there is concern that the pa-  7.  Not desecrating  Yom Tov  in order to come home – One
 tients will commit suicide, as pointed out above by Dr. Tzvi Distenik.  should not return home from the hospital if doing so involves
                desecration of Yom Tov, because there is no pikuach nefesh on
 1   AnsweR to Question 2  the way home.
              A Torah observant person will be careful with all of the aforemen-
 If a patient who is post eye surgery, feels weak because of the pain,   tioned details and it is therefore preferable for him be scheduled to
 and wants to eat on Yom Kippur, since the wound is internal and the   come to the hospital on Yom Tov.
 patient is asking to eat- meaning that his illness will worsen if he does   Despite this, if the physician feels that traveling on Yom Tov will
 not eat- according to the Mishnah Berurah (#618:2) he is allowed to   seriously bother the patient, ruin his pleasure in the Yom Tov, and
 eat. One can certainly be lenient in allowing him to eat half a shiyur,   cause him great anguish, to the point that he will feel none of the
 and it would be most preferable for him to make do with eating a raw   holiness of the holiday, then there is no prohibition against accommo-
 potato.   dating his request. This is also not causing the other dialysis patient

           to sin, since he too is a dangerously ill patient, and thus permitted to
 1   SuMMaRy and Conclusions  travel. The facts that he will arrange for a driver on Yom Tov, activate
           the meter, pay the driver, and go outside the techum were not caused
 Regarding question 1:  by the doctor. In the doctor’s point of view, everything could be done
 In the first case (endophthalmitis) and in case 3 (deep wound in   in the halachically allowed way. Therefore, the doctor is not guilty of
 the eye) one should treat immediately and desecrate Shabbos and Yom   “do not put a stumbling block before a blind man.” (Vayikra 19:14)
 Kippur for these life-threatening conditions.  This is especially so if one can assume that the second patient
 In the second case (retinal detachment), it would be best to have   will write, water his garden, or do other transgressions on Yom Tov
 the surgery performed by a gentile physician. If that is not possible,   at home. He will thus not be desecrating the Yom Tov any more by
 perhaps the surgery should be done by a Jewish physician. The matter   travelling to the hospital. In fact, there will be less desecration since
 needs more study. If there is a possibility of suicide, it is permissible.  he will be involved in permitted activities. If this is the case, then one
 Regarding question 2:  should accommodate the wishes of the Torah observant person.
 If the patient says “I need to eat”, one feeds him. And it would be   So, too, in question 2:  It is preferable that the Torah observant
 good if he could eat raw potatoes or the like.  physician take his shift in the hospital on Shabbos, since he will try to

        avoid and prevent desecration of Shabbos as much as possible. He will




 308   1  Medical-HalacHic Responsa of Rav ZilbeRstein  Shifts on Shabbos and Yom Tov, Dialysis on Chol Hamoed  2   337
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