by Dr. Noah Nesin
“Whoever destroys a soul, it is considered as if he destroyed an entire world. And whoever saves a life, it is considered as if he saved an entire world.”
Jerusalem Talmud, Sanhedrin 4:1 (22a)
This is perhaps one of our tradition’s most familiar and most often quoted teachings. I can certainly attest to its frequent citation among Jewish doctors who must take calls on Shabbat, who care about the granting of exception from the Sabbath’s usual proscriptions, and whose healthy egos enjoy the whole “save the entire world” thing. The Babylonian Talmud actually uses more specific wording: “…whosoever saves a Jewish life…” Most of us would be very uncomfortable with that level of particularism. I would argue that the Talmud’s instruction in this instance calls for particularism to an even greater degree.
Each of us ought to apply this wisdom to our own life. I am suggesting that you, whoever you are, reading this blog post at this moment, think about saving your own life, about living healthier, longer, and more intentionally so that you can continue to do those things that matter to you, to your family, to your people and to the world, and to do them longer and with sustained vigor. To think of one’s self in this regard is not an act of narcissism or isolated self-interest. It is an answer both to Hillel’s vexing question, “If I am not for myself, who will be for me?” and his more straightforward follow-up.
Many of us think of “saving a life” in the context of immediate threats to health or well-being, or, in the case of doctors, of their work to manage chronic disease and medical screenings or treatment that may help reduce the risk of dramatic diseases like cancer, stroke and heart attack. But in medicine, it is often the case that the most effective interventions are the least dramatic, that the most elegant solutions are the simplest, and common sense, person-based solutions trump complex (and often contorted) disease-based thinking.
There is such a simple and elegant intervention available to virtually everybody. It costs nothing, has very limited risk, can be obtained anywhere and in addition to helping to prevent diabetes, heart disease, stroke, depression, anxiety and obesity also effectively helps to treat those diseases. It has the additional salutary effects of giving you more energy while you require less sleep, decreasing your appetite, enhancing your sense of well-being, and improving your libido.
This intervention is regular exercise. I have seen it work to beneficial effect in every medical situation where it is embraced by the patient, and I see the significantly healthier lives of those who make vigorous exercise a regular priority.
Adapted exercise can make meaningful improvements in the health and well being of those who are disabled or homebound, a simple walking program can be initiated by even the most sedentary of the able-bodied, and the world of exercise options (Zumba, anyone?) makes excuses hollow. And exercise includes the opportunity for community in almost all situations. What could be more Jewish? My own passion is for bicycling, a relatively inexpensive and highly gratifying experience during which I have my best thoughts (such as they are), relieve the stresses of the day, gain insights into personal and professional challenges, and enjoy the sights and sounds and smells of rural Maine, the vitality of the streets of Boston, the graceful grandeur of the Berkshire mountains, the peacefulness of the Golan Heights, and the holiness (yes!) of Jerusalem. I also think our prophets may have foreseen bicycling as a Jewish endeavor. Isaiah 14:4 describes the cyclist’s figurative, if not literal ideal: “Every valley shall be lifted up, and every mountain and hill shall be made low; and the rugged shall be made level, and the rough places a plain.”
Each year at my work, I lead a biking group, which often includes many people who have not been on a bike since they were children and some people who have never done regular or rigorous exercise. Our guarantee is that we will start with rides that all can do, that nobody will be left behind ever, and that we gradually will increase the effort. By the end of the summer we do a 50-mile (somewhat hilly) ride to mark Community Health Center Week. These people rediscover their childhood joy in riding, break through their own perceived limits, and learn that they can do so much more than they imagined. You should join us.
Noah Nesin, MD is a family physician, Medical Director at Health Access Network in Lincoln, Maine and Chief Medical Officer of Maine Community Health Options, the state’s consumer oriented and operated insurance plan created under the Affordable Care Act. Noah, who does not have a sleek biker’s body, is an avid cyclist who has participated in five Ride4Reform bike rides in Israel.