| Calligraphy |

Heart Defects

“You need to choose to fight this monster or he’ll get the better of you. You can live a happy life, you can break free of this. The first step is to want to get better.”


“What’s your favorite part of your job?”

Standard second-date fare. But my mind races and my hands are clammy. What should I say? What can I offer that won’t add another lie to the growing pile?

“Um, uh, I love being able to help people.” Ugh, that sounds so lame. What am I, some starry-eyed 19-year-old? Those days are long gone. I try for some damage control.

“In the hospital, there are so many concrete ways you can make a difference. You’re seeing people at their most vulnerable. Spending the extra few minutes explaining a procedure—” help, I don’t think a nurse does that. Too late now, just plow ahead— “or, uh, bringing them the extra pillow,” yes, that’s the perfect nurse example, “all of it can make such a difference. I appreciate being able to impact people’s lives like that.”

Yosef nods his head slowly. That’s one of the things I like about him: He’s a great listener. He’s not thinking about what he’s going to say next; he’s fully absorbing what you have to say.

“It sounds like you’re a very dedicated nurse.”

My cheeks get hot. Quick, I have to move the conversation from this topic. I’ll just flip the question.

“So why did you become a social worker? Was it something you always wanted to do?”

He laughs, a rich, warm sound.

“Not quite. I mean, how many seven-year-old boys dream of being a social worker? Back then I was going to be a fireman — or maybe I was up to an astronaut at that point.”

He’s silent for a moment.

“I guess I wanted to do the same thing you do — relieve pain. But I’m trying to get to the pain you can’t see.”

“Do you ever feel like it’s too much? All the pain, I mean.” I’m asking about his job, but I’m thinking of my own.

He thinks for a full minute before replying. Another thing I like about Yosef, the way he thinks before he speaks, how he doesn’t feel compelled to fill empty spaces with chatter, and how he selects his words rather than dumping them.

“There are hard days,” he finally admits. “But facing pain head-on has a beauty of its own. I think half the world’s ills come from people trying to escape pain. When they’re willing to look it in the eye and tackle it — it’s a tough journey, but a rewarding one. There’s nothing like facing life with honesty.”


Facing life with honesty. His words stay with me long after he drops me off, they haunt me through the night. When I get up at four a.m. for my early shift, they follow me, mocking.

Once I get to Centerfield Memorial Hospital though, there’s no time for thinking. It was a busy night in the ER and there are four new patients on my ward. I’m instantly sucked into the rhythm of the ward, doing intake, analyzing blood test results, prescribing meds.

Three of the four patients are classics: an elderly man with a family history of heart disease; a driven, stressed businesswoman in her 50s; an obese man in his early 40s. When I enter the last room, I stop short.

A teenager lies on the bed, dozing. Her face is all gaunt angles, skin nearly translucent. I know the diagnosis before I even glance at her chart. Anorexia not only robs the body of all the nutrients it needs, it also wreaks havoc on the heart.  I stifle a sigh, look at the chart, and call the girl by name.


Her eyes flutter open. I give her a warm smile. “Good morning. I’m Dr. Langer. I’m an attending cardiologist here, and I’ll be treating you. I see you came in last night with a lot of pain in your chest.”

Melissa eyes me warily and says nothing. I’m not going to get into a power struggle with this girl — I’m sure there are plenty of people in her life doing that already. The nutritionist will be here in three hours; I’ll let her be the bad cop.

Instead, I give Melissa another smile. “Can I examine you?” I ask gently. She jerks her head in what can sort of be defined as a nod, then turns to the wall. I warm the stethoscope against my gloved hand and press it to her chest. Her heartbeat is frighteningly erratic. The tests showed that last night she didn’t have a full-blown cardiac arrest, but it was close. I note her fluctuating blood pressure and low body temperature, and I order another EKG, an echo, and more bloodwork.

I’m getting ready to leave when Melissa looks up.

“Will I die?” she asks.

I stop short.

It’s a question I’ve heard so many times. Usually, there’s barely concealed panic beneath the words, a terror the patient is trying desperately to keep at bay. This girl asks the question in flat monotone.

I sit on the edge of her bed and look her in the eyes. “What would you like to hear me say?” I ask.

She blinks, startled. But she recovers her composure quickly. “How about the truth?”

“Always a good place to start,” I say. Yosef flits through my mind, and I wince. I focus on Melissa. “Your heartbeat should regulate soon. But you’re going to need some nutrition to be able to recover. And whether that happens or not is up to you.”

She narrows her eyes. “Oh, give me a break. I know what you guys will do. You’ll give me an IV, or maybe even a feeding tube, and pump calories in my body, all the calories I worked so hard to lose. Don’t say it’s ‘up to me.’”

She’s been through the system.

“Yes, we will do whatever we can to keep you alive,” I tell her. “But the ultimate result is up to you. We both know all the ways to beat the system.”

For a moment the mask of indifference slides off her face, and I catch a glimpse of tortured turmoil. I grab my chance. “You need to choose to fight this monster or he’ll get the better of you. You can live a happy life, you can break free of this. The first step is to want to get better.”

A second later, Melissa gives an elaborate shrug and pretends to drift off to sleep. I stay another minute, wishing I could pump the will to live into her veins.


A fourth date is still nothing, I tell myself, trying to keep excitement — and its flip side, disappointment — at bay, as I yank on a tie and brush my hat.

The weather is balmy, and after I pick up Aviva, I suggest Summit Gardens, a huge park just outside the city.

We’re perched on a bench overlooking a placid lake, and Aviva starts telling me about her newest patient, who is anorexic. “It’s so hard to treat patients with eating disorders, they sometimes seem bent on destroying themselves.”

I raise an eyebrow. She must have caught it, because she rushes in to explain. “I know, I know, it’s not in their control. The urges are bigger than they are….

“We got a resident from psychiatry involved,” she continues. “He claims it’s a textbook case — distant mother, critical father. Apparently, it’s her third admission. He didn’t seem too hopeful.”

A sigh escapes me before I manage to swallow it.

Aviva looks at me curiously.

“‘Textbook case,’” I finally say. “Do you hear the arrogance there? As if those parents are just flat representations of ‘father’ and ‘mother.’ As if they aren’t two real, live people who are watching their daughter waste away, sick with terror.

“Doctors! All this focus on pathology. I see it again and again with my own clients — so much judgment from the doctors in their lives. Why can’t they take a good look at their patients and try to understand what hurts them most? Labels and assumptions aren’t good enough.” My voice is rising. I catch myself and lower my tone.

“Good thing those patients have a nurse like you. It’s the nurses who create the human connection, isn’t it?”

I offer her a warm smile, expecting her to smile back. Instead, she shrinks into the bench, and her face shutters. Have I come across as too harsh? Sometimes this woman confuses me.

“Let’s walk around,” I say quickly, rising to stand while searching for a safer topic. “So you mentioned you like traveling. What was your favorite trip?”

It works. As we walk up the gentle slope towards the lake, Aviva animatedly describes the week she spent in Panama and I’m telling her about the cross-country trip I took with two friends one summer. I try to describe Sedona, the beauty of the famous colored rock formations.

“When you’re there looking at all that, the world seems so expansive, so majestic,” I tell her. “After months of hearing about inexplicable pain, there was something so healing about being near all that inexplicable beauty.”

She’s looking at me intently, nodding thoughtfully. She gets it. She gets me. This feels so different from the last girl, the one who said, “Awwww, that’s so sweet,” when I shared this thought with her, and different from the one before that, with whom I wouldn’t have even allowed those words out of my mouth. Aviva has depth and doesn’t seem afraid of genuine emotion.

It’s just a fourth date, I remind myself again. Nothing ever gets too far. This is bound to blow up.

And the very next week, it does.


Good thing those patients have a nurse like you. His words replay in my head again and again, as I lie in bed after our date.

It’s normal to have insomnia while dating. I’ve heard my friends describe what they agonize about: What did he mean when he said that? Why did he change the subject when I finally opened up? Is the way he treated the waiter a red flag? And on and on.

The sleeplessness is nothing to do with Yosef’s behavior. What’s keeping me up at night is my own.

As I focus on the sliver of moon entangled in the branches outside my window, a memory floats into my mind. It’s of Jo-Jo Goes Shopping, a book my mother used to read to me when I was little, and years later I read it to a growing cadre of nieces and nephews.

Jo-Jo’s mom sends him to buy ingredients for lemon pie. He gets what’s on the list, but the candy aisle beckons….

Yes, it’s a bit predictable — Jo-Jo splurges on candy instead of bringing back the change — but the tales he concocts for his mom begins as fantastical and end as outrageous: He claims a bird swooped down and grabbed the change.

Here’s the problem: I’m Jo-Jo.

It started with a small tweak to the truth, a little shift to make reality more palatable. But I’m being forced to embroider and embellish the story, and soon I’ll be describing great birds swooping down on me.

Mrs. Gellis was the trigger.

Well, not really.

Mrs. Gellis was only responding to Tzvi Weber.

Yes, it’s definitely Tzvi Weber’s fault.

Tzvi was a nice enough date. A junior accountant in a mid-level firm, well-mannered and pleasant. He could chat about yeshivah, and elections, and sports.

Once we moved past those areas, his knowledge and confidence both plummeted, but he was normal and a mensch, and I was already 29 (and this was back when I thought that if I’d turn 30 without getting married, I’d become a pumpkin or suffer some other horrible fate), so I wasn’t going to say no until I was really, really sure there was no way I could marry him.

I need not have bothered being noble about it. He dropped me after the third date. And Mrs. Gellis, the shadchan, was not happy.

“Why?” she moaned to me early the next morning. “Why do you have to ruin every good thing I send your way?”

“Ruin?” I echoed dumbly.

“Yes, ruin! Look, it’s great that you’re so smart, and hopefully once you’re married, your husband will appreciate your gifts. But in the meantime, you have got to downplay those brains.  Luckily for you, you have that sweet, eidel look, so there’s some hope. But then there’s your job. What frum girl becomes a doctor? And a cardiologist no less!”

“I’m not a doctor yet, I’m just a resident,” I muttered.

That wasn’t a wise move (I should never open my mouth before I’ve drunk some coffee).

“Oh, a resident, pardon me. But even as a resident, you still manage to intimidate every single boy I set you up with. I don’t want to think what will happen once you’re a bona fide cardiologist!

“Boys don’t want to hear about how you diagnose some woman with Bardugo syndrome—”

“Brugada,” I say before my brain can stop me.

“See! This is exactly what I’m talking about! Tzvi is a really nice guy and he deserves better than a woman who talks down to him.”

“Talks down to him?” I was genuinely bewildered. “He had just told me a long, convoluted tale about this tax shelter he had managed to create for a client. I thought I’d share something about my day. And that patient really stumped me. She had the symptoms of—”

“Spare me. And spare your dates as well. No one wants to date a brilliant female doctor, the last thing you should do it is rub it in their faces.”

And then she hung up, leaving me to make a coffee — and cry into it. I don’t know if she cursed me or if she was just right about no one wanting to date me, but that was the last date I had for a full year.

Then my residency finished, and I was offered a fellowship in a prestigious hospital 300 miles away. I grabbed it. For two months I pretended shidduchim didn’t exist, but after my mother not-so-subtly asked me about the local shadchanim for the 84th time, I pulled out my eidel-meidel sweater, dabbed on some lipstick, and went to see Mrs. Rosen.

Mrs. Rosen lives in a rambling house painted teal, with little pots of fresh herbs growing on the porch. She wore a simple lavender dress and a beautiful tichel tied in an unusual twist. She gave me a smile that looked genuine with no undertones of pity.

“It’s always such a treat to meet someone new!” she said. “How is our little town treating you?”

I wasn’t going to tell her that I spent nearly every waking hour in the hospital and all I knew about her town was that it had a ridiculously small selection of chalav Yisrael Greek yogurts. I just smiled and said something about how beautiful the parks were.

She beamed back. “I heard from Mrs. Blau — she said she sees you in shul every Shabbos — that you work in Centerfield Hospital. She said she was in the hospital the other day, her husband has diabetes and it gets out of control sometimes, and she caught a glimpse of you in a white coat. So I guess that means you’re a nurse?”

I was about to correct her, when I stopped short. My hand clutched the tumbler of iced tea I’d been drinking, and my mind raced. I took a deep breath. The living room smelled like lemon and basil.

Sitting opposite that sweet stranger who knew nothing about me, I suddenly realized what a priceless opportunity I’d been given.

Was it a lie if I didn’t actually say the words? If I just gave her another smile, and sort of nodded my head?

Nobody wants to date a female doctor, Mrs. Gellis had assured me. But nobody minds dating a nurse. Doctors are intimidating, nurses are sweet. Doctors are arrogant, nurses are compassionate. And really, we’re all medical professionals; does it make such a difference exactly how we spend our time in the hospital?

That’s how my little lie was born.

Like Jo-Jo’s, it got bigger and bigger.


It’s Shabbos mevarchim this week, which means I have to head home. Or, to be more accurate, I have to head to my parent’s house; my own home is the little apartment I have on Spruce Drive. The house I lived in for the first 28 years of my life, minus my two years in Israel, never really did feel like home.

It is well-kept, Mom makes sure of that. It’s huge and balabatish, Dad’s job ensures that. The five of us did all the kid things there. We tumbled off the bus, ate supper, did our homework, brushed our teeth. We had playdates and Shabbos parties and even the occasional sleepover.

But there were also the things we didn’t do. We didn’t climb trees or slide down bannisters or try wacky science experiments in the basement. Dad’s explosive temper took care of that. And we didn’t argue or get into fights with each other. Mom’s high-strung nerves ensured that.

My siblings all escaped into marriage as soon as they possibly could. Somehow the formula didn’t work for me. The Melbroks’ fourth child was different; he didn’t snag a star shidduch within six months of starting to date. Nor within six years.

And that was when I realized that I needed to stop waiting for the good stuff to happen and do what I wanted to do. I did two things that year. I went back to school for a social work degree, abandoning the resume-perfect, glossy actuary job I hated. And I moved out of my childhood home.

There’s so much I love about my new life, from watching a client’s slumped shoulders straighten, to the nightly learning sessions I have with Naftali, my chavrusa from yeshivah who has a wife and four kids but can still pound the daf.

And I never want to step back into the old one. But kibbud av v’eim and the fact that I live just a 15-minute-drive away mean that every Shabbos mevarchim I walk up the familiar path with the familiar clenching in my gut.

“Hey, look who finally decided to visit his old folks,” says my father as soon as I step into the kitchen. He holds out his hand for me to shake.

“How are you feeling, Dad? How are things at the office?”

“Things are good. Old Ronny finally retired and I was able to give Ben his best cases. He’s doing great work. Just took the family to the Fiji for midwinter.” My father never loses an opportunity to remind me how well my brother is doing in his law firm. He looks me over.

“So how’s the famous psychologist?”

“Social worker,” I mumble.

“Right, of course, don’t aim too high, that’s always been your belief, hasn’t it?”

I’m Teflon. Their words slide right off.

My mother chimes in. “And did you see that piece about Elana? Can you believe she was in Entrepreneur’s 30 Under 30? I mean, she’s always been ambitious, but this is the big leagues. I have a copy of the article on the coffee table in case you want to see it.” I didn’t bother reminding her that she’d already sent me — and every other relative — a scanned PDF minutes after the issue hit the newsstands.

Mom takes a steaming pan out of the oven. “Want some fresh potato kugel? I made it special for you; we’re both on a low-carb diet.”

I was starving on the drive over, but I shake my head. No appetite.


Mom waits until the soup to ask about my dating life.

“So, anything on the horizon?” she says with forced nonchalance as she nibbles at a cauliflower knaidel (their only resemblance to the real thing is that they’re round). “Are you meeting anyone?”

Deflect and downplay is my usual route. But there’s a flash of something across Mom’s face — longing, or maybe simply sadness. And nothing gets to me like authentic emotion.

“Well, actually, I am.”

The joy on her face makes the admission worth it. But then her eyes narrow and the interrogation begins.

“Who set you up? Where does she live? What does she do?”

“It was Mrs. Rosen’s idea. She just moved here recently. She’s a nurse.”

Mom deflates. “Oh.” Nobody could pour as much disapproval into a single syllable as my mother.

“Hey, not everyone can be a doctor,” says Dad in his faux-jovial voice. “The world needs nurses, too.”

“I’m sure she’s very sweet,” my mother rushes to add.

“She is really nice. But she’s not a bland pushover if that’s what you mean. She’s bright and well-read and empathetic and….”

I trail off, suddenly realizing that I don’t want to tell my parents about Aviva, I don’t want to risk having to view her through their eyes, when there is still only the flimsiest of connection between us. Particularly when the things they admire are not the things I want in a wife, in the future mother of my children.

“So, when are you meeting her next? Would you like to bring her for supper? I can invite Elana and Avi too if that would be more comfortable. We could have—”

I hold up both hands. “We’re nowhere near that stage. Really, Mom, we’ve met only four times. It’s nothing yet. Probably will be nothing.” I feel like a traitor adding that last line, but I have to protect Aviva.

I have to protect myself.


“Dr. Langer, can you summarize the patient’s medical condition?”

We’re having a meeting about Melissa. I’m sitting at the scratched table in the conference room, along with Roberta, her primary nurse, and Denise, the ward’s social worker. The psychiatric resident — I think his name is Neil — is here, and so are Melissa’s parents, Lewis and Kate Henderson.

This is the first time I’m seeing them in the ward. They’re dressed impeccably; the mother has diamonds glinting on her throat, wrist, ears, and the father’s watch costs more than I earn in a year. I note the stiffness of the mother’s posture, the father’s comment that this better be quick because he’s wasted enough time on Melissa’s craziness already. And I can’t help but think distant mother, critical father.

Then I hear Yosef’s voice in my mind. And I look more closely. I notice Kate’s pallor beneath the impeccable makeup. I watch Lewis closely as he runs his fingers in circles over the wooden grain of the table, see the raw hurt in his eyes. Two people in terrible pain.

I take a deep breath and start to outline the ways in which Melissa is slowly destroying her heart. “Melissa is presenting with severe bradycardia, and she also has hypotension.” I notice the mother looks bewildered, and switch to simpler terms. “Malnutrition impacts the electrical activity of heart, and also causes the heartbeat to become erratic.

“Melissa’s heart is beating too slowly. In addition, her blood pressure is too low, which means the blood isn’t being pumped through her body at the rate it needs. All that leads to damage of the heart’s walls as they work harder and harder. The chambers of Melissa’s heart are enlarged.”

Lewis’s fingers are tracing smaller and smaller circles on the wood. Kate clutches her Gucci bag as though it’s a life preserver. I give them a small smile.

“The good news is that the damage can be reversible. If Melissa begins eating normally, over time, her heartbeat should rise and stabilize, and the muscles can repair themselves. At least at this point in time.” My voice drops. I hate having to share brutal truths. “However, if she doesn’t begin eating normally, soon the damage will be irreversible.”

Neil takes this opportunity to push for Melissa to be transferred to the eating disorder unit as soon as she’s medically stable. “As a psychiatrist I can tell you from experience that that’s our only way to guarantee she’ll gain weight.” The tone of his voice brooks no discussion, makes no room for anyone’s feelings.

I’m not the only one who’s bothered. “She’s been to an eating disorder clinic twice,” Denise says. “And while she initially regained a little weight, she lost it all within a matter of weeks. Force doesn’t seem to be the way to go.”

“What options do you have left?” Neil responds.

Kate looks down at the table.

“What do you feel?” I address the question to Kate.

She looks up at me, clearly flustered. “Um… I don’t know. I’m not the expert in eating disorders.”

“No, you’re not.” I say softly. “But you’re an expert in your daughter.”

She gives a brittle laugh. “I wish. I look at her these days and feel like she’s a stranger.”

“Could you get to know her? Could you meet her where she is right now?”

Neil and Denise both stare at me. I’m overstepping and I know it. But I can’t bear to watch Melissa’s parents give up in helplessness. Their daughter needs them to see beyond the demons consuming her mind, beyond the skeletal body, she needs them to acknowledge the pain that’s oozing out of every pore. To see her.

There’s a long silence, and when Kate looks up again, tears streak her face. “I want to. I just don’t know how.”

Denise reaches out and takes the perfectly manicured hand in her own. “We can help,” she says.


The lounge I choose for our fifth date is one of the city’s best-kept secrets. It’s nearly an hour from the frum community, so most people don’t even consider it. But it’s on the top floor of a 60-story building and has a panoramic view of the harbor and the finance district. At night, the smog and tired gray buildings fade, and a thousand lights are glitter sprinkled across the city.

On the car ride over we share our camp experiences. I learn that Aviva loves wilderness treks and admit that I’m terrible at baseball but can play a mean game of ping pong.

“Watch out!” she says with a laugh. “I’ve won a few ping pong tournaments myself.”

It’s only when we’re ensconced in leather armchairs, drinks on the coffee table, and a breathtaking view below us, that I describe a little of my Shabbos.

“There was a write-up about my sister’s business in Entrepreneur,” I tell her. “She’s on their 30 Under 30 list.”

“Wow,” she gives a low whistle. “Niiiiice.”

I give a perfunctory nod. Then she cocks her head to the side and looks at me intently.

“What does that mean to you?” she says.

It takes me a minute to be able to respond because no one has ever seen me like that.


The date went so well, I’m feeling cocky afterwards. And the next morning, when I look at my calendar, see that I have 12:45 dentist appointment, and realize that my dentist’s office is on the campus of the hospital Aviva works in, I decide to surprise her.

I head over to the bagel shop and order a tuna bagel, an iced coffee, and a blueberry muffin. Aviva told me she can go an entire shift without eating. Not surprising; nurses are notoriously overworked. Today, I’m going to make sure she’s well-nourished.

I’m humming when I pull into the Centerfield parking lot. In the lobby I scan the list of wards. Cardiology, Coronary Care Unit, Intensive Coronary Care Unit, Pediatric Cardiology, Pediatric Cardiac Intensive Care. Yikes, how will I find her?

I decide to go with plain Cardiology and head up to the sixth floor. The ward is busy, doctors hurrying by, relatives arriving with Get Well Soon balloons, aides pushing metal trolleys loaded with lunch trays.

I make my way to the secretary seated in front of two computer screens.

“I have a package for Aviva, Aviva Langer. She’s a nurse here. I mean, I think she’s on this floor, but maybe not….” I’m suddenly feeling foolish.

The woman fixes me with a withering stare. “Do you mean Dr. Langer?”

“Doctor?” My voice sounds weird.

She sniffs. “You men are all the same. You see a nice young woman taking care of your parent and assume of course she’s a nurse. But guess what? It’s 2023, and a woman can do anything she wants. Dr. Aviva Langer is a cardiologist on this ward. Do you want me to give her something?”

“Um, no, it’s fine, never mind. I’ll… I’ll… be in touch with her later. Thanks for your help.”

It’s only once I stagger into the elevator that I realize I tilted the bag, and there’s iced coffee running down my arm.


When I do my rounds, I’m astounded to find Melissa’s mother in the room at 7:30 a.m. Not just in the room, but actually interacting with her daughter. I mean, assuming you can call watching the same show interacting.

But still, this is serious progress.

“Good morning,” I practically sing.

“Hello,” Kate says with a smile that’s almost friendly.

Melissa is quiet. I approach her bed. “Can I listen to your heart?”

“As if I have a choice,” Melissa says.

“You do. If you say no, I’ll respect your wishes. Even as I’ll let you know it isn’t medically advisable.” What this girl needs more than anything, more even than medical treatment, is a sense of ownership. Of her body, of her life.

“Then the answer is no. You can’t check me.” Her voice is clear and firm, so different from her usual apathetic drawl.

“Okay, then. No examination today.” I let the stethoscope I’d been reaching for fall back against my white coat. I check her chart, glance at the heart rate machine she’s attached to. Stifle a sigh, it’s still erratic. But at least it’s higher than when she was admitted.

“So, what’s the plan?” Kate asks.

“You tell me,” I respond, looking straight at Melissa. “How do you feel about joining our eating disorder program?”

“You mean getting locked up and forced to eat disgusting amounts of food? What do you think I feel?”

“Doctor, can I see you privately for a minute?” Kate’s voice is shrill. She strides out of the room, heels clicking on the tiles, before I even respond.

“We’ll be right back,” I say to Melissa. A kaleidoscope of emotions plays across the girl’s sharp features. There’s defiance, then anger, then sadness, and then it all collapses into the dull blankness of defeat.

As soon as we’re both in the hallway, Kate whirls around. “What are you thinking? Why on earth are you involving Melissa in this decision about what to do next?”

“Because it’s Melissa’s life.”

Kate rolls her eyes in a gesture that reminds me a lot of her daughter. “Oh, you’re going to give me the whole speech about ownership and autonomy, are you? Well, listen. Melissa’s an anorexic,” she says. “She’s not capable of deciding anything.”

“Melissa is troubled, and is dealing with an eating disorder, but it’s not who she is. She needs you to see past the diagnosis.”

Suddenly, Kate slumps against the wall. She closes her eyes. “What if she dies?”

“The way to stop her from dying is to give her reasons to live. That’s not going to come from a protein shake.”

I leave the Hendersons drained. And my day has just begun. I examine patients, prescribe medications, sign orders for blood tests and stress tests, echocardiograms and MRIs.

By the time a grumble in my gut reminds me that I’ve put nothing in my mouth all day, it’s 1 p.m. I stagger into the staff room, rummage through the fridge for the yogurt I stashed there.

As I eat, I finally allow myself to check my phone for messages. There’s one from Mrs. Rosen. And, for a change, I’m actually excited to open it.

Until I see her text: Called you twice, no answer. Yosef just asked me to pass on a message. He said he would have been happy to date Aviva, but he’s not willing to date Dr. Langer. What on earth is he talking about?

The spoon drops from my hand, splattering blackberry yogurt all over my white coat.

Purple flecks streak my name tag.

Dr. Aviva Langer. Dr. Dr. Dr.


Damage control first.

Throw out the leaking iced coffee. Find a homeless guy near the hospital and deposit the carefully packed lunch bag in his hands. He gives me a toothless grin. I hope he likes blueberry muffins.

I glance at my watch. If I hurry, I can make a quick stop at home, change, and get to the clinic in time for my four p.m. client.

As I drive, my emotions are erupting.




A blue Camry slides in front of my car and I nearly crash into it. Stop. Right now you need to function. You can fall apart tonight.

I make it through the day: Change. See my clients. Update their records. Catch a minyan for Maariv. Drive home.

As I sink into my couch, my phone rings. Ma.

I groan. I can ignore this. But maybe something’s wrong?

Kibbud eim,” I mutter, jabbing the talk button.

“Hi sweetie, how’s it all going?”

“Fine, Ma. How are you?” Please get to the point and let me mourn in peace.

“We’re good. Daddy has a big case coming up, so he’s been putting in a lot of overtime.” There’s a pause. “I was just thinking about you. And wondering how things were going with that sweet nurse of yours.”

Nooooo, not now.

“Ma, she’s definitely not mine. And she’s not a nurse, she’s a doctor. I just found out.”

“A doctor! She must be so intelligent and ambitious!” Ma is delighted. Of course she is.

“Amazing for some other guy maybe. I just said no to her. Ma, I gotta go, ’kay? We’ll talk on Friday.” And for the first time in my life, I hang up on my mother.

She’s just given me another reason to stay far away from Dr. Langer.


Sunlight wakes me up at six a.m. I’m still fully dressed, sprawled across the couch, eyes gritty. I take a hot shower, head out to Shacharis. On the way home, my phone rings. Mrs. Rosen, shadchan.

“Hello,” I say warily.

“Yosef,” Mrs. Rosen’s voice is soft and compassionate. “Aviva would like to meet you one last time. She said she knows you owe her nothing at all, but she wants the chance to explain.”

“I don’t think that’s a good idea!” My voice is rough and angry. I take a deep breath, try to modulate it. “Mrs. Rosen, I really appreciate the time you put into this shidduch, but it isn’t going to work.”

“I don’t think we’re discussing this shidduch working right now. We’re talking about giving her a chance to explain, a way to provide closure for both of you. I’m sure you know how important closure is.”

She’s painted me into a corner. If I refuse, I’ll look unreasonable. And I can’t afford to have the best shadchan in town think I’m unreasonable. I sigh.

“Fine. Tell her to meet me at the entrance to Summit Gardens at two p.m. tomorrow.” I have a break then. I don’t really care if it’s convenient for her.

Mrs. Rosen grabs the opportunity. “Thank you, Yosef. I’ll let her know.”


It takes eight phone calls and the promise to take two night shifts before I’m able to find someone to cover for me.

As I drive to Summit Gardens, my hands tremble slightly on the steering wheel. Yosef is already at the entrance, pacing, his hands behind his back, face tight. The warm, open man is gone. He nods when I approach.

“Hi,” I say, and my voice squeaks. “Thanks for agreeing to meet.”

Another nod.

Was this a huge mistake?

“Should we go in?” I ask, pushing off the inevitable.

Yet another nod. We walk through the ornate gates, and I can’t help thinking about the last time we were here. There was so much promise, so much hope. Now there’s just ash and bitter regret.

We walk in silence until we reach the bench we sat on during that date a lifetime ago.

“Do you remember my patient with anorexia?” I find myself saying.

Yosef looks perplexed, but he says “Yes.” Finally. We’ve moved from nods to monosyllables.

“I have to admit that until I spoke with you, I did tend to see patients with anorexia from a place of pathology. I believed they were self-destructive and resistant, and the parents were usually distant and controlling.”

Yosef flinches at the description.

“It was wrong,” I rush in to say. “As you said, it was arrogant. These are people in pain, people with their own stories and journeys. Seeing that changed the way I interacted with them, changed my conversations.”

I take a deep breath. Why am I talking about Melissa? I’m not sure, but something propels me forward.

“Well, this girl I was treating, it was startling what happened when we changed our approach and asked for her input into the decisions about her care.”

Yosef is finally looking at me, his face curious.

“She agreed to go to a treatment center. Not the eating disorder unit the psychiatrist was pushing for, this place is supposed to be more holistic. A place where they’ll see her as a multi-faceted person, not as a girl with an eating disorder. It may not work, she’s very sick” — my voice is slick with pain — “but I think this may give her a real chance at recovery.”

I lapse into silence. It stretches for a minute, then two.

“Why did you just tell me that?” Yosef finally asks.

And suddenly I know the answer. “I guess I’m wondering if you could do what you advised me to do.”

“I’m sorry?”

“I’m someone who made a mistake. A big mistake. But I am not my mistake. There’s more to me than that.”

“You lied to me.” His voice is steely. “How can I trust someone who isn’t honest?”

“Maybe if you knew that person’s story it would change things.”

He shrugs, looks off into the distance, towards the water. “You can try,” he says finally.

It all tumbles out. The dream I’d pursued, the way it had come between me and every boy I met, the prejudices, the preconceived notions, the assumptions. The scathing comment from the last shadchan, the conversation with the current one.

“I never planned to lie. My friends will tell you I’m honest to a fault. I just…” suddenly, I’m so exhausted I can’t even finish the sentence. Shame burns on my cheeks, scorches my heart.

“You wanted to be seen for who you were,” Yosef says. “You wanted people to meet Aviva, not Dr. Langer.”

“Yes!” I nearly yell. “Yes, yes, yes.”

Now it’s my turn to stare at the shore ahead. “But I just made things worse,” I say in a low voice. “Now I’m not only a doctor, I’m also a liar.” The tears threaten to spill down my cheeks; I will them to stay put.

Beside me Yosef exhales. The anger seems to seep out of his body. He’s quiet for several long minutes, wrestling with something I can’t see. Finally, he looks up at me.

“You weren’t so wrong in your assumptions. I would have never dated a doctor…. Partially because of experiences I’ve had with too many of them. And partially… well, let’s just say that the topic of professions is pretty loaded in my family.” He gives a rueful grin, and it’s like the sun has emerged from behind the clouds. “Clearly I was also labelling people.”

A seagull circles above us.

“I’m not sure we can move past this,” he says, “but I’m willing to give it my very best shot. Dr. Aviva Langer, can I take you out on Thursday night?”


(Originally featured in Mishpacha, Issue 956)

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