R

av Izzy was a popular kiruv rabbi — one of Ohr Somayach’s finest — and over the years had built himself a name as a force to be reckoned with on college campuses, fighting for Yiddishkeit and against assimilation in some of the most unfriendly arenas.

Rav Izzy could play the debate game and knew how to talk about the Big Bang or evolution with kids who wanted scientific answers. He fought hard on campus against anti-Israel sentiment and Boycott Divestment and Sanctions, and turned this hostility around as a means to strengthen Jewish identity. And boy, could he sing at the Shabbos table. This towering figure would bear-hug his students during “Yom Zeh Mechubad,” as he regularly hosted 30 fraternity kids for Shabbos lunch and had them all dancing while gobbling down bowls of his famous cholent.

He was known and respected for his work in the community, where he’d become a much-loved figure — as he’d pat his ever-growing stomach and say, “Some people are already recognizing that I’m a big rav.”

Rav Izzy’s yearly Lag B’omer Bash was all set to be a tremendous success with well over a hundred students from six college campuses participating. The simchah and energy were palpable and the hot dogs and hamburgers were flying off the grill at breakneck speed. But after giving a particularly inspiring derashah and leading a wild dance with the boys, Rav Izzy began to feel something wasn’t right and sat down.

Apparently what happened next was that one of his students — who’d trained as a Hatzolah volunteer — recognized the shortness of breath and chest tightness as worrisome signs. Rav Izzy was reluctant to leave his Lag B’omer party but with the evening winding down and at his rebbetzin’s urging, he agreed to go to the emergency room to get checked out.

Baruch Hashem it wasn’t a heart attack; it turned out that Rav Izzy had pulled a muscle in his rib cage while trying to do a cartwheel with the students. But although Izzy’s heart was healthy, the doctor wasn’t going to let him off so easily.

Rav Izzy and I were old acquaintances, and on a trip back to Israel last week, he made an official appointment with me. As he sat down, he pulled out the ER doctor’s note and told me, “Apparently I have high blood pressure, high cholesterol, and high sugars. The only thing that’s still intact is my sense of humor.”

Reviewing a copy of his laboratory tests and his EKG, it was clear that Rav Izzy needed to take better care of himself.

“Based on these tests it seems like you’ve really got to be careful,” I said. “But why the appointment? I mean, I’m a psychiatrist — I’m not a cardiologist or a bariatric surgeon.”

Rav Izzy looked nervously at the floor. “I know. I just wanted to come talk to you because I’m anxious. So I thought… well, anxiety is a psychiatric problem, right?”

I asked Rav Izzy a series of screening questions, and it was clear that he wasn’t having PTSD, panic attacks, OCD, or any other form of pathological anxiety. Rather here was a guy who was legitimately worried about his health. He wasn’t worrying so much that he couldn’t sleep or was unable to teach his famous Rambam class at one of the local schools. But this news had been taking a toll on him over the past few weeks.

“I’m thinking about it a lot and yeah, I’m nervous. Hey, I’m only 42 and I have high blood pressure and high cholesterol and borderline diabetes. This is really bad.”

I had to agree with him.  “I’m nervous too, Rav Izzy. The Jewish People need you. Everyone knows how important your work on campus is.”

“Yeah, well, we’re here to talk about my anxiety, not yours,” Reb Izzy quipped. “So how do I know if I have an anxiety problem that needs treatment?”

It was actually a great question. I took some time to discuss the idea of dysfunctional anxiety as opposed to appropriate anxiety with Rav Izzy.

“What you’re experiencing, Rav Izzy, is very reasonable anxiety. What that means is that you’ve been given a bunch of troubling news, and if you weren’t a bit anxious about it, then I’d say you’re not in touch with reality.”

“Wait, so I should be anxious?”

“Absolutely. Anxiety is a good thing in this case because it will motivate you to lose weight, eat healthy, exercise, and do what you need to do in order to make it to 120.”

“So you’re saying that anxiety is normal then? It’s not some kind of neurosis, but a healthy reaction that’s supposed to get me to a better place? It’s going to help me do my hishtadlus and take care of myself?”

I was happy to explain. “Listen, Rav Izzy, my best buddy from residency training used to tell a story about the paranoid young man who came to the emergency room at Stanford. My friend, who was a medical student at the time, heard the patient’s story about being wire-tapped by the Feds and ‘seeing agents outside of his window.’ His mother had called the police, and now he was sitting in the emergency room telling his story to a medical student. ‘I’m not crazy!’ pleaded the patient, but his diagnosis of paranoid psychosis was clear — at least until three federal agents came to pick him up from the hospital and escorted him off to interrogation in an unmarked vehicle.”

“So he wasn’t paranoid after all, he was just realistic?” asked Rav Izzy.

“You got it. Just like you and I are delusional when we say that we talk to G-d three times every day because we’re the Chosen People.”

Originally featured in Mishpacha, Issue 713. Jacob L. Freedman is a psychiatrist and business consultant based in Israel. When he’s not busy with his patients, Dr. Freedman can be found learning Torah in The Old City or hiking the hills outside of Jerusalem.  Dr. Freedman can be reached most easily through his website www.drjacoblfreedman.com8)