B eing angry doesn’t really get you anywhere. Rabbi Naftoly Bier the rosh kollel of Greater Boston who I still call my rebbi always says “A person becomes furious because he wants to be in control but now that he’s angry he’s completely lost control.”

So Rabbi Bier encourages his students to learn Iggeres HaRamban. The letter the Ramban wrote to his son nearly a thousand years ago is still relevant as an essential plan for living a successful life: speak calmly avoid anger be humble think about what you want to say before you say it.

Armed with the Ramban’s wisdom I entered into my training as a psychiatrist — where I found myself constantly tested by various frustrating situations. Working overnight in the emergency room was often a serious challenge to the policy of remaining impartial and objective. There’s little more humbling than having someone spit at me after threatening to sue me at four in the morning before I even had the chance to introduce myself. I remember the first time I heard “you’re a criminal and psychiatrists are just in it for the money.” It hurt a bit. If I was in it for the money wouldn’t I have been a dermatologist or an ophthalmologist instead? But now after years of being insulted and threatened I’ve gotten pretty good at maintaining my composure at work. After all most of those insults might be true: I am bald Jewish and getting older.

I prided myself on never being angry in front of a patient and certainly didn’t expect the first time to be in front of a yeshivah bochur. Heshy was a bochur from Australia who had experienced his first manic episode right after Shavuos. There were several risk factors — including a family history of bipolar disorder in an uncle — but it was only after all the other bochurim took a nap after their cheesecake and Heshy continued to delve into the Zohar long into the following night that people started to get nervous. By the time I met Heshy I recommended he go to the nearest emergency room and seek inpatient psychiatric hospitalization. He certainly wasn’t dangerous but he hadn’t slept in days and was convinced that he needed to head to the Temple Mount to make a vow of nezirus.

Baruch Hashem I was able to coordinate a hospital stay at a local facility and Heshy began treatment. I spent time on the phone with Heshy’s father and with a social worker back in Melbourne. Heshy’s father a very accommodating man grasped the situation and told me he was sending his older son to bring Heshy back home. Two weeks later Heshy was cleared for discharge and we scheduled another appointment before he flew back.

He and his brother Donny came to my office and although it was clear that Heshy had improved he still needed care. He no longer wanted to become a nazir but he did tell me “I’m probably closer to being the next Rav Shach than being just another yeshivah bochur.”

“Heshy what medications did they give you when you left the hospital?” I asked.

Heshy handed me his prescription list when Donny suddenly spoke up. “You know Dr. Freedman being in the hospital didn’t help him at all. Hospitals just make people worse. We had an uncle who died in a hospital and was taking dozens of medications for bipolar disorder and in the end he had some sort of side effect that gave him a heart attack.”

I looked at Donny and told him “I’m so sorry to hear that. But the medications Heshy’s on are pretty safe. In fact he’s only taking two pills a day and they’re not the kind of medications that cause any cardiovascular problems.”

“I think just getting him out of that hospital is making him better ” Donny challenged.

“Donny ” I tried to explain “Heshy is still sick and needs to take his medications to get back to normal so that one day soon he’ll be able to return to yeshivah.”

“One day soon?” said Donny suspiciously. “He needs to get back tomorrow and he needs to stop listening to crooks like you guys who are slaves to the pharmaceutical industry.”

Heshy tried to shush his brother but Donny just plowed on. “What do you get out of this anyways? A few hundred shekels from my dad and a few thousand shekels in kickbacks from the drug companies?”

“That’s enough Donny.” I felt the heat rising as I spoke. “I don’t force anyone to do anything and I didn’t even prescribe the medications for Heshy; his doctor at the hospital did. The only reason I want him to take the medications is because he’s preparing to be the next Rav Shach and clearly isn’t at his baseline.”

Donny started up again and I had to take the liberty of shushing him myself this time. Unfortunately in the process I raised my voice. “Donny you need to leave my office now so I can help my patient.”

Donny stormed out of the office cursing me and slamming the door before sitting down angrily in the waiting room. It took a few moments before I regained my composure. “Heshy I’m sorry but your brother is out of control and my job is to defend my patients.”

Heshy nodded. “Let’s call my dad and see what he thinks.”

I was in agreement. We had a very productive conversation over the speakerphone and agreed that meanwhile Heshy would be better off at home. I also let Heshy’s father know that I was worried about Donny’s problematic behavior and that he might try to convince Heshy to stop his treatment which would be very unwise at the current time. Luckily we were all in agreement with this as well. He assured me that Donny was only there to get Heshy onto a plane back home and that he wasn’t about to let Donny make any medical decision on Heshy’s behalf.

After hanging up the phone I wanted to do right by Donny. I had no idea what his personal or family issues were but he probably wasn’t a bad guy and I needed to judge him favorably as a fellow Yid. After all he schlepped across the world to come and help his little brother get back home. It’s common for family members to have a tough time understanding the treatment process especially when they’ve had a previously rough experience with it.

“Donny ” I said gently as I went outside the office to bring him back in “I owe you an apology for raising my voice but you need to let Heshy take the treatment that will help him to recover.”

Donny nodded and half-heartedly accepted my apology with an embarrassed handshake. As I returned with Donny to the office the three of us sat together and I pulled a copy of Iggeres HaRamban off of the shelf and put it on the table in front of us. “We are all here to help Heshy be the best that he can be ” I said to them both “so let’s learn some Torah together in his zechus.”

Originally featured in Mishpacha Issue 687. 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.com.