M ost psychiatrists aren’t lacing up their basketball shoes during business hours.

Then again this wasn’t your average situation.

As part of the painstaking process of transferring my medical license after making aliyah I suddenly found myself working for a stretch in the Wild West of psychiatric hospitals. Back in the US I’d grown accustomed to rounding on all the patients with a multidisciplinary team. Here though there was only one nurse for the whole unit and she was way too busy for anything besides emergencies. Back in the US I’d seen my patients in a treatment room overlooking a serene lake. Here our patients were regularly admitted in handcuffs and interviewed chained to their beds. Back in the US I’d gone to work each day wearing a suit. Here I hadn’t seen a doc with a tie in months.

Convention was out the window and I was forced to bring an open mind to work each day. So when my patient Gil challenged me to a game of one-on-one outside on the hospital’s basketball court I did the natural thing and brought my old Nikes out of retirement. Lacing up my shoes evoked some nice nostalgia of my glory days back in college. But today the stakes were a bit different.

Gil was a young man with a history of bipolar disorder and many psychiatric hospitalizations who was currently manic and happened to think he had messianic powers. He had scared enough people in his neighborhood and was now sitting in our hospital following a court order. Hospitalized against his will he was refusing medications — and he told me that if I managed to beat him on the basketball court he’d be willing to take any medication I picked.

“And if I lose Gil?” I asked wanting to make sure we had set the parameters straight before we started to play.

“Then you agree that I’m probably Mashiach ” he said.

“Can’t do it Gil ” I told him. “Something else you want if you win?”

“You gotta promise that I don’t have to take any meds if I win ” he said.

“Fine... you start.” And so I tossed him the ball and we began our game.

In spite of the stakes the play-by-play details of the game weren’t particularly interesting. Gil was about five and a half feet tall and I stand at over six feet and used to be a pretty good player. I beat him handily and he demanded a rematch which I won again just as easily.

“I’m still not taking your meds Dr. Freedman ” he screamed at me after I scored the final point of our second game.

“You were never going to take them anyway Gil ” I responded calmly tossing him a towel and his water bottle.

He was still pretty angry but nodded and said “True. But would you have kept your word and let me go without meds if I had won?”

It was a tough question but I was prepared. “First off you weren’t going to win Gil. I’m half a foot taller than you and I used to be a decent baller. Plus you’re super overtired because you haven’t slept in days. But even so I would have kept my word if you had won because it’s halachah. But perhaps most importantly I’m not in the business of forcing folks to do stuff. I’m in the business of working on a team to help folks out.”

He was more relaxed but still a bit incredulous and responded “But for real you wouldn’t have tried to force me to take meds if I had won?”

“Nope ” I said. “I think you’d benefit from medications but you’re not interested in that right now. In the end it’s not up to me anyway. Your next court hearing is in a few days and the judge will be the one who makes the decision about whether or not you’ll have to take medications.”

“I hear that.” Gil was somber for the first time since I’d met him more than a week ago when he was brought in by the police. “Maybe we could play again tomorrow anyway?”

“Sure Gil. But you have to agree to take your medications if I win.”

He smiled. “I guess I can agree to that now that I know you’re an honest guy and not just some shrink who thinks he can lie to me and hide behind a beard and a kippah.”

“I got nothing to hide Gil ” I told him trying to look as honest as I could beneath my beard. “So you’ll agree to take your medications whether I win or not?”

Gil laughed and told me “I appreciate your honesty and I’ll be happy to repay the favor to you.”

“So you’ll take them if I win?” I asked for the third time.

“Absolutely not ” laughed Gil. “But at least I’m being honest with you that I’m not gonna take them either way and that should be worth something... right?”

“It absolutely is Gil and I thank you for it.”

And so we spent another few days on the basketball court together until Gil’s court hearing. Frankly I’m still not sure which of us was more surprised to hear that the judge was willing to let him leave the hospital without medications. But perhaps the bigger surprise was finding out from Gil that he was willing to stay in the hospital to take the medications anyway.

When I asked him why Gil was as honest as could be and told me “I wanted to keep my word from the original wager.”

I almost let him beat me on the court that afternoon.

Jacob L. Freedman is a psychiatrist and business consultant based in Jerusalem. He serves as the medical director of services for English-speakers at Bayit Cham a national leader providing mental health treatment and outreach within the religious community. (Originally featured in Mishpacha Issue 654)