[Avodah] Eating on Yom Kippur

[Chana Luntz]

RMB writes:
> Back to the KhC, in practice it's hard to think when you would have a real
> chashash which doesn't reach safek pikuach nefesh level. Usually if there's
> a real chashash that's already the kind of safek which would make it hard to
> say it's mutar to fast. And if >there's no chashash then how is he a choleh?

> So still having difficulty fitting the criteria of this halacha, as per
> KhC, into any modern medical scenario.

Don't know if it helps, but I just had a modern medical situation in
which at least one doctor (who is also a rabbi) clearly felt there was
a real chashash but still a requirement to fast (to the extent of not
taking medicines). Unfortunately I just didn't have time to get a second
opinion, and was completely baffled what to do, so I did what he said
(seemed easiest), but don't know if I was stupid or not.

Basically, somehow I got what the proscribing nurse at my GP surgery
thinks are bites from insects in grass that have become infected. Went to
the GP on Monday afternoon and was seen by the proscribing nurse, who
said - it is infected, you need antibiotics. I said to him - but I have
a big fast on Tuesday night/Wednesday - he said to me "I know you want
to fast for religious reasons, but your leg is infected, and there is a
risk of sepsis, which carries a risk of death!" - Bottom line - he didn't
mince around with it. So I got the prescription for the antibiotics, and
the instructions on them when I got them from the pharmacist was "take
four a day, an hour before food, or two hours after food". I said to
the pharmacist, does that mean that I can take them when I am fasting -
and she said "fine - better actually". But the person my husband often
asks shialas to is not only a rabbi, but a GP (ie a doctor), so I phoned
him up on Monday afternoon as soon as I got home.

He asked me lots of medical questions (did I have temperature (no -
36.9, the practicing nurse had taken that as well)), how far up the
leg was it red and swollen (about mid-calf), how long was the actual
"wound", how much was the dosage of the antibiotics (500mg), and then
he said - and I could have fallen over - I don't see a problem you not
taking them. Try and take two today (it is supposed to be four a day,
but it was late Monday afternoon by the time I started) and then try
and fit in four tomorrow before the fast, and then start taking again
immediately after the fast. A break of 25 hours won't matter! I said
to him that if I take the last one for the day right before the fast,
I will have just stuffed myself full of food, so it won't be "an hour
before food or two after". He said that didn't matter.

I said to my husband, I am not sure that I shouldn't be getting a second
medical opinion on this, and we tossed around some names, but while we
know a few frum doctors, none of them come near to the learning of this
particular doctor who is also a rabbi, and we honestly didn't have time
to go asking, even if I knew exactly how to ask somebody as to whether
they thought this course of action was irresponsible. So I did what he
said - and I guess if I end up in hospital or worse, you will know it
was not the right psak. The leg doesn't seem to have gotten any worse,
but on the other hand it doesn't seem to have gotten any better either
(I did struggle to walk to shul on it and sat down in shul more than I
would normally, but it was manageable, even without painkillers).

So here would seem to be a case where there was unquestionably a chashash
and I can't see how I can be described as anything other than a choleh,
but the rabbi/doctor was clearly convinced that stopping taking the
antibiotics for 25 hours was not a real risk - with the corollary being
that I shouldn't take them over yom kippur!! And while if it had been
somebody else I probably could have come up with a large number of
halachic arguments why one shouldn't do what he advised, but when it
is oneself that is very difficult (or at least I find it difficult).
And it is not really about how I felt, I was sure I would physically
manage over Yom Kippur - it is presumably really whether by doing this
I am giving the infection time to become immune to this antibiotic,
or to spread too far, or similar.

So to try and feed into the CKC's analysis, here there is presumably
a case where yes, there is a pikuach nefesh risk (I don't think the
rabbi/doctor was disputing the risk of sepsis), but the chashash was, as
this doctor/rabbi understood it, does one stop antibiotics for 25 hours
and then resume, and that risk presumably he didn't think was high enough.
And I have absolutely no idea what that risk really is.

Regards
Chana