Excerpted and adapted with permission from "Embracing Life and Facing Death: A Jewish Guide to Palliative Care," published by CLAL: The National Jewish Center for Learning and Leadership.

One of the paradoxes of the human condition is that even though we know that we are mortals, we wish that those we love could live forever. We also wish that our own lives could be lived out with less pain, suffering, uncertainty and fear. But incurable diseases know no boundaries of geography, religion, race or ethnicity. Life-altering sicknesses eventually make their presence felt in our lives, forcing unexpected changes.

But the ways we react to these changes vary in each culture and in each family. In the last decade, new advances in medical technology both have made it possible to live longer with serious disease and have complicated the choices we have in treatment. Collectively, these new realities have impacted the ways communities, families, and individuals are responding to illness.

If you or someone you love is facing such a life-threatening illness, then you may be asking not only the practical questions - "How will I find the support, comfort, strength and care I need to get through this?" but the existential questions--"Why is this happening? Why now? And what choices lie ahead?"

Addressing both sets of questions is at the heart of an honest, spiritual approach to illness. Being honest about serious illness begins with admitting that the ultimate causes of disease cannot be fully explained, well-intentioned prayer cannot save everyone, and medical technology has its limits. But what you do have power over is the way in which you can respond to serious illness.

Your response can lessen your pain and suffering, enhance the quality of your life, and in many cases actually extend life. A genuinely spiritual response to disease can turn a situation of deterioration and despair into an opportunity for finding purpose, evoking courage, fostering strength and promoting healing.

For centuries, Jews have developed a worldwide reputation for our ability to persevere through countless trials, and to survive the most brutal of regimes. In this way, Jews have been forced to make meaning out of suffering. That said, though, we have no corner on the survival market, nor a magic formula to bring to a time of crisis. In fact, Jews have drawn on strength from many sources-- from the wisdom contained in spiritual practices, from a deep sense of responsibility for one another, and from a covenantal connection to God.

A Jewish approach draws its power from some fundamental assumptions about life. Life is created, as the Genesis story reads, "in the image of God." From our very first stories, we affirm that each single human life has worth and dignity beyond any use or function--it is sacred in and of itself. From a Jewish perspective, human life, even in a state of frailty, is of infinite value. As one popular Talmudic saying goes: "If you save one life it is as if you have saved the whole world."

Even more important, though, is the sense that our lives are bound to one another - that in the connections we have to one another we experience what it means to truly live. As philosopher Martin Buber taught, we meet the sacred in the place that exists "in between" one another. A spiritual path centered on the self is only partial. In articulating a Jewish spiritual approach, we highlight our connections to each other, reflecting on the ethical teaching of the early rabbis "all the people of Israel are reliant on one another."

There is a profound integration in a Jewish spiritual approach, one best articulated by the 19th century sage Rabbi Nachman of Bratslav when he said: A person reaches in three directions: Inward, to oneself, up to God, and out to others. The miracle of life is that in truly reaching in any one direction, one embraces all three.

Reaching in, up, or out is no easy task. It would probably be easier to deny that disease causes change. But as difficult as it is to be honest about your fears of the future, it is only by articulating those fears that a vision for the time ahead will emerge.

How Jewish Resources Can Help
The Jewish approach to serious illness does not deny the reality of the disease, paper over the suffering, or expect "presto you're healed!" miracles. It is one that acknowledges that living with disease or debilitation is a profound challenge, which requires courage, sensitivity and reflection.

In this spirit, generations have turned to the Psalms--many of which are written from a place of brokenheartedness. Three thousand years before the birth of the blues, David sang of woe, loss, love, and despair, as in the 77th Psalm, where he cried:

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