On September 25, 1974 my 50-year-old father sustained a major heart attack. He was at home; I was in synagogue for Kol Nidre. It was my final year of medical school. I lived in Manhattan, but that day I returned home to my parents’ house following an all-day national exam given to senior medical students to determine if they qualified to apply for their medical licenses. My girlfriend at the time and I had the pre-fast dinner with my parents, and then she and I walked to synagogue.

When we returned home, I found a note from my mother saying that my parents had gone to the hospital. This was the exact situation I had been dreading for years, and now my fears were being realized! I was positive my father was having a heart attack. There was a lot of heart disease in my father’s family, and I had been worried about his health for years. I walked to Franklin General Hospital as fast as I could, not knowing if my father was dead or alive. His chest pain had started shortly after dinner, and fortunately he had had the good sense to tell my mother. His primary care doctor arrived at the hospital soon after I did, and he showed me my father’s EKG. It showed what doctors called “tombstone ST elevation” consistent with ongoing heart muscle damage in the area of the Left Anterior Descending (LAD) coronary artery, otherwise known as the “widow-maker”. There were still R waves indicating that most of the heart muscle involved in the heart attack, although in the process of dying, was still alive.

My father had a history of difficult-to-control hypertension, elevated cholesterol, obesity and a previous history of smoking. One of his doctors had told my father that hypertension was “The silent killer”. Now at age 50, he was facing “The silent killer” in living color.

I felt upset, anxious, angry, frightened and somewhat disoriented. I was afraid my father would die, and even if he survived this event, I was worried that he would not have long to live.

I went back to synagogue the next day. For me, as a 24-year-old, I still felt a sense of awe during Rosh Hashanah and Yom Kippur. For most of the year God was in the background, but He moved to the foreground during the High Holidays. I took the prayer describing God as omnipotent and omniscient (words I had to look up in the dictionary) seriously.

Unlike my older cousin, who when her mother underwent a breast biopsy for probable breast cancer, promised God that if the biopsy were benign (it was) she would no longer ride on Shabbos, I did not bargain with God. Instead, I would describe my feeling in synagogue as one of hoping. I hoped that if my father were allowed to survive at least until the Book of Life was sealed, maybe he would be given another year of life. In those days, I believed it might be true that between Rosh Hashanah and Yom Kippur God decided each individual’s fate. So, if my father could get through Ne’ila alive, maybe God-willing he could have another 12 months. I was focusing on one year at a time.

Visting hours were limited to 15 or 30 minutes twice each day. The afternoon of Yom Kippur I visited. Now the EKG showed resolution of the massive ST elevations. That and the fact that the R waves had disappeared suggested a large amount of heart muscle death had occurred. My father was alive, but with a significant amount of heart damage.

During the next several months I prepared myself mentally for my father’s death. I read Death as a Fact of Life by David Hendin. Because the last few months of medical school consisted of electives, I was able to return home every weekend. Ironically, during this period my father’s blood pressure was better controlled, and he lost weight. He looked great. As a sanitation worker for the City of New York, and because of the union, he was able to remain out on sick leave.

Then, during the evening of February 8, 1975, one day following his 27^th wedding anniversary, my father collapsed suddenly at home. He was again brought to Franklin General Hospital where he was pronounced dead. Unlike the claims in the Amidah, God did not bring him back to life.

In my sadness, I did not blame God, but I did feel at that time that God had the power to keep my father alive and perhaps grant him another year of life, and for whatever reason, He did not do that. That was naïve on my part.

Now, fifty years later, I think differently. If God exists, He is in the background, and He does not come to the foreground ever. To paraphrase George Carlin, God does not have the time to individually intervene in the lives of the several billion individuals who now inhabit this earth.

As a cardiologist, I have held two competing views. In my profession, I have often wrestled with the Angel of Death. Taking care of my patients is like playing chess. You have a general game plan; you make a move and then see the consequences (hopefully positive). The next move is contingent on the success or failure of the previous move. Sometimes these moves are minor, like moving a pawn. Other times these moves are very consequential, like moving the queen or protecting the king. Sometimes moving that pawn, a seemingly inconsequential move, can come back to haunt you. Until recently, I never thought whom I was playing against– the Angel of Death.

On the other hand, I also believe that when it’s your time, it’s your time. One might think that I reached this conclusion because I witnessed patients die who should not have. Just the opposite. I witnessed patients who should have died but managed to live, and live for years. One weekend day in 1983 I was called to the ER because the EMTs were bringing in a patient who was undergoing CPR following a cardiac arrest. After two hours from the beginning of his arrest I was asked when I would call the code. One could say his life was partly in my hands since I was the one who would make the decision about when to stop. I said that we would give him another two minutes. That is when he turned the corner. He was not out of the woods yet, but we were able rescue him from the grip of the Angel of Death. He recovered and returned to work, and he lived another 10 years.

Recently I met an older couple wheeling a stroller. We started talking and they told me that the man to whom I was talking had a previous cardiac arrest. He was brought to a hospital while they were doing CPR. Twice the doctor came out to the wife and requested that they stop CPR. Twice she asked that they continue. She did not feel ready to give up. Then his heart started. He is now the recipient of a new heart (heart transplant). It just was not his time to go.

Given that I believe when it’s your time, it’s your time, and God is not going to intervene, why do I go to synagogue almost every Shabbos? First, I like Judaism. It is a landmark religion, I want to be part of it, and I want to pass it on to my children and grandchildren. Next, we all need ritual. Years ago, one Thursday night I solicited someone for a donation for Shomrei. His answer was, “I don’t go, I don’t really need the shul, so I am not giving the donation.” The very next night I saw him at the synagogue saying Kaddish on the anniversary of his parent’s Yahrtzeit. During difficult times, such as the death of a loved one, we look to ritual.

But why go to shul if you don’t necessarily believe in God, or if you believe God sits on the sidelines? I don’t go as a supplicant. If anything, I feel lucky for what I have. However, for me there is a sense of holiness (separation) sitting in the sanctuary. The prayer service fosters a sense of a shared purpose as well as an invitation to become better than who you are. There is sense of peace and tranquility as well as the opportunity to sing in community. Emotionally, religion can give us strength and guidance in our lives.