סטודנט לרפואה הסובל מבעיות פסיכיאטריות + מחלות מעיים

To whom it may concern,

I am a 27 year old medical student and I learned in Yeshiva for a significant amount of years), I am married with one child. I have Crohns (diagnosed by biopsy and colonscopy), Lupus (I have 7 for the 11 criteria) and bipolar 1 disorder with psychosis (that could be bipolar or Lupus related). I have had a lot of troubles with my health over the past three years with all my disorders and have been on numerous medications. I have both Halachik and Hashkafik questions.

First off shacharis has become a big problem for me, both technically and Mussar/Hashkafikly. For example I was in the bathroom this morning until 10:30AM (explosive liquid diarrhea). However, I didn't Daven until 11:40. Although, saying krias Shema before zman is over, it is easy to walk aout of the bathroom and simply say kriat shema. However, making zman tefila is very difficult. Should I quickly put on my teffilin and say Shemoneh Esrei, I don't even know on bad Crohn's days if I can stay out of the bathroom long enough to say the modicum of psukei d'zimra, and birchat kriat shema. However, on some days I can. If I am well enough in the morning to go to minyan then I obviously daven b'zman and my davening is good. But when I don't feel well my kavanah is horrible. I know the Shulchan Aruch says a choleh is patur from tefila (Ramah argues) it seems to be crazy to do this on a daily basis – however, on the other hand it is hard to daven b'zman on a daily basis when one is so sick. Furthermore, the longer I don't go to minyan the more my kavanah suffers. However it is worse if I am holding explosive diarrhea in. What should I do with regards to Tefillah? Do you have any idea how to keep up Kavanah in this situation?

Secondly, I find myself drowning in my own work due to my illness, and to add a seder to this is really difficult. Although, during the small periods of remission I have – I find myself having very nice sedarim? How does one balance, very severe illnesses, medical school and a chiuv talmud torah?

When I don't feel well I find myself having lazy, spending a little more time reading the paper, etc. Although when I am healthy I rush to do my research, learn torah and I obviously spend loads of time studying medicine. This may make sense for a person who gets sick once a year or even a month – for someone who gets as often as I do this poses many problems. This is particularly difficult because I have a psychopathology and my manic episodes are really bad – I do not enjoy them at all and they are very disruptive.

These diseases have made me very much a somewhat hermit, I do go out once and a while. I go to Mincha Maariv almost everyday and I try to learn in a beit Midrash. But I have set up my study as a complete study center with a desk an entire library of sefarim – completed with newest edition of the bar-ilan cd. What should I do?

Finally and most importantly, I would like to have some halachik and mostly hashkafik framework to see my experience. Now the physical ailments are easy there has been much ink spent on it and it is only theologic question a sefer about, aka Iyyov (which I have read with mefarshim). However, a psych disorder is very difficult for me to comprehend. I spoke to a gadol about this and he told me your real problem is that yahdus is based on bechira chafshis and psychiatric diseases (in particular psychosis) takes away ones bechira chafshis. Is there anyway to see this through the lens of the torah and possibly even get some chizuk from its meaning? I found the Ramban on Iyyov very inspiring to deal with my physical ailments but I did not feel it answered my psychiatric ailments.

Thank you very much,