Dr Judith Guedalia

Elokai Neshama: The Miracle of G-d Given Breath
Chaim K. rolls into my office with a determined look on his face and a twinkle in his eye.  I am filled with relief that his dark days seem to be coming to an end.  Over the past six years we have been meeting in my office at the Shaare Zedek Medical Center in Jerusalem for his therapy sessions and have achieved a level of comfort with each other.  Awe, mutual respect, friendship, frustration and excitement have often joined hands during the more-or-less weekly sessions.  We have learned to understand each other in a way that sometime resembles an old married couple (at 23 years of age Chaim K. is the age of my eldest grandchild!). 
Today, I see the old twinkle in Chaim's eye replacing the dull and sad resignation of recent months.  He begins talking immediately and I know he is talking to YOU his audience; he is in a different mode, he feels he has something to contribute to others, not just take, a word he uses to connote his extreme dependence.
He begins:  "One morning I awoke to find myself in the hospital with tubes coming out of me from every possible, and even some impossible places.  I didn't understand what had happened to me.
"I tried to get up, but I couldn't.  I tried to sit, but I couldn't.  I tried to speak and I couldn't.  I went into a panic.  They told me that I had been in a VERY serious car accident and was injured in my C2, which is the second cervical vertebra.
"They told me I was paralyzed; my whole body was paralyzed; I would never be able to move or breathe on my own again.
"The first time I was disconnected from the external breathing machine I was very frightened.  Suddenly, I felt as though I was being choked.  I couldn't breathe!  I was so afraid; instantaneously one of the disconnected machines started to beep; almost screaming, but I couldn't raise a peep from my voice.  I had the realization that I had no air to scream, but worse than that, to even breathe. 
"I didn't understand what had happened to me; it seemed like forever until "they" galloped in and hooked me back on to the respirator.  From that time to now, almost ten years, I have a tube from my trachea to the ventilator, 24/7.
"It is hard to live with the knowledge that your life is totally dependent on a machine which can "mess up" at any second.  A number of times already over the course of ten years the machine has gone kaflooey  - I can't breathe and the same choking sense envelops me.  The only difference between the first time and now is that I am not as panicked, because I know what is happening and that help will soon arrive.
"One of the downsides of being hooked up to a respirator is that the machine requires electricity at all times.  When I am home the machine is plugged into the wall.  When I go out of the house, I have a battery on my electrified wheelchair which keeps the respirator fully juiced all the time.  The battery lasts just a few hours a day so that I have to plan for every eventuality, all the time.
"A few months ago, my pulmonologist explained that Israel is just about to import a new machine that will change my life.  In the States it isn't at all that new, but here I would only be able to receive it if I qualified for a grant and fit the profile of one who could succeed with this type of technology.
"The device known as a Diaphragm Pacer and it is very much like a heart pacemaker.  It sends an electric pulse to the nerve that causes the diaphragm to raise and lower itself, thereby allowing the lungs to rhythmically fill and empty of air.
"This will allow me to breathe without the respirator.  I can't imagine what it will be like not hearing the constant noise of this infernal machine - day in and day out, night in and night out.
"Baruch Hashem, I completed the surgery to implant the device in my body just three weeks ago.  After the surgery one has to wait over a month before they activate the device giving the body a chance to heal from the surgery and the imposition of this new machine into it.  Next week my Doc is going to turn it on and my diaphragm and I will begin "training" for the big day.  Day one is just a few minutes of me breathing on "my own."  Every day we will increase the amount of time the Diaphragm Pacer works and I breathe without the respirator.
"I can hardly imagine that in about two months I will be - Tra-Ra-Tra-Rom - breathing on my own.
"I lie in my bed and try to imagine when my diaphragm, my body, will move on its own.  For ten years I have forgotten how my body feels when it is breathing. 
"Every day I thank G-d that He created the minds of the inventors of this and other medical miracles.  I keep praying and hoping that one day they will find a cure for the situation I and other spinal injured people are in.
"You probably do not pay attention to the rhythmic pulsing of your diaphragm, your chest rising and lowering at an even pace. 
"You probably don't pay attention to your first morning prayers especially, Elokai neshama shenatata be tehora Ata Nafachta be My G-d, the soul with which Thou hast endowed me is pure.  Thou hast created it.  Thou hast formed it.  Thou hast breathed it into me. Thou dost preserve it within me, and Thou wilt hereafter reclaim it and restore it to me in the life to come.   So long as there is soul within me, I avow before thee, Lord my G-d and G-d of my fathers, that Thou are the Sovereign of all creation, the Ruler of all living, the Lord of all souls.  Lord who does restore the soul to the dead, blessed art Thou.
"Next time you inhale a deep breath, stop a moment to savor it and think about the wonderful gift Hashem gave you.  For me this is not a given, it is a Miracle." 

Dr. Judith Guedalia is Director, Neuropsychology Unit; Senior Medical Psychologist; Shaare Zedek Medical Center; Licensed Psychologist; Supervisor and Specialist in Medical, Rehabilitation, and Developmental Psychology;  EMDR Level II, Co-Chair Nefesh Israel. She can be reached at her website: www.drjudithguedalia.com.  Chaim K. may be reached at his email: