The Unreasonable Request

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The consultation with Mrs. Burger was just about as parve as it could be until I asked a question about her surgical history.

“I’m sorry,” I said as I was quite confused by her answer. “Your husband wants you to do what?”

There was no way I’d heard her correctly.  But then Mrs. Burger repeated herself and I was even more lost.

I figured I’d lost my hearing or maybe I’d lost my mind.  Perhaps I was dreaming?

“Did you just say what I think you just said?” I asked one more time.

As Mrs. Burger nodded, I wondered if this was one of the most bizarre things I’d heard in my career. That was saying a lot coming from a fellow who had worked in a State Psychiatric Hospital for a few years. And yet here I was sitting with Mrs. Burger and listening to her blow my socks off.

So I repeated myself one last time, “Your husband wants you to do what?”

“He wants me to get cosmetic surgery and to fix my nose to help with shalom bayis (marital harmony).”

Now that I was sure I’d heard her correctly, I had to ask the proper follow up question, “Maybe I’m missing something, but why would having a cosmetic surgery to ‘fix’ your nose help with shalom bayis?”

“Because he said my nose doesn’t look very nice and this would help him to find me more attractive.”

At this point I felt completely baffled and figured that I must be misunderstanding something or maybe my Hebrew wasn’t as good as I thought it was. This was a very normal-looking woman and her nose was particularly unremarkable. Luckily, Mrs. Burger was originally from Argentina and spoke fluent Spanish so I was able to clarify using my own knowledge of the language.

Except for the fact that she told me the exact same story in Spanish as well: her husband wanted her to “get a nose job” to help with shalom bayis.  So while I was relieved that my Hebrew was in fact at more than a professional level, I was frankly baffled to hear her story.  With this in mind, I briefly excused myself and went to ask a question from a female colleague who worked in the office next door.

Dr. Epstein was a psychologist and a lovely woman who had been working in the frum community as a domestic violence specialist for more than 20 years. As it turned out, she had actually met Mrs. Burger around a month ago and completed an assessment that had eventually referred the patient to my office for the treatment of panic attacks but without any history of known spousal abuse.

As I told Dr. Epstein the story, she gasped.  “That nice frum lady from South America?  But she’s downright beautiful and doesn’t need any surgery anyways beyond the fact that this is absurd!  What is going on here?”

“So I’m not the only one who thinks that this is completely wacky?” I asked.

“No way!  This is horrible!  This isn’t for shalom bayis at all!  The man must be off of his rocker.  No wonder she has panic attacks!”

I asked that Dr. Epstein join me in my office as I wanted to have a frank discussion with Mrs. Burger and felt that having another clinician, especially a female, would be tremendously helpful.  Dr. Epstein agreed and, per similar interventions we’d done in the past, we discussed our strategy privately before entering the room.

“Mrs. Burger,” I said as we sat down, “I know that all you wanted to do was to bring me up to date regarding your surgical history, but I’m wondering if there is more here than meets the eye.”

“What do you mean, Dr. Freedman?”

“He means that were are concerned for your safety, Mrs. Burger,” said Dr. Epstein.

“What, like my husband is abusive?”  Mrs. Burger laughed nervously.  “He doesn’t hit me or anything like that.”

“Physical abuse isn’t the only form of domestic violence,” I said very honestly.  “There are many ways that a person can hurt their spouse.”

Dr. Epstein continued with our shared message, “You are a very beautiful, special woman and what you’ve been asked to do is not normal.”

“My husband told me that many women have done this kind of thing for their husbands,” Mrs. Burger interrupted defensively as she burst into tears.

Dr. Epstein took her hand and we sat together in a shared silence.  After a few moments, Dr. Epstein continued, “we need to let you know that we are here for you and that it’s okay for you to say no.”

“He doesn’t hit me, you know,” said Mrs. Burger.  “He’s not a bad man, he just told me that I need to fix my nose and it didn’t sound so crazy until I found myself here saying it in front of the two of you.”

Dr. Epstein and I nodded in unison.  I was inclined to believe Mrs. Burger that this wasn’t just a simple case of physical violence.  Maybe he had developed some strange obsession with her nose? Maybe this was some odd sort of body-dysmorphic-disorder-by-proxy?  I left the room with my colleague for a moment to discuss the best plan moving forwards.

After speaking it over, Dr. Epstein felt that the best thing to do would be for us all to sit down together with Mr. Burger as well.  Then we could discuss where to go from there. I was inclined to trust her judgment and it sounded like perhaps her husband could use a good referral himself anyways.

When we walked back into the room together, it was clear to see that Mrs. Burger had been working hard to compose herself.

Speaking from a place of tremendous sincerity, she told us, “My husband is a good man.  He’s not a violent husband or a bad person.”

I started to interject when Mrs. Burger put up her hand almost to shush me and said, “It’s okay, Dr. Freedman. I know you want to defend me, but let me finish.  He’s not a violent husband or a bad person but I really appreciate you taking the time to try to help me, to protect me. I appreciate the time you are taking to help me through this.”

I smiled and looked across the table at my colleague who was smiling as well. Dr. Epstein held Rebetzin Burger’s hand and told her, “that’s what we’re here for.”

Not one to avoid getting in the last word, I said, “Now let’s get your husband in here too and help him to understand how to draw the line between reality and his incorrect assumptions of what’s appropriate to ask of one’s spouse.”

They both nodded and we set a time to make it happen.

Jacob L. Freedman, MD, is a psychiatrist in Boston, Massachusetts, and Jerusalem, Israel. Dr. Freedman is also a health care and a risk-management consultant as well as a suburban mountain biking enthusiast. For more information regarding Dr. Freedman, please visit his website at

The words of this author reflect his/her own opinions and do not necessarily represent the official position of the Orthodox Union.