The period between the start of Rosh Hashanah and the end of Yom Kippur is known by many Jews as the Ten Days of Repentance. Repentance, however, can be a relatively amorphous process to carry out. In the Mishneh Torah, a code of Jewish law and ethics, Rabbi Moses Maimonides, an esteemed physician, philosopher, and astronomer of his era, offers several suggestions for making the repentance process more concrete. His list includes giving charity, distancing oneself from sin, straightening out one’s ways, and changing one’s name. Maimonides explains: “When I change my name, I am no longer the same individual who committed previous actions.”

I never really understood Maimonides’s interpretive reasoning behind the name-change suggestion—that is, until I began to practice oncology, treating tumors at a hospital in Israel. As they undergo chemotherapy or radiation treatments, nearly 15% of my patients either add a new name or change a name entirely.

The most commonly adopted appellations are “Hayim” and “Haya”—male and female variants of the Hebrew word for “life.” This choice seems to result from focusing on a desire to extend life or to enhance its quality. Women also popularly choose “Nehama,” meaning “comfort”, and Ruth, meaning “compassion.” Men, on the other hand, often select “Elijah”, the ancient prophet who, according to the Book of Kings, achieved immortality.

Sometimes when I forgetfully lapse into using my patients’ original names, which come from medical charts, they alert me to my error and insist on being called by their new name. Many even demand that I adjust their electronic health records, too. Indeed, my professional experience illustrates that, because it contributes so much toward defining who a person is, altering a name can be a significant—and potentially life-changing—gesture. My colleagues in Geriatrics often remind me that the last fact erased from memory by Alzheimer’s disease is a person’s name.

Throughout Jewish history, name changes have been associated with the immigrant experience. For instance, consider the Book of Exodus, or “Shmot”, meaning “names”, as a testament to the exiled Children of Israel’s resolve to cling to their names. Or the fact that the first prime minister of Israel, David Ben Gurion, who encouraged the Hebraization of surnames to simultaneously cast aside influence of the diaspora and build a collective Israeli identity. (His suggestion, however, provoked sharp controversy, evidenced by the choice of Israel’s first president, Chaim Weizmann, to retain his family name.)

So if a name carries such significance, what’s going on when my patients change their names?

For some, their name change manifests Maimonides’ cryptic, if not mystical, remark about not being the same person who committed previous (sinful) actions. Another explanation goes like this: as scriptures equate disease (and even death) with punishment for transgressions, if the afflicted change their name, then they are no longer that person and therefore cannot be the object of God’s retribution. Yet, even among my religious patients—some even conduct a formal name-change ceremony in the hospital chapel—only a minority maintains such a fundamentalist view. What’s more, at our cancer center, I’ve observed that name changes are undertaken by equal percentages of religious and secular patients; there must be another reason.

When I first became aware of this name-changing phenomenon, I concluded that it must be a sign of desperate fear. But I have come to appreciate that, while the ritual may, on occasion, be motivated by fear, it is actually far more often a statement about hope—a hope to find a better day and to affirm faith in the human ability to re-invent oneself in the face of hardship. As a result, name change, it now seems to me, is less about a new name and more about the opportunity for change.

On a regular basis, many who contend with serious illness can vividly hear page-turning within the Book of Life and the Book of Death. Perhaps, during the upcoming Ten Days of Repentance, even we who need not attend so urgently to that existential and mortal sound still may find important lessons in the strength and beliefs reflected by my patients’ gestures. Those insights might prove valuable when we contemplate modifying, if not our names then at least our behaviors, during this time of renewal.





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