ish me a mazel tov!” “Mazel tov, Chaimke!” I responded reflexively.

Chaim thanked me, and I was getting curious as to what the mazel tov was for. He was only out of the hospital for a month or so and still wasn’t 100 percent by any means. So while I was certainly happy to hear some good news, I was a bit nervous as to what might come next. Was he suddenly moving to Thailand to set up a kiruv organization, or did he just have a new nephew?

“Are you nervous I’m going to tell you something bad?” Chaim said, clearly reading my mind.

“Umm, should I be?”

“I hope not. I’m getting married, Dr. Freedman!”

My stomach lurched. Certainly I hoped and davened for Chaim to reach a stable enough place that he would be able to be a successful husband and father. But he had been diagnosed with schizophrenia a year ago and was still in very early recovery from his second hospitalization this year. We had yet to find an ideal medication regimen, and he hadn’t shown himself to be the most compliant patient to date.

“What’s wrong, Dr. Freedman?”

“Let’s be honest, Chaim. You aren’t in the most stable place these days, and you only just got out of the hospital after Shavuos. I’m afraid that maybe you’re moving a bit too quickly.”

Chaim smiled playfully. “I’m not getting married today, Dr. Freedman. The truth is, I’m not even dating or engaged. It’s just that eventually I want to get married. It’s not good to be alone, right? I mean, why not? I’m a good guy. You always tell me I’m a good guy — so why shouldn’t I get married soon?”

I breathed a giant sigh of relief. What was I worried about?

Well, first of all, I was worried that any young woman who would be willing to marry Chaim in his current state wasn’t necessary 100 percent herself either. Chaim was going to need a partner who understood his unique challenges and would be willing to support him in his ongoing treatment — which included medication adherence, maintaining a healthy sleep-wake cycle, and building a regular daily schedule. Without such support, any marriage would be doomed from the start. Plus, Chaim wasn’t necessarily ready for marriage himself.

“Chaim, I don’t think it’s fair for you to get married right now.”

He looked at me quizzically, and I continued. “I mean, last week you wanted to go out to Nepal to open a tefillin factory. I don’t think that right now you’re ready to provide your future wife with the support and stability she’d need to be happily married.”

There was a time when I thought about cases like Chaim’s differently. It was earlier in my career, and I was more rigid in my assessments of patients and their individual and interpersonal potentials. How could a patient with schizophrenia possibly get married? What could he possibly offer a spouse?

But this was the “wisdom” I’d heard from the experts and professors who held a perspective very different from that of our Torah sages. I’ll never forget the first time I met a patient with severe and chronic mental illness who was happily married to a very supportive and lovely woman. She’d stuck it out with him through thick and thin and had helped him to achieve a level of stability that never would have happened had he remained single. Sure, there were ups and downs, but they were certainly made for each other and extremely devoted to each other’s well-being. In fact, they had very exemplary shalom bayis and often served as role models in their community.

I remember discussing this issue with a prominent chassidic rebbe, who told me, “Who am I to choose whether or not someone should get married just because he or she has a genetic condition? Plenty of people who are ‘sane’ make ‘insane’ spouses, and I’ve seen it the other way around, as well.” The rebbe then gave me some practical advice. “Your job is to help them to be as stable as possible, and to be as honest as you can between parents and shadchanim. If your patient is stable and everyone understands the situation, you can go to the chasunah to wish everyone mazel tov.”

With time these words sank in, and I became open to the idea of preparing my patients for marriage. Based on discussions with colleagues and poskim, I helped my patients to achieve the requisite year or so of mental stability with good treatment compliance, increased independence, and interpersonal successes. When the time came and my patients were ready to seriously talk about marriage, I was happy to meet with the appropriate individuals — of course, after receiving permission to do so — and to give my thumbs-up, as well as recommendations for specific things that might contribute to a successful future. Sure, there are some patients with refractory mental illness that would not make good spouses — I’d once met a chronically suicidal woman with borderline personality disorder who was on her fifth husband. Still, my perspective on marriage for the emotionally and mentally challenged has clearly changed.

So as I sat with Chaim, I did a bit of mental math and told him, “Chaim, I am so excited for your marriage, and you can bet I’ll be there to dance with you.”

“You really think I can do it, Dr. Freedman?”

“Of course! But first we need to get you as stable as possible in order to ensure that we can find you the best possible shidduch.”

Chaim looked a bit despondent as he said, “So I’m not ready now?”

“Not if you want to get a fine, stable girl. You deserve a great kallah, Chaim, and once you’ve been in a good place for a year, we can make it happen.”

“Oy, a year is a long time, Dr. Freedman!” he lamented, obviously disappointed.

“Not when you’re planning to be married until 120. Let’s focus on getting you to a good place and then we can find your zivug. Deal?”

“Hey, one year from now is Tu B’Av next year!” Chaim exclaimed optimistically. “It would be perfect!”

I nodded in agreement. “But we have a lot of hard work first, Reb Chaim, before your rebbetzin comes into the picture.”

“Well, if you think it’s a reasonable goal, then I’m willing to do the work! But I’m really serious about that tefillin factory in Nepal. Think you could find me someone who’ll go along?” 

Originally featured in Mishpacha, Issue 720. Jacob L. Freedman is a psychiatrist and business consultant based in Israel. When he’s not busy with his patients, Dr. Freedman can be found learning Torah in The Old City or hiking the hills outside of Jerusalem.  Dr. Freedman can be reached most easily through his website www.drjacoblfreedman.com