Many sessions at the recent 91st National Convention of Agudath Israel of America were extremely well received. Following the response to these sessions, the Agudah staff prepared two for publication.
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A Clash of Cultures: Observant Patients in the Modern Hospital
A loved one has been admitted to the hospital, and you are unsure whether he is receiving appropriate medical care. A close relative is undergoing emergency surgery on Shabbos. How can we ensure that someone can accompany him or her and have appropriate accommodations? A patient's family needs help in deciding if they can take their loved one home. These are just a few of the many issues that the Jewish community liaisons in New York's hospitals deal with on an ongoing basis.
At this year's annual Agudath Israel convention, a presentation was given that described many of the challenges that arise for the frum community in a hospital setting. The panelists, who are all involved in this area, each gave examples and guidelines of what to do, and just as importantly, what not to do, when seeking and undergoing serious medical treatment. The increasingly important role of Jewish community liaisons in the hospitals was explained at length.
In a follow up conversation with Agudath Israel this week, Israel Rosman, a pioneer in Jewish patient-hospital relations, summed it up: "In today's health care system, we can get good care, and we can get bad care. It is every person's responsibility to make sure that they receive good care the right way."
We asked Mr. Rosman for his impressions of the medical sessions at the conference. "I think there were two tremendous accomplishments," he said. "First, the initial session, which included over 30 liaisons from throughout New York and the Tri-state area, provided a forum to discuss new ideas of how to introduce the intricacies of the health care system to the heimishe community. Second, we met with rabbonim who confront and deal with hospital related issues, to discuss the role of Jewish liaisons as a part of the hospital team."
Mr. Rosman likewise expressed hakoras hatov to Mr. Daniel Czermak, President of Leisure Chateau and Acute Care Health System in Lakewood, who felt that community liaisons needed more exposure to the myriad issues that exist within this arena, and as a result, generously sponsored the sessions at the Agudath Israel Convention.
Speakers at the Friday morning session were Rabbi Gedaliah Weinberger, Chairman Emeritus of the Board of Trustees of Agudath Israel of America; Rabbi Boruch Ber Bender, President of Achiezer Community Resource Center; Solomon Rosenberg, Program Director, Office of the President, Montefiore Medical Center; Israel Rosman, Senior Patient Liaison for NYU Medical Center; Dr. Howard Lebowitz, Chief Medical Officer, Acute Care Health System of Lakewood; and Rabbi Shmuel Lefkowitz, Vice President for Community Affairs - Agudath Israel of America.
Rabbi Gedaliah Weinberger opened the session by sharing some of his profound knowledge of the health care system from his 35 years of experience working within the health care system and directing Agudath Israel's Chayim Aruchim program.
Rabbi Weinberger noted the special resources of the Jewish community that provide critical services from "before the cradle until after the grave," from help with infertility issues, to the Chevra Kadisha, often at reduced or no cost. "Chayim Aruchim has become part of the continuum of care in the later stages of life, in terms of advising people in end of life situations," he explained.
While emphasizing the quality and professionalism of New York's health care institutions, many of which are rated among the best in the world, Rabbi Weinberger pointed out the relative lack of cultural sensitivity to the Jewish Orthodox community that is still apparent throughout the system. He stressed the importance of family members actively advocating for the patient and that doing so can often spell the difference between life and death.
Nevertheless, the community must also be aware that there is a clear distinction between the right way and the wrong way of relating to medical institutions. This is where the hospital's Jewish community liaisons step in. Even though some of the liaisons are paid employees of hospitals, their mission to help the Jewish community goes well beyond the scope of their employment contract.
Rabbi Boruch Ber Bender explained that experienced community liaisons perform a vital service for Klal Yisroel, guiding patients through a complicated and often confusing system, preventing each person from having to reinvent the wheel for his or her personal situation. "Klal Yisroel works best when we work together, when we can use each other's kochos (strengths)," he said. It is crucial that the public is informed about the work of the Jewish community liaisons since they have laid groundwork in many hospitals. Hospitals can then ensure that Jewish patients receive the necessary services from within the system. He emphasized that if we work within the system that already exists, volatile situations can often be easily corrected - and the community liaisons can make that happen.
The third speaker, Solomon Rosenberg, community liaison at Montefiore Medical Center, described how he relates to his hospital administration. "I explain to them that we are not giving Jews anything more than any other patient in the hospital. A Jew who walks in has less than others in the hospital. He doesn't have his religious environment, his shul, his kosher food, and as a result, he may feel uncomfortable. My job is to bring him to par with others in the hospital. And that they understand."
Mr. Rosenberg detailed just a few of the many calls he receives daily. Calls range from the ridiculous, to life-and-death situations. He pointed out that the favors and special treatment that individuals sometimes expect, for example having a doctor waiting to receive them in the emergency room when they arrive at the hospital with a broken bone, border on chillul Hashem. "Emergency rooms work on a triage priority basis. If you are kept waiting, you should daven and thank the Aibishter that your condition, though painful, is not serious enough to be seen right away!"
Israel Rosman, community liaison at NYU Medical Center, emphasized that the health care system is changing at an incredibly fast pace, and community liaisons are becoming increasingly necessary in helping the Jewish community navigate the system.
"Hospital liaisons can be compared to a manual of a complicated machine," he explained in a follow-up conversation. "You would not touch a machine's parts if you knew that one wrong move could damage the entire machine. The liaisons know exactly which tape to cut, the red tape, yellow tape, and green tape. They encounter challenges every day that shape them and make them even more capable to do their work. Trust the liaison when you do not know how to proceed in a medical situation. When you take things into your own hands and get someone from the outside involved,you are going to harm yourself, and there is often a point when you will not be able to fix it."
In his talk, Mr. Rosman related a poignant story which illustrated the wrong way of approaching the health care system. A young man was, R"l, undergoing chemotherapy for leukemia. He suddenly began experiencing abdominal pain and was taken to the hospital. The medical team immediately suspected that he could be suffering from a perforated intestine, a possible side effect of chemotherapy, and conducted appropriate testing. The testing confirmed their suspicion and called for emergency surgery. When Mr. Rosman was informed of the situation, he immediately contacted a doctor who has performed hundreds of such surgical procedures. The doctor rescheduled his office appointments and rushed to the operating room to perform emergency surgery. A short time later, Mr. Rosman got a call from the surgeon. "Israel, something is terribly wrong. There is a rabbi in the room telling me not to go through with the surgery. He thinks a different surgery in this case is more appropriate. This patient has about an hour to live unless I begin this procedure."
Mr. Rosman could not believe what he was hearing. He immediately called a medical askan from the chassidus that the patient belonged to. "Do you know that this patient's life is on a clock?" Mr. Rosman asked.
"No!" replied the askan. "I was not aware. I made some phone calls!"
"Did you speak with a doctor?"
"I missed the doctor," he said.
After a few more calls, the rabbi finally said, "Yes, let's go ahead with the operation right away," but by that time, the patient was fighting a very tough battle for life.
There is a time and a place for second opinions and considering alternative options, but when life and death decisions need to be made, trying to circumvent the health care system can, unfortunately, often result in death. Liaisons can serve a crucial role in guiding patients through the complex system, as well as giving practical advice based on their vast experience in the field.
During his follow up discussion Mr. Rosman also said, "We came away with new perspectives on how to address the issue properly. Collaborating over shared experiences and exchanging pertinent information helped cultivate a feeling of team work and unity. Additionally, meeting many of the doctors, with whom we consult regularly but have never met personally, was very beneficial to cultivating the ongoing professional relationship we value."
Jews in the News: Dealing with the Uncomfortable Spotlight
Rabbis Chaim Dovid Zweibel and Labish Becker do not look alike. They differ in size, facial features, hair color and almost everything else. Yet, a non-Jewish child who saw the two standing together several months ago nonetheless said, "Mommy, they're the same person."
What bound the two in the eyes of the child, and what binds them together in the eyes of the average American, is what binds each and every one of us: our identification as Orthodox Jews.
Every one of us has on more than one occasion cringed at the uncomfortable feeling we get when even just one of our brethren is the subject of some unsavory media headlines. When one Orthodox Jew - of any stripe - is perceived to be less than fully upstanding, we are all suspect, or even seen as accomplices.
As unfortunate as that is in so many ways it need not be so. We can prevent and offset a lot of the collective damage.
Following Rabbi Becker's introduction of the "Jews in the News: Dealing with the Uncomfortable Spotlight" convention session, three prominent speakers offered some fascinating insight and advice.
Ben's Brother
Rabbi Aaron Brafman, Menahel of Yeshiva of Far Rockaway, is an accomplished, white-bearded talmid chacham, mechanech, speaker and writer. Yet, more often than not, he regretfully finds that he is identified as "Ben Brafman's brother," referring to the prominent criminal defense attorney. He related that his brother, too, wishes he'd be less known professionally in our community. "My heart aches," said Rabbi Brafman. He pointed out that every case brought against a member of our community entails much more than meets the eye. Spouses suffer, children suffer, relatives suffer, friends suffer — we all do.
Rabbi Brafman explained that when a community as a whole grasps the severity of legal and moral misdeeds, and looks with disdain at unsavory actions, the likelihood of individuals engaging in such activities significantly diminishes.
Modern technology has made it significantly easier to commit sin away from human eyes, but Rabbi Brafman stressed that recent revelations about governmental collection of personal electronic communication data can teach us a powerful lesson about the potential for "secret" sins becoming public, leading to the desecration R"l of both Hashem's and the sinner's honor.
Ultimately, though, Rabbi Brafman urged us to focus on the bright side and emulate those who make public kiddush Hashems. "Let's look at Rabbi Noach Muroff who returned $98,000 in cash he found in a desk (and addressed the convention on Motzei Shabbos)," he said, "or the 11 year old HANC student who refused to participate in a prestigious ping-pong championship on Shabbos despite various heterim she was offered."
"Jews are not 'in' the news, we are the news. The world is fascinated with us."
Rabbi Avi Shafran, Director of Public Affairs for Agudath Israel of America, is a master at positively presenting our community's perspective to the media and world at large. He is as aware as anyone of the world's propensity to tar the Orthodox community with a broad brush - "There seems to be a quota in some papers for negative stories," he says - but he is equally aware of how little it can take to counter that.
All it took for noted Harvard University Professor Noah Feldman to pen a glowing op-ed in Bloomberg News about the Orthodox world - after becoming known for his previous negative sentiments - was to pay a visit to Beth Medrash Govoha in Lakewood. Professor Feldman saw firsthand how the chabura system is. In his estimation, it is more of a democracy and meritocracy than what is found in secular universities, and he raved about that to the world.
Rabbi Shafran related other recent news items, including the story of an Orthodox woman in Montreal who won elective office after earning public accolades for teaming up with a native Palestinian woman on behalf of common local political interests; and the much publicized story of the Orthodox Jewish man traveling home on the subway who allowed another person who had fallen asleep on his shoulder to continue his nap undisturbed. Every smile, good word, or minor honorable deed that we show the world at large, feeds our communal cloud with positive moisture, said the Agudath Israel leader, and eventually causes gishmei beracha to rain upon all of us. "Even when we do (good) things that no one will ever know of," Rabbi Shafran stressed, "that feeds the cloud."
From the Other Side
Avi Schick is a dynamic veteran attorney and community activist. What he stressed most during his presentation at this forum is what he has gleaned from his decade of work for New York State government.
When Mr. Schick participated in a crucial negotiation session between a team of female government officials and male Orthodox community activists, he stressed in advance that the avoidance of a handshake was no reflection on our attitude towards the women, but rather a reflection of our community's lifestyle and values. The meeting proceeded without a hitch, and those officials were promoted to top positions - taking along with them a very positive view of our community.
Although we may often be tempted to advance our community's agenda through political clout and the belief in the moral superiority of our argument, Mr. Schick advised against that approach, particularly when dealing with a world drifting further away from our morality standards by the day.
The best results come when we instead highlight our own beautiful values and work to get others to appreciate their importance to us. When we do not come across as scolds, others can more easily respect our concerns and help us protect ourselves from what we see as detrimental to our lifestyle.
Mr. Schick concluded with the powerful words of Rav Yitzchok Hutner zt"l, who wrote to a talmid that the Torah values he learned in yeshiva can be reflected in his every action in the business world. "Rav Hutner taught us that the Torah does not only protect you in the outside world; it has the power to transform everything you do."
Audio recordings of the entire convention are available. Please contact Zalman Umlas, Tel. (718) 252-5274 or email: zalmanumlas@netzero.net
