Rabbi Leonard (Yehuda) Blank MS, BCC
Director of Chaplaincy Commission and External Affairs
Rabbinical Alliance of America/Igud HaRabbonim
April 30 ,2020
I am dedicating this week’s article to Rabbi Mordechai Katz zt”l and Rabbi Shlomo Elozor Wulliger zt”l, both well-known chaplains. Rabbi Motty Katz as most knew him by, was a chaplain at NYU Langone Medical Center in Manhattan, NYC. where he was always helping and being mashpiah upon people as was mentioned in a Yated Ne’eman (pg 77 30 Nisan 5780/April 24, 2020) article written by Rabbi Chaim Serebrowski. “He was known to be a walking, talking Kiddush H serving as an example to everyone in the hospital as to what a Yid Is. Doctors and nurses in the hospital are heartbroken over his petira. One of the hospital staff members even drew a heart around his picture in the hospital, to them, he represented G and he always had a kind word for all of them”. Rabbi Serebrowski went on to mention the encouragement and support Rabbi Katz gave to the patients and how he would be mispallel for them. I met Rabbi Katz on several occasions and whatever my request was on behalf of patients he always found time to fulfill those requests. He did so with a full and caring heart. He died at NYUMC after a long bout with the COVID 19
In an article also in the Yated Ne’eman (pg 89 30 Nisan 5780/April 24,2020) “Rabbi Wulliger used his influence in New York as a chaplain, a position he held at the Brooklyn Developmental Center, a state institution in the Spring Creek area. That began in 1972, when Rav Wulliger led a shul in Flatlands, about a mile from the center and he started volunteering one day a week and then more frequently. Later, when the center was looking for a full-time chaplain, he was offered the position. Because of his efforts Rav Wulliger was chosen from 230 different institutions with chaplains to receive the Zagelbaum Family Award for Chaplain of the Year. Rav Wulliger authored “I Am My Brother’s Keeper” a guide for dealing with those with mental disabilities.
There are many challenges and roller coaster events every moment of the day and night it is amazing what health care chaplains continuously achieve. Their responsibilities can be collaborating with and between the medical staff and other staff and community liaisons with family members, care givers and patients. Yet, their responsibilities with tremendous increased patient emergency admissions can be enormous .But, there are other aspects of what a chaplain does, such as giving the spiritual hope and prayers for and to the patients , family members, care givers and yes, the medical staff who are dealing with situations where changes happen so rapidly – life and death can mingle in a matter of minutes. It is difficult for everyone to hold back their tears. These are difficult times when family members and care givers in most medical institutions are not permitted to visit. How lonely and frightening it must be for those patients who do not have anyone to advocate for them or for themselves due to their medical conditions. Though many chaplains are in touch with medical staff, patients, family, care givers and liaisons via phone and other technological means, there are chaplains in the medical facilities making rounds and collaborating with the medical staff while wearing safety PPE’s. Rabbi Simcha Silverman Director of Chaplaincy Service at Lenox Hill Hospital, as with many other chaplains who are rounding at their medical facilities, find collaboration with medical staff, liaisons between patients, families and care givers so important for the sanctity, emotional, spiritual, meaningful and well-being. He shared with me about connecting with COVID- 19 patients to offer support and addressing their fears and loneliness, assuring adequate kosher provisions during an extreme surge of patients who eat kosher food, liaising with community organizations and helping them provide the critical support services that they offer, ensuring appropriate protocol for those working in the morgue to maintain sensitivity to the value of each life, sending viduy via text ten minutes before shkia for the start of Shabbos for a son to say over the phone with his father who was dying, but still awake, offering a prayer to a family on the other side of the USA and allowing them to speak with their loved one via a phone held by the patients ear even though the patient isn’t awake and could not respond.
Rabbi Doniel Kramer Jewish Chaplain at the VA Hudson Valley Healthcare System uses various different skills and tools in his pastoral care with patients. One of the latest he has shared is Spiritual Care Boards for non – verbal communications/ventilated patients. Initially, these special boards were being used for intubated patients during this COVID-19, but now being used for other patients (for information about these communication boards please contact me). One of the important discussions Rabbi Kramer has with families is to encourage them to consider making advanced funeral arrangements “so should death come, hopefully after 120 years so the hospital knows which Jewish funeral director to contact especially when there are so many funerals being planned.” The National Association of Chevra Kaddisha under the leadership of Rabbi Elchonon Zohn has distributed through the major rabbinical organizations important and vital guidelines especially dealing with COVID-19 issues and concerns. They have been included in this newsletter following this article. It is important for families and caregivers to complete the Halachic Medical Directives and health care proxies to ensure the medical institutions know what the patient and or legal designated person(s) decisions are regarding intubation, resuscitation, medical decisions and end of life concerns. Members of the Rabbinical Alliance of America should ascertain who the chaplain is of a specific medical facility they are inquiring about on behalf of a relative, congregant or others and who to contact at that facility. As, I have stated in previous articles, because of the HIPPA guidelines, anyone requesting information about a patient must be a legal caregiver unless authorized by the caregiver or family. However, it is all right to inquire from the chaplain for assistance. Also included in this newsletter following this article is a listing of medical directives accepted in many states throughout the USA available through Agudath Israel and Chayim Aruchim.
Rabbi Dr. Hillel Fox Director of Chaplaincy Care and Education at North Shore University Hospital shared “the intensity keeps increasing daily and the isolation and fear of the unknown adds a deeper layer of emotional need for pastoral care. Especially for the Jewish patients requests for all the necessary religious needs for the Pesach sedarim. Families were also asking for assistance with special deliveries
to patients to help them in isolation. He mentioned how fortunate we are to have the technology to connect with patients and families with “virtual visits” through Tele chaplaincy!” His chaplaincy department in collaboration with the hospital developed a Heroes (for kids) and iCare Notes (for all ages). Children sketch their hospital hero on a special drawing page. A download in a link provided and the drawing will be displayed in the hospital. A special download for the iCare for whoever would like to acknowledge a staff member or patient with a note written by that person.
Rabbi Tziphonia Kreger Jewish staff chaplain at New York Presbyterian/ Columbia Medical Center is in touch with patients, medical staff, families and care givers. He is frequently speaking on the phone offering chizuk, inspiration and offering pastoral care to family and care givers. He is often called upon by the medical staff for his sensitivity, spiritual and emotional support due to end of life situations of patients and staff as well. Grief and bereavement have become an important part of the supportive care he has been giving. He also collaborates with and between liaisons, staff and families.
Chaplain Margo Heda, Jewish staff Chaplain at the Hospital for Special Surgery in New York City shared how important it is to keep in touch with patients, family members and staff on the phone when in person meetings are not possible. “I have been attending interdisciplinary rounds and rounding on patients remotely, meeting over the phone with patients and sometimes family members as well. I have reached out to staff via phone, text and WhatsApp. On a hospital – wide basis our Spiritual Care Department participates in the Wellness initiative, sharing reflections and resources with our staff. “With the concurrence of Pesach, I go to lengths to ensure that patients have what they need for the sedarim and that patients with chumras need not compromise on their spiritual and dietary needs. This sometimes entails coordinating with Jewish charitable organizations and Infection Control to ensure that any deliveries take place within hospital pandemic guidelines. In this time of intense need, it is heartbreaking we must be present remotely, yet technology is now one of our blessings as it allows us to be present and preserve health and safety at the same time.”
Rabbi David Keehn, Jewish chaplain at New York University Langone Medical Center shared how the past weeks have been the most challenging times in his more than 25 years in chaplaincy. “With this disease hitting our community hard and Pesach in the middle of it all, we chaplains had to reach into our “tool bag” and come up with the inspirations of the moment. There were many times he acts as an intermediary between families, the patient, staff and collaborates with liaisons. He has been dealing with end of life issues with families and offering much spiritual and emotional support for the staff. He also has shared the many sensitivities of end of life issues and concerns with the staff. In addition to using tablets he is often speaking on the phone with patients, families and care givers. “Doing visits on the phone has sharpened my skill of seeing with my ears”. Except for end of life, families as with most hospitals are not able to visit their loved ones. “It goes against the grain of what we are used to doing in chaplaincy. Being in the presence is a cornerstone of our work” He also gave in services to the kitchen staff at the main campus as well as Langone Orthopedic Hospital before Pesach. “This was mostly a review since the staff was taught well by Rabbi Katz zt”l).
Those who are hospice, police, fire, military and correctional chaplains also have numerous new challenges. It is interesting to note, that a few years ago the Rabbinical Alliance of America in collaboration with the National Council of Young Israel had a special seminar at Lenox Hill Hospital which was arranged by Rabbi Silverman and the Lenox Hill administration. It was attended by chaplains, rabbis and rabbinic interns to learn about important issues and concerns they often must deal with. We were privileged to have distinguished presenters from the Lenox Hill Hospital medical staff, a presentation by Rabbi Dr. Richard Weiss, a tour of the emergency room and other vital aspects of the hospital. Looking back, one could see how their medical services are needed now as in medical facilities throughout our Country.
There are three major components in chaplaincy; Spiritual assessments: where professional chaplains are uniquely able to hear and identify the patient and family’s spiritual distress and spiritual/religious strengths and needs in a reliable and standardized way. This assessment can then be communicated clearly to the health care team via a standardized note in the medical record, in conversations with the medical team and through participation in interdisciplinary team meetings. Interventions: which are guided by what is learned in the spiritual assessment, and are what chaplains do to provide care to patients or families. Interventions range from assisting a patient into exploring their spiritual and/or religious belief system, to their image of the Divine to identifying spiritual or religious-based coping resources. Outcomes: which are the observable results of the care and interventions that the chaplain provides. They are based on what the chaplain can see, hear of feel as, according to Art Lucas, outcomes are “sensory based”. (Caring for the Human Spirit magazine Summer 2014 pg 20 “Outcome Oriented Chaplaincy is Key to Effective Spiritual Care” by Rev. Sue Wintz BCC). Of course, as you have read the beginning of my article and from what some of the chaplains have shared above, there are many other vital responsibilities that are an integral part of chaplaincy in health care. I hope to be bringing you throughout the year insights of what other chaplaincy disciplines are about.
On the one hand the COVID -19 is a dreaded disease and there is no proof the end is near. We mostly hear and read about the flattening of the curve. But, what about all those who are still becoming ill and still dying. Yet, across America and throughout the world everyone wants to go back to normal. That is understandable, but why go from one extreme to another where social distancing, wearing masks and other leniencies are already taking place. What will happen in the spring and summertime when the weather gets warmer. What about the children- when will they be allowed to visit their grandparents? When will the grandparents and those with underlying medical conditions be able to resume normal activities? When, when, when – only the Aibershta knows when. But, until we are able to resume life as it was before COVID-19, we must not abandon listening to those in our communities who have been advising us the appropriate approaches to caring for ourselves, our families, our neighbors for Klal Yisrael. Yes, it is sad when we read or hear about those in our communities who have succumbed to this virus. We continue to care for those children and spouses whose loved ones died both in charitable and spiritual ways. We pray and hope a vaccine will eventually be available- sooner than later. Until then, we must continue to live our lives as best as possible. To be thankful for the silver linings that are often overlooked, but brings sunshine into our homes, our apartments to each other and to ourselves. It sounds easier said than done, but with the multitudes of programs, webinars and so on for rabbonim, chaplains and others by the National Council of Young Israel, Rabbinical Alliance of America, Rabbinical Council of America, Agudath Israel of America, OHEL Childrens Home and Family Services, AMUDIM and NAJC amongst others we have more tools, skill building and chizuk- tremendous inspirations than ever before. Especially the inspirational words from our Sages, our Torah mentors, our Tefilos and our Tehilim.
For many years, a Jewish chaplain was often thought to be a rabbi who will visit, make a mishabairach, distribute religious articles and or siddur, sefer, Shabbos lights etc. For those who were not familiar with professional chaplaincy, or have not read my previous articles about chaplains, I hope our readers will have a better understanding what professional chaplaincy is about. Please note that due to the limitations of space for this article, I was unable to include the phenomenal work of other Jewish chaplains. I do want to acknowledge the wonderful collaboration, efforts and above and beyond the call to duty of chaplains from other religions and denominations. Though there are many challenges dealing with diverse issues and concerns, praise must be given to the administrations and staff of the various hospitals for their tremendous efforts caring for their patients.
Please continue to be mispallel for all cholim and include Keila Lutza bas Tzipora.
Thank you Sincerely Yehuda Blank