Chaplaincy Commission Update

The Nine Days, Tisha B Av, the destruction of the Beis Hamikdash, Beitar, the Spanish Expulsion and Inquisition. Is it possible to fathom what the death of 8,000,000 is from the Holocaust? Is it possible to comprehend the cruelty, horrendous deaths, torture, suffering and unthinkable experiences our brethren through the generations throughout the world have had to endure?  Unless one has seen with their own eyes, have heard from those who have lived during the various atrocities to men and womenkind, read about them, or have seen pictures, it is difficult to really comprehend what it was like. Do we really understand what anti-Semitism is all about? Even in recent months we have seen what many call the ugly head of anti- Semitism being shown in our own neighborhoods. What can we tell our children why there are people in the world who wish to do us harm or for that matter, do harm to others? Yet, from all the way back to the time of the meraglim, we learned about the misgivings of Klal Yisrael, the often lack of emunah and betachim in the Ribono Shel Olam, lashan harah, sinas chinam and tremendous machlokes. It is not the goal of this writer to elaborate nor try to explain what happened in the midbar, the various plagues, and the eventual cause of many not being able to enter Eretz Yisrael. Many years later the destruction of Yerushalayim and the Beis Hamikdash with many other tragic events throughout Jewish history. The Benei Yisrael in the midbar cried for naught due to their lack of betachen and their willingness to be swayed with rhetoric, lashan harah with unforgivable and unfortunate results. Unfortunately, the Yetzer Horah is still around, lashan harah and sinas chinam can still be found. However, Boruch H there is also the Yetzer Tov, and we do not have to look, nor go far to find erlicha, kind, caring, men, women, and youngsters who can be found doing all the right things that we pray will bring Moshiach sooner than later. Despite all the tragedies, there are so many wonderful things to have simchas hachayim and to be joyous about. One of the most important components for such a person is to have feelings for others and to be sincere. Someone who genuinely cares for others with a sincere heart, to be like Aharon HaKohen Gadol, will seek kindness and goodness and not want to even associate with those whose way of life is filled with negativity and ill feelings toward others.

I would like to share a few chaplain stories where machlokes reverted to kindness, cooperation, collaboration, and much goodness on behalf of the patients who were in hospice. There were two sisters, I will call one Sheryl, and the other Miriam. Sheryl did not want her father to suffer and have hydration especially since the IV needle came out of his arm and did not want to keep “pushing” needles hurting her father for something he did not need. She was informed by a nurse that towards the end of life, the body no longer needs hydration. Miriam especially after discussing her father’s condition with her rabbi, felt strongly to at least keep up the hydration. (A specific type of nutrition was not feasible). I requested speaking to both sisters at the same time in a quiet room in the hospital. I asked Sheryl if the IV could be reinserted without causing any pain and there would be no discomfort having her father continue with hydration that would not be harmful to do so would she object and she said no.” But what would you know about anything? You are just a chaplain, not a medical person.” I did not respond in any negative tone. Before having this discussion, I reviewed this case with the medical team. It was incumbent on me to be familiar with as many facets about a patient before having a family discussion and would always defer a medical question to the appropriate medical person. I wanted to be sure of the feasibility of having the IV once again and if the hydration for this patient would be appropriate. Hydration for some patients can be harmful for various reasons. I then asked Miriam if the medical team cannot insert the IV without pain, and if continuing with the IV hydration would be harmful would she agree and be understanding. Miriam was grateful to have a discussion with the medical team and agreed not to continue with the IV Hydration if it would be harmful or painful for her father. She just did not want to give in just because her sister or nurse felt otherwise and not in line with what her rabbi discussed with her.  Sheryl was surprised that her sister would be willing to agree if necessary. I then requested the medical team to meet with us so those questions could be asked together. The outcome was continuing with the IV Hydration would neither be harmful or painful and they would have a nurse specialist to reinsert the IV Hydration. However, should it come out again and putting it back in would be painful or should his body no longer be able to absorb the fluids which could be harmful then it would not continue. The team also agreed to contact them with any changes in his condition. Miriam was satisfied with the discussion, that her voice was heard, that her sister also agreed. It was helpful for the medical team to know what the patient’s daughters have decided as his health care proxy. After the medical team left the room, Miriam shared how relieved she was and for her sister to be so understanding. Sheryl was also relieved and shared her sentiment of not wanting to be the cause of his death, but at the same time, did not want to see him suffer any longer. They wanted a blessing for their father and for both of them which I did. They also said a tefilah they remembered from their youth, and they thanked me for bringing them together. As I was leaving the room, I saw them hugging each other while crying. I then joined them with their father at his bedside. You could see and feel the love they both had for their father and for each other. I did recite the vidui some days before.  Eventually their father’s condition deteriorated and the IV did come out again. The veins collapsed and could not hold the IV needle anyplace in the body. Trying would have been painful for him. Also at that point, the body would not have been able to absorb the extra fluid. Sheryl apologized if she was in any way abrupt with me and thanked me for my understanding as did Miriam. (Please note- no last names were given, and these were not their names).

Another story at another hospice location. I was visiting another patient when a new patient female in her early forties was brought in and in pain. With her was her brother and husband. Her brother was her spokesperson with her husband’s consent, but the husband was the healthcare proxy. The brother with a loud voice was insisting on the patient to be given pain medication immediately even if she would be out of it. The nursing staff tried to explain they first had to receive orders from the doctor, who would be examining her and reviewing her medical records. He was unruly, and the husband did not know what to say or do. The staff requested I intervene and speak to the family which I did in a private room while the patient was being brought to her bed, making her as comfortable as possible. She had a tumor in her esophagus and metastasized to other areas as well, causing her difficulty breathing and swallowing. The brother wanted her to have whatever medicine was possible not only for her not to be in pain, but to sedate her so she would not be awake, as she was scared of dying and gasping for air causing her death. The doctor, nurses, social worker, and I listened to the brother with the husband’s consent and explained there are medications and treatment which would relieve her pain, relax the breathing and she would not have to be sedated as the brother wanted. I asked the brother and husband, if it were possible as the doctor mentioned, why would he then want her to be so sedated. I then asked if they had a rabbi who they have a relationship to discuss this with, to seek his guidance and blessings. Their response was yes, and they don’t know why they did not think of him. I asked if they could contact him and if I could speak to him as well. I also requested the doctor speak to the rabbi to explain to him his thoughts on how to treat the patient and how it is possible to relieve her pain, relax her to enable breathing with oxygen, and to be alert. Together with myself and the social worker would address her fears and other concerns she has. The rabbi was enthusiastic and said he was coming right over which he did. Together with the team, the rabbi and the brother and husband, they agreed to the treatment to be given. Her prognosis was not good with perhaps days, or a few weeks left to live. Of course, all is up to H. The rabbi was extremely pleased he was called to be part of what was happening, and the brother and husband more relaxed. They appreciated my interventions and continuous pastoral care. Fast forward. The patient had a married son with an infant she had not held for some time and another unmarried son. I and the social worker spent time with them as well. Their rabbi was also in constant touch with this family. With the appropriate medications, wonderful care from the nursing staff, continuous follow ups by the social worker and myself, was able for her to be relaxed and spent time with her family. She mentioned those days were the best days of her life in recent weeks, having quality time with her family, being able to breathe and having her pain under control. Her brother had no words to express his appreciation and realized what he thought was in the best interest of his sister he admitted was not. More than that, he felt he should have really involved her husband and let him share his thoughts and opinions. The husband and wife had quality time late in the evening without other family members. The husband and brother at individual sessions had their own time with the social worker and I as did the sons. The rabbi shared with me his deepest appreciation not just for being involved, but for learning about how hospice gave the patient extra days of quality and meaning of life with the right treatments and care. She was so grateful for being able to hold her grandchild in her arms. Of course, everyone had to hold their tears to the side. The patient was stronger than they thought and told them it was all right to cry. Yes, she will miss them, but prays she will be in Shamayim and no pain when she dies. She shared with the team her greatest fear was not of dying but that she would be in terrible pain leading up to and during her death. That was what her brother was hoping to avoid keeping her so sedated she would be out of it. He had no idea she could be so comfortable and at ease. Eventually, after a few short weeks she did succumb to her illness. She died without any pain, in her sleep and with her family with her. Of course, my time with her as with many of my patients was emotional. Dealing with older patients, younger patients, pediatric patients, and their families as with any of the medical teams is not meant for everyone. I always admired my colleagues and fellow team members as well as other medical staff for the care they gave their patients and caregivers, for themselves and others as well. Choosing the right words, conveying the appropriate information and most of all responding appropriately or not at all when someone might say something that seems offensive.

The following is from the Yated Ne’man July 9, 2021, page 42. “The Kedushas Tzion of Bobov Rav Bentzion Halberstam ZTL Eighty Years Since His Passing.” “The Greatest Mofes” “It was after the war when the Tshebiner Rov, Rav Dov Berish Weidenfeld, who had survived the war in Siberia and was living in Eretz Yisrael, was visited by Rav Leibel Stempel of London. Rav Leibel was a grandson of the Kedushas Tzion, a son of his daughter and son-in-law, Rav Moshe Stemple.”” You may have heard many stories and miracles about your grandfather, the Kedushas Tzion, “the Tshebiner Rov told Rab Leibel, but I will tell you a personal story of a mofes that I had with him that is perhaps greater than all the other mofsim”! “When I was Rov in Tshebin, I married off my son. At that time, your grandfather was living in Tshebin, and I invited him to participate in a sheva brachos, He was accompanied by your father, Rav Moshe Stemple, and a number of chasidim. In the middle of the seuda, your grandfather took some money out of his pocket and gave it to one of the bochurim, asking him to go buy a barrel or beer. “When I saw this, I came over to him and said, “Why does the rebbe have to spend unnecessary money on beer? I am hosting the seudah, and there is plenty to drink.” “Tosafos says,” the Kedushas Tzion answered, “that it is the custom for a guest to buy drinks for the person hosting him.” “There is no such Tosafos in all of shas! I responded. “Your grandfather didn’t reply-he just kept quiet. They bought the beer and put it out on the tables. A while later, I was learning Maseches Kesubos, and I came to Tosafos on daf 57b. The words of Tosafos jumped out at me, ‘It is the custom for a guest to bring drinks to his host to find favor in his eyes.’ I realized that your grandfather was correct, but he did not respond. He let himself be embarrassed rather than reply to my words, even though everyone had heard what I said! That made such an impact on me that I whenever I learn this Tosafos with talmidim, I tell them about the greatness of the Bobover Rebbe, who embodied that which Chazal state about a person who lets himself be shamed and does not answer, “To me,” the Tishebiner Rov concluded,” this story is more choshov than any stories about miracles that he accomplished!” (Binyan Shlomo).

Being a baal gaiva is so far removed from the path of being humble. We do not always know what to say, or the right approach caring and helping another person. We are mispallel to H for His wisdom and proper derech in life. We hope to be able to help others with sincerity and with truthfulness. Should one come across a situation where it is best to say “I don’t know “I will find out ““I will look it up” rather than give over information that is not accurate, misleading, and surely if not appropriate. I have been in Rav Dovid’s shiur or asked him personally when he would say he has to and does look something up. Mispallim, patients, clients and other, expect honesty. Being humble, sincere, and caring goes a long way. H Yisbarach specifically through the Torah has shown us the many experiences of the Benei Yisrael the consequences of wrongdoing and the kindness of H and all His goodness He gives Klal Yisrael for our maysim tovim.  We truly thank Him for all the opportunities of doing maysim tovim He gives us. May this coming Tisha B Av turn into a yom tov, but whatever H’s decision will be, we pray that the days, months, and years ahead should be filled with much happiness, simchas, refuah shelaima, shidduchim, achdus, to be able to be mekadeish H as often as possible with continued zeal and conviction. Hopefully, Moshiach will come soon. This and all my articles are dedicated to Klal Yisrael. Thank you
Sincerely, Rabbi Yehuda Blank