From the desk of Rabbi Leonard (Yehuda) Blank MS,BCC
Director of Programming, Chaplaincy Commission and External Affairs
Rabbinical Alliance of America/Igud HaRabbonim
917 446 2126 firstname.lastname@example.org
August 27, 2021 ###
A SPECIAL REVISED ARTICLE INCLUDING AN
EXPERIENCE WITH A PEDIATRIC PATIENT
ADVOCACY, EMPOWERMENT, EDUCATION, DIPLOMACY,
CARING FOR THOSE IN TIME OF NEED
BEING MEKADEISH H PERSONAL REFLECTIONS
My Rebbi Rav Dovid ztkl was an anav, very humble. He surely would not have spoken about himself (see my quote at end of this article). As a talmid, I surely should not speak of any of my accomplishments through the years. However, whatever I shared in any of my articles was for a limud and example of why I have done so. I have hakaros hatov to the Ribono Shel Olom, to my Rebbe who was like a father, a mentor a confidant to me , my parents A”H and my wife A”H. As we enter a New Year, I can only be mispallel to the Ribono Shel Olam all that I have acquired these past years, will give me the koach to continue helping others and in a sense, begin a new life filled with Torah, Avoda and Gemilus Chasadim . May all of us have a year filled with simchas, share besuos tovos and maysim tovim with good health and much happiness. For me to write anything about Rav Dovid would do an injustice in just few lines, but want to share in my theme of how much we all can be a shliach of H, not just in achdus, and being mekadeish H, but advocating for our mispallinm and for those who are ill, dealing with doctors, medical staff, and others. Especially giving support to them, their care givers and family members. I am sharing my own experiences as a chaplain, a rabbi and also how my other positions brought me robust opportunities of helping others which might be helpful to others in similar situations. I hope whatever positions I will share will not chas veshalom appear to be with gaava. In honesty, I humble myself before the hundreds of rabbonim, chaplains, rebbitizens and other professionals who might be reading my article. The major theme throughout is educating and empowering professionals, diverse staff, care givers, family members and others the ability to advocate for ones self, for family members and so on with education and training. Interesting how clergy including rabbis found encouraging their congregants to step to the plate and be the voice of their loved ones, their relationships and so on which could enhance and even save lives.
At the United Jewish Council of the East Side, a local social service organization and umbrella organization for many Jewish institutions, as well as serving the Lower East Side community of men, women and children of diverse backgrounds, I served under a number of well known Executive Directors, the last one was Mr. Joel Kaplan Esq. ( also a noted and well know Chazan). He is a person not only of distinction, but a professional who encouraged and supported dedication, devotion, bright and meaningful ideas and opportunities bringing those ideas to fruition. In my position as Director of Special Programs I helped create, partner with and facilitate many diverse programs for the Jewish community and entire community at large. It would take a number of pages to share the many programs I was involved in from the youth to the senior age populations. Mr. Kaplan’s mission was to always be Mekadeish H ,to give care with expertise, professionalism, sincerity, honesty and integrity. All those who were given or sought the assistance at the UJC were always to be treated with utmost respect and courtesy. He appreciated creativity and ideas that would be the finger on the pulse of what was beneficial. It was there that I spearheaded a number of programs including the Manhattan Coalition on Mental Health Issues of the Elderly in response to suicides of the elderly. There were quite a number of suicides occurring on the Lower East Side and I was also notified by the local NYPD precinct . I responded to the location and even found in their pockets why they were committing suicide. Many which occurred jumping from their apartment windows while a spouse or relative was in another room unaware of what was happening. There were also other methods of suicide occurred not for discussion in this article. After doing much research on this topic including meetings and interviews with specialists in the field of geriatric suicides and suicides of other age groups, visiting families of those who committed suicide and becoming a member of a number of mental health organizations and agencies, I partnered with a wonderful professional Mrs. Martha Pollack LCSW Director of Social Work for the UJC. Her love and passion for her profession was and continues to this day as the Senior Director of Elder Abuse Protective Services for Jasa. We were a fantastic team, making the coalition well known throughout NYC. The coalition made up of psychiatrists, psychologists, social workers, medical doctors of different disciplines and other professionals. My knowledge and expertise grew by leaps and bounds, all with the encouragement of Joel Kaplan and Martha Pollack. We did presentations and training programs together throughout the city for professionals, front line workers, senior groups and many government, and social service organizations and agencies. The MCOMHIE members worked together in facilitating important out reach, developed information and creative ideas reaching the masses about the mission of our coalition. What was important how, when, why being an advocate for ones self, for clients, for congregants of the clergy was so important. Many seniors for instance who were having serious symptoms were diagnosed later on with clinical depression amongst other serious mental health diagnosis but were not being treated adequately, in a timely fashion, and often not encouraged to seek the care of a mental health professional. Patients were often being given psychotropic medications without the appropriate mental health follow up. Material was developed, aimed at medical practices and other areas as well. It was important to empower through education, support and encouragement for seniors, their caregivers, family members and others to learn the various symptoms to bring to their pcp and other professionals in their lives including and especially the ergy. Suicide often occurred after having seen their pcp only within a month .The importance of advocating on behalf of a loved one, a family member, or a member of a congregation to ensure proper care, to encourage appropriate intervention, before serious consequences would occur. Helping to recognize the symptoms by front line workers, even someone who delivers meals on wheels if noticing something of concern would share that information with his or her supervisors. I became a member of mental health, social service and caregiver organizations. I gave either together with Martha Pollack ,other members of the coalition or my own solo presentations workshops and as a panelist through the years including cultural sensitivity, end of life issues, palliative care, spirituality, depression, dementia, coping with loss and grief, stress management, caring for all backgrounds, successful strategies of self care and other vital topics as well. These presentations were given at NYU, NYC Caregiver Conference at Fordham University, Pace University, Alzheimer’s Conferences, Jarvie Commonweal Conference, social service organizations, agencies, and many others through the years. This coalition was quite busy following 9/11 with numerous presentations and workshops. I still have in my possession a stuffed bear with a note from an elementary school child. Thousands of stuffed animals were collected from throughout the United States meant to be given to the children of those who died or to their loved ones. Our coalition gave them out to seniors and others who were going through difficult times at our many presentations. Attached to my bear was a 5 ½ x 5 ½ round laminated note “ I hope you like this Teddy Bear and I know that your Mommy or Daddy died. I hope this makes you feel better. David _____ Flowermound Elementary Sept 2001”. I also eventually became the Executive Director of the Lower Manhattan Health Care Coalition initially created and led by Mr. Joel Kaplan facilitated and developed many vital and important programs His influence on good will and care for all continued. He continues to be a wonderful role model and is the Executive Director of Yeshiva Darchei Torah, Far Rockaway, NY.
At the Bialystoker Center for Nursing and Rehabilitation, where I was the Director of Pastoral Care and chaplain developed, facilitated various chaplaincy interventions and contributed to the interdisciplinary team meetings and collaborations. Diplomacy was a major component in any of my successful collaborations, training, advocacy and remaining loyal to the administration, my coworkers, patients (though they were called residents) family members, caregivers etc. Diplomacy always had to be with sincerity and honesty. The word trust had a special meaning . Never coming across as I know more or I know better was part of diplomacy. There is no question that CPE ( Clinical Pastoral Education)was extremely helpful and beneficial. It added credence as a professional having taking professional clinical education that was offered nationwide and recognized by the US Dept of Education. Also recognized by major chaplaincy organizations such as National Association of Jewish Chaplains ,Healthcare Chaplaincy. I created various programs and collaborated with other organizations, agencies, institutions of higher learning and clergy from diverse religions to benefit those patients and staff of diverse religions and cultural backgrounds. The Bialystoker for many years was only for those of the Jewish faith, but eventually their charter changed and accepted men and women from all backgrounds. Family and caregivers were pleased being their voice dealing with end of life issues, ethics, religious and spiritual rights not only when the patient was at the snf, but also when sent to the hospital or other facility. Staff and administration including all clergy in the neighborhood, knew I worked and was supportive of the patients, their healthcare proxies, family members and caregivers. When after 80 years the Bialystoker snf were to close their doors, I was part of the discharge committee. For those who had no family, I became their family ensuring their care when they were discharged to another facility which continued until their deaths. I was involved in being their voice, making sure they were given all the care necessary including whenever they were hospitalized. I actually saved their lives. I was in constant touch with their medical doctors whenever they were hospitalized. Sometimes they were given up, but there was a change in attitude at the hospitals when they realized I was involved and intervened speaking to the medical and social service staff. I remember one of the patients who was on one of the occasions hospitalized. I received a call at about 5 AM from the hospital and it was the first day of Pesach. Yes, I made sure to answer all calls whenever it pertained to those patients in my care. The doctor who I spoke to on that shift shared the concerns, and procedures that could be risky. That doctor advised against any procedures and to let him die naturally. I asked a number of questions which I was familiar with and requested that doctor to call me back with the answers I was seeking. I refused to consent to doing nothing and wanted to do everything within reason to not only keep him alive, but with a decent chance of survival. I waited and waited, but the phone did not ring. In the meantime, I met Rav Dovid on his way to the yeshiva for davening and shared with him my concerns and decision making. He shared his thoughts and was very supportive to what I felt should be done depending on the responses from the doctors. I was not going to daven when this patients life is in my hands. So, I called the hospital and another doctor spoke to me reviewing his chart. She shared the pros and cons of the procedure would be and mentioned he did had a decent chance of survival. I therefore gave permission to proceed. In the meantime a family meeting was called for after the procedure to decide what to do if death occurs. I was told I would not be receiving any calls until after the procedure scheduled for later in the day. I finally spoke to a doctor in recovery who said my concerns, questions, and support of the doctors with the blessings of my G, the procedure was successful. A family meeting with the medical staff and social workers would take place later on in the week or after the Jewish holiday. I kept in touch with the hospital and the day the meeting was to take place I was informed the patient was no longer at the hospital. He was discharged back to the snf he was living at and in good spirits. He went on to live a number of years. The same experiences I had with the other patients I became family for. I received absolutely no renumeration for anything I did for them. Any funds they might have had went directly for their care. There are many stories of end of life and other concerns at the snf which I was their voice and or the voice of their family. I did the same throughout my years at the snf for all patients Jewish and not Jewish. I even made sure to keep non Jewish patients who died from being buried at Potters Field finding funds for them to have a funeral and burial collaborating with other religious or cultural organizations and a local funeral home. There are many stories and experiences I could share, how important it is to be an advocate or help educate others on many important matters of life and death. While writing this article, I remember one year on a Shabbos on East Broadway a man was hit by a car and unconscious. He had no identification on him and I did not know who he was other than he was Jewish and had to be rushed to the hospital. I got on the ambulance and made sure to say I was somehow related. The bus flew to Bellevue Hospital ER and then taken to surgery. I was asked if I could give consent for him to be treated .The doctors said they could save his life. There was no choice other to let him die. He survived and somehow relatives were found. I remember being given a seat in an office with peculiar looking specimens in a large glass jar when I came to realize it was a brain from someone who had died and being kept as a specimen. This experience brought back memories about a devoted caring human being who was a rebbe in the Yeshiva MTJ ,Rabbi Naftoli Reichman ztl. He was a Bresleva Chasid who was so remarkable what he often did. Whenever there was a poor person with no family who came to find a place to hang out in MTJ or he found out about who had no family and was hospitalized at Bellevue Hospital, he became their family. He visited them everyday when in the hospital, bringing whatever nourishment or items they needed and not provided by the hospital. In those years, Bellevue Hospital had rooms called hospital wards with a lot of patient beds lined up facing each other. Rabbi Reichman would take it upon himself to ensure the those people he knew how important it was to be their family and advocate for them. This was to safeguard and protect them making sure they got all the medical care. I once heard the same from Rav Nisan Alpert ztl all the reasons even a rabbi as himself should be like family for a Jewish person to ensure he/she got the best care possible and not to feel or be alone in this world. These two great rabbi’s felt strongly especially years ago for the hospital medical staff to know the patient had family and were more keen on giving them better treatment and care.
So how did Chaim Aruchim come into this picture. When I started working at Metropolitan Jewish Health System, I also partnered with Chaim Aruchim with it’s devoted head Rav Shmuel Lefkowitz .Unfortunately, hospice was not looked upon favorably by some as it was thought there might be medical and nursing staff promoting dying peacefully. Also the use of medications that many felt if not used appropriately or even sparingly, could cause difficulty with respiration. Chaim Aruchim with the collaboration of MJHS did many trainings, on various medications nutrition and hydration amongst other issues and concerns. I was to promote good will about hospice and to better understand the spiritual and religious concerns of those Jewish families who wanted quality of life for as long as possible. I have written in previous articles how hospice can actually enhanced the quality of life of a patient with appropriate pain management, treatments and excellent care. It was not unusual with quality hospice care for some patients to live longer than expected .Some of my responsibilities were to be part of family meetings of possible hospice patients , or during intake, and often at the actual time patient was becoming a hospice patient. To be a liaison for and with the family, hospice staff and rabbi .To ensure everything was clearly understood, all of the concerns and issues family and caregivers might have had were addressed. I would also meet with family rabbis to encourage them to be involved with the family with their consent . When no rabbi was involved I would advocate and be the voice of the family and patient. It was also shown how medications some were concerned about actually enhance breathing rather than suppressed breathing greatly enhancing their condition . This too was mentioned in a previous article how a young mother’s last weeks of her life was more relaxed, medication that controlled her pain enhanced her breathing and enabled her to have quality time with her husband, children and family. Her family rabbi was consulted, family meetings as well as IDT meetings were held . Another area I worked on was to encourage the patient or family member rabbi who is knowledgeable to speak and discuss as many times as needed with the hospice or family doctors for their knowledge in helping the family and or patient make the right decisions. I myself have helped to clarify for the family about medications their effects with the assistance of the medical team and to share what the family concerns are with the treatments.
Eventually, Chaim Aruchim trained a group of rabbis under the guidance of well known poskim and medical specialists including from MJHS. How did Chaim Aruchim help families. Unfortunately, there are rabbonim who are not knowledgeable in medical, medications, treatments, or and end of life situations. The famous cliché the rabbi would tell a family member should a person have a heart attack to do everything to try to get the heart beating again on its own. But there is a lot more to being resuscitated (CPR)or intubated. It is not a comfortable picture to see. There are numerous shailos regarding CPR, life support, and various medical procedures. The same with other end of life concerns.. Though I still have a relationship with Chaim Aruchim I no longer worked with them as they developed a group of well trained rabbis knowledgeable in halacha, medical and medicine. As I mentioned there were numerous times when I was the liaison between the family, the medical staff and the family or patient rabbis if there was one. The same as I mentioned earlier with medical staff in a hospital setting. Chaim Aruchim has been a meaningful solution for rabbonim who were not knowledgeable in medical language and education and either deferred any such questions or for family members or care givers to contact Chaim Aruchim. There are many who do not know how Rav Dovid ztkl often was involved in end of life issues or medical procedures brought to him by patients and family members. He would often have discussions with medical doctors to help him decide and respond to the patient and or family. Brouch H we now have other rabbonim and poskim who have taken an active part often visiting the patient and being in contact with the patients medical staff such as Rabbi Hershel Welcher ,Rabbi Dr. Aaron Glatt who were recently panelists for a nationwide webinar for healthcare chaplains and rabbonim, Rabbi Mordechai Willig ,Rabbi Hershel Schacter and other well known posikm from the entire spectrum of orthodox communities. I personally have been in touch with on behalf of patients and or family members. I remember being with a hospice patient and his daughter who was staying with him on a particular Shabbos with them in Washington Heights. It was still about 2 hours until Shabbos and having on going conference calls between the MJHS doctor and the daughters family rabbi in New Jersey. He had a well known popular radio program. The rabbi told his rebbitzen who I heard in the background he was not leaving for his shul until a number of questions and concerns were clarified and I was not leaving until that happened. What a meaningful experience with the pressure and the clock ticking Shabbos is coming. How was I ever to get home in time for Shabbos. Finally everything – medication, pain management , hydration and other possible end of life issues were resolved. The MJHS doctor was remarkable with his tremendous patience , understanding, knowledge and sincerity giving on going responses to certain questions the rabbi had as well as the daughter and myself. Finally, I was able to leave with everything in place. The daughter was so appreciative and was able to enter the holy Shabbos with relief she knew what to do and what to expect. With her rabbi’s blessings for her father and for herself, she was more relaxed. The rabbi also gave her reassurance of what to do on the Shabbos. I called for car service and what I was tempted to call it a miracle, there was no traffic going all the way to my apartment building with enough time to get ready for Shabbos. My wife at that time the years before her diagnosis was used to my emergencies including my years at the snf. There were two wonderful and caring individuals who I worked and collaborated with at MJHS . They were very supportive of the work I did on behalf of the patients, family members, care givers and staff and their influence was truly meaningful. Rabbi Charles Rudansky Director of Pastoral Care and Mrs. Toby Weiss, Director of Cultural Sensitivity and Jewish Programming both amazing professionals to work with. Their encouragement for me to pursue the many facets of hospice care, working with other disciplines throughout the MJHS system including palliative care, pediatrics, end of life grief and bereavement teams . Helping to educate others about Jewish religious concerns and beliefs, and encouraging family members and their rabbis how to share their concerns and work together with hospice staff on behalf of their loved ones. It was also an honor to participate with the palliative care IDT’s with the with palliative specialists under the leadership of the renown Dr Russ Portnoy .My devotion was caring for patients of different faiths, cultures, and backgrounds. All of my work including collaborating with the system wide MJHS staff all the way up to and including administration was truly rewarding. With diplomacy, being sincere, and the love of working with so many devoted and dedicated staff who conveyed and shared the same sentiment as mine was truly special. There were many opportunities advocating and successfully being able to make things work for the sake of the diverse patients. There were the occasional challenges, but with disyata dishmaya, with faith in H and the sincere desire to be Mekadeish H any obstacles were resolved and the end result was to see the benefit for the patients and their family members. Being part of IDT meetings were so important. But, there has to be an effort and desire to try ones best to work things out. The has to be a willingness to want to collaborate and work cohesively with co workers, other staff and administration as well. Just to mention one other experience, I was often part of the pediatric hospice IDT and one of the well known patient at the New York Presbyterian Morgan Stanley Childrens Hospital. The rabbi involved was Rabbi Elimelech Bluth ztkl. At the same time, there was another adult patient whose rabbi was Rabbi Bluth. They were both (in different hospitals)in situations where there was constant shailos that had to be responded to. They were both in hospitals during Pesach. Rabbi Bluth gave me instructions to keep my phone next to me at all times, as I will be the liaison between him, the hospital and Rav Dovid. I reside in the same neighborhood as Rav Dovid. I would be going to Rav Dovid either in shul or to his home day or night with shailos needed to ask Rav Dovid. Mind you, Rav Bluth himself was a posek, but there were specific shailos that needed to be asked of Rav Dovid. This was an experience for my family knowing of my responsibilities even on the Yom Tov. Unfortunately after a number of weeks, the child succumbed to his illness. The parents tried throughout his illness to do everything possible to save his life. I was also involved in discussions with VITAL ONE a Jewish emergency medial transport airline helping in special times of need. Collaborating with the MJHS, with the interdisciplinary teams at Morgan Stanley, with Rabbi Bluth and most of all the parents and family of this child was very special indeed.( Please note, as in any of the cases mentioned in this article, no names are given).
There is so much to gain for a rabbi, a chaplain, rebbitzens ,family members, to use every opportunity to be involved in caring for our fellow human beings .I have been zoche in my many positions to use whatever creativity the Holy One has given me to help inspire, to educate, to help empower being an advocate, a voice for patients, family members, clients to seek the truth and the best way to be of assistance in the proper way. There are many other experiences and personal releflections from the diverse positions I held. I did not share in this article the other positions , presentations, webinars, I have held or been involved in or the many topics I have given workshops, trainings, webinars, ,panelist and so on, though some I have mentioned in previous articles .I thank the Ribono Shel Olam for all the opportunities He has given me and still doing in other ways. I thank Rabbi Mirocznik for all of his support in the many programs I have created and facilitated and I am working on presently for the RAA and other rabbinic and chaplaincy groups.
What is really important to know what a wonderful influence we can be and all the G given opportunities He gives us to care for a fellow Yid and human being. There is a famous saying “ Where there is a will, there is a way”. It is so important for rabbis to know not every situation is meant to be “fixed” by the rabbi or rebbitzen. Nor should a rabbi or rebbitzen feel everything should be addressed by the rav, but should be referred to whatever specialist would be most useful for that person or persons. I learned that from Rav Dovid ztkl. He was knowledgeable in so many areas of halacha, in his wisdom, but if a person needed advice from a specific type of specialist he did not hesitate to recommend doing so. He was so humble and did not think of himself as the Gadol Hador. From the MTJ Virtual Yeshiva event film from an interview with Rav Dovid” My best title would be an apotropos of the yeshiva -supposed to be responsible even if the faucet doesn’t work it’s my fault, so get someone to fix it” This is a quote from Rav Dovid ztkl he said about himself. I mentioned at the beginning of this article, I humble myself to the hundreds of rabbonim, chaplains, rebbitzens and other professionals who are par excellent in the work they do. I also mentioned about a new life in this forthcoming New Year. In a sense it is like a new life. Opportunities, we pray for to enhance our own lives and the lives of those who we have relationships with, and to develop a personal, meaningful and spiritual relationship with H.
The following is an excerpt from the The Shottenstein Edition of Selichos Artscroll Series Mesorah Publications Ltd Overview “By teaching Moses the Attributes of Mercy, G was teaching the Jewish people that in order for their prayers to be efficacious, they must emulate the merciful traits of the One to Whom they pray. AS R’ Yochanan put it, G told Moses, “Let them perform this procedure”, G did not teach Moses words alone, He told him that the message of the words must be carried out. The “procedure” to be performed was the content of the Attributes of Mercy. G thus showed Moses that in order to merit G’s mercy, Jews must be merciful to one another”.
May we all be zoche a Keseeva Vechaseema Tova and a Shanah Tova Umesuk
Thank you. Sincerely, Rabbi Yehuda Blank
This is a picture of the Teddy Bear I mentioned in my article above.