Hasidic Jew Admitted for Bone Marrow Transplant

[oncnursemsn]

For those who don't live in leukemia/lymphoma world, this is a rare type of lymphoma that presents with open weeping, bleeding difficult to heal skin lesions anywhere on the body. The only definitive treatment for these sores is chemo followed by a transplant.

Prior to Yoshi's BMT admit, he had endured many rounds of chemotherapy, so he was somewhat familiar with the drill. He had a steady parade of Hasidic visitors- all from Boston. What we didn't realize is how closely knit this community is- and once the Boston Hasidic Jews heard that "one of their own" was in their city, they rallied and came to visit on a regular basis. It didn't matter that they didn't know him, they were there to support him through his treatment. On Shabbat (Friday, the Sabbath), the Rebbe (Rabbi) would come with many more visitors and have a modified worship service. Every visitor came with food- tons of Kosher food. They couldn't cook in our kitchen as it wasn't Kosher- so they brought their own hotplate! It was an honor to be approached by a bearded young man with a plate heaping full of food. Unfortunately, not all the staff embraced their show of gratitude with acceptance. Some nurses (and housekeeping staff) complained and moaned when they saw these visitors approach the kitchen with their food and hotplate... They were loud, took up a lot of space and monopolized the kitchen while they were cooking!

So the many chemo visits helped us to identify what was going to be important for this young man, and also draw up a contract. As the weeks of treatment passed, we began to see that the transplant admission was potentially fraught with problems. Coming in for chemo is a routine admission- the actual transplant a bigger deal. One must expect to stay 3-6 weeks on average while marrow recovery takes place. The patient is much much more immunocompromised for a longer period, and preventing infection that much more important. Though patients generally recover faster today due to growth factors, they still expect to get pretty sick- fevers, chills, mouth sores, diarrhea, possible sepsis, respiratory failure, etc etc. There is a slight chance that they won't recover.

Hasidic Jews don't worship with both sexes together- they are extremely modest. Yoshi preferred male nurses and docs, but that wasn't always possible. He frequently had a room full of visitors- as many as 10 men in huge fur hats, coats. Visiting hours didn't apply to his visitors. He was able to eat through his chemo treatments, so his room was usually covered with boxes, jars, bags of Kosher food- more than one person could reasonably eat in a 4 day period! One of his visitors even brought him a HUGE stuffed toy horse- what reason- I never did find out. As this is an adult BMT unit, we don't allow overnight visitors unless the patient is eminently dying or there is a language barrier and we need the visitor to translate.

Prior to his, BMT admits, the team sat down with Yoshi and his father. (His wife would stay behind in NYC.) It was agreed to keep visitors to 4, that food would be cleaned up and put away at the end of every day, that he could have one visitor stay with him at sundown on Friday night. Observant Jews are not permitted to do any work on the Sabbath. Pushing the call light- is work! Pushing the steel plate to enter and exit the unit- is work! I still remember the 3 or 4 men patiently waiting at the entrance of the unit for someone to come and push the steel plate. When they were ready to leave, again would stand patiently until someone noticed and let them out. (I never did find out how they got to the street level from the 8th floor- walking down 8 flights of stairs seems more work then pushing two elevator buttons, but what do I know?) He had to agree to sometimes having female nurses and doctors- who had to examine him. Even in his modesty, he complied. In general, most Hasidic Jews have tremendous respect for the medical community and are compliant with rules and treatment.

Male Hasidic Jews wear full beards, white dress shirts, and black pants and dress coat. After he was admitted, Yoshi maintained this dress during his entire transplant, though he did lose much of his beard and hair. He had open oozing lesions on his arms, back and abdomen- that by the end of the day, had oozed on his white dress shirt. Ugh. His visitors faithfully kept him in clean white shirts. The actual transplant was quite an ordeal, he got very sick. His friends didn't understand that when he had bleeding mouth sores and ulcers down his GI tract, that he couldn't eat. The food still flowed, it just was eaten by visitors and not Yoshi. We had to constantly reinforce the "food put away by end of the day" rule- they seemed to be mystified by our hypervigilance with hygiene. We repeatedly reminded them about the need to reduce bacteria in the room- hand washing, gels, no sick contacts, etc. I was explaining to one young man that bacteria could pose Yoshi great harm, only to come back later and find the visitor on the floor. He explained that he was "looking for the bacteria." These men typically spend many many hours studying and discussing the Torah-(the first 5 books of the Bible), but after doing my own research of this culture, often don't have more than an 8th-grade education. This visitor didn't have a concept of what bacteria are- invisible to the eye but potentially lethal.

Yoshi had specific times in the day when he studied the Torah and prayed- and I knew during this time he didn't like to be disturbed. He was scheduled for a CT scan at 2 pm, and he had to get washed up and changed into a hospital Johnnie. I reminded him in the morning, and as it got closer to 1, he was still in a white shirt and black pants. Getting nervous, I interrupted him while he was reading- and he gave me what I thought was the "thumb's up" sign. Great! He's going to get ready. Only to come back later, and he's still reading and hasn't changed. Once again, I interrupted, to get the same thumb. He put everything away later and explained he was trying to signal that at 1 pm he would get ready. They believe that you can't point your finger up- it's disrespectful to Adonai. (The Lord) Clearly, I didn't get it!

Yoshi made it through his transplant thankfully. Unfortunately, after he returned home to NY, his lymphoma returned, and he and his wife decided not to return for more treatment. He died last year, and his wife sent us a wonderful thank you letter- that she was impressed that we showed Yoshi and his visitors' respect and bent a lot of rules to accommodate his faith. I was struck by how tight this community is, and how they rally to support their members. I hope too, that our staff learned a bit of tolerance and acceptance of those from different faith and lifestyle. I grew up in a very liberal Jewish home and really didn't know much about this branch of Judaism.

I am not so naive as to not recognize the difficulties that particularly the younger members of this faith experience living a very conservative and simple lifestyle in the 21st "techno" century. Observant members must dress differently, are forbidden movies, TV, and a lot of modern conveniences. Knowing some of the challenges Yoshi faced, makes me even more impressed that he made it through one of the more aggressive therapies.

[achot chavi]

reality and hospitality differ:

cultural differences have been a way of life in large cities with many different ethnic groups. it's very important to seek help from the leader (in yossi's chassid sect that would be the rebbe in charge), and ask questions about what is and isn't possible for his group. then mutually establish a plan that incorporates adjustments to those impossibilities. then the rebbe would communicate the regime/plan and it would be enforced by him.

i don't know the poster but this isn't generally true. as a jew, i would prefer the staff ask me rather than go "above my head" to a rabbi (even my own) to ask these question. if i don't know than i would rather ask than have the staff do it- it can also lead to misinformation. as with all special requests- from any group- get it from the pt or her poa than an outside source.

as another poster indicated, the educational level in earlier times was quite low, as it was for most groups. however, education became the pathway to success and so most chassids respect that and attend school as long as is feasable economically.

again, this differs based on the location of the group, their economic situation, the restrictions forced upon them by local governments etc. i think education is, and was, always valued- but not always available or feasible.

a great sense of humor, particularly for themselves exists, and is illustrated in the "stories from chelm" about european jews whose sense of the ridiculous entertains everyone. i think the bacteria searcher under the bed was an example of that.

just to be clear- the stories from chelm were fictitious not real. i think most groups searched for entertainment and humor as an outlet.

no patient should be subjected to extreme noise when in a compromised state, and yossi's needs as well as those of patients near his room needed to be respected, so it would have been prudent when the chassids' voices escalated, to arrange for a conference room, classroom, whatever for the participants who could then have a spokesperson deliver the results, having ascertained from the group that what would be said is actually what had been decided. disagreement could erupt if diversion occurred from some who hadn't really accepted the decision.

totally agree- the staff's job is to maintain some semblance of order and quiet and it is their right to limit visitors if that is in the pts good. i once had the unfortunate experience of sharing a hosp room (after giving birth) with a staff member who had a constant flow of at least 20 people night and day- her husband and sisters all worked in the hosp and they all kept coming to visit. after 24 hours i gladly waved goodbye and went home to sleep.

religious services can be done only when a "minyan" of 10 or more people is present. if someone is ill, they need not attend. in judaism one does not say prayers for another, as christians do.

i think prayer can be done in any form- while it is preferable with 10 men, it can be done in private, in any language and jewish people do pray for other people but not instead of or in place of other people.

it surprised me that on shabbat, heavy dishes of food and apparati were carried by the chassids into the hospital.

actually that isn't a problem if prior to the shabbat an "eruv" or boundary was prepared so that the area from the hospital to the home it came from was include.

in jerusalem

not just jerusalem but in many many areas all over the world!!!!!!!!!!!!!!!

for shabbat the very orthodox place a rope

not just a rope, this is a complicated issue and can not be simplified as you are describing it. i am sure that the group took care of what they had to

around as many houses as is wished for a large group, making the area within the rope like the same house. then heavy casserole dishes, etc. could be carried to all. otherwise, that isn't done house to house. so accommodations in observance result from all the discussions, and can happen on the spot, if needed and the head rebbe is present.

this isn't a forum for religious explanations but one need not be a rabbi to create an "eruv" as you described. again i am sure that the group did what they had to and it was fine.

[Vito Andolini]

reality and hospitality differ:

cultural differences have been a way of life in large cities with many different ethnic groups. it's very important to seek help from the leader (in yossi's chassid sect that would be the rebbe in charge), and ask questions about what is and isn't possible for his group. then mutually establish a plan that incorporates adjustments to those impossibilities. then the rebbe would communicate the regime/plan and it would be enforced by him.

the good intentions of the nursing staff for yossi's religious needs didn't include boundaries, as our needs to accommodate differences can lead to an "anything goes" attitude. a chain of command was needed, to ensure compliance that benefited yossi, even if some were disappointed.

as another poster indicated, the educational level in earlier times was quite low, as it was for most groups. however, education became the pathway to success and so most chassids respect that and attend school as long as is feasable economically.

a great sense of humor, particularly for themselves exists, and is illustrated in the "stories from chelm" about european jews whose sense of the ridiculous entertains everyone. i think the bacteria searcher under the bed was an example of that.

it's easy to think that the observances of one of the members of another culture, reflects that of all. in ancient as well as modern times, disagreement is a way of life, which explains the need for constant discussions among chassids the goal of which is to come to some agreement about the subject of the disagreement. that involves a lot of talking, hence noise.

no patient should be subjected to extreme noise when in a compromised state, and yossi's needs as well as those of patients near his room needed to be respected, so it would have been prudent when the chassids' voices escalated, to arrange for a conference room, classroom, whatever for the participants who could then have a spokesperson deliver the results, having ascertained from the group that what would be said is actually what had been decided. disagreement could erupt if diversion occurred from some who hadn't really accepted the decision.

chassids are a jolly group who like to have their antics appreciated, so it sounds like the exaggeration of yossi's gustatory needs is an example of that. it certainly isn't required that a banquet is given nightly. in fact the usual hospital discouragement of visitors eating with patients would have been appropriate. mothers in the culture tend to overfeed their children and make them feel guilty if every morsel isn't consumed. hence pressure to do that may have made yossi uncomfortable. the remaining food could have been taken to the cafeteria to be consumed on paper plates with their own plastic utensils by the visitors. nothing in jewish law prescribes that it be kept by the patient. usually the saturday meal is cooked friday before sundown and left in a warm oven, so a small crock pot would have sufficed for yossi's saturday meal.

religious services can be done only when a "minyan" of 10 or more people is present. if someone is ill, they need not attend. in judaism one does not say prayers for another, as christians do. "say one for me" isn't done. if yossi felt up to it, shabbat services friday night and saturday might have been done with 10 men, in an abbreviated form in his room. if his dressings were changed before that, grungy linens and his white shirt need not have been seen.

it surprised me that on shabbat, heavy dishes of food and apparati were carried by the chassids into the hospital. possibly that happened before sundown on friday. then those necessary for yossi would have to stay there until sundown saturday. however a non jewish person could have carried the other accoutrement down to a waiting taxi (whose driver was not jewish) to be delivered wherever the group agreed they should go. however, money cannot be exchanged on shabbat.......another dilemma which might be resolved by someone who wasn't jewish lending the money for the cabbie. ingenious ways are invented for such things, with the enjoyment of all afterward.

in jerusalem for shabbat the very orthodox place a rope around as many houses as is wished for a large group, making the area within the rope like the same house. then heavy casserole dishes, etc. could be carried to all. otherwise, that isn't done house to house. so accommodations in observance result from all the discussions, and can happen on the spot, if needed and the head rebbe is present.

i remember a gypsy sect whose leader was dying in the hospital where i was inservice coordinator. hundreds of members camped in the parking lot of the hospital and frustrated police by their refusal to be removed. the police wanted to be respectful and let them stay. that also avoided angry demonstrations. by the time the leader died, the whole lot of them were regarded as guests who had overstayed their limits. my job was to keep the peace between hospital employees and the gypsies so resentment didn't swell and accommodation needs were respected.

jews/chassids will not resort to anger if their requests are denied, but will find a way to circumvent the inconvenience (like walking down 8 flights). in jewish hotels in america and israel, there is one working elevator on shabbat, which can be used by the infirm or non religious. a meeting of minds solves everything.

most interesting. as for using the working elevator - i thought that riding was prohibited on sabbath. wouldn't riding an elevator be included in that category? it was once explained to me that one can't ride in a car because starting it is work, thus prohibited. creating the spark = work.

near me is an orthodox neighborhood, including some hassidim, some of whom i know and talk with about all of this, as i like kosher meat and sometimes shop at the local kosher butcher shop, where we sometimes sit and have coffee and a kibbitz (friendly chat, passing the time). they find it most interesting that a black guy is buying kosher meat. yes, many black muslims eat essentially kosher but they have their own butcher shops. anyway, that's where i get my information on this topic. i just have never heard an explanation that satisfies - about the shabbos goy who comes in and turns lights off and on for the people observing sabbath, who will fix the electric box, the heater, whatever. i know that sick people are allowed to do whatever is necessary to preserve life, no matter what day it is - sabbath, holiday, normal day. and those who care for the sick are considered to be doing mitzvot - good deeds, thus are not violating any religious laws. animals, babies, children, the aged, the sick, the infirm, pregnant women - all are cared for, no matter what. this makes perfect sense to me, as i think god does not want us to be cruel to the suffering.

i just don't comprehend why it's ok to do things like force observers of sabbath to wait for someone to come turn their electricity on when it's freezing or roasting in their home, where i thought resting from work included being as physically comfortable as reasonably possible. to me, it is more work to be miserable than to be comfortable. i know the day is to spent in reflecting on god and his mercies, studying his word, and enjoying family and friends, resting up in general. i mean no insult but i think that some religious practices are not necessarily scriptural but are man-made. that goes for my own religion as well, so please don't think i'm picking on anyone's religion. just my .

as for carrying heavy dishes - is there not a weight limitation on what can be carried on sabbath? so even if the distance limit is obeyed by setting up a rope, isn't the weight limit be still in force? interesting that you state that a way is often found to circumvent the inconveniences by the leader making a ruling on the spot. no insult intended but haven't these things been settled long ago? to me, this is what jesus meant when he castigated the religious leaders of his day, telling them they should enjoy a day of rest and not strain or force others to strain to obey various man-made rules. he said the sabbath is for man, not man for the sabbath. again, just my musings. i know religion is an awfully volatile topic and it is easy to be offended. please know that i am not criticizing, only straining to make sense of it all. shalom. peace. btw, i have nothing but the highest regard for the people whom god chose above all others, the people of whom he himself was born.

oh, another thing - those who cannot walk to the synagogue don't get to go. they get isolated by having to stay away from the congregation. this doesn't seem in keeping with what sabbath is about. does anyone have any insights on this? although, a few weeks ago, i was amazed to see an elderly man being pushed in a wheelchair to synagogue on sabbath by another orthodox man! i was really surprised. yes, i see people pushing babies in strollers but that comes under caring for the babies, something necessary and blessed. but never have i seen anyone pushed in a wheelchair before and i have lived in this area for a long time. i'm going to have to ask about it at my next butcher shop kibbitz. shalom.

[achot chavi]

most interesting. as for using the working elevator - i thought that riding was prohibited on sabbath. wouldn't riding an elevator be included in that category? it was once explained to me that one can't ride in a car because starting it is work, thus prohibited. creating the spark = work.

near me is an orthodox neighborhood, including some hassidim, some of whom i know and talk with about all of this, as i like kosher meat and sometimes shop at the local kosher butcher shop, where we sometimes sit and have coffee and a kibbitz (friendly chat, passing the time). they find it most interesting that a black guy is buying kosher meat. yes, many black muslims eat essentially kosher but they have their own butcher shops. anyway, that's where i get my information on this topic. i just have never heard an explanation that satisfies - about the shabbos goy who comes in and turns lights off and on for the people observing sabbath, who will fix the electric box, the heater, whatever. i know that sick people are allowed to do whatever is necessary to preserve life, no matter what day it is - sabbath, holiday, normal day. and those who care for the sick are considered to be doing mitzvot - good deeds, thus are not violating any religious laws. animals, babies, children, the aged, the sick, the infirm, pregnant women - all are cared for, no matter what. this makes perfect sense to me, as i think god does not want us to be cruel to the suffering.

i just don't comprehend why it's ok to do things like force observers of sabbath to wait for someone to come turn their electricity on when it's freezing or roasting in their home, where i thought resting from work included being as physically comfortable as reasonably possible. to me, it is more work to be miserable than to be comfortable. i know the day is to spent in reflecting on god and his mercies, studying his word, and enjoying family and friends, resting up in general. i mean no insult but i think that some religious practices are not necessarily scriptural but are man-made. that goes for my own religion as well, so please don't think i'm picking on anyone's religion. just my .

excellent question, your definition of work is different in the torah and its laws. you will have to study it to really understand.

as for carrying heavy dishes - is there not a weight limitation on what can be carried on sabbath?

no

so even if the distance limit is obeyed by setting up a rope, isn't the weight limit be still in force? interesting that you state that a way is often found to circumvent the inconveniences by the leader making a ruling on the spot. no insult intended but haven't these things been settled long ago? to me, this is what jesus meant when he castigated the religious leaders of his day, telling them they should enjoy a day of rest and not strain or force others to strain to obey various man-made rules. he said the sabbath is for man, not man for the sabbath. again, just my musings.

i'm not going to debate a conversation that was held over two thousand years ago. each person has to do what is right in their own eyes.

i know religion is an awfully volatile topic and it is easy to be offended. please know that i am not criticizing, only straining to make sense of it all. shalom. peace. btw, i have nothing but the highest regard for the people whom god chose above all others, the people of whom he himself was born.

no offesnse taken!!!we are all born in g-d's image. we must all take care of each other.

oh, another thing - those who cannot walk to the synagogue don't get to go. they get isolated by having to stay away from the congregation. this doesn't seem in keeping with what sabbath is about.

beleive it or not it is more important to keep the tenets of the shabbat than to pray at a synagogue with a minyan ( ten men).

does anyone have any insights on this? although, a few weeks ago, i was amazed to see an elderly man being pushed in a wheelchair to synagogue on sabbath by another orthodox man! i was really surprised. yes, i see people pushing babies in strollers but that comes under caring for the babies, something necessary and blessed. but never have i seen anyone pushed in a wheelchair before and i have lived in this area for a long time. i'm going to have to ask about it at my next butcher shop kibbitz. shalom.

if there is an "eruv" turning the whole area into a private courtyard than it isn't a prblem according to most rabbi's/ pushing babies in strollers does not fall under taking care of them as it is possible to care for a baby in your home and not take him our for the duration of the one day, pushing a carriage would be the same as pushing a wheelchair.

[Vito Andolini]

If there is an "eruv" turning the whole area into a private courtyard than it isn't a prblem according to most Rabbi's/ Pushing babies in strollers does not fall under taking care of them as it is possible to care for a baby in your home and not take him our for the duration of the one day, Pushing a carriage would be the same as pushing a wheelchair.

I appreciate your response, Achot Chavi. I don't understand it all but do appreciate it. Thanks!

[achot chavi]

I appreciate your response, Achot Chavi. I don't understand it all but do appreciate it. Thanks!

These are difficult laws, ones that take Rabbis a long time to decipher, as a nurse and in a limited space i couldn't expect you to understand. Carrying anything - even a tissue in a public area is not allowed on the Shabbat, there are ways to turn public areas into private courtyards thereby allowing Yoshi;s friends to bring him food on the Shabbat.

[FireStarterRN, BSN, RN]

Thanks for a fascinating story.

[oncnursemsn]

A quick clarification- all the food delivery and cooking was done well before sundown on Shabbat, and I do remember there being pots with lids on them being brought in from someone's home- already prepared and warm.

Achot chavi was correct in the Rabbi's interpretation of the laws- how can it be "less work" for someone to stay with the pt and physically come to the nurse's station to let the nurse know that Yoshi needed something- instead of just pushing a white bell? The act of pushing- using electricity is "work". Fascinating...

[hzrizen]

That story was informative and insightful. Thanks so much for posting.

[mmiriamasher]

Chavi is short for Chavatselet, name of a flower, the daffodil I think.

[sewnew]

Chavi is short for Chavatselet, name of a flower, the daffodil I think.

Actually, Chavi is short for the name Chava. Chava is the Hebrew equivalent of the name Eve (as in Adam and Eve). I have never heard of a Chavatselet before, but it is very possible that Chavi is short for that as well.

Many thanks to the OP for this story!

[RATCHETT, BSN, RN]

Incredible story.

[acissej]

Thanks Jess!

I learned so much from your article

:)