IN-DEPTH FEATURES
Bnei Brak's Medical Miracle: A Truly Jewish Hospital

Part II

The medical miracle known as the Mayenei Hayeshua Hospital is celebrating its tenth anniversary: Ten years of impressive technological and professional achievement in the Torah's mitzvoh of Venishmartem. For the last decade, Mayenei Hayeshua has been fighting the stereotypical, modern medical understanding of patient care, particularly in the treatment of terminally-ill patients, and more generally, the distorted worldview that the world "belongs to the young."

The first part discussed the difference in perspective that a religious medical director brings to his job at Mayenei Hayeshua, and the special challenges faced by the rov of the hospital and how he deals with them.

The Seventh Floor

We ascend to the seventh floor. As we leave the elevators, on our left is the Children's Ward. On the right is the Geriatric Ward.

The hospital is very quiet, in contrast to the unhealthy tendencies of other hospitals, notwithstanding their natural desire for noise control. Maintaining a level of quiet is one of the accomplishments of Dr. Moshe Rothschild, the hospital's director. The Pediatric Ward's walls are decorated with vibrant watercolor paintings, all in accordance with Jewish values.

Dr. Breuer amplifies this seemingly minor detail: Look what the children see here, and what do children see at hospitals for the general public?

If one were to ask Dr. Rothschild why the Pediatric Ward is located opposite the Geriatric Ward, he would certainly answer: "Know where you came from, and where you are going to" (Pirkei Ovos).

While the hospital is celebrating its tenth anniversary, the Pediatric Ward is celebrating its first.

How far-reaching is the role of hospital rabbi? Rav Hoffner relates the following story: The Pediatric Department staff decided to make its own birthday celebration. They made reservations at a Tel Aviv restaurant. "If I participate, the food must be kosher lemehadrin," said Rav Hoffner. After clarifying that the restaurant's kashrus was not up to standard, Rav Hoffner announced his refusal to participate. He warned the organizers that the kashrus is questionable. "Generally, they would ask me in advance. This time, they didn't ask. They were a bit angry with me, but the majority of the staff is chareidi, and fully understands the matter." Even when under attack, Rav Hoffner accepts the staff's criticism with love.

If one would wish to condense this article to one sentence, it would be realizing how just two words of greeting could make all the difference to the patient: When Dr. Breuer leaves the patient's bedside, he is scrupulous in wishing, "Refuah sheleimoh!" to the patient.

We stopped by the bed of an elderly Jew in the Geriatric Department. The man, deeply asleep, is hooked-up to medical equipment and tubes. "This patient is demented," Dr. Breuer clarifies. The old man is at an advanced stage of Alzheimer's disease. He refrains from eating and has forgotten how to swallow. According to the American Heritage Dictionary, "dementia" is the "deterioration of mental faculties along with emotional disturbance resulting from organic brain disorder." Between 50,000 to 100,000 people in Israel are estimated to be afflicted with dementia.

"He was at Ichilov (Hospital), not eating nor drinking. In such a case, one must insert a feeding-tube into the body. However, the administering physician over there refused to do this since, according to that doctor, he is an old man who has finished his task in this world. (The doctor) didn't help him at all. They transferred the patient here. In the merit of the warmth and loving-care that the department gave him, he was able to recover."

Depression from Chilul Shabbos

A young comatose patient was admitted to the hospital. He was treated at a geriatric hospital for the last five years. In order to ease the burden of visitation for his Bnei Brak family, he was transferred to Mayenei Hayeshua. Dr. Breuer reveals that "in reality, the main reason (for the move) was simply that a Jewish atmosphere was crucial."

Rav Hoffner adds the following point: "There are many old people who don't mind dying, as long it will be in a Jewish environment." Rav Hoffner relates how an elderly, religious Jew was admitted to a different hospital where his condition was deteriorating. He did not speak or even respond. When the patient was transferred to Mayenei Hayeshua, his condition suddenly started to improve. Later on, it was understood that the patient had been in a depression after witnessing the Shabbos desecration and lack of modesty at the previous hospital. "We brought him down to the synagogue on Shabbos. His condition improved. He lived for another two years."

In another case, a 90 year-old patient was evaluated by a different hospital's medical staff as having "no chance to live." The staff had even given orders that in the event of cardiac arrest, they would not resuscitate. The patient's family consulted with Dr. Breuer, whom they knew personally. The decision was clear: Transfer him to Mayenei Hayeshua. The patient remained in Intensive Care for four or five days, and then two more days in the Internal Medicine Ward. He went home, completely recovered. "A fresh story that took place only a few days ago," says Dr. Breuer proudly.

Dr. Breuer speaks about a doctor that was fired from Mayenei Hayeshua for his refusal to admit an elderly, demented lady to the Intensive Care Unit. The doctor had wanted to save the hospital beds for younger patients. Dr. Breuer insisted that his colleague admit the patient. The doctor remained adamant in his refusal.

The hospital management's policy is to give preference in treatment to the elderly, some of whom may have been afflicted with dementia. Medical personnel are bound to this decision. Says Rav Hoffner, "According to halochoh in the case of a resuscitation, if a young person and an elderly person both need certain particular life-support equipment, it's possible that the elderly would take priority. In modern medicine, the world belongs to the young. In medicine according to Judaism, we are commanded to preserve life, which precedes the quality of life."

Tamar, a volunteer chessed organization, operates in the hospital. Female volunteers from Bnei Brak give support and assistance to the hospital's patients and to the patients' family. "Exceptional dedication," praises Dr. Breuer. "If you would wish to know what doing something lesheim Shomayim is, go to the Tamar volunteer organization."

We are standing at the room's entrance, but we aren't allowed to enter. In a hushed tone, Dr. Breuer tells about the patient behind the door. The patient is afflicted with an acute respiratory condition which caused his state of consciousness to deteriorate. The patient's family requested not to resuscitate him due to the patient's enormous suffering from artificial resuscitation in the past. In fact the patient, himself, had made a request to his family not to resuscitate. Then it happened.

"This would've been death in a matter of minutes," relates Dr. Breuer. " `Page Rav Hoffner, the hospital's moro de'asra,' I ordered." Rav Hoffner, together with Dr. Breuer, quickly came to the dying patient's bedside. They came to the conclusion that it was depression that caused the patient to request his family not resuscitate him. So there was no choice but to resuscitate. After being resuscitated, the patient's condition improved. Two days later, he was able to communicate. Four days later, he was already out of danger.

A hospital morgue is not typically a place to which one would give rave reviews. Dr. Breuer thinks otherwise. How does a hospital prevent tumas cohanim when a patient dies? Dr. Breuer relates when an elderly man had been admitted to the hospital with a heart attack, he needed CPR that is administered in the Intensive Care Unit. The EKG monitor showed a straight line. After intensification of resuscitation efforts, the monitor still continued to show a straight line. Dr. Breuer started reciting the verses that one says upon a soul's departure. In the meantime, the hallway doors were shut and the guard at the front door was notified not to allow cohanim to enter. The deceased was removed from the hospital ward in a special elevator that is detached from the rest of the hospital building. The elevator descends to the morgue, which is also isolated from hospital premises. The hospital is a place which brings together the orchestration of life and death.

We did not visit the entire hospital. However, we caught a glimpse of the prenatal nursery. Dr. Breuer relates a dilemma that was encountered when an infant was born prematurely, in the 20th week, with no chance for survival: Up to what point is it the hospital's duty to care for the child? Either way, he will not live.

Rav Hoffner's beeper starts ringing. The surgical ward urgently needs his signature. Simultaneously, the rabbi's cellular phone rings. The mashgiach is on the line. A kashrus question arose in the kitchen. Rav Hoffner is requested to check out the situation.

With all the activity at Bnei Brak's medical miracle, Dr. Breuer will need a special miracle in order to catch the Yom Kippur Koton prayers!

The hospital continues to function in accordance with halochoh, well into its eleventh year.

The Hospital's Professional Activities Encompass the Mitzvah of VeNishmartem Mayenei Hayeshua Hospital has a total of 220 beds. It has the following departments: First and foremost, the Institute for Halochoh and Medical Ethics, headed by HaRav Yitzchok Zilberstein. The institute meets weekly. Participants include both rabbonim and medical specialists who constitute the hospital's ethical committee. The Department of Emergency Medicine, headed by Dr. Yosef Leibman, secretary of Israel's Emergency Medicine Committee, editor of the Committee's professional journal and Yated columnist; The Pediatrics Department headed by the renowned Professor Vrasno, one of the world's top pediatricians. The children's doctors are specialists who received training at Petach Tikva's Schneider Children's Hospital. "There are an average of 500 births per month, may this increase," extols Dr. Breuer. He also relates that the number of caesarean births at the hospital is amongst the lowest in Israel -- and in the world. "The hospital instructs its doctors to perform as few of these surgical procedures as possible, as complications are bound to arise, especially for a chareidi woman who gives birth," Rav Hoffner explains. In order for a doctor to perform certain surgical procedures, he first must obtain a signature from Rav Hoffner, the hospital rabbi. The hospital has not hesitated to fire a doctor who operates without rabbinic approval. Other departments include: The Surgical Ward, headed by Professor Alexander Deutsch; Cardiac and Cardiac Intensive Care Unit; Children's Emergency Medical Unit; Surgical Emergency and Gynecological Wards; Internal Medicine department, headed by Professor Avrohom Weinberger; Post- natal Gynecological Department, headed by Dr. Benny Chen; Neonatal and Prenatal Department; Geriatric Ward; Department of Gastroenterology; Surgical and Recuperation wards; Chemical and Clinical Hematologic Laboratory, including the blood bank, blood clotting, and endocrinology; Bacteriology and Parasitology laboratory, headed by Professor Sampolinsky; X-Ray and Ultrasound Imaging Department; an inter-departmental center of non-invasive surgery, which includes laser treatment for treating gallstones and orthopedic procedures; in the near future, an ophthalmological (eye) surgery unit is scheduled to open.

Mayenei Hayeshua Hospital's Director, Dr. Rothschild: A tranquil atmosphere is preserved at Dr. Moshe Rothschild's home. Dr. Rothschild, director of Bnei Brak's Mayenei Hayeshua Hospital, takes pride in maintaining a quiet atmosphere at his hospital, Dr. Rothschild's second home. Dr. Rothschild is lying on a hospital bed, recovering from surgery. A far cry from the sterile, white doctor's frock and tie, Dr. Rothschild is wearing pajamas, bedecked by his tallis koton. This room hosted the doctor's private clinic some 30 years ago. Notwithstanding the doctor's casual attire, the room broadcasts the doctor's demand for cleanliness and order. The doctor's stubborn standards have made an impact at the hospital for the last decade, and have been felt at his clinic for the last 30 years. Dr. Rothschild takes pride in meriting to have been physician for a long line of past gedolei hador, including the Steipler Rav, the Baba Sali, and the mashgiach, HaRav Yechezkel Levenstein. Although the doctor is technically licensed as a pediatrician, he became their family practitioner. In 1971 Dr. Rothschild made aliya from Switzerland, becoming Bnei Brak's sole pediatrician. Thirty years ago, Bnei Brak had lacked appropriate medical facilities. Anticipating the heavily-populated Bnei Brak of today, the doctor realized the importance of establishing a local hospital. Says Dr. Rothschild, "Without a hospital, people will die, and it's possible to save lives." He explains: the hospital's primary goal is to bring (public) awareness to the sanctity of life and its longevity. The secondary goal is to heal." Dr. Rothschild participated in the Ponevezh Yeshiva's yarchei kalla over 40 years ago, becoming very close with the Yeshiva's mashgiach, HaRav Yechezkel Levenstein. Dr. Rothschild developed a friendship with HaRav Kahaneman, the Ponevezher Rov. The doctor even traveled with the Ponovezh Rov to Europe. When I asked Dr. Rothschild if he is a contemporary version of Dr. Wallach, Shaarei Tzedek Hospital's founder who sought the advice of Rav Yosef Chaim Zonnenfeld, the doctor replied, "If I were only . . . " Dr. Rothschild would recite the slogan, "I was angry about it," many times during the course of the interview. Perhaps he was amazed by looking back at the past. He had revealed an episode which sheds light from a totally different perspective on his amazing odyssey of conceiving the hospital: Many years ago, there was a young boy from Switzerland who had problems in school. He came to Eretz Yisroel, living with a foster family, where he received his education. His father went to the Steipler, zt"l, asking him if he should get health insurance for the child. The Steipler responded: "Get insurance for illnesses, but don't get (insurance) for operations and hospitalization. For that, Rothschild has already finished the hospital." This took place even before Dr. Rothschild had bought a lot. Nevertheless, the Steipler's blessing bore fruit. The same youth who needed an operation was able to receive medical care at Bnei Brak's newly-opened hospital. The hospital's first appendectomy was performed on the very same young boy. "Everyone said that you're crazy," he relates. I had asked if he also thought that he was crazy. He replied in the affirmative. However, as a physician, after working for a year at Jerusalem's Shaarei Tzedek Hospital, Dr. Rothschild saw a great need in his fulfilling what seemed like a pipe- dream. How did he know that he would succeed? The gedolei hador's constant push and support was, without a doubt, a prime motivating factor. Dr. Rothschild has never complained about his income. Even when he was setting up his hospital, he never had to swim in a sea of debts. He would only build when he had the capital. He placed a tzedokoh box in his private home clinic. Each patient was requested to make a contribution to his hospital in lieu of payment. From the doctor's collection box, a fund- raising trip around the world and in 250 hospitals, he had successfully raised the necessary capital. "And I'm not a professional schnorrer," quipped Dr. Rothschild. Dr. Rothschild's patients built the hospital. When he paid for the lot, and didn't receive it, he stresses, it was an orchard -- but the hospital stands today. He received a letter from Bnei Brak's Mayor Gottlieb: "You wasted your money." Dr. Rothschild has kept the letter as a souvenir. Mapam (the far-left predecessors to Meretz) government officials told him that there was no need for a hospital. He replied: "There will be a day when you won't be here, but the hospital will be here." The hospital took about four years to construct. With much protektsia, as he calls it, he received the coveted building permit. He praises Reb Yehoshua Heller, the builder, who was willing to commit himself to the project before its actual construction. Even today, Dr. Rothschild is only willing to hire top-notch staff. It is impossible to conceal the incredible siyata deShmaya that has taken place at the hospital; Dr. Rothschild's siyata dishmaya is equally impressive. Dr. Rothschild gives an account of his efforts in building the hospital, in ensuring that no details were overlooked. All essential services, such as the maternity and emergency wards, are located on the first floor. The hospital's responsibility to reduce chillul Shabbos is not the only reason for the floor plan. The well-designed layout of facilities plays a significant role in increased hospital efficiency. For example, the third floor laboratory is next door to the outpatient clinic. The planning was so precise that a Bais Yaakov Seminary girl who was commissioned to paint a mural of Krias Yam Suf which adorns the wall of the hospital lobby, was given exact dimensions before the wall was even built! Over 200 births took place in the hospital's first month of existence. Dr. Rothschild adds that when a chareidi woman comes to give birth, she will find someone with a similar background in the adjacent bed. Today's average figures are 500 births per month, bli ayin hora. I challenged Dr. Rothschild by stating that his colleagues say that he is hard to work for. Dr. Rothschild, himself, was not embarrassed to admit this. "I'm a tough boss," he immediately acknowledged with a sweet but mischievous smile. He constantly makes hospital rounds. He says that "with time, the fear of me turned into an asset. "Understand, there's no other way," he adds. Today, the hospital employs about 650 personnel. "We're a family, we give each other support. I have amazingly dedicated workers who possess middos. Their job input is much more than I am able to pay," says Dr. Rothschild. Each Shabbos, the director makes his rounds throughout the wards, making kiddush and saying a dvar Torah on the weekly parshah. Dr. Rothschild is meticulous to speak with each patient on Shabbos. These anecdotes give the reader an understanding who Dr. Moshe Rothschild truly is. "Look," he says, "really I built the hospital for only one reason. Do you think that I built it for Shabbos? True, we have more than 40 gentile workers on Shabbos, but it is a mitzvoh to desecrate Shabbos for a dangerously ill patient [so we did not need a chareidi hospital for that]. Are you going to tell me that it's for kashrus? A dangerously ill patient is allowed to eat anything. "I only built the hospital for the value of life and how to prolong it. Ask hospital directors throughout Israel what they say to me: Rothschild, we're sending you geriatric patients. With us, they would die. With you, not only are their lives prolonged, but they recuperate, becoming completely healthy. "We now have a prematurely-born infant in the prenatal department who was born with a weight of 500 grams (1.1 pounds). He went down to 390 grams (13.7 oz.)." Dr. Rothschild recounts the episode with such warmth that one might think that this was the hospital's only patient. "Already for two weeks, we have made every effort in order to improve his condition. The child, may Hashem prolong his life and years, will be with us in the hospital for at least half a year. This is the definition of valuing life. "My slogan," Dr. Rothschild attempts a public-relations pitch, but his Jewish feelings overcome it, "We don't just treat the illness, we treat the patient." Out of sixty thousand women who have given birth, the hospital only had to transfer one woman to another hospital. Dr. Rothschild attributes this fact to siyata deShmaya. The doctor does not consider it dishonorable to transfer a patient to another hospital. "We don't rely upon siyata deShmaya. We simply have it," he remarks casually. "Recently, I was visiting Mexico. They want to build a Jewish hospital there. What is a Jewish hospital? Very simple: Preserving the value of life. I once heard a patient telling his doctor, `I'm going to explode from pain!' The doctor replied: `Explode!' I immediately fired the doctor. Within the hospital walls, you are religiously observant in every respect. This is one of the requirements that we demand of our staff. The first and foremost prerequisite is the most fundamental: acceptance of da'as Torah." Dr. Rothschild describes a few of his halachic-technological inventions: the door to the main entrance that opens from person's weight; a nurse- paging system that works by air pressure, without electricity; a special elevator for cohanim, located adjacent to two rooms at the end of the corridor. The rooms look identical to the other rooms. If there is a possibility that a patient will die, he is brought to one of the two identically-looking rooms, so that the patient will not realize that he is terminal, but he is near the elevator. (The cost of the elevator was $100,000.) The elevator is halachically outside the building, preventing the transmission of tumas cohanim. Dr. Rothschild relates that the hospital does not allow any patient to be alone with a gentile. The doctor is very pleased to allow other hospitals to duplicate his inventions. He ensures me that if his chavrusa would not arrive at precisely 4:45, and our conversation would not have commenced at precisely 4:00, he would have eight hours of stories to tell. Dr. Rothschild begs me to call him to hear more, if there is a need. "The hospital is in a tremendous deficit," says Dr. Rothschild. "The deficit stems mainly from the dedicated treatment of the elderly. Their resuscitation and life-support requires extremely expensive medication, resuscitation and special personnel for weeks, day and night, around the clock. This is the price of extending life and the value of life," he explains. The hospital is hardly subsidized by the Ministry of Health and Bnei Brak's municipality though Dr. Rothschild is very interested in receiving their financial assistance. Most of the hospital's cash flow comes from the kupot cholim. The hospital's budget is nourished from an injection of funds from kupat cholim referrals and from Bituach Leumi paying for women giving birth. Although the hospital is private, it is recognized by the Ministry of Health as a State Hospital. This arrangement is similar to the Chinuch Atzmai School network's recognition. Although Chinuch Atzmai is a recognized school system, it receives less than parallel state schools. Dr. Rothschild relates that even one of the Satmar Admorim stated that the hospital is allowed to receive funding from the State of Israel. The public's participation in supporting the hospital does not approach the hospital's high financial needs. Dr. Rothschild is trying to galvanize the public to make donations. "On Thursday, I'm coming back to the hospital," announces Dr. Rothschild with the same mischievous smile. This time, he is returning not as patient, but as director. Practically speaking, it won't make too much of a difference: Even now Dr. Rothschild is managing the hospital from his recovery bed.

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