"Tatte, I’m ready! I’m doing my hishtadlus!"
I’d just finished a lecture at a mental health conference on the topic of “Can a Person with Mental Illness Be a Good Spouse and an Effective Parent?” But no sooner was I out the door, running to make my afternoon chavrusa, than I noticed I was being followed by a pleasant chassidishe man who introduced himself as Mr. Heilbloom. His question was direct, if not a bit desperate.
“Does the doctor really believe that people with schizophrenia can get married?”
“Most certainly,” I replied. “It takes effort and can be challenging, but I wouldn’t have said it if I didn’t believe it.”
“But marriage is a lot of responsibility. How can someone with schizophrenia make it happen?”
I was walking at quite a clip, but Mr. Heilbloom clearly wanted to ask a few more questions as he kept at my side. “But what about the question of children? You know that parenting is tough for anyone, let alone someone challenged by mental illness.”
“True, but if a person is dedicated to taking responsibility for his or her treatment and has a devoted and supportive family, many people — even those with serious mental illness — can be effective parents. Diagnosis is less important than achrayus, Mr. Heilbloom.”
Catching his breath, Mr. Heilbloom told me, “I’ll call you to set up an appointment, yes?”
“I’d be happy to meet with you as well as with whomever you’d like me to meet,” I offered.
“Bassy.” he said. “I need to bring in my daughter Bassy.”
And the following week I had the zechus to sit with Mr. Heilbloom and his daughter. Bassy was a quiet young woman who had been hospitalized twice in her late teens with paranoia and the unsettling experience of unexplainable “voices” that had threatened to hurt her. She had tried stopping her medication a few months after being discharged from the hospital, but when the voices came back and she was readmitted, the trauma of those months was enough to prompt her decision to stay on the meds for good.
Bassy was now in her early twenties and was employed as a seamstress for her aunt’s tailoring business. She had gained a fair amount weight from her antipsychotic medication, “but,” she herself explained, “it’s a small price to pay for staying out of the hospital and being a part of the family.”
Her medication dosage was stable for over 18 months, and she was without the notable delusions and hallucinations that had characterized her illness at its most severe point. She was a bit flattened and monotonal, but these were chronic symptoms — some of them drug related — and may not have been particularly noticeable were I not doing a formal assessment. True, she wasn’t exactly animated, but as we continued our consultation, Bassy became more open and smiled briefly when discussing her nieces and nephews, as well as fondly recalling the blintzes she’d prepared for Shavuos.
Bassy was well aware of her situation and her limitations. She knew she had a thought disorder, that the voices and the meds sometimes made it hard for her to follow conversations, that sometimes she’d “get lost,” and that she often had to surrender and trust other people’s view of reality as opposed to her own. But, accepting the permanent, incurable nature of her illness and not wanting to remain severely delusional, she’d committed to take the full dosage of her antipsychotic medications — no more games.
“So what does the doctor recommend?” asked Mr. Heilbloom, laughing somewhat nervously. At this point, there were no secrets from Bassy.
“I think your daughter seems great, Mr. Heilbloom,” I responded enthusiastically after perusing her medical file. “She’s working, she has good interpersonal relationships, and she’s clearly stable from a psychiatric perspective.”
“So, can I get married then?” Bassy asked with more emotion than I’d yet seen from her.
“Do you feel like you can get married?” I asked her pointedly.
“I think so. I mean, I know I’d probably need a lot of support from my parents — my father would have to find a good boy who would understand me and my mother would have to help me take care of the house. But I’d like to get married. I think that I could help support a man learning Torah. I have a job.”
It made sense to me. Certainly the shidduch process would be a bit complex — the other side would have to know that people with schizophrenia, even as it’s controlled by medication, can sometimes behave irrationally, don’t always think clearly, and struggle with their emotions, which can be confusing and even hurtful if not understood in their proper context. But having open discussions about strengths and limitations as well as concrete family commitments for support would allow for the best possible chance of success for Bassy and her future chassan.
“B’ezras Hashem, Doctor,” Bassy smiled.
“B’ezras Hashem. You’ll let me know if you need my help moving forward,” I said as Bassy stood up, walked out the door, and sat down in the waiting room.
“I know you say this, Doctor Freedman, but is it emes?” asked Mr. Heilbloom. “I mean, you gave your derashah at that conference, you write these articles, but is it actually emes? I know, tracht gut vet zein gut — think positively and you’ll get positive results. But tachlis — do you actually have patients with schizophrenia who get married? And not just make it to the chuppah, but actually get married and stay married? With kids?”
“Yes,” I said honestly.
“Because I need to know that you’re not stretching the truth. I need to know that there is something real behind my tefillos. That there is a tachlis answer. For me, Bassy getting married would be nothing short of a miracle.”
“Good thing we believe in miracles then, Mr. Heilbloom,” I said as I handed him a picture of a chassidishe man who didn’t look too much different from himself. The man in the picture was wrapped in a tallis and holding a baby on his lap.
“What’s this, Doctor? Your baby at his bris? Is this your rebbe who’s the sandek?
“Well, not exactly. This is Reb Gruenbaum holding his grandson Yossele at the bris,” I answered. “The family gave it to me and asked me to share it with my patients any time it was shayach.”
“He was a patient of yours? This Yossele’s father?”
“He still is. Comes in once a month for his regular check-in and baruch Hashem, he’s stable and able to build a family.”
Mr. Heilbloom burst into tears as he handed the photo back to me. He threw his arms in the air, looked upward, and yelled, “Tatte, I’m ready! I’m doing my hishtadlus. Tracht gut vet zein gut!”
He gave me a fierce embrace and then wiped away his tears. “Soon you’ll have two pictures!”
I didn’t want to spoil his moment by letting him know I already had another few. One more wouldn’t be any less of a neis.
Identifying details have been changed to protect the privacy of patients, their families, and all other parties.
Originally featured in Mishpacha, Issue 771. Jacob L. Freedman is a psychiatrist and business consultant based in Israel. When he’s not busy with his patients, Dr. Freedman can be found learning Torah in the Old City or hiking the hills outside of Jerusalem. Dr. Freedman can be reached most easily through his website www.drjacoblfreedman.com
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