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Never Alone at the Hospital

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I t’s a rainy Wednesday afternoon and I’m scheduled to meet Sima Bachrach at the Chesed 24/7 Bikur Cholim room in the Guggenheim Pavilion a 625-bed facility of Mount Sinai Hospital in New York City. I’ve been told Sima can work miracles and I’m looking forward to meeting this energetic and caring woman who serves as Chesed 24/7’s patient liaison for the Jewish community.

But first I have to find her.

The building is massive. I enter the lobby with its gleaming tile and soaring atrium and suddenly feel very small. A heimish fellow directs me toward the Chesed 24/7 room down the hall on the second floor. As I wait for the elevator a parade of assorted hospital personnel hurry past dressed in scrubs or uniforms. This place is a world unto itself.

I enter the Chesed 24/7 room and start making a coffee while I wait for Sima. I’m surrounded by a cross section of New York Jews. A young woman is on her cell phone a middle-aged man absentmindedly stirs his tea a few ladies are deep in conversation others are searching for sandwiches in the fridge. Everybody here has a story.

Sima appears and leads me from the room through the labyrinth of corridors navigating the hospital halls like a pro stopping occasionally to greet a nurse (“Hi Desiree! Are we moving the patient to five? Wonderful!”) or an orderly (“Francine how are you?”). We arrive at Eleven West a secluded area on the eleventh floor lined with private patient suites and upgraded services. It’s where celebrities and the well-heeled come to heal.

We arrange ourselves on gray leather couches a white marble coffee table between us and a breathtaking view of Manhattan in the oversized windows in the background. With its dark mahogany nurse’s station and cheerful smiling staff Eleven West seems more like a four-star hotel than a hospital ward. But the stark reality becomes clear once Sima begins to speak.

No Typical Day

I ask her what exactly she does as a patient liaison. What’s a typical day like? She eyes me clearly amused. Did I really think there’s such a thing as a typical day?

She starts out by telling me how her position developed. Dealing with serious illness is equal parts frightening and humbling and that’s especially true when a hospitalization is necessary she explains. The patient may be surrounded by dozens of health-care workers but still feel very alone.

Chesed 24/7 — the organization founded by the New Square community to aid patients and their families — had already been taking care of the physical needs of patients and their caregivers by establishing and maintaining Chesed 24/7 Bikur Cholim rooms in over 20 hospitals in the New York area. Over half a million people use these rooms during the course of a year! But they realized the hospital patients and their families needed something more.

“Whenever we came to restock our Chesed 24/7 rooms ” says Operations Manager Yossi Greenberg “we were approached by flustered family members with questions. They needed additional services. They needed guidance. So we decided to bring somebody on-site to help these families.”

Sima who’d been active in Bikur Cholim at Columbia Presbyterian for years was enlisted for the job. Tall graceful and poised she exudes a quiet self-confidence and heartfelt sincerity that wins the trust of her many patients.

As patient liaison she explains her job is to make a patient’s hospital stay as comfortable as possible. This could mean many different things depending on the situation. No two patients are alike and no two circumstances are the same. Sima never really knows what the new day will bring.

There are times when she can hasten the admission process so a patient isn’t stuck in the ER for hours on end. She can provide a recliner for a family member who wishes to stay overnight. She can explain hospital protocol to anxious family members. And then there are times when she simply holds the hand of a frightened elderly patient.

Sima spends many hours at the hospital but she doesn’t even have an office. Mostly, she walks from room to room, checking on her patients. Once she’s home in Washington Heights, she’s still really working. “My phone is on 24/6,” she says. It’s not uncommon for Sima to be in contact with the hospital until the wee hours of the morning, ensuring that a patient’s needs are met.

Sima speaks with a quiet intensity, barely above a whisper. She’s seen lots of people healing and recovering, but she’s also seen plenty of pain and suffering. She is clearly emotionally invested in her job. “There are times when I go home and I cry,” she says. “But I come back again the next day because if I can help someone even a little bit, it can make such a difference.”

According to Rabbi Shulim Greenberg, executive director of Chesed 24/7, Sima has won the admiration of most of the hospital staff, and that includes doctors, nurses, and even the administration. “She has a great relationship with every nursing supervisor,” he says. “And if you have that, you can work miracles.”

Sima’s also won the trust of her patients, many of whom are from the chassidic community. “My Yiddish is helpful with that,” she points out.

“Call Me First”

When patients arrive at the emergency room, they often become overwhelmed and confused, but Sima urges them to stay focused. “First,” she says, “call me. There’s a whole process that patients go through before being formally admitted. They need to be triaged. They need to be seen by a nurse and a doctor. Often, tests need to be run, and that could take hours. There are times when I could push these things along and get the ball rolling.

“Much of the staff is familiar with Chesed 24/7, as we’ve established a presence here. So they’ll often respond and move things forward.”

There are times when Sima has to use her diplomatic skills to smooth ruffled feathers or explain hospital procedures to families. Recently a family wished to have their hospitalized grandfather serve as a sandek at his great-grandson’s bris in his private room. “I understood where they were coming from,” she tells me. “He was becoming depressed and this would have brought him tremendous joy. But it was simply impossible. The patient was quarantined, and bringing the baby into his room would have posed a huge risk both to him and to the infant.”

Understandably, the family was disappointed. “I calmed them down,” says Sima. “I explained that there are protocols to follow and that safety was the primary concern. Eventually, they held the bris elsewhere.”

Another time, Sima helped avert disaster for a patient who was developing severe digestive issues, on top of her chronic medical condition. “She had discharged herself from another medical center and I met her in the ER. She was laying there with an NG tube down her nose. It’s very uncomfortable, but they were hoping it would clear a blockage.”

But the woman was clearly in distress and Sima couldn’t bear to see her lying there in pain. “I do have a professional relationship with a few doctors. I called a gastroenterologist to come and see her and also a gastric surgeon. They both agreed to take the case.” Years later, that patient still insists that “Sima saved my life.”

Devorah, whose mother spent many months at Mount Sinai, found Sima’s guidance was invaluable. “She moves mountains in the softest possible way,” Devorah says. “And her resources are tremendous. When it was time for discharge, she put us in touch with the proper people. When we needed to see a surgeon, she knew who we should call. And all with unbelievable empathy and compassion.”

Unfortunately, end-of-life issues also arise at times, and Sima helps these patients with sensitivity and compassion. She works closely with Chayim Aruchim when serious sh’eilos arise, as they often do. And she does her best to guide families through this difficult time.

More than once she was instrumental in convincing a bereaved family to avoid cremation and opt for a proper Jewish burial. “I was once visiting with a dying patient. His sister told me, ‘I think we’ll just cremate Andrew.’ But I’d visit him daily and although he was not religious, he asked me to call him Avrumi. I sat down with his sister and told her that I’m sure he would prefer to have a proper Jewish burial. And I called the Hebrew Free Burial Society to make the arrangements. In the end she agreed, and he passed on shortly after that.”

At times like these, she feels HaKadosh Baruch Hu guiding her every step of the way. “I remember visiting Avrumi once and he told me, ‘You know, Sima, you’ve become a special friend to me and I think you’ll become an important part of my life.’ Looking back I feel it was his neshamah talking to me, telling me that he’s counting on me to take care of things and make sure he gets a proper burial.”

Sima tearfully remembers another terminally ill patient who was not religious and had no immediate family members. “She suffered terribly,” says Sima, “and I visited her as often as I could.” This patient initially opted for cremation, but Sima gently coaxed her to change her mind. “I used the analogy of a sefer Torah. When it’s passul, we don’t burn it. We bury it. That’s because the parchment is holy. Similarly, our body is holy in that it houses our neshamah, our soul. Somehow that spoke to her. And in the end we managed to arrange a respectful Jewish funeral and burial for her.”

It made a tremendous impression on a young friend of the patient, who had spent weeks at her bedside. “After the funeral,” says Sima, “he approached me and said, ‘I want to become Jewish. I see how you all take care of each other.’ ”

Sima often acts as a patient advocate, especially when there’s nobody else to do the job. She once noticed a patient who was admitted but had no family members at his side. “It turned out his father was once my teacher, and a big talmid chacham. This was a loving and caring family, but it simply wasn’t possible to be at the patient’s bedside on a regular basis.” So Sima stepped in to do the job, discussing the case with the attending physician daily.

When a decision had to be made on whether to perform a procedure to ease this patient’s condition, Sima understood that the benefits far outweighed the risks. “I found a doctor who agreed to review the case and do the procedure. Today, the patient is not completely cured, but he’s free of the infections that were plaguing him for many months.”

Still other patients have discovered that Sima can speed up appointments at specialists’ offices. “One patient was told the earliest appointment at a certain doctor was six months from now. I made a call, and the wait was reduced to just two weeks.” How does she do it? “I leave no stone unturned,” she says. “And the rest I leave up to the Eibeshter.”

The Pain Perspective

It’s not easy for Sima to watch her fellow Jews as they struggle with their medical crises, and I wonder how all this affects her. She thinks for a few moments and says, “Overall, I appreciate my health more than anything. I realize that there’s so much to be thankful for. How can I complain about the little things that bother me? When I see the suffering that people go through, it puts things in perspective.”

Sima adds that Modeh Ani in the mornings has taken on a special significance. “It’s one tefillah I take very seriously. Waking up in the morning and having your body working and your limbs moving is a tremendous blessing. I thank HaKadosh Baruch Hu for that.”

I ask Sima if she can offer any advice to families who are undergoing a medical crisis. “If possible, it’s very important to be in the hospital with the patient all the time. Nurses will inevitably give more attention to the patients whose family members are with them. That’s just the way it is.” That’s why she makes it her business to stop in at least once a day to see patients who have nobody else with them. “It’s important to show the staff that somebody is paying attention.”

It’s also important to treat the staff with dignity and respect. “People don’t realize that little words like ‘please’ or ‘thank you’ make such a difference. In the secular world, it’s a really big thing.” Aside from the fact that it makes a kiddush Hashem, it can also help your patient.

How’s that? “I talk to the housekeeping staff the same way that I talk to a doctor,” Sima tells me. “And I greet them by name. Do you know how important that is? You think they mop the floor and pick up the garbage, and so what? But housekeeping staff has to sanitize the rooms between patients and this can take up to an hour and a half. If there are four rooms that need to be cleaned, I’ll go over to them and say, ‘My patient’s waiting so long. Can you please clean her room first?’ That can cut down the waiting time tremendously. And all because I treat them with respect. Respect goes a long way.”

As difficult as a hospital stay can be, it gets even more complicated if it includes a Shabbos or Yom Tov. Judith will never forget how lost and alone she felt when her father-in-law was admitted on Erev Shavuos, at the start of a three-day Yom Tov. “Somehow,” she remembers, “our food didn’t arrive. And I had no clue what we were going to do.”

Then Sima walked in. “It was like a malach came from Heaven, a gift from Hashem. She told us not to worry, that she will arrange all the food for us. We spent nine months in the hospital, and she was with us from beginning to end. She cried with us and smiled with us. I don’t think I could have managed without her.”

Sima won’t sit down to her own Shabbos table until she knows that her patients are cared for. She’s instrumental in acquiring cots or recliners for family members who wish to spend the night in a patient’s room. “Sometimes I’ll stay up really late arranging this,” she says. “I say to myself, ‘How can I lie down in a nice comfortable bed while they are breaking their bones on a plastic hospital chair?’ So I’ll be up until three in the morning until I get that cot.”

Happy Endings

The work is both physically and emotionally draining, but it’s also rewarding. And along with the sadness and suffering there are also lots of happy endings.

Recently, Sima met a chassidish yungerman in the Chesed 24/7 Bikur Cholim room. He asked her to visit his wife, who was in Labor and Delivery. “They were married over 20 years,” says Sima, “and she was about to give birth to their first child. Understandably, she was afraid.”

Sima entered the hospital room, and the woman began to cry. “I know I’m supposed to be the stoic one, but I cried with her. She told me she’s so scared. I took her hand and said, ‘Don’t be scared. You only need to have one pasuk on your lips: “Lishu’ascha kivisi Hashem.” Say it over and over again.’ Then I gave her a brachah and stayed with her a few more minutes. Baruch Hashem she had a beautiful baby girl. I was so happy for them.”

The cycle of life repeats itself over and over again underneath the soaring atrium at Guggenheim and at medical centers around the world. Families come to grips with joyous beginnings, devastating ends, and wondrous healings. It can get overwhelming. And terrifying. But at least at Mount Sinai, patients and families know that there’s someone who will accompany them on their journey.

Guidelines for Visitors

Bikur cholim is a tremendous mitzvah. But it needs to be done right. Here are some of Sima’s suggestions:

  1. You may think your presence will cheer up the patient, but there are times when the patient just isn’t feeling up to it. “Feel their vibes,” Sima advises. “If it seems like this isn’t a good time, then just smile, say refuah sheleimah, and come back another day.”
  2. Never ever walk into a patient’s room without knocking. “It’s their daled amos, and we need to respect that. Often a patient’s door will be wide open, but that’s to give the nurses easy access. It’s not an invitation for visitors to walk right in.”
  3. If there’s another patient in the room, acknowledge his presence. “Show respect. Smile at him and wish him a speedy recovery. He’ll probably be pleasantly surprised.”
  4. Follow hospital rules, especially when a patient is in contact isolation and signs are posted requesting that visitors wear a gown and mask. These rules are there for a good reason. The patient’s system is compromised. You don’t want to make matters worse.
  5. Always wash hands before entering a patient’s room. Most hospitals have Purell stations in every patient’s room. Use them.
  6. Be mindful of the time. If visiting hours end at 9:00 p.m., don’t come at 8:45 and start settling in. That may seem early enough to a healthy person, but a patient is usually exhausted by this time.
  7. Never discuss the patient’s diagnosis or medical condition with him. The purpose of your visit is to distract the patient or give him a little chizuk, not to discuss the relative merits of specific doctors and medical procedures.


(Originally featured in Family First Issue 558)

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