One Visit at a Time

How One Rabbi Helps Patients Face Terminal Disease

By Roxy Kirshenbaum

Published May 21, 2013, issue of May 31, 2013.
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Rabbi Charles Rudansky brings Irving Silver a challah each time he visits. It’s their tradition: Rudansky carries the bread, wrapped in plastic, under his arm as he gets into his red Corolla. Before driving to Silver’s apartment in Manhattan, he lifts the lid of his soup-to-go cup and digs in. The smell of squash fills the car. Lunch.

As Director of Jewish Services at Metropolitan Jewish Hospice in New York City, Rudansky ensures that the hospice provides the best end-of-life care for patients with terminal diseases. As a hospice chaplain, he works with patients and their families to ease psychological and physiological suffering. “Sometimes patients need something to hold on to,” he said.

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After finishing his soup, Rudansky drives to Silver’s apartment in the East Village, parks on the street and flips through a booklet of patients’ names, addresses and medical conditions. Silver, who is 89, has lung cancer, and he lost his actor son Ron Silver to esophageal cancer in 2009. He has lived in the same neighborhood for 87 years — and in the same apartment for 51 of those. Silver’s wife died unexpectedly two years ago from a stroke. He often tells the rabbi he’s ready to go.

“What am I still doing here?” Silver asked during a recent visit.

Questions like this one help the rabbi to remember that his job is life-affirming. “Yes, people are dying, but we’re trying to bring comfort and ease and positive energy,” he said.

Before visiting patients in their homes, Rudansky visited prisons for over 20 years, counseling and praying with Jewish inmates at Sing Sing Correctional Facility and Downstate Correctional Facility, both in New York. But the state cared little about rehabilitation, he says, and considered chaplains thorns in its side. Simply gaining access to prisoners came with obstacles. Once, when Rudansky met an inmate in solitary confinement, the man stuck his arm through the bars to shake the rabbi’s hand. Rudansky later received a call from his supervisor claiming he had handed the inmate something. The inmate’s cell was ransacked, but prison officials found nothing.

“He just wanted human touch,” Rudansky said. “After that, I thought, I wanted to do this work but I’d like to stay out of jail.”

He left prison chaplaincy and found his professional and spiritual home in hospice care. “I’ve called him about difficult patients and families because he goes above and beyond to meet their needs,” said Joan Sheehan, 69, a nurse who’s worked with Rudansky for more than a decade. “It’s not always religious; he just touches people’s lives.”

At Silver’s apartment, Rudansky waited in the living room while Silver’s home-care aide explained that it would take a minute for the elderly man to greet him. Clutching his aide’s arm for support, Silver appeared, trembling. He wore black sweatpants and a black t-shirt with a picture of brilliant yellow, green and red frenzied dancers that seemed to barrel across his chest.

“I’m losing my trousers,” he said to Rudansky. “How’s that for an introduction?”

Silver’s aide, a young man in baggy jeans and braids, helped him into a leather chair. Silver stretched his leg out on the ottoman and said he’d been having extreme pain. “He fell about two days ago,” the aide explained. “He was walking to the kitchen and tripped in the hallway.”

The rabbi inched closer and tenderly took hold of Silver’s slightly bruised leg. “Did you listen to the president’s speech last night?” Rudansky asked.

“No. Did he say my name?” Silver responded. Rudansky laughed and said the president should have. He turned to the aide to say how much he admires Silver’s spirit.

Easing the Pain: Sanders Cohen, 83, lies in his bed in a darkened apartment having end-of-life discussions with Rabbi Charles Rudansky. ‘I’ve got pain everywhere; it’s the cancer,’ Cohen said.
Roxy Kirshenbaum
Easing the Pain: Sanders Cohen, 83, lies in his bed in a darkened apartment having end-of-life discussions with Rabbi Charles Rudansky. ‘I’ve got pain everywhere; it’s the cancer,’ Cohen said.

“The vodka doesn’t hurt,” Silver replied.

Particular cases haunt the experienced hospice chaplain. Rudansky remembers a mother of four who died of lung cancer at 51 — despite never having smoked. “It’s hard to wrap your mind around that,” Rudansky said. “Cancer doesn’t discriminate and an untimely death like that gives you real angst and anxiety.”

Sometimes, patients ask if the hereafter exists in Judaism. Rudansky responds by asking what the person’s religious thoughts are, in order to learn which answer might offer comfort. “We need to find out what will bring inner peace,” he said.

Silver pointed to a hardcover book on a nearby table and the rabbi turned its glossy pages. One section described the U.S. Institute of Peace in Washington, D.C., including a section on the library that bears Ron Silver’s name. “My son was appointed by President Clinton to help with peace initiatives in foreign affairs,” Silver said. It’s clear that he misses him, and is proud of everything he accomplished. Silver always tells Rudansky, “I had a great life until I lost my wife and son.”

“It’s Purim soon,” the rabbi said, changing topics.

“Again with the Purim?”

“I’m going to bring you some hamantaschen,” Rudansky replied. He told Silver he’d be back soon, then leaned in for a hug and kissed him gently on the cheek.

“Thanks for coming, rabbi,” Silver said, watching him walk away.

“He’s been sleeping a lot lately,” the aide whispered in the hallway. “Hasn’t wanted to get out of bed much but today, with you, he was more up.”

The rabbi nodded and said it was the medication making Silver drowsy and less lucid, and that if there was a problem, the aide should call. “I’ll be back in a week,” he said. “And I’ll bring those hamantaschen.”

Rudansky has had to figure out ways to cope with the difficult nature of his job, in which every patient eventually dies.

“I have a strong family support system,” he said. “I have also learned to compartmentalize, by having an equilibrium between this death and dying … and my own personal life.”

Rudansky pursues healthy distractions like playing basketball and baseball with his children. It helps that his wife, a psychologist who has worked with dementia patients, can relate to his work.

“Thank God my whole family is still alive,” Rudansky said. “I deal with death every day, but I know nothing about it. I’m always wondering, when I do find myself as a real mourner on the other side, how I will approach this work subsequently? I’m not exactly looking forward to it.”

Roxy Kirshenbaum is a graduate of the Columbia University Graduate School of Journalism. She grew up in Toronto.


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