I am a rabbi in a hospital ICU. This is what the COVID surge looks like to our exhausted staff.
Healthcare workers tend to a patient with Covid-19 who is having difficulty breathing in a Covid holding pod (Getty Images)
(JTA) — As a rabbi who works as a chaplain at a hospital in Indianapolis, I’ve held my tongue a lot when it comes to COVID-19 and the emotional strain it puts on medical staff. But now — as my team at Indiana University Health is responsible for pastoral care in the Medical ICU and its associated unit — is the right time to speak about it.
My unit is where the sickest of the sick in the state come for care. Our ICU houses patients that other hospitals can’t handle. When it’s a last-ditch effort, they send them to us.
Most of the patients I see in the ICU are COVID-19 positive. Yes, there are other units that hold COVID-positive patients who have less severe symptoms — mainly vaccinated patients with strong working immune systems. Other patients are suffering illnesses unrelated to the coronavirus. But the vast majority on my patient lists are COVID-positive.
What is it like walking down the halls of the pods of the ICU? It’s cold, it’s dark and it’s quiet. The patients are all intubated, hooked up to massive amounts of equipment, with machines breathing for them and feeding them through tubes.
Heavy blankets cover their bodies. Some of the machines are so big that you can’t see anything but their legs. Families aren’t around much: It’s dangerous to visit the hospital these days. COVID has spread to the staff, with over 1,000 staff members out statewide. Nurses are overworked, covering two to three patients each – far more than what’s typical in the ICU.
COVID-19 is an especially cruel disease. To those who have overcome adversity, cancer, multiple sclerosis, bone marrow transplants and the like, COVID swoops in and takes them away from their families. They may have finished chemo just months ago, their diabetes was under control, and yes, they did everything right. They got vaccinated (if they could, as sometimes it’s useless for those with compromised or no immune systems). They overcame great odds, and yet they come to my unit to die.
“Teach us to number our days,” Psalm 90 tells me, “that we may get a heart of wisdom.”
There are far more who come who are unvaccinated.
The numbers don’t lie. We are swarmed with the unvaccinated. Their family members tell us, “He/she was so stubborn.” They tell us, “Well, I’m going to get vaccinated now” (all it took was the death of a loved one). They tell us they didn’t believe “it” was real, referring to a virus that is soon on track to take 6 million lives worldwide.
They tell us to try to pray. Can you imagine? Sitting in my PPE gear, my M95 mask pinching my face, my face shield fogging up, my gloves tight on my hands, I am asked by the unvaccinated wife to pray for an unvaccinated husband as he lays dying.
What prayer is appropriate? Prayer in these cases is no substitute for action – preemptive action that would have said louder than any psalm or supplication, “My faith compelled me to appreciate the miracle of vaccination and act on behalf of the elderly and the vulnerable.”
An old Yiddish tale tells of an exhausted Hasid who came running to his rabbi. “Rebbe, help. Take pity. My house is burning.” The rebbe calmed the Hasid. Then, fetching his stick from a corner of the room, he said, “Here take my stick. Run back to your house. Draw circles around it with my stick, each circle some seven handbreadths from the other. At the seventh circle, step back seven handbreadths, then lay my stick down at the east end of the fire. God will help you.”
The Hasid grabbed the stick and started off. “Listen,” the rebbe called after him, “it wouldn’t hurt also to pour water. Yes, in God’s name, pour water. As much water as you can.”
A nurse walks by as I stand in the doorway of another patient. Their family has moved them to comfort care, with a do-not-resuscitate order. There’s nothing else to do. “Was he vaccinated?” I ask.
“I’ve stopped asking,” she says. “Either answer makes me upset.”
As I walk from room to room I think of the words of the Shulchan Aruch, the book that forms the foundation of Jewish law: “One must refrain from putting coins in one’s mouth, lest it’s covered with dried saliva of those afflicted with boils” (Yoreh De’ah 116). The code of Jewish law lists other certain and suspected dangers, including precautions to take in the face of plague, but concludes with this from Rabbi Moshe Isserles: “A person who guards his soul will distance himself from [dangers] and it is prohibited to rely on a miracle in all of these matters.”
Those last words accompany me as I see nurses setting up feeding tubes and ECMO oxygenation machines: “It is prohibited to rely on a miracle in all of these matters.”
Patients are afraid. Families are heartbroken. They cry and argue in the “quiet rooms,” wondering who brought COVID into the house, which aunt refused to get vaccinated and spread the virus that is now is killing the grandfather. There’s guilt, there’s shame, there’s anger.
And then there’s us.
Some people drink, some people eat, to cope with what has become a sort of horror show on repeat: When one body is taken out of the room, another patient takes their place. I experience fatigue. At any point in my work day I could close my eyes and go to sleep right where is sit or stand.
“Modeh ani l’fanecha, melech chai v’kayam, shehechezarta bi nishmati, b’chemla raba emunatecha,” I revive myself with the prayer that is traditionally spoken each morning upon waking. “I thank You, living and enduring sovereign, for You have graciously returned my soul within me. Great is Your faithfulness.”
I’ve got to stay awake, provide care for the crying and stressed nurses, provide care for the families, vaccinated and unvaccinated, provide prayer for those dying alone, with only the sound of the machines to accompany them. Why? Because as a Jew I am obligated to do so, as the Torah teaches me: “You shall not stand idly by the blood of another.”
Indeed, people’s lives are in danger. I’ve been at this since August. The doctors and nurses have been at this for years. How they manage I’ll never know. But even a hello and asking how they’re holding up makes a difference. If you know a nurse or doctor, give them a hug, tell them they matter, thank them.
We seem to be fighting a losing battle. People are dying every day. And when we return to our staff meetings we hear the words “surge,” again and again. It’s scary. It’s exhausting.
Gam zeh yaavor**, **This too shall end. Until then, I remember the words of another sage, F. Scott Fitzgerald: “Tomorrow we will run faster, stretch out our arms farther…. And then one fine morning — So we beat on, boats against the current, borne back ceaselessly into the past.”
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