When Rick Tash, a member of my synagogue met his future wife on the Jewish dating app “Saw you at Sinai” — it was love at first sight. Bambi and Rick were both divorced, their children grown, and falling in love came as a surprise to both of them. There was only one thing standing in the way: Bambi had metastatic cancer. Rick, undeterred, proposed in spite of it. Love, it seemed, would conquer all. In the last two months of Bambi’s life, her suffering became too much to bear. Hospice was called in to manage symptoms and Bambi soon felt better than she had in months. Family members flew in from overseas for a final reunion. But when her sons needed to fly back to Israel, Bambi reassured them, saying, “It’s OK. Rick will need a lot of help, but our synagogue community will be there. It won’t be a problem.”
We Jews think of ourselves as a culture that “does death well.” Where non-Jews may be blindsided when a loved one dies, our communal rituals around death — shiva, shloshim, the reciting of Tehillim, the tearing of our garments, Kaddish — keep us afloat even in the midst of profound grief.
But as an ICU and palliative care doctor who is very much tied to my synagogue community, I would argue: we Jews might do death well, but dying? Not so much.
When Bambi and Rick gave me permission to film their story, I felt like I’d been given an opportunity to show the power and beauty of Jewish culture when it comes to supporting a good death. All of the elements were there; the strong female protagonist who faced her death with courage and humor, the members of our strong modern-Orthodox community that provided support, the beautiful music and prayer led by our rabbi on his visits. So I was surprised to discover — while watching an early version of the film — that our community fell short. We had done a good job of attending to Bambi’s needs, but we had completely overlooked Rick’s.
I had originally thought of Rick as a supporting character in the film. But as I watched him grow increasingly haggard and fatigued, I realized that I had missed what I have since learned is a rising public health crisis — family caregiver burden. Rick had joined the 53 million Americans who are working double-time and for free in a job they are untrained for.
With rising debt, divorce, dropping birthrates, and the aging of our baby boomers, we have been steadily driving toward a national crisis. This invisible workforce is suffering financially, medically, and emotionally as it becomes increasingly depleted — slaving to do a job that is almost impossible.
Many systems are failing caregivers. The government has no national strategy. Employers don’t provide adequate flexibility. Healthcare providers focus only on the patient and overlook the caregiver. Healthcare insurers pay for medical procedures and drugs but don’t provide adequate support for people to live at home. These are complex issues that will take many years to fix.
But we, the Jewish community, can start now. Accepting death as a part of life doesn’t mean we should allow our caregivers to be pushed toward an early grave. How are we able to help in the days, weeks, and months, even years, leading up to a death?
When Rick was drowning under the weight of caring for his dying wife and his three-year-old granddaughter, he didn’t need another casserole. But he did need a lot of help. Yet, instead of asking Rick what he needed, well-intentioned members of our synagogue defaulted to the time-honored tradition of bringing food. What Rick really needed was help with cleaning, shopping, and child care so that he could have some time to himself. He wasn’t hungry; he was exhausted, anxious, and depressed. So much so that he became ill himself.
When Jews have a problem, we form a committee — Chevre Kadisha, Bikur Holim, Tikkun Olam, annual fundraiser. What if we formed a family caregiver committee, that identified caregivers and coordinated a tailored approach to supporting them? Many of Rick’s responsibilities did not require any specific skill and could have easily been delegated to volunteers — something a committee could help organize.
And it’s not only the physical support that would be helpful, but the communal acknowledgment of the role. Many caregivers feel guilt or shame expressing distress or asking for help. They don’t realize they are deserving of help, and that they will fall apart without it.
We Jews are well-positioned to provide this support, because we are already comfortable facing death and we want to help. And now, COVID has given us a window into the future — any one of us could become a family caregiver in the blink of an eye.
During the final days with his newlywed wife — moments which should have been defined by connection and reflection — Rick was simply exhausted, sick, and spent. He said to me, with tears in his eyes, “This isn’t what I signed up for.” If instead of that casserole, Rick had gotten some time to himself each week, their final nine weeks might have been transformational instead of a grueling marathon to the end. As a palliative care doctor, I believe everyone should have a wonderful last phase of life. Not just for themselves, but for the people supporting them. And as a Jew, I feel like we can help make that happen.
Dr. Jessica Zitter, MD, MPH specializes in Critical Care and Palliative Care medicine, and practices at a public hospital in the San Francisco Bay Area. She is the author of Extreme Measures: Finding a Better Path to the End of Life. Her work is featured in the Oscar and Emmy-nominated short documentary Extremis, and her newest film, Caregiver: A Love Story.