A pandemic of separation
Because of the high rate of infection associated with the coronavirus, hospitals have banned family members or any visitors from COVID-19 patients’ bedsides. Nurses like Milikowsky and Rosner have taken on the responsibility of connecting patients to their loved ones.
“The family ends up being almost our second patient,” Milikowsky explains, adding that in general, families are highly involved in caring for those in the ICU. “[Now] we need to change our role both with the patients and with the daily interaction with family.”
Rosner has worked as a nurse for 15 years. The past 13 of those years have been at the New York Presbyterian Hospital, where she is assigned to the Neonatal Intensive Care Unit. Many of the mothers giving birth are carrying the coronavirus, she says, so if a baby needs to come to the NICU, they must be treated as if they themselves are sick. Only one parent can visit at a time, and mothers and fathers feel left out of the process.
“We do have a patient in our unit now: The mom was positive so she couldn’t visit, dad also was just getting off it so he couldn’t visit and the baby … needed surgery after birth,” Rosner says. “So the baby is going through it alone, without the parents.”
Making sense of tragedy
Although Milikowsky had received some training in epidemics during the 2014 Ebola crisis, the coronavirus outbreak is not something she ever thought she’d experience. “I knew I would see sick people, but I didn’t ever imagine seeing this quantity of sick people,” she admits. “I would say about half of our COVID-19 patients in ICU are dying.”
Another member of the Orthodox Jewish Nurses Association, Mara McCrossin, works at Stony Brook Hospital on Long Island as an ICU nurse specializing in neurological issues. Although she has recently seen a reduction in COVID-19 patients at her ICU, McCrossin says the numbers change daily and the sense of urgency is still dominant.
Rosner, Milikowsky and McCrossin all say they have found some solace from the tumult and uncertainty in their Jewish faith.
“There is of course the value we ascribe to every life,” Milikowsky says. “I do find myself saying a brief prayer for my patients, usually before I am about to do a procedure. Having belief in a higher being gives me strength in knowing there is purpose and meaning behind this all, even if we don’t see it now,” she explains.
Rosner says that navigating the crisis has actually strengthened her faith. “So much is unknown and seems so random. I truly believe that this is Hashem, God running the world, sending strong messages to us,” she says. “I’ve been strengthened that there is a master plan, because if you don’t believe in that, you just can’t make sense of this tragedy.”
“I think my faith has a lot to do with how I practice most of my life,” McCrossin says. When it became apparent that the outbreak meant she would have to work on Passover or Shabbat, McCrossin says she consulted a rabbi to make sure she was “on the right track in terms of what I should and should not be doing.”
She adds that some of the videoconferences organized by the association are led by rabbis with medical backgrounds, who have helped her deal with the crisis by putting its issues in a Jewish context.
A community in the spotlight
As the crisis has unfolded in the United States, the Orthodox community has received an outsize amount of attention. Although Orthodox leaders, rabbis and organizations have called on their public to heed government instructions, and community members overwhelmingly comply with the guidelines, some incidents have attracted media attention.
Last week, a crowded funeral in Brooklyn led Mayor Bill de Blasio to post a controversial tweet addressing “the Jewish community” as a whole, which some warned could exacerbate the anti-Semitism already present on social media.
“As someone working with COVID-19 patients, and who sees the horrific manifestations of this virus on a daily basis, I get very frustrated and upset whenever I hear about anyone – whether in the Orthodox community or in the world at large – breaking social distancing guidelines or behaving in a manner that can put others at risk,” Milikowsky says.
“That small percentage of Orthodox Jews who do flout restrictions and place others at risk will have to answer for their actions to a heavenly court one day. It is inexcusable,” she adds. “That being said, I personally have not seen much of that behavior in my Orthodox community. And, from what I hear, most other communities in my area are adhering strictly to social distancing guidelines.”
Orthodox Jews, she says, are not disproportionately represented in her area’s hospitals, but some fellow members of the association from other states had reached out to ask Milikowsky to “inject some fear” into their community members, who were not grasping the importance of social distancing.
“This is another example of community leaders being proactive and making sure those in the Orthodox community take all necessary precautions,” she says.
“As with any group, there will always be a few bad apples. That being said, I and my Orthodox colleagues are also struck by the way the media focuses on the breaches in our community, while often overlooking those in other communities.”
The high population density of the New York area’s Orthodox community, along with its intimate social structures, Milikowsky says, make it more likely that the disease will spread more quickly among its members. “So the takeaway for our communities is that we need to be even more strict on some things than the general public.”
For McCrossin, the severity of the outbreak within the Orthodox community has influenced her view on the crisis. “I know that just by nature Jews are creatures of congregation, that’s how our religion is … and by nature that puts us at higher risk and greater risk of developing the disease.” But she notes that this effect is not restricted to any one population group or religion, or even behavioral patterns. “It’s not selective to those who congregate; it affects everyone.”
Rosner concurs. “I think for people who don’t have sick family members or friends, it’s hard to believe what we’re all dealing with,” she says. “But unfortunately, once we started having people pass away, it became more real and people took it more seriously. Obviously, we don’t want to scare anyone off and share horror stories – but the truth is, there are horror stories to share, there really are.”
“It’s like nothing I’ve ever seen before in my career,” adds McCrossin, who has been a nurse for 11 years. “There is no other way to put it.”
But amid the chaos, the ultimate message is still hope. At Milikowsky’s Maryland hospital, the current motto refers to that canvas in the nurses’ break room that shows the tree and deep blue sky. “We’ve been telling patients, ‘Be a flower, not a star,’” she says. 