Someone sent me this responsa from R’ Asher Weiss to a young nurse, who had to use old respirators and accidentally applied it wrongly, resulting in the patient’s death. She wrote to him, asking how to atone for killing a patient.

His response made me cry, made my colleagues
cry. To providers who worked through the surge, who ran into infectious disease wards instead of away from them, these words are the most comforting ones I have read recently.

People who lost loved ones, or had hospital stays which were terrible experiences, have accused
us of killing patients, ignoring them, not feeding them, keeping them isolated.

You know nothing. You don’t know the conditions we worked in: surges of patients lining hallways, staff out sick or scared to work, no PPE, and no clue how to treat this disease.
And then there’s R’ Weiss, this holy Tzaddik whose response to the anguished nurse included this gem:

“Those who must give an account of their actions and confess their sins are not the doctors and nurses working devotedly in inhuman conditions while endangering their lives
but rather the people who in their arrogance and stupidity ignore the directives of doctors and act with cruelty, causing the spreading of the pandemic which has killed so many.”

Halevai the lay people and lesser Rabbonim valued the healthcare providers of the communities
and exorted their followers to behave safely.

Here is his entire response to the nurse who felt she murdered her patient:…

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More from @MarcusBlimi

12 Oct
My client died on Friday night. As an end-of-life provider in my community, I help Orthodox Jewish people die without suffering, and according to Jewish law.

When the family begged me for a timeline weeks ago, I predicted (with the caveat that only God knows) that he’d live
until just after Sukkos. But he progressed rapidly at the end of the week and I wasn’t surprised to receive a call on Friday night. His son called, afraid, that his father didn’t look well at all.

“His oxygen is 72% and he’s on 5 liters,” he said. “And he’s breathing quickly.”
I told him to turn on a timer and count his breaths for 1 minute.

I listened, noting that he counted a breath per second, over 3 times the normal breathing rate.

“Let’s give him morphine,” I suggested gently.

Step by step, the young man did so.

“He will die tonight,” I said
Read 7 tweets
7 Oct
This morning I am sitting at work in numb silence. What happened in my neighborhood last night was painful and unacceptable, and 100% preventable.

A thread.
The choice to see the Governor's words as an attack on religious freedom led many to argue that the treatment of our neighborhoods and zip codes was based on "picking on" the Jews, "anti-semitism," "reminiscient of the Holocaust."
The alt choice would have been to unite the community with safe public health behaviors.

Two rules: wear masks, avoid crowds. That’s all.

It is no secret that from May-Sept my community failed to follow these rules.

Many felt the disease had run its course in our streets.
Read 10 tweets
25 Sep
Make no mistake, what is about to happen in the ultra-Orthodox communities in Brooklyn will be catastrophic. School closures, business closures, synagogue closures and fines to everyone will rock the community and pain them - WITHOUT FIXING THE PROBLEM.
I am all for punitive responses and mandates and fines, but only after an effective, community-centered approach towards education and participation. This has not happened. This hasn’t even pretended to happen.
Instead, clueless methods to improve mask wearing and social distancing were implemented - 2 days ago - and now there are threads to attack the community from all sides by early next week. 3/
Read 5 tweets
15 Sep
"So, the first thing we're going to do is give you 1.5mg of dilaudid in your IV line to get you out of this immediate pain crisis. I already entered the order," I told the patient, crouched at her bedside and holding her hand. She closed her eyes briefly and nodded.
I took her call button and whacked it. We gazed at each other and the unit assistant blared out a "Can I help you?" to which I replied "Yes can we get pain meds please?"
I placed the button back in her hand. "I also placed a consult for our palliative pain team - they will help us get your pain under control with medication. They'll get all the right medications ordered in the right doses so that we keep you comfortable around the clock."
Read 6 tweets
30 Aug
We got into the car, and with my Bluetooth connected, were assaulted with Christian gospel music.

My husband raised an eyebrow at me. He’s used to my rambling taste in music but this was new.

I grinned. “That was for my patient.”
Miss Mary came in every two weeks for chemotherapy for pancreatic cancer. 77 years old, she rarely complained, but I did catch her wincing a few weeks ago. After a lot of probing it appeared she had a lot of pain which didn’t respond to Tylenol or ibuprofen.

I prescribed 5mg
of oxycodone for her, and she had reported that it worked well and she only took it during severe pain attacks.

But then she came in for chemo and the pains arrived. She didn’t have her oxycodone with her and we don’t have it in the clinic.

I gave her Tylenol and hot packs.
Read 6 tweets
26 Aug
At 7pm I slung my bag over my shoulder and wheeled around to the door, ready to sign my patients over to the team of physicians on night duty, my 12 hours of managing complex care completed.

Then the intern’s pager went off: “Patient in room 1032 expired. Family distraught.”
I glanced at the intern. His resident left and he looked alarmed.

“Do you need help?” I asked tiredly.

“What do I have to do?”

“Console the family, pronounce his death, call the organ donation network, write a death note, and enter into the NYC Vital Statistics records.”
Blank stare.

I set my my bag down. “Come. This is what you do when your patient dies.”

We entered the patient’s room. The widow was surrounded by 3 nurses and 5 family members around her. A basin in her lap, a nephew fanning her, a son holding a cup of water.
Read 7 tweets

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