Caring for patients’ spirits: Chaplains heal emotionally ailing at Soroka

Science and Health

This story begins as many hospital stories do, with a woman lying alone in her bed. In this case, she was in Soroka-University Medical Center in Beersheba and she was dying. According to Prof. Victor Novack – professor of medicine, head of the Research Authority and Department of Medicine at Soroka Medical Center – nobody came to visit her until one day when Novack heard screams and saw hospital staff members trying to calm down a man who was “really tall, really big and really angry.” The man said the woman was his mother, and she was so bad to him he wanted her to die.

Novak tried to calm the man down and even thought to call the police. Then Boruch Siris, Soroka’s chaplain, arrived. Siris sat with the man and talked with him for two hours. The man “made peace with himself and with his mother. She died that same day. 
“The man was so thankful that she didn’t die during their argument,” Novack said. “And that is something I won’t forget.”
Siris began his job as the hospital chaplain in 2019, as part of the Spiritual Care Department, a relatively unknown, developing field in Israel. The idea of spiritual care is to accompany and support people and their families when faced with disease, physical limitations and mortality. Siris says he sits with people during the most painful times of their lives. 
The chaplaincy program at Soroka is one of the first of its kind in Israel, and Novack, who was asked to set up the program, had his doubts at the start. That was until he saw how Siris worked with the dying woman and her son. “At first, the idea of trying to connect to people spiritually seemed like a strange idea,” Novack said. But he has since recognized that doctors often don’t have the time to sit with patients and the hospital chaplains can “touch people on different levels, crossing religious and cultural barriers.”
Dr. Leonid Barski, director of the Internal Medicine Department at Soroka, said that he and other doctors are involved in evidence-based medicine but “I now see that it’s also important to look at the spiritual side.”
Siris has worked on the hospital staff since the program’s inception and was recently joined by Frieda Ezrielev, who prefers to use the term spiritual caregiver; in Hebrew, a “melavah ruchanit.” Both she and Siris studied Clinical Pastoral Education, or CPE. The two speak with the patients and their families, and they consult with the doctors, nurses, social workers, physical therapists and other staff members. (The hospital is currently looking for a CPE-certified Arabic-speaker.) Siris and Ezrielev currently work in the departments of internal medicine, oncology, hematology, surgery, orthopedics and physical rehabilitation. This past year, Soroka was among the first Israeli institutions to introduce chaplaincy visits into the COVID-19 unit. Siris said the hospital staff is thinking about expanding the program to the pediatrics department. 
Clinical Pastoral Education is beginning to become more developed in Israel; in the US it is very common to have a chaplain – rabbi, priest or minister – on staff. 

“Any self-respecting hospital in the US is concerned with the spiritual needs of the patients,” Siris said. 
Siris, 46, grew up in New Jersey and, after graduating Harvard University in 1997, moved to Israel where he spent 25 years learning Torah. He never expected to be in this line of work until he met Prof. Itzhak Avital, director of the Legacy Heritage Oncology Center and the Larry Norton Institute at Soroka, who talked to him about the importance of hospital chaplaincy. One thing led to another; Novack helped initiate the program at Soroka and then invited Siris to be part of it. 
Siris, meanwhile, went to study at Cedars-Sinai Medical Center in Los Angeles, and has continued his CPE studies online. He explained that the idea of chaplaincy has been around since Charles V, also known as Charles the Wise, who was king of France in the 14th century. The king was a deeply religious person who, Siris said, wasn’t “touched by davening in a cathedral.” Charles the Wise invited a priest to sit with him in a small room, which would later be known as a chapel, and talk about spiritual ideas “that went beyond prayer.” 
Siris said that when his first wife, Noa, died of cancer in 2007, she had been a patient at Memorial Sloan-Kettering Cancer Center in New York City, an experience which made Siris understand what it was like to be a patient. (Since then, Siris is remarried to his wife, Tzipi, and has four children, including one from his first wife.) 
As a chaplain now, Siris goes “down to the pit where the patient is, and sits with them.” But first, he said, he needs to get patients to talk to him, something not all patients are willing to do. He breaks the ice by saying in Hebrew that he’s a chaplain, to which people ask, “mah zeh?” “What’s that?” He then tries to offer empathy and compassion, sometimes explaining that he isn’t there “just to get a patient a pair of tefillin.” FRIEDA EZRIELEV, a spiritual caregiver at Soroka: ‘Something magical happens when I’m with patients. (Dina Frenkel)FRIEDA EZRIELEV, a spiritual caregiver at Soroka: ‘Something magical happens when I’m with patients. (Dina Frenkel)
SOROKA, ADMINISTERED by Clalit, is the second-largest hospital in Israel and the only one in the Negev, serving approximately one million people of all religions and ethnic groups. Siris said chaplaincy does not discriminate. It does not make a difference if a patient is religious; it does not matter if someone is Jewish or what their lifestyle is. It is not about judging or giving advice or coaching, he said; it’s simply navigating according to the person’s own strengths.
“Suffering is suffering and pain is pain,” Siris said. “It doesn’t know any religious or ethnic boundaries.”
Frieda Ezrielev, 49, and mother of two, said that she never knew anything about being a spiritual caregiver, laughing when she explained that she had always worked as an office manager. Then she started doing volunteer work at a hospice and began studying Clinical Pastoral Education, also known as spiritual caregiving, in Hebrew. There are several courses taught throughout Israel, offering a curriculum that combines working with patients, theoretical lessons, individual and group supervision. Students learn about spiritual texts, singing, religious scriptures, personal prayers and guided meditation.
Ezrielev had never thought about working in a hospital – she thought it was a cold place – but Soroka hired her and she now sees that the people who work at a hospital really “care and want to help.”
Patients in hospitals are lonely, she said. They don’t want to tell their families the truth because they don’t want to worry them. For some, there is also the barrier of language and they are frustrated. Ezrielev, a native Russian-speaker, said she is able to reach them. She said the patients give her more than she gives to them.
“I love people and I love hearing their stories,” she said. “I love to joke with them and I also love to sit with them in their distress. The patients are surprised because they never heard about anything like this. I’m not with them to help with forms or with pills, just to be with them. They can be atheist but they’re happy that I’m listening.”
Ezrielev said that when people are in a crisis, their belief in the security of life shatters. 
They suddenly look at themselves and are forced to deal with their inner life. They ask “the big questions. What is life? What’s the purpose of it all? What will happen if I die?” 
Siris recounted a conversation he had, right after the Abraham Accords, with a Muslim man who had just finished praying, in which Siris mentioned how “Beersheba is where our common ancestor, Abraham, prayed to the God of the whole world.” Even though it was during COVID-19, Siris and the man hugged one another in a “spiritual moment that bridged our spirits.” Siris often brings Muslim patients improvisational prayer mats so that they can pray. He has Muslim prayers from YouTube on his phone and holds it up to help people pray. 
“Being a chaplain is about helping people find hope and meaning and what is sacred,” Siris said. “The person may be talking to me, but I get the sense that he’s really talking to whomever or whatever is sacred for him.”