New York, NY - The Rabbi For The Mentally Ill
New York, NY - For the past thirty-five years, Rabbi Moshe Lerer has been witnessing hopeless people transformed: mental-hospital patients who have been institutionalized for the better part of their lives, thinking they have utterly failed in deserving Divine mercy, finally finding some solace in the realization that they are still beloved in G-d’s eyes
Some residents have been living there for decades.
Closed off in the wards of psychiatric facilities, trapped in the web of overwhelming guilt, shame, trauma, or emotional or organic mental imbalances, can these people find a way out of the personal churban that has become the entire scope of their lives?
Rabbi Moshe Lerer, the Jewish chaplain at Pilgrim State Psychiatric Hospital in New York, believes there is always a way to touch the Jewish soul, no matter how twisted or tortured the mind has become. Not too many rabbis have the personal satisfaction of revealing that spark of G-dliness in the most broken of “clients” (as residents are referred to in psychiatric facilities), but then again, not too many rabbis would choose their mission in the corridors of a mental hospital.
Rabbi Lerer, who reached retirement age almost two decades ago (“retirement is the curse of the generation,” he says ruefully), has been at it for thirty-five years, witnessing hopeless people transformed: indigents who have been institutionalized for five or six decades, thinking they have utterly failed in deserving a crumb of Divine mercy, finally finding some solace in the realization that they are still beloved in G-d’s eyes.
Not everyone admitted to a psychiatric facility is in for life; some have a stay of two or three weeks until medication can be balanced and the client can resume functioning on the outside. But Pilgrim is a long-term care facility, and that means that many of Rabbi Lerer’s clients, like Chaim, have spent the better part of their lives on the inside.
“Chaim was an extremely bright fellow, who graduated at the top of his class of 400 with another Jewish boy,” Rabbi Lerer recounts. Chaim had received a scholarship to an Ivy League college, but something happened that summer that sent his plans into a nosedive. “His friend, the valedictorian, had a rich father, who bought him a boat for his graduation. But on the boat’s first voyage, on which for some reason Chaim didn’t participate, there was an accident — the bodies were never recovered. Chaim was overwrought with guilt. He was a strong swimmer and felt that had he gone along, he could have saved his friend. Most people have internal resources for dealing with such guilt, but with Chaim, it just devoured him. He spent one semester in university and then quit. He couldn’t concentrate and started hearing voices. Soon after he was institutionalized.”
That was over 50 years ago.
“I befriended him years ago,” continues Rabbi Lerer. “He had dropped much of his connection to Yiddishkeit, but eventually he began to put on tefillin. He loved tefillin. So I trained him to make the rounds with me putting tefillin on others, and he felt so productive, successful, and needed. At our model Seder, he would say the Kiddush, on Rosh HaShanah he would call out the tkiyos, and he’d set up the candles on Chanukah. I bought him tzitzis and he wore them every day. About a year ago, I got him out of the hospital and into an assisted living facility, where he’s finally found some measure of comfort. ‘Rabbi,’ he once said to me, looking back on his wasted life, ‘where were you 50 years ago?’”
Rabbi Lerer, who is currently the longest-serving rabbi in the mental health chaplaincy in New York State, says that the uniqueness of his department — shared by a Catholic priest, a Protestant minister, a nun, and a Greek Orthodox cleric — is in its confidentiality. “Clients tell us things they would never tell their doctor or therapist. We are nonjudgmental. We never take notes. And we can’t be subpoenaed.”
Didn’t He Graduate? Rabbi Lerer is from that genre of American-born, Yiddish-speaking rabbis who fought to maintain their yeshivah education even as their peers were off to public school and university. When he was a child in the 1930s, his father’s dry goods store and the kosher butcher down the block were the only stores in their Brooklyn neighborhood that were closed on Shabbos; and his father went against the friendly advice of his more progressive landsmen and sent young Moshe to Torah Vodaath instead of the neighborhood PS. (“The only time I went to public school was to vote,” he says.)
In 1953, with a fresh smichah from Torah Vodaath, a degree from Brooklyn College and a new wife, Rabbi Lerer took his first pulpit in Carbondale, Pennsylvania, ten miles out of Scranton.
“When I finished the 7 a.m. minyan, I was basically free until the afternoon Talmud Torah, and spent much of my time learning with a rabbi in an adjoining town. At a board meeting, one of the fellows stood up and asked, ‘Rabbi, we want to know how you spend your day.’ So I told them, ‘I’m doing extensive Talmudic research with another rabbi.’ ‘But Rabbi,’ they said, ‘didn’t you graduate already?’ They couldn’t understand that I was still sitting and learning.
“This was the mindset of the balabatim over 50 years ago. It embarrassed them to have a rabbi who still needed to learn. After that, we learned in my house instead of the shul. I felt a bit like a Marrano having to hide.”
Carbondale was the beginning and the end of his career in the rabbinate. Soon after, the Lerers moved to Stamford, Connecticut, where the community was looking for a couple to teach in the Talmud Torah. Rabbi Lerer, together with principal Mr. Walter Shuchatowitz, helped found the Hebrew Day School of Stamford and his wife, Vivian, was the first kindergargen teacher. The first year, Rabbi Lerer took his own car and gathered up the students every day, as transportation was promised as an incentive.
The ten years he spent in Stamford were satisfying as well as spiritually rewarding. He established a rapport and a base of influence in Torah learning with many of the balabatim, and was instrumental in building a kosher mikveh in Stamford, under the guidance of Rav Nissan Telushkin ztz"l. But he wanted more for his children.
“From age eight, my son was on a train at 6:30 a.m. to go to school in Washington Heights. Then it was my daughter’s turn, and we just couldn’t do that to her.”
At the time, the Yeshiva of Belle Harbor elementary school was looking for a principal, and Rabbi Lerer made the move. But eventually the population shifted, and he too was ready for a new challenge at this point. Rabbi Lerer went back to school for a master’s degree from Ferkauf Graduate School.
No More Graves That was 1976. At the time, Central Islip Hospital, a huge psychiatric facility on Long Island, was looking for a Jewish chaplain, and although mental health was not a field Rabbi Lerer ever expected to enter, his patience, empathy, people-mindedness, interpersonal skills, and his ability to look away when things aren’t “normal” has served him well these last thirty-five years.
Central Islip was one of three massive psychiatric hospitals in western Suffolk County. More than a century ago, the Manhattan Insane Asylum, as it was then called, opened an experimental farm colony on 1,000 acres of wild countryside. Inmates cleared the land, constructed buildings for shelter, made their own furniture and clothing, and grew crops and raised cattle and fowl. The idea of a self-contained community quickly caught the attention of the state’s Commission on Lunacy, and soon, Suffolk County, with its cheap land and a steady supply of patients from New York City, became the global capital of psychiatric hospitals.
At their peak in the 1950s, Kings Park, Central Islip, and Pilgrim State hospitals — all within a ten-mile radius of each other — together housed over 35,000 patients.
When Rabbi Lerer began at Central Islip, the hospital had about 500 Jewish clients, most of them elderly residents who had been living there for decades.
“There were so many old people there, that I had to deal with several deaths every month. The indigent, lonely people from mental institutions are buried in a potter’s field, dropped into a pit in a corrugated box, with nothing but a number to mark the grave. After my first such burial, I said, ‘This is never going to happen again.’ But where would I find proper Jewish burial grounds?”
Rabbi Lerer approached the Suffolk County Board of Rabbis. Maybe they could help.
“‘I have a serious problem,’ I told them. ‘I’m doing four, five levayahs a month and I need kevarim. These people are bereft of kin and are my achrayus. Where do I put them?’ One of the representatives said, ‘Okay, Rabbi, we’ll take your meisim.’ But I had one caveat. I told him, ‘I’m Orthodox, and these people are my responsibility, and I need to know that when I send them on their final journey, it will be according to halachah.’ ‘Rabbi,’ he said, ‘You have our word.’”
But the volume was ultimately too much, and they couldn’t maintain the deal.
Next, Rabbi Lerer turned to Shomrei Hadas in Boro Park, and they agreed to take care of anyone, rich or poor. “That meant that if someone died on my turf, they sent out a hearse, picked up the body and brought it back to Brooklyn for the taharah and arranged for a grave. There were various defunct chevras, so finding a grave here or there wasn’t a problem. But after a few months of this they said, ‘Rabbi, this is too much for us — every few days sending out a hearse, buying a grave …’”
Suffolk County has huge expanses of land, and Rabbi Lerer decided he needed a little of that land for a Jewish cemetery for his people.
“I met with the hospital’s clinical director — he was a devout Catholic,” Rabbi Lerer remembers. “I gave him a dvar Torah. I told him about the hierarchy of Kohein, Levi, and Yisrael, and how elevated the Kohein is, how he can never defile himself going to a funeral except for close relatives. Then there is the Kohein Gadol, and he may never defile himself even for a relative. But if, on the way to his holiest service of the year, on Yom Kippur — when he alone will enter the Holy of Holies — he finds some derelict Jew lying dead, and there is no one else around to care for him, now it is a mitzvah to take care of him.”
“Rabbi Lerer, what do you want?” said the visibly moved director. Rabbi Lerer: “I need a cemetery.”
So with the help of Mendy Shayowitz of Agudath Yisrael and the intervention of Governor Hugh Carey, Rabbi Lerer got his cemetery on state property, the only such cemetery in the US.
Next, Rabbi Lerer went back to the director for another request: none of the thousands of graves from the psychiatric hospitals had markers with names — each plot was simply marked with a number on a cinderblock, presumably to maintain anonymity of those who died in a mental hospital.
“I wanted to erect a simple marker, with the person’s name and date of death,” he explains. “After all, all that’s left of these people are their names.”
The hospital couldn’t help him out with that, but salvation always comes from somewhere.
“In Stamford years ago, there was a very special woman named Minnie Manger, a real tzadeikes — who in fact was Senator Joe Lieberman’s grandmother. Her son Ben was very wealthy, and I approached him. ‘Let’s do something for your mother that will bring her up close to the kisei hakavod. I have indigent people I have to bury, but there is no money for matzeivahs. Let’s do it for your mother’s memory.’ He wrote me out a check then and there, and since his passing, I continue to get a monthly check for the upkeep.”
Eventually however, as the state began to move out of the business of mental health and the psychiatric field moved from institutionalization to reintegration into society, Central Islip closed its doors and merged with nearby Pilgrim State Hospital in 1996, selling off its assets to Suffolk Community College, New York School of Technology, and other state and private institutions. Decades of deinstitutionalization emptied out the hospitals. Today Pilgrim State, with 700 inpatients, is the token survivor of the old system. The cemetery, however, is considered hallowed ground and cannot be touched.
In fact, the all-but-forgotten cemeteries in the three hospitals — about 24,000 graves without visible markers — became a hot topic of debate among state planners who wanted to maximize commercial land opportunities. Some civic planners suggested moving the graves and using the prime green space as a picnic area, or for a planned courthouse.
People were horrified at these suggestions, however, and so the area of all the cemeteries has been designated inviolate open space. But although his cemetery is safe from commercial developers, Rabbi Lerer can’t use it for further burials either. So since he’s been with Pilgrim, he struck a deal with the Hebrew Free Burial Society, which has plots in Staten Island. Under Orthodox supervision, he knows his clients — who have no one else to advocate for them — will be buried k’das uk’din.
At one point Rabbi Lerer felt like he’d entered the funeral business, but when he tells the story of Jack, he realizes that Providence puts you where you’re supposed to be.
“Jack was one of the most difficult clients we had,” Rabbi Lerer remembers. “He would whack people, pinch them — no one wanted to be near him. But he was really a hero, a decorated soldier in World War II. His platoon was caught in a valley with the Germans on top of the hill, shooting down at his men. So he crawled up the hill on his stomach and hurled a grenade at the soldiers. But when the war was over, he wound up in the hospital, traumatized and shell-shocked.
“One day I went to see him, and he was in the medical surgical ward, curled up in a fetal position like a pretzel. He died the following day, and as per my arrangement with Shomrei Hadas, I had him taken for a taharah. I was curious to see if there were any relatives to notify, so I went into his medical records and discovered that he had a sister who lived ten minutes away from my home in Belle Harbor, which was interesting because no one ever visited Jack. I didn’t think he had anyone. I called her up, offered my condolences and assured her he’d have a proper kosher funeral. And then she started to cry on the phone, ‘Rabbi, please forgive me for not visiting. I live in this high-rise and since I had a stroke, I can’t leave my apartment.’
“So I called Shomer Hadas and arranged that when they bring back the body, they should pick me up, and I told the driver to pass by the sister’s building and wait. She lived on the 14th floor. We stood near the bay window, I tore kriya with her, and then delivered a hesped while we looked down at the hearse with the back door open to the coffin. I’ve officiated at many funerals, but never one so highly emotionally charged as this one.
“The next day I went to be menachem avel. I asked her how she managed with food if she couldn’t leave her apartment. She admitted that she would get Meals on Wheels but ate them sparingly. So I called Bikur Cholim of Belle Harbor and arranged for them to stock her kitchen and prepare meals for her. I visited her about a month later. ‘Don’t you have any other family?’ I broached. ‘Rabbi,’ she admitted, ‘I have two sons, but they don’t come — they’ve abandoned me.’
“So I called the sons. ‘Look,’ I said, ‘I’m in your mother’s house now. I don’t know what happened between you, but now your mother is all alone and helpless. I want you to reopen communication.’ P.S. — the boys came and now they take care of her. Whatever years she has left, she at least has her sons back. So in his death, that difficult client caused his sister to be cared for and a family to be reunited.”
Everyone Has a Spark While caring for the deceased has become a large part of the job description, caring for the living is an even greater challenge. Most rabbis expect a certain level of decorum in the synagogue, during services and programs, but in a psychiatric facility, nothing is a surprise.
For the most part, Rabbi Lerer uses the basics of Judaism: tefillin, Shabbos candles, a succah (which the state purchased for him to accommodate 70 people), kosher meals, and Torah classes to reach those parts of the Jewish soul unsullied by the trappings of life’s sad entanglements.
“No one, not even someone in the closed ward of a mental institution, needs to be written off,” he says. And his job is to try to uncover that Divine spark.
Meilech was an old European Jew who had never put on tefillin in his life.
“It was Erev Yom Kippur and I was making the tefillin rounds,” says Rabbi Lerer. “It’s a terrible thing for a Jew to die without ever wearing tefillin — a terrible stain on the neshamah. I begged him, ‘Reb Meilech, tomorrow is Yom Kippur. Tu mir a toivah uhn leig tefillin.’ He was stubborn. ‘Ich vill nisht.’ ‘Ein mohl — one time…’ He finally, begrudgingly agreed, and even remembered Kriyas Shma from when he was a child. The next day, Yom Kippur, he died.
Rabbi Lerer cannot reveal details about why one 27-year-old client was committed, or why he wasn’t allowed to attend his father’s funeral three years ago. “But this young man went to yeshivah and actually knows a lot, and happens to love modern Jewish music. He has permission to come to my office, and I let him play background music while we talk. Last month was his father’s yahrtzeit, and I thought — let me take a chance, and ask the clinical director if I can get permission for him to say Kaddish. He had never said Kaddish for his father. The Gurwin geriatric center is nearby, and they have a 2 p.m. Minchah. Could I take him ? Dr. Amy Klein, the deputy clinical director, agreed.
“What a transformation. He put on a suit, tzitzis, and a tie. I didn’t want to take him alone in my car, so I took the Protestant chaplain, Reverend Alvin Mills, along with me. And this young man said Kaddish for his father for the first time. It made him feel connected.”
The Orthodox community is not immune to psychiatric disorders that require hospitalization, and when someone must be institutionalized — either because he is a danger to himself or others, or because psychotropic medications have not succeeded in stabilizing him — Rabbi Lerer is there to make provisions. “At one point I had 50 people putting on tefillin every day,” he says, although the phylacteries — because of their straps — cannot be left on the wards unattended. And, he doesn’t pick his clients. Even the criminally insane.
“My job isn’t to pass judgment,” he says. “My job is to make sure these Jews can still do some mitzvos, no matter what else they’ve done.”
Mental illness, says Rabbi Lerer, might always be a stigma in the Jewish community, although in his years in both Jewish education and the chaplaincy, he’s seen families become more receptive to treatments and to acknowledging problems that can be treated.
“We’re trying to normalize their lives,” says Rabbi Lerer, and to that end he’s mobilized the greater surrounding Jewish community to participate in his mitzvah. Twice a year, the East Northport Jewish Center invites Pilgrim’s Jewish clients to a royal event in the synagogue’s opulent ballroom. Every year between Rosh HaShanah and Yom Kippur, the men’s club of the Northshore Jewish Center goes out to the Central Islip cemetery and visits each of the 101 graves, making sure those souls, bereft of kin, are not forgotten.
For a number of years, students from the Hebrew Academy of Nassau County (HANC), together with principal Rabbi Moshe Gottesman and teacher Rabbi Yossi Lieber, would visit the clients before Chanukah and Purim, bringing a little joy into their dreary lives. Mrs. Chaya Teldon, a Chabad shaliach in Commack, New York, and principal of the city’s Jewish day school, brings her students to Pilgrim every year before the holidays.
“When I was still at Central Islip, the kids from HANC would come and do a program in the main auditorium,” Rabbi Lerer recalls. “But one building had clients who were not ambulatory and I felt bad for them. So I called Rabbi Tuvia Teldon from Chabad in Suffolk County and asked him to bring down some sisterhood ladies who could sit with the elderly, immobile clients. One lady brought her infant, and an elderly resident, who’s been institutionalized for decades, asked her in Yiddish if he could hold the baby.
“This man was a Holocaust survivor who saw his own wife and children tossed into the fires. So he took this baby and started singing an improvised lullaby — ‘don’t be afraid, ales zoll zein b’seder, di mame vet aheimkumen (mother will soon be home)’ — calling the baby by the name of one of his murdered children.”
Too Early to Retire Rabbi Lerer doesn’t limit his devotional projects to Pilgrim State. In his community of Belle Harbor, Rabbi Lerer has no intention of slowing down. He speaks at the Shabbos morning hashkamah minyan, he gives a regular Gemara class, and was founder of the community’s Hatzolah. He’s the steady ambulance driver and still goes out on calls.
“In my home,” he says, “my eineklach know that Zeidy answers the phone on Shabbos.”
And it’s specifically on Shabbos and Yom Tov that Rabbi Lerer exercises his rabbinic position together with his medical knowhow. Some people simply refuse to get into the ambulance on Shabbos.
“Ten years ago on the first day of Pesach, as I was walking out to Minchah, I got a call from an elderly neighbor whose husband is an old Gerrer chassid from Lodz. He had every symptom of an oncoming massive cardiac arrest — crushing chest pains, pain down his left arm, nausea and diaphoretic. I said, ‘Reb Chaim, we have to go to the hospital.’ ‘Ich fort nisht oif Yom Tov.’ He refused to get into the ambulance. I was afraid he was going to die, so I pulled my rabbi rank on him with a forced psak. I told him, ‘I brought the ambulance on Yom Tov. If I bring back an empty ambulance, it’s on your head.’ So he said, ‘ich for’ — I’m going. At the hospital his heart stopped, but because we were there in time he managed to live another ten years.”
And although Rabbi Lerer is not a medical professional in the classic sense, he’s most proud of a paper he delivered to the American Psychiatric Association, which met in conjunction with the Association of Mental Health Clergy, entitled, “The Performance of Mitzvos in Lieu of Psychotropic Drugs.” Rabbi Lerer discussed several cases where mitzvah involvement brought on a measure of healing.
One of those cases was an elderly man named Dovid, who was listed in the hospital records as “mute.”
“I had a gut feeling that this was selective mutism,” Rabbi Lerer explained. “So when I went on my tefillin rounds one day, I helped him put on tefillin and said, ‘Dovid, ich halt az du kenst zogen Shema Yisrael. One time, Dovid. Try.’ And he said the words. The nurse was passing by and heard, and shouted, ‘Rabbi, I don’t believe it! He spoke!’
“Why did he speak for me? This was his story. He grew up on the Lower East Side, had his bar mitzvah, got his tefillin and was on top of the world. Then suddenly his father died and his world fell apart. He needed money, so he went to Philadelphia and tried his hand at boxing, when his sparring partner knocked him unconscious for a few seconds. When he came to, he realized what a fuss everyone was making over him, so maybe it would be better to act as if he were really damaged. They would have rachmanus on him. They kept him around, bought him sandwiches and took care of him, and that’s how he survived. But because he refused to talk, his family put him away in a psychiatric facility. So what happened after sixty years? I wrapped him up in his tefillin. I made him feel good, brought him back to the day of his bar mitzvah when life was good for him.
“He never became an orator, but his vocal chords were still intact. He died about six months later. Poor Dovid, medicated, institutionalized all those years, and he talked with a pair of tefillin.”
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