| A Tale Of Two Cities And Life's Passages |
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If you are "sane" enough to say you are crazy, you are not insane enough to be taken seriously (see Catch 22 by Joseph Heller, 1961). Two parallel existences go on. The inhabitants of both "cities" project their hopes and dreams on one another. _option_option
Another axiom is that of' "passages". In our lives, if we are fortunate, there are many passages. In a sense the importance of passages was highlighted most dramatically during the Exodus from Egypt. At the behest of Hashem, Moshe instructed his people to mark the lintels of their home with the blood of a sacrificed animal. The passage from Egypt into The Promised Land was "marked". Parents of children with special needs are experts in finding doors and portals through which their children may pass, sometimes well girded for the next passage, other times, less able to take an equal place with their same-aged peers. As each passage in life begins to appear on the horizon, it is as if a parent is "stabbed-in-the-heart" yet again, with a painful reality. "My child is different than others his/her age"; "I thought that this time we had finally made it" − the entry into the "good-enough" if not perfect life. These "Two Cities" do not have to be in a geographical divide, rather they exist in the same time a place yet a different dimension, yet though they may co-exist, they rarely intersect, establishing is a constant "Push-Me Pull-You" (see Christopher Lofting's Dr. Dolittle), between what might-be and what-is. When an advertisement for a "special" Yeshiva for a year of study in Israel appeared in the local Jewish newspaper, Mrs. Lahav* was thrilled. Her son, Rephael* (not their real names) would be able to attend a Yeshiva abroad, just as his age-mates would be doing. Rephael was diagnosed as having psychiatric problems from age eight. His parents noticed difficulties with his development from age five and over the years have done everything in their power to provide him with the special medical attention and environment that would allow him to take his place among healthy children his age. There were some better years and some years that painfully required hospitalization. Now at 19 years of age he was pretty aware of his limitations, yet dreamt of taking his place among his friends and neighbors who were going to Eretz Yisrael for a year-or-so of study, before going on to "Learning", college or work. The ad in the paper was the opening of one such window. Under "Rabbinical" and "Professional" supervision, young men with mental health issues were invited to submit their applications for acceptance to a one-year program. It was costly, more than other such Yeshiva programs, but this was a small "special needs" group, Mr. and Mrs. Lahav were cautiously elated at the opportunity. What transpired was every parent's nightmare. Once he arrived at his "Yeshiva," Mrs. Lahav had been in contact by phone with Rephael at least once daily. After a few weeks it tapered to twice weekly. He was so happy in Israel, in general, and in the "Yeshiva," in particular. He sounded homesick but the "Rabbi" in charge said this was to be expected and that he was doing quite well. Mrs. Lahav felt there was some hesitation creeping up in Rephael's voice and it seemed that he was always tired or sleeping, but kept hoping that his homesickness would soon be resolved. She asked friends whose sons had been in Israel for the year and found that this was not an unusual reaction − "off on their own"; "up until all hours"; "new freedom" all sounded plausible. When he didn't call at the appointed time she felt he was really "getting into learning" and things were moving along well. She tried to reach the Rabbi after Rephael "missed" two phone calls she made to check on what was going on. The report was positive and she was pleased. Ten days later she began to be concerned. When she finally spoke to him, he sounded confused and anxious. She decided that maybe Israel was too far away for someone with his history and began looking into options in the New York area. The environment, which she felt would be optimal, required a current Neuropsychological evaluation, and they referred her to me in Jerusalem. She decided she would fly over to see Rephael and also accompany him for the assessment which usually takes about six to ten hours over two or three days. Rephael presented as a well-groomed and attractive older adolescent. He did show some facial and motor tics and as the initial interview continued began to behave somewhat erratically. As I took a history from the Mom, my colleague went into another room with Rephael to continue with further neuropsychological testing. When I rejoined Rephael, the tics and recurring thoughts had become more pervasive. And, added to that, were as I feared, early signs of psychosis that was affecting his cognitive ability. I recommended that we take a break in the testing, and consulted with Ms. Hinda Schryber, a psychiatric social worker and the Director of Or L'Nefesh. Or L'Nefesh is an organization that provides services for the mentally ill in Jerusalem, and Ms. Schryber is a native English speaker. After speaking with Mrs. Lahav, and impressing upon her the urgency of a psychiatric consultation (it wasn't hard to do given that Rephael's state seemed to be deteriorating before our eyes), she arranged to take a taxi to Or L'Nefesh. What transpired afterward was the following: In subsequent hours Rephael's medical/ psychiatric condition further deteriorated. Ms. Schryber referred them to Eitanim Child and Adolescent Psychiatric Hospital where he was checked by a physician who found signs of physical abuse on his body. It seems as though there had been ongoing physical injury and that he may have also been sexually abused. Though he was unable to communicate clearly, it seemed as though his recurring thoughts and anxiety stemmed from the nightmare he had lived. Further, there was another young man in the same hospital with similar signs who had attended the same "Yeshiva"! Contrary to the glowing references in the advertisement, the "Rabbi's" name was already connected to similar cases; No professionals were employed by the "Yeshiva"; the "Yeshiva" was not licensed by the State of Israel to operate a "psychiatric" residential environment; Neighbors later reported hearing screams coming from the apartments connected with the "Yeshiva", but did not report what they heard to the authorities. The police were called in and revealed that they had already had complaints of similar cases regarding the "Rabbi" and "Yeshiva". When they went to investigate, they found hand restraints on the beds and the "Rabbi" was missing. He has yet to be found by the police, and it is thought that he fled to England or Canada. Rephael received requisite psychiatric and medical care and within a few weeks was able to make the trip home with his Mom. The "Yeshiva," which is in fact, a few apartments in a religious town outside the Jerusalem, lies empty, the "Rabbi" has not, as far as I know, returned to Israel. This horrible story ends on a more positive note vis-à-vis Rephael. His Mom reports that he has recovered from this harrowing experience and is doing well in a frum residential facility in the States and has begun taking courses at a local college. Mrs. Lahav* has given me permission to release her name to those who wish to consult about her experience, she has also agreed to testify in Israel should the "Rabbi" be indicted for this and other acts of abuse. Please consult with organizations such as Nefesh Israel (www.nefeshisrael.com), the "local" branch of Nefesh International (www.nefesh.org), the networking organization for Orthodox Mental Health Professionals through which we may be able to make contact with various individuals and organizations and will try to use "due diligence" in researching "special" institutions in Israel. But as always, Caveat Emptor - Let the Buyer Beware. Originally published in the Jewish Press on June 4, 2008. |
