I walk into the hospital. Most of the men are fully dressed in a black suit, black dress shoes, black top hat. They also fashion themselves with a vest under their white shirt that has strings attached to the sides. And they all have long curly sideburns. The women are dressed modestly, shirts that cover their elbows and dresses that go below their knees. If they are married, they cover their hair with head coverings or wear a wig.
I recently started my pediatric rotation in an ultra orthodox Haredi hospital. The Haredi are ultra orthodox Jews who abide by the Jewish law in everything they do. This makes the doctors’ jobs a little more complicated as they often have to consult a rabbi to explain to the parents that this procedure is allowed according to the book of law.
One of the first patients that we saw was a young boy who presented with a swollen erythematous elbow. He had a history of reactive airway disease and had recently finished a course of antibiotics for severe pneumonia. Given the history and clinical picture, joint aspiration was indicated to rule out septic arthritis. However, the mother refused on the basis that she needed to consult her rabbi. The doctors offered to bring the hospital rabbi, but she insisted that she call her own. After an extended discussion, with doctors calling rabbis and rabbis calling other important rabbis, she consented. Unfortunately, the pediatric orthopedist had left for the day by that point…
We encountered other interesting cultural differences and challenges. One of the most important things in Haredi society is to marry and bear children, lots of children. The marriages are arranged by the parents, who talk to everyone to find out every detail about the prospective suitor. This has an unexpected but frustrating consequence in the hospital: the parents will never admit to any disease straight up for fear of not being able to find a suitor. Is there a family history of reactive airway disease? Tss tss tss, no. Does your child have asthma? Bless His name, no. Does your child need inhalations? Yes, 3 times a day. As a result, we cannot ask general open-ended questions like we were taught to in medical school. Everything has to be direct and pointed.
Another interesting aspect is the separation of gender. Although not as strict as the doctors made it sound during our orientation, there has been more than one awkward instance. Some men will not talk face-to-face with a woman who is not his wife. So when one of the girls went to take a history, the father looked at the floor while talking to the student. Sometimes men will not share the elevator with women. There have been several instances where men would not come in the elevator because there were women in the elevator. Sometimes they will walk out when a woman comes into the elevator. One time I walked in an elevator with a man. He turned around to face the wall and started praying, while swaying back and forth. I think he thought I was a girl.