A volunteer jokes with a patient during a holiday party at St. Louis Hospital. (photo: Debbie Hill)
Physical therapist Basel Baddour helps a patient stretch his arm. (photo: Debbie Hill)
A nun and patient pray during Mass in the hospital’s chapel. (photo: Debbie Hill)
An electric gurney is used tomove Manal, Mr. Abu Shukra’s daughter, into bed. (photo: Debbie Hill)
Jawaher Ghret draws a picture during a session with art therapist Tammy Einstein. (photo: Debbie Hill)
Marcie Alter enjoys the company of Dennis, a therapy dog that visits patients once a week. (photo: Debbie Hill)
It is the start of the day at St. Louis Hospital in Jerusalem, and Ataf Muhammad Abu Shakra cradles his daughter’s head in his broad hands, as he does every morning after the nurse has bathed and dressed her.
His daughter, 34-year-old Manal, lies immobile and uncommunicative, strapped into an electric gurney used to transfer her from the hospital bed to a wheelchair.
For the past four years, the once-vibrant young mother has been in this state. While undergoing a Cesarean section to deliver her sixth child, Manal received generalized anesthesia from which she never fully awoke.
Soon after, the family brought her to St. Louis Hospital. Run by the Sisters of St. Joseph of the Apparition, the 131-year-old facility provides hospice care and palliative care for chronic illness.
“Manal was like a mother to her brothers and sisters when she was younger. She was so gentle,” reminisces Mr. Abu Shakra, as he arranges pillows around his daughter’s arms, legs and neck. “Now we take care of her.”
Manal is never alone. During the day, either her brother or uncle, both of whom work in the neighborhood, stop by. Her sisters, too, visit her when they can get away from their housework and children. In the evening, her other brothers come to the hospital after work to relieve their father. Her mother, however, does not visit as often as other family members because she gets emotionally overwhelmed when she sees Manal.
“When I am not here, I can’t sleep,” says Mr. Abu Shakra. “I worry about her. Maybe her arm is crooked; maybe she is coughing. I feel better when I am here.”
With calm efficiency, Manal’s father cleans out the mucus from her tracheal tube.
He then turns his attention to her feet and legs. He straightens her atrophied feet, washes them and expertly massages her toes before slipping on socks. He bends her knees and places her feet on the wheelchair’s footrest.
“She is my daughter. What if she wakes up and no one is here?”
Now that Manal is seated, Mr. Abu Shakra brushes her thin hair, pulling it back in a ponytail. In keeping with Muslim tradition, he then covers her hair with a brown hijab, the Islamic headscarf.
For a moment, Manal leans toward her father and opens her mouth as if about to say something. But no words form on her lips and she blankly stares into the distance.
The family has learned to adjust to Manal’s condition, says her father, by keeping faith and hoping God will one day bring her back. Until that day arrives, the family continues their unfaltering vigil.
In the next bed, Sarah, an elderly Orthodox Jewish woman suffering from dementia, demands a cup of tea. Originally from an Arabic-speaking country, she shouts in Arabic.
Mr. Abu Shakra smiles, walks over to her and kindly points to the cup of tea already on her tray. She then asks him for more sugar.
“How much sugar do you want, auntie?” says Mr. Abu Shakra. “I am your son. Tell me how much sugar you want.”
Placated, she sips the sweetened tea with a grin on her face.
“We are all one family here,” says Mr. Abu Shakra. Political and religious differences, he adds, are left outside the hospital’s doors.
St. Louis Hospital is an oasis of tolerance and compassion in a city where those virtues are often sorely missing. Its 60 professionals and 25 volunteers come from all religious and ethnic backgrounds. And together, they provide around-the-clock care to 50 patients from all walks of life. These patients reflect the mosaic of Jerusalem’s multicultural population. They are Jewish, Christian and Muslim; religious and secular; Israeli and Palestinian; immigrants and migrant workers.
Both Israeli and Palestinian cultures center on the family and visitors to the hospital abound. Still, about 10 percent of the patients do not receive visitors.
“When you live together on a day-to-day basis because you have a common aim — which is caring for a dying loved one — you see the other person whom you would have otherwise never met,” says Sister Monika Dullman, the hospital’s energetic 47-year-old director.
“In this city, people live very closed off from each other in their own groups,” she says. “They may walk on the same streets, but they don’t look at each other.”
But here, behind the fortress-like walls of St. Louis Hospital, in the face of death, people finally see each other’s humanity.
“You see that he also has a mother who is dying from cancer, so he is the same as you. You realize that what has been separating you because of [religious or political] differences does not really count, because what really counts is that your mother is dying from cancer,” says the German sister who left her native country to work at St. Louis Hospital as a volunteer.
“Though no one is thinking of interreligious or political dialogue, people get to know each other and get to love each other in a way because they have passed through a hard time together.”
St. Louis Hospital consists of three wards: hospice care, palliative care and convalescent care.
The ward for convalescent care mainly serves as a residence for elderly persons who have recovered from chronic conditions, such as bedsores, but are not well enough to live alone. Many of its residents are elderly Catholic religious who have spent most of their lives in the Holy Land.
The hospital, which runs on a shoestring budget largely from donations, is at capacity. New patients must register on a waiting list. However, Sister Monika says the hospital will soon add ten beds when the ten St. Joseph sisters vacate the corridor where they are living. The elderly, retired sisters will move to the third floor. Sister Monika and the two other working nuns have already moved to a small house on the grounds.
Israel’s health care system is the best in the region and consistently ranks among the best in the world. Health care is universal and all Israeli citizens and permanent residents have access to quality care.
St. Louis Hospital is fully integrated into the Israeli health care system. Most of its patients have Israeli heath insurance, which fully covers the cost of their care. The hospital, however, does set aside a modest fund to pay for the care of patients without health insurance, such as migrant workers.
St. Louis is one of two hospice facilities in Jerusalem. The other, a 12-bed hospice, is located in the Hebrew University’s Mount Scopus Hospital.
A larger public palliative and hospice care hospital is located in the West Bank settlement of Ma’ale Adumim, just outside of Jerusalem. However, it is difficult to reach and many Palestinians resent the idea of spending their last days in a facility in a West Bank settlement.
The Palestinian Authority occasionally requests St. Louis Hospital to admit a patient from the West Bank. In such cases, the hospital procures travel permits within 48 hours for the patient and a few close family members.
Generally, these patients wish to return to the West Bank as soon as possible to be with their family and friends. St. Louis’s medical team stabilizes the patient, teaches the family how to care for their loved one, supplies them with medications and discharges the patient. The hospital, however, does not have the resources to provide in-home nursing care, and the patient or a family member must come to the hospital to refill medications.
“The Israeli health system tries to get people home and to care for them there as much as possible,” says Sister Monika. “We are part of the backup system of home care. If somebody at home cannot manage and there is not a bed at the university hospital, they turn to us. Within two hours we can receive a patient like this.”
Rita Abramov, head of social work at Hebrew University’s Hadassah Hospital, works closely with the social worker at St. Louis and often refers patients to the hospital. She says St. Louis is among a small group of Catholic health care institutions in Israel providing vital treatment to seriously ill patients whom other hospitals are sometimes unwilling to accept.
“It is a very special place,” she says. “It is rare to find a place like it in Jerusalem.”
For Marta Wahbeh, a 77-year-old Catholic widow, St. Louis Hospital has been nothing short of a godsend. Her 57-year-old son, Michael, suffers from cancer. At first, he received treatment at Hadassah Hospital, which was too far from the elderly woman’s home in the Old City for her to reach it by public transportation.
“Now, I can come visit him every day,” says Mrs. Wahbeh, as she folds napkins and places them next to the cakes and traditional baked apples laid out on a table in the common room. She and other volunteers have organized a party for all the patients and staff in celebration of Rosh Hashanah, the Jewish new year.
“Everyone is the same here,” she says. “The hospital also has a party for Christmas. Thank God there is a place like this.”
Sister Monika delights in what many patients and their families say about St. Louis Hospital.
“They say they feel it is a place where people pray,” she says. “There is for sure a very special love and respect here. If we devote our lives to this, we should have this. Maybe it really is the fact that we have a lot of people in this house who are praying that gives it its special feeling.”
Working at St. Louis is often physically and emotionally draining. However, the staff is unified in its commitment to, and love for, the patients and their families.
“It is by knowing how much God loves me and loves the others that I can do just a little bit to share this and to make people feel there is hope. They can be comforted even in a very difficult situation. They need not be alone,” says Sister Monika. “Sometimes, even if we can’t do much because there are things you cannot solve, at least we don’t run away. It is very clear that you can’t separate your love for God from the love for the people you live with. We live the love of God for everybody with no differences.”
For Natalie Parmentier, a 26-year-old occupational therapist from Belgium who volunteers at the hospital through the French Catholic Delegation for Cooperation, working with chronically and terminally ill patients is difficult but rewarding.
“Before I came, I asked myself if I was ready to work with people in such conditions. Even in this difficult part of life, we are there. It is important for the families to see that there is a human being inside, even if there is dementia and we can’t help with that, we are taking care of the human being inside,” she says.
With the Rosh Hashanah party in full swing, Ms. Parmentier clowns around with a patient in a wheelchair, who dons sunglasses and a scarf belonging to another volunteer.
“This could be a good example to spread to the outside,” says Basel Baddour, a Christian Palestinian and the hospital’s sole physical therapist, about St. Louis Hospital. “If everyone would treat each other like a human being, the world would be a much better place. Life would be better.”
All patients receive one session of physical therapy per week. A few with special needs get two sessions. The hospital also provides art therapy and counseling sessions with a psychologist and social worker.
Once a week, a Catholic priest visits the hospital and celebrates Mass. Sister Monika maintains contact with pastors and priests from other Christian denominations, who visit the patients when they request it.
An Orthodox rabbi regularly comes to the hospital’s kitchen to verify that Jewish dietary regulations are followed for the Orthodox Jewish patients. A Conservative rabbi also visits the hospital to provide spiritual guidance to all patients who desire it, regardless of their religion.
Three years ago, the hospital joined a project in which volunteers bring therapy animals to the hospital. For some patients, the project has been a great success.
Marcie Alter, a 44-year-old Orthodox Jew originally from Pittsburgh, has been a patient at St. Louis for eight years. All week, she looks forward to her time with Dennis, a Boxer mix.
Almost completely paralyzed and unable to speak, she uses a computer and a letter board to communicate. Most of her family lives in the United States, though she has many friends in Jerusalem who visit her.
A smile spreads on her face when Dennis arrives and jumps on her bed. She reaches out to pet him. With the dog by her side, she points to the letters on the board, spelling out: “It feels like home.”
In another room, Tammy Einstein, an art therapist who has worked at the hospital for 16 years, sits at a table with Juwair Ghetret, a 57-year-old Muslim Palestinian. Never married, Ms. Ghetret became paraplegic in a car accident four years ago.
A large sheet of brown paper is spread out in front of Ms. Ghetret. On it, she has drawn a blossoming lemon tree and a traditionally dressed Palestinian couple, holding up a tray of coffee — a symbol of hospitality. A chicken scratches the ground nearby.
“My hand hurts today,” she says, as she draws a geometric pattern around her creation. “But being here with Tammy gives me a chance to take my mind off of the pain.”
A few days ago, Ms. Ghetret was one of the first patients in the hospital to ride on Jerusalem’s new light rail. It stops right in front of the hospital. Her brother accompanied her to the downtown mall where she got a manicure.
“Here at St. Louis, it is still very much about life,” says Ms. Einstein.
Jerusalem-based contributors Judith Sudilovsky and Debbie Hill cover events in the region.