I

t was late Thursday night after a long, hectic day and returning home from the last neighborhood Maariv, I was finally able to sit down and treat myself to a sachlav — but then the phone wouldn’t stop ringing.

I checked the caller ID — it was the rebbetzin of a local seminary for at-risk girls. I knew how hard she worked and how much she cared about her students.

“Dr. Freedman, thanks for picking up,” said Rebbetzin Schwartz on the other end of the line. “You know I wouldn’t call three times in a row unless there was a serious issue.”

And it did sound serious. The Rebbetzin told me about Julie Hamedani, a young woman from the Persian community in Los Angeles. She had a history of anxiety that had gotten progressively worse since she’d come to Eretz Yisrael, and was now having daily panic attacks. Rebbetzin Schwartz was not inclined to send Julie to the emergency room, but unless a mental-health professional (i.e. me) would be willing to do some late-night intervention, she felt she had no choice.

I agreed. “But only if you promise to send me some of your famous Yerushalmi kugel for Shabbos,” I told her.

I’d had the pleasure of working with Rebbetzin Schwartz long enough for her to know the way to keep me happy and available to work with her students: Yerushalmi kugel (it kept my wife happy too, especially since it was a short Friday and Shabbos was about 14 hours away). Rebbetzin Schwartz also knew to send along the standard form for emergency consultations to the patient and her family: a release of medical information, practice policies, and information on how to make an electronic payment.

I drove back into town and met my new patient. Julie was honest and articulate, and proceeded to tell me the story of her family: her father’s escape from Persia in the 1980s through the mountains of Pakistan, and how he’d built up a small fortune one step at a time after opening a single restaurant back in 1991 that had turned into a series of solid real estate investments.

“Dr. Freedman, I think it’s important that you understand something about my father. He’s a self-made man who had a horrific trauma fleeing his home country and worked very hard to build a future for his family. But it was terrifying growing up in the house with him.”

Julie proceeded to tell me of the physical and emotional abuse that she would experience on a daily basis growing up in her father’s palatial Beverly Hills mansion. While her brothers received the majority of smacks, she bore her share of violence as well. Even as the intensity of the physical abuse calmed down with time, the emotional abuse persisted — and Julie turned to marijuana and alcohol, and away from Yiddishkeit, by the time she reached adolescence.

From a clinical standpoint, her case was relatively straightforward. There was a history of trauma, there were acute symptoms of panic, and there was problematic drug and alcohol abuse.

Julie didn’t need a hospitalization, but she did need to stop killing the pain with substances, as the rebound anxiety was only making things worse. She would benefit from a skills-based therapy to decrease substance cravings and to address the lack of coping skills for dealing with her anxiety. Additionally, there was a need for medication intervention at this point, given the severity of her symptoms.

Julie was suffering, and more than willing to give this plan a try. We discussed the benefits and risks of medication treatment and I made a referral to a highly-skilled colleague to work her magic with the necessary psychotherapy. Julie and I scheduled a follow-up appointment for about two weeks down the line and I encouraged her to call me with any questions.

As I locked up the office for the second time, I was feeling pretty satisfied about my good deed for the night. And then my phone rang with an unknown number from Los Angeles. Figuring that it was Julie’s father, I prepared myself for what might be a difficult conversation.

“This is Mr. Hamedani!” boomed a hostile voice over the phone.

I began to introduce myself but was abruptly cut off. “I know who you are — you’re the psychiatrist I’m supposed to pay, but guess what — you’re not getting a dime from me!”

I took a deep breath and reminded myself that my new patient had grown up with this dictator of a father. Whether or not I’d see a dime or more, it was incumbent upon me to share some facts with this fellow for the sake of his daughter.

“Let’s avoid the topic of payment for a moment, Mr. Hamedani,” I said with as much calm as I could muster as I began to relate my understanding of his daughter’s story, her diagnosis, and the recommended treatment.

But Mr. Hamedani wasn’t interested in any of that, and picked up where he left off: “Thanks for your help, but I know what’s right for my daughter and I know that I never agreed to pay you a dime. If she needed a doctor, I would have sent her to one!”

Remaining as pleasant as I could, I responded, “Mr. Hamedani, your daughter is suffering. I was called in by her seminary to do an emergency evaluation in the middle of the night. I sat with her and came up with a plan of treatment, and with Hashem’s help she’ll soon be in a better place.”

Mr. Hamedani didn’t seem to be listening as he proceeded to bulldoze through a dozen reasons why everything was fine and he “didn’t owe me a dime.”

“Mr. Hamedani,” I said, “your daughter agreed to payment before the visit that I did expeditiously as a favor to Rebbetzin Schwartz. But believe me, I don’t even care about payment. Let’s focus on your daughter’s health.”

 “What do you know about my daughter?!”

“Well, I know that her father’s anger has directly contributed to her current situation, and unless you calm down a bit, it’s going to perpetuate her distress.”

“I don’t care!” he shouted. “You’re fired! You were never hired! I want a real doctor, not some fake chareidi shrink. Get me a real doctor who went to Harvard and speaks Persian! That’s the only doctor I will pay!”

I couldn’t help myself and started to snicker.

“You’re laughing now?! What kind of doctor are you anyway?”

“Mr. Hamedani,” I just had to tell him, “I’m the kind of doctor who trained at Harvard Med School and also speaks Farsi. Hodafez, Mr. Hamedani,” I said, wishing him goodbye in his native tongue.

As I walked to my car, I ignored his subsequent phone calls — I was already on the phone with Rebbetzin Schwartz discussing the plan for Julie. I would call him back later.

“Rebbetzin,” I said, “I don’t want a penny from this guy. If he pays anything, it’s going straight to your fund for the seminary girls who can’t afford treatment.”

Rebbetzin Schwartz was impressed. “Dr. Freedman, tonight you’ve earned your Yerushalmi kugel.” —

*Names and identifying details have been changed to protect the privacy of patients, their families, and any other involved parties.

Originally featured in Mishpacha, Issue 736. Jacob L. Freedman is a psychiatrist and business consultant based in Israel. When he’s not busy with his patients, Dr. Freedman can be found learning Torah in The Old City or hiking the hills outside of Jerusalem.  Dr. Freedman can be reached most easily through his website www.drjacoblfreedman.com.