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The Next Hill

Jacob L. Freedman

The look on Malachi’s face nearly broke my heart

Wednesday, February 20, 2019

M

alachi was a man with a future. He was the sixth son of a prominent community activist who had built a vibrant religious kehillah north of Jerusalem. Twenty-nine years ago, Malachi was born into a culture of service for Am Yisrael, Toras Yisrael, and Eretz Yisrael and grew up in the hills overlooking Shechem.

Life was simple and full in their yishuv, even as the roads leading in and out were often dangerous. In fact, one of his earliest memories as a child was attending the funeral of a cousin who’d been murdered by terrorists while returning home for Shabbos.

But where less dedicated people would have packed up and moved to a “safer place,” Malachi’s family was inspired to build a new community in the memory of their fallen loved one. Malachi’s father led six families into caravans on the nearest hilltop to establish a yeshivah for off-the-derech hilltop youth — and it was here that Malachi learned Torah, tended to his family’s olive groves, and prepared himself for the service of his people.

At the age of 18, Malachi joined a prominent hesder yeshivah where he split five years between Torah learning and the front lines as part of the Golani Brigade. Malachi’s Torah wisdom grew, even as he received a medal for bravery — he carried a wounded fellow soldier back from behind enemy lines. Following his army service, Malachi returned to yeshivah full-time, and soon married Tzofia. Four years and four babies later, Malachi and his young family decided to return to the hilltop where he’d grown up, in order to help his father run the yeshivah.

Under his direction, the program flourished. Disaffected youth who had been unable to succeed in — or had be thrown out of — the standard Mizrachi yeshivah system came to Malachi. They studied in the mornings, tended to the olive trees and pressed award-winning organic olive oil in the afternoons, and studied chassidus in the evenings. They’d carved out a little piece of Gan Eden.

In an instant, everything changed. Malachi’s truck was hit by a barrage of stones, and he was found unconscious after crashing into a tree. While the security forces captured the perpetrators, Magen David Adom volunteers raced him to the hospital for emergency brain surgery to stop the bleeding.

Days in the ICU quickly merged into weeks in a neurological rehabilitation center. Given the extent of his initial injury, progress was nothing short of miraculous — but Malachi’s trademark enthusiasm just wasn’t returning. Two months after his injury, Malachi came home with an intensive outpatient neuro-rehab program in place. But something about his once-fiery personality was off.

He seemed intact on the surface: He walked well, he spoke normally, and his amnesia started to lift. But something wasn’t right with Malachi. There was no smiling, no frowning, no anger, no emotion whatsoever. And while they tried an assortment of antidepressants, stimulants, and supplements, Malachi remained heartbreakingly flattened. This legendarily leibedig fellow had become a veritable couch potato with no desire to interact with his wife, kids, or talmidim.

I was asked to see Malachi by a neurologist friend who diagnosed him with a traumatic brain injury and wanted to know if something more could be done on a psychiatric level. As I heard the case, I told my colleague that it seemed like a case of organic pathology as opposed to a primary mood disorder — in layman’s terms, that means Malachi wasn’t depressed, but that his brain wasn’t working properly due to the injury and he wasn’t likely to respond to any psychopharmacological treatments. But just to see for myself if there was anything I could do, I decided to drive up to the area of Har Gerizim and see Malachi for myself.

As I entered the caravan lined with seforim of Rebbe Nachman, Rav Kook, and the Lubavitcher Rebbe, the look on the face of the man sitting there nearly broke my heart.

It was the same vacant stare I’d seen as a resident, when I met a construction worker who’d taken a cinderblock to his head. With the prodding of a loving talmid, Malachi turned to me and stuck out his hand to grasp my own in a minimal attempt at an introduction. After telling me his name, I waited to see if there was anything he’d like to add, but Malachi continued to stare at the wall until I asked another question, this time wondering if his wife was around.

“My wife is at the grocery store,” he responded. Even as I asked about the yeshivah, his children, and the accident itself, I was met with a very restricted set of robotic responses.

“I was hit in the head and now I’m okay,” he said, describing the terror attack to me. But he clearly wasn’t okay.

Tzofia entered the room holding the baby and quietly sat down next to her husband. As I began a more structured cognitive exam and tested his memory, Tzofia began to silently cry. It was clear that Malachi had ongoing serious deficits in cognition, as well as an obvious lack of motivation and emotion.

Finally Tzofia turned to me and cried, “My husband is a tzaddik — he could have been a gadol! He was a leader, and now he sits and looks at the wall…. And these animals who did this to him will sit for a year in jail until they’re released to a hero’s welcome in their village! I ask Hashem every day where the justice is, for my husband, for our People….”

Malachi continued to stare into space as his children played on the floor, seemingly oblivious to their mother’s distress and their father’s horrifying lack of response. I asked Tzofia if we could go outside  — I wanted to share my thoughts on what we could do.

As we walked into the great open space outside of their caravan, I gazed across the hills overlooking Shechem. I went through the diagnosis of traumatic brain injury from a psychiatric perspective. Due to Malachi’s failed response to multiple psychopharmacology trials, it seemed as though ongoing occupational and physical therapy services would be the mainstay of treatment, as opposed to any curative psychiatric interventions.

But something interesting happened as I described my relatively bleak treatment plan. Instead of breaking down further, Tzofia became increasingly resolute and stared into the horizon with me.

“When my husband’s cousin was murdered, Malachi came here with his father and redeemed the land on this hill.” I listened as she pointed to the next hilltop, where a number of young men stood with saplings and shovels. “Do you see that ring of trees over there? That is where my husband’s talmidim have begun planting a new olive grove. We will continue to build and to redeem Hashem’s land and in time our children and grandchildren will build new yeshivot in the merit of my husband.”

I stood there thinking about Malachi and his wife. I thought of her children and how to get some extra resources to support them as they grew up in a house with a father suffering from a horrifying traumatic brain injury. And then I thought about the talmidim who I could see planting trees on the nearby hilltop in the merit of their rebbi whom they so adored.

Identifying details have been changed to protect the privacy of patients, their families, and all other parties.

Originally featured in Mishpacha, Issue 749. 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

 

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