Judge Rachel Freier has helped dozens of Orthodox Jewish women in New York City get training and start work as emergency medical technicians. In doing so, she challenged her community's conception of the role women can play in public and professional life.
The test presented itself, as tests so often do, on a completely ordinary day.
Charna Goldsmith was driving with her family on the Belt Parkway. Her attention was pulled in multiple directions at once — from her children crying in the back seat to her mental catalogue of errands. The Brooklyn air was heavy with midsummer heat. The parkway, as usual, was congested.
But up ahead, a four-car pileup was snarling traffic more than usual. And in the first car, a man, roughly 135kg by Goldsmith's estimate, seemed to be unconscious at the wheel. There was no ambulance in sight.
It was the summer of 2019 and Goldsmith had just concluded months of training as an emergency medical technician — much to the chagrin of her husband and other members of her Orthodox Jewish community. But suddenly, her skills were needed.
Her husband turned to her. "Um, hello," he said. "You can help him!"
She grabbed her emergency supply kit and leapt out of the car, leaving her young son and newborn daughter with her husband. She managed to place a cervical collar on the injured driver, stabilising his spine until the rescue workers arrived five minutes later. Once the Fire Department started tending to him, Goldsmith got back in the car — feeling shaken, but with a new jolt of confidence — and her family continued home.
Goldsmith is one of dozens of Orthodox Jewish women in New York City who have trained and begun working as EMTs in recent years, providing services separate from those of the 911 network. In doing so, they've challenged their community's conception of the role women can play in public and professional life.
For decades, the Orthodox Jewish community has relied on its own EMT services through the volunteer ambulance group Hatzalah. But because Hatzalah has an all-male local EMT force, Orthodox women — who might want to preserve their modesty, even in medical emergencies — have not always been able to get proper medical care.
The women's EMT services are coordinated by a nonprofit organisation, Ezras Nashim, which was established in 2014 to serve Orthodox women. It was founded by Judge Rachel Freier, known as Ruchie, and its launch got a frosty reception in the Orthodox community. Many saw the group's members as agitators, upending gender norms for no good reason.
But in the last year, as the number of calls to the organisation have ticked up, members of Ezras Nashim have all but made their case that the need for more emergency medical responders is crucial — especially in a community hit so hard by Covid-19.
But tensions remain: When the EMTs were doing a drill from their ambulance on a busy Brooklyn street in October, one Orthodox man stopped to tease them (jokingly, some of them said).
"Maris ayin!" he called out to the female EMTs. That's a concept, in Judaism, that suggests one person doing something seemingly (though not technically) prohibited by Jewish law might encourage others who see it to follow their lead.
Why call a woman for help?
Freier is the type of woman whose name, when mentioned in the neighbourhood of Borough Park in Brooklyn, tends to inspire an outpouring of stories. Many Orthodox families have memories of receiving help from Freier, whether in her capacity as a community advocate, before she became a judge, or as a neighbour delivering food and medicine to friends in need.
So it's not surprising that in the summer of 2011, when a small group of Orthodox women needed advice, they turned to her. They told Freier that they had decided to train as EMTs together, completing independent courses outside the Orthodox community, but they hadn't been able to put their skills to use. They were being blocked from joining Hatzalah, whose local affiliates do not accept female volunteers.
The women knew that challenging Hatzalah's gender divide wouldn't be well received. Hatzalah is renowned in the Jewish community; it started in the Williamsburg neighbourhood of Brooklyn in the 1960s, after a Hasidic man who had a heart attack died while waiting for an ambulance. That inspired a group of Orthodox men to create their own emergency response system, composed of volunteers and separate from the Fire Department and hospital EMTs who respond to 911 calls. It now has chapters across the globe.
New York doctors say that the service Hatzalah provides is high quality — and that it fosters trust. "The amount of faith that the Orthodox Jewish community has in Hatzalah's leadership, drivers and volunteers is remarkable," said Dr. Dara Kass, an emergency physician.
State officials agree. "Community-based volunteer services are an important extension of the health care network," said Gary Holmes, a spokesman for the New York State Department of Health.
So Freier wondered: With such trusted emergency medical providers on hand, why did the community need female EMTs?
But she concluded that God must have connected her with these women seeking to become EMTs for a reason. She began researching the issue, and was disturbed to hear accounts from dozens of Orthodox women who had delayed calling for medical help because they were uncomfortable being seen by men while undressed or in an immodest condition. In other words, their lives were being put at risk.
"Women were traumatised when they gave birth and saw 10 men invading their bathroom," she recalled. "I saw women turn pale, like a ghost, just reliving the trauma."
As Freier heard these stories, she began to think it was clear that Hatzalah should accept female volunteers. But many of the local rabbis, some of whom seemed to face pressure from Hatzalah, said they didn't agree. And the more she brought it up, the more she heard condemnations, ridicule and even threats. Members of Hatzalah told her it wasn't appropriate for men and women to work side by side.
After a year of trying to make her case, Freier decided to take a new approach: If Hatzalah wouldn't take female EMTs, then the women should start their own group.
She began raising money to buy emergency medical supplies and contacted local health officials to learn the steps involved in forming a Basic Life Support First Response Agency, which has the authority to dispatch its own EMTs.
"Every time I confronted a hurdle, God sent somebody who would help me overcome it," Freier said.
In 2014, she launched her own group, which took in the women already trained as EMTs and coordinated training for new volunteers. She named it Ezras Nashim, which in Hebrew has a double meaning: It translates to "assisting women" and is also a term for the women's section of a synagogue.
Almost immediately, the calls for help began to pour in, on a phone line Freier had publicised with the help of dozens of volunteers. They received calls from women in labour. Elderly women who had fallen in the shower. Women who sustained burns from cooking.
"When a woman is in a compromised state, in her weakest moment, having another woman there is a big help," said Sarah Weisshaus, 28, an EMT with Ezras Nashim.
During one of Weisshaus' first emergency shifts, she arrived at the home of an Orthodox woman giving birth. She found the woman in the bathtub screaming, "I'm pushing."
Weisshaus urged her to breathe deeply and get in a better birthing position inside the bathtub. She could tell that the woman, vulnerable and undressed, was comforted by the presence of another woman. Almost immediately, a tiny head emerged, and Weisshaus caught the baby.
As Weisshaus answered emergency calls, she thought of a cousin who had died after putting off a call to Hatzalah. "She was in the shower, one of her veins burst and she was undressed so she didn't want to call her local EMS," Weisshaus said. "She called her husband instead and by the time he got home she was dead."
The opposition
Last year, Ezras Nashim's phone line received some 475 calls, up from 428 in 2019. The group has now expanded to include more than 45 Brooklyn-based EMTs and raised money for supplies from women in the Orthodox community. But one of its earliest challenges still remains: lack of community buy-in.
From the outset, many men in the community worried that the female EMTs were trying to subvert Orthodox Jewish gender norms by having women do work typically performed by men. On social media and on street corners, they speculated that the women were motivated by feminism, not modesty.
Some, especially Hatzalah's volunteers, said the members of Ezras Nashim were just trying to "pick a fight," according to Freier. Much of this pushback came from the Hasidic community, an insular subset of Orthodox Jews; Freier is Hasidic, though many of Ezras Nashim's volunteers are from the wider Orthodox community.
"People would go to the rabbinical leadership and say, 'These women are not good, they're doing this as part of some radical feminist agenda,'" Freier said. "When they presented us to the rabbis that way, the rabbis didn't like it."
Hatzalah did not respond to requests for comment. Ezras Nashim's leaders said the vocal pushback from Hatzalah members had largely subsided, especially in the last year.
Freier and her daughter, Leah Levine, who is the group's chief operating officer, said they countered the scepticism by emphasising that they don't see themselves as people who oppose ancient tradition.
"My mother and I don't use the word 'feminist' to describe ourselves," Levine, 22, said. "When people say 'feminist,' that means that women want to be equal to men. But my mother always says she's happy with the way God divided it, and gave men their roles and women their own separate roles."
The goal, as Levine sees it, is simply to make sure women get proper medical attention, and preserve their dignity. "There are women endangering their lives because they're embarrassed to have men look at them," she said.
Adina Sash, 33, sees it a bit differently. She became a volunteer EMT for the group partly because she was frustrated that Hatzalah didn't allow women in its ranks.
"They're the heroes of the Orthodox community," she said. "When you have a member of your family who is part of Hatzalah, that comes with street cred. It's a symbol of pride."
Ideally, Sash said, Orthodox women would be able to join any EMT group they'd like, instead of having to start their own. She acknowledges she is more progressive than Ezras Nashim's leadership.
Still, Sash said, she sees Freier as a role model. She's showing Orthodox women that they can be medical providers, regardless of what traditional groups like Hatzalah permit.
The ambulance battle
Even after Ezras Nashim got its license and started taking calls, the battle wasn't quite over. The group needed its own ambulance.
For years, the women had been driving to medical emergencies in their own cars, responding to the patient's needs and then calling 911 if transport to the hospital was needed. Having an ambulance would allow the EMTs to take the severely sick to hospitals themselves instead of waiting for the Fire Department to step in.
The notion that Ezras Nashim could begin operating its own ambulance set off a fresh wave of criticism from members of Hatzalah, who revived their argument that a women's group wasn't needed.
Hatzalah's representatives pointed out that their group had a speedier average response time — two minutes, compared with Ezras Nashim's eight minutes and two seconds. (The women said they could cut down that time if they had their own ambulance.)
More community pushback followed, but in 2019 Ezras Nashim filed an application for an ambulance license with the Regional Emergency Medical Services Council of New York, a nonprofit that coordinates city medical services. It denied Ezras Nashim's bid by a 12-7 vote, falling short of the 14-vote majority needed for the permit.
Ezras Nashim's volunteers noted that several of the men who voted against their group had ties to Hatzalah, either as onetime volunteers or as friends of Hatzalah workers.
But Ezras Nashim appealed the decision to the New York State Emergency Medical Services Council, and in August 2020 — a year after they had first applied and as Covid-19 was tearing through their community — the state council voted in favor of Ezras Nashim, by a margin of 23-2.
Levine and the other volunteers shouted with joy when they heard the news. The group was set to get its own ambulance, at last.
Two months later, a dozen members of the group gathered on a street corner near their homes in Brooklyn to celebrate the ambulance's arrival. It was a crisp day, the streets bustling with Sunday shoppers, when the siren rang out in the distance, the driver's greeting for the women.
"Did you hear that?" Levine said, wearing a purple vest emblazoned with the group's name and phone number. "That's ours. It's our ambulance."
'God should grant you luck'
At some points last year, predominantly Orthodox Jewish neighbourhoods had coronavirus test positivity rates seven times that of New York City's overall rate. Everyone in Ezras Nashim knew people sickened with Covid-19; most knew people who died. For the EMTs, days and nights bled into one another, all marked by calls for emergency help.
"I was petrified," Levine said. "You didn't know who was going to be next."
Some of the patients were so sick that there was little the EMTs could do once they arrived on the scene.
In one instance, Goldsmith drove to a woman's home and found her unresponsive. Wearing full protective equipment, Goldsmith started doing chest compressions. When Fire Department workers arrived, and after several rounds of CPR, they determined the woman could not be resuscitated and called her time of death. Goldsmith had to deliver the news to the woman's son by phone.
"It was terrifying," she said. "We were wearing gowns, goggles, face shields, and I was eight months pregnant. It was traumatising."
For Goldsmith, the crisis turned even more personal when her husband fell sick with Covid-19, though he swiftly recovered. "I've been directly exposed dozens of times," she added. "Whatever happens to me, I do this to help people."
Then the vaccines arrived like a miracle, like a testament to their faith — just as the ambulance had felt.
On a frigid Sunday morning in January, hundreds of EMTs from various city organisations gathered in the Midwood section of Brooklyn for a long-awaited day: to receive a Covid-19 vaccine.
Freier, who was one of a dozen people administering the shots, sat on the second floor of a warehouse-style building, greeting each EMT who walked through the door with the same set of queries: "Do you have any allergies?" "Are you afraid of shots?" Then she assembled a syringe, while they rolled up their sleeves.
In that airy space, brimming with masked EMTs beaming with relief, the members of Ezras Nashim who had lined up for vaccines blended into the crowd.
There were members of Hatzalah and members of non-Jewish medical groups. Some of the Hatzalah volunteers recognised Freier and nodded in greeting; some thanked her for her community work.
After each injection, she offered the same well wishes. "God should grant you luck and blessings," she said. "And may you continue your work."
Written by: Emma Goldberg
Photographs by: Yana Paskova
© 2021 THE NEW YORK TIMES
