April 20, 2021

Ezras Nashim founder Rachel Freier and E.M.T. Miriam Milder during a wellness check house call in Brooklyn.Yana Paskova for The New York Times

By Emma Goldberg

"Whatever happens to me, I do this to help people."

— Charna Goldsmith, an E.M.T. with the group Ezras Nashim

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 catalog of errands. The Brooklyn air was heavy with midsummer heat. The parkway was, as usual, congested.

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But up ahead, a four-car pileup was snarling traffic more than usual. And in the first car, a man, roughly 300 pounds by Mrs. Goldsmith's estimate, seemed to be unconscious at the wheel. There was no ambulance in sight.

It was the summer of 2019 and Mrs. 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, stabilizing his spine until the rescue workers arrived five minutes later. Once the Fire Department started tending to him, Mrs. Goldsmith got back in the car — feeling shaken, but with a new jolt of confidence — and her family continued home.

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Mrs. Goldsmith is one of dozens of Orthodox Jewish women in New York City who have trained and begun working as E.M.T.s 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.

An exercise drill for aspiring E.M.T.s led by the Ezras Nashim director Rachel Freier, second from right.Yana Paskova for The New York Times

For decades, the Orthodox Jewish community has relied on its own E.M.T. services through the volunteer ambulance group Hatzalah. But because Hatzalah has an all-male local E.M.T. 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 E.M.T. services are coordinated by a nonprofit organization, 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 organization 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 E.M.T.s 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).

E.M.T. Emanuella Rabaev, 22, left, and E.M.T. Etty Benitzhak, 27, test out the organization's first ambulance.Yana Paskova for The New York Times

"Maris ayin!" he called out to the female E.M.T.s. 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?

Judge Freier is the type of woman whose name, when mentioned in the neighborhood of Borough Park in Brooklyn, tends to inspire an outpouring of stories. Many Orthodox families have memories of receiving help from Judge Freier, whether in her capacity as a community advocate, before she became a judge, or as a neighbor 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 Judge Freier that they had decided to train as E.M.T.s 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 neighborhood 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 E.M.T.s 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 Judge Freier wondered: With such trusted emergency medical providers on hand, why did the community need female E.M.T.s?

The all-male Hatzalah volunteer ambulance and the all-female Ezras Nashim volunteer ambulance side by side in front of Maimonides Medical Center in Brooklyn.Yana Paskova for The New York Times

But she concluded that God must have connected her with these women seeking to become E.M.T.s 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 traumatized 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 Judge 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, Judge Freier decided to take a new approach: If Hatzalah wouldn't take female E.M.T.s, 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 E.M.T.s. "Every time I confronted a hurdle, God sent somebody who would help me overcome it," Judge Freier said.

Leah Levine, 22, the chief operating officer at Ezras Nashim, and Adina Sash, 34, an E.M.T. trainee with the group, asking a hair accessory store in Borough Park in Brooklyn to keep their organization's donation box in the store.Yana Paskova for The New York Times

In 2014, she launched her own group, which took in the women already trained as E.M.T.s 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 Judge Freier had publicized with the help of dozens of volunteers. They received calls from women in labor. 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 E.M.T. with Ezras Nashim.

During one of Ms. Weisshaus's 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."

Ms. 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 Ms. Weisshaus caught the baby.

"Having another woman there is a big help," said E.M.T. Sarah Weisshaus.Yana Paskova for The New York Times

As Ms. 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 E.M.S.," Ms. 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 E.M.T.s 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 E.M.T.s 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 Judge Freier. Much of this pushback came from the Hasidic community, an insular subset of Orthodox Jews; Judge 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,'" Judge 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 past year.

Judge Freier and her daughter, Leah Levine, who is the group's chief operating officer, said they countered the skepticism by emphasizing 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," said Mrs. Levine, 22. "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."

Rachel Freier and her daughter Leah Levine at their home in Borough Park in Brooklyn. Yana Paskova for The New York Times

The goal, as Mrs. 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 E.M.T. 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, Ms. Sash said, Orthodox women would be able to join any E.M.T. group they'd like, instead of having to start their own. She acknowledges she is more progressive than Ezras Nashim's leadership.

Still, Ms. Sash said, she sees Judge 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 E.M.T.s to take 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-to-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 to 2.

Mrs. Levine and the other volunteers shouted with joy when they heard the news. The group was set to get its own ambulance, at last.

Outside the Ezras Nashim office in Brooklyn during a training session.Yana Paskova for The New York Times

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?" Mrs. 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 neighborhoods 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 E.M.T.s, days and nights bled into one another, all marked by calls for emergency help.

"I was petrified," Mrs. Levine said. "You didn't know who was going to be next."

Some of the patients were so sick that there was little the E.M.T.s could do once they arrived on the scene.

A magnet features Ezras Nashim's slogan: "Women for Women"Yana Paskova for The New York Times

In one instance, Mrs. Goldsmith drove to a woman's home and found her unresponsive. Wearing full protective equipment, Mrs. 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. Mrs. 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 traumatizing."

For Mrs. 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 E.M.T.s from various city organizations gathered in the Midwood section of Brooklyn for a long-awaited day: to receive a Covid-19 vaccine.

Judge Freier, who was one of a dozen people administering the shots, sat on the second floor of a warehouse-style building, greeting each E.M.T. 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.

Ezras Nashim director Rachel Freier preparing to administer a dose of the Covid-19 vaccine.Yana Paskova for The New York Times

In that airy space, brimming with masked E.M.T.s 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 recognized Judge 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."

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