Years ago, Alexandra Friedman saw a T-shirt bearing a message she never forgot: “Become the doctor your mother always wanted you to marry.”
It seemed like an impossible goal for a Hasidic woman in Monsey, N.Y., a predominantly Orthodox Jewish enclave some 30 minutes north of the city that is home to some of the strictest Orthodox communities.
Many women marry young, and their lives revolve around caring for children, speaking Yiddish and abiding by inflexible lifestyle and dress guidelines to adhere to Hasidic traditions.
Ms. Friedman and her husband, Yosef, have 10 children, ranging in age from an 8-month-old son to a 21-year-old daughter.
But last month, Dr. Friedman became an anomaly in Monsey by graduating from medical school and obtaining a residency in pediatrics. Her graduation makes her one of the few female Hasidic doctors in the country, said Dr. Miriam A. Knoll, president of the Jewish Orthodox Women’s Medical Association.
“It’s unusual for medical students to have any children, let alone 10 children,” Dr. Knoll said. “So to come from a conservative background and have that many children, you’re fighting an uphill battle, one that just takes extraordinary drive and commitment.”
When Dr. Friedman began thinking about medical school five years ago, even her best friends had doubts. One of them, a mother of 14 children, thought Dr. Friedman’s already busy schedule as a wife and mother would never allow her to handle the rigors of medical school. Another urged her to become a store cashier instead.
Dr. Friedman believed that pursuing medicine would augment her spirituality, not detract from it.
“In Judaism, there’s a belief that if you don’t use the gifts given to you by God, you’re not really honoring God,” she said in a recent interview.
Even while struggling with the arduous academic demands over the past four years, she met the domestic responsibilities expected of an ultra-Orthodox mother. She continued tending to her children and refrained from studying on Jewish holidays and on the Sabbath, each Friday evening through Saturday evening.
None of her obligations seemed to hurt her grades or keep her from graduating on time within four years, and she even gave birth during her studies to three children: her 8-month-old, Aharon; and her 3-year-old twin girls, Mimi and Layla.
She graduated first academically of the 135 students in her class at Touro College of Osteopathic Medicine in Middletown, N.Y.
Dr. Friedman was not always Hasidic. As the daughter of a U.S. Army general, she was part of a secular Jewish family that moved around the country a lot.
She considered herself a feminist — and still does — and earned a bachelor’s degree in biology. In her 20s, she began medical school but dropped out and developed an interest in Orthodox Judaism, following its strict guidelines and avoiding many distractions of the outside world.
She studied Yiddish and began wearing a wig and modest, full-length clothing. She stopped driving and having casual conversations with men or even looking them in the eye. Smartphones and the internet were off-limits.
In 2008, after she had moved to a Hasidic section of Crown Heights, Brooklyn, to study at a Hasidic seminary, she met Yosef Friedman, a widower with two daughters from his previous marriage. They married and eventually settled in Monsey.
After having several children, her mind turned back to her medical education.
“Being religious was kind of a full-time job, but once I got the hang of motherhood and Orthodox life, that yearning sort of came back,” said Dr. Friedman, who approached her religious mentor, Rabbi Aharon Kohn, and asked him in her still-imperfect Yiddish for guidance.
Both realized that medical school would be doubly challenging for a mother from Monsey. The Hasidim in Monsey largely handle judicial issues among themselves, shop at Jewish stores and send their children to religious schools.
Also, there would inevitably be clashes between academic requirements and Hasidic guidelines. Dr. Friedman would need to use the internet and interact with male students, teachers and doctors. What if emergency medical treatment lasted into Shabbos? And since Hasidic women are discouraged from driving, how would she even get there?
Touro’s sensitivity to Orthodox students, she said, made it “an easier sale” to the rabbi, who recounted a story about how his grandfather, also a rabbi, once urged a woman in Israel to become a midwife to help other Hasidic women.
He ultimately agreed, even after Dr. Friedman wondered if her friend was right about her becoming a cashier instead.
“He said absolutely not — he wanted me to be of service to my community,” said Dr. Friedman, who interviewed for admission to medical school four days after giving birth to the couple’s seventh child.
Dr. Friedman’s new path raised eyebrows in her tightly knit Hasidic Jewish community.
“People would say, ‘What? You’re going to medical school?’ and I’d say, ‘The rabbi said it was OK,’” she recalled while sitting recently in her neat two-story home in a leafy section of Monsey.
She sat near shelves bearing a shofar and a menorah. Scattered on the floor were children’s toys. The family was packing for their upcoming move to Boca Raton, Fla., to begin her residency.
As a medical student, Dr. Friedman began assuming a sorely needed role advising Hasidic female acquaintances who had limited information on medical issues but many questions — ranging from menstrual and infertility issues to how gynecological treatment comported with Jewish law and cultural guidelines regarding modesty.
“People became excited to have a woman who understands the community and understands medicine,” said Dr. Friedman When Monsey became a coronavirus hot spot last year, she began fielding calls from friends seeking more updated information than Yiddish weekly newspapers provided.
“They felt comfortable asking me, ‘Is it getting better, getting worse?’” she said.
She urged friends early on to wear masks, and in recent months, as more calls have come in regarding vaccination for the virus, she has recommended getting the shots.
She and her husband both contracted the virus last year but experienced no serious symptoms, she said.
Mr. Friedman, 50, who makes minimum wage as an aide for patients with disabilities, said the family has lived paycheck to paycheck to afford medical school and relied on various scholarships. Student loan money sometimes helped pay the rent.
“Every obstacle seems to get blown out of the way,” said Mr. Friedman, who received a dean’s award from Touro for being a supportive spouse. “It makes me realize that this was just meant to be. This is what she’s meant to do.”
He began working nights in order to tend the children during the day.
Far from being a distraction, Dr. Friedman said her busy family life provided balance and stress relief from the tense demands of studying for boards and exams.
Instead of hitting the library with her fellow students, she studied at home with her children around her. They quizzed her with flash cards and adorned her anatomy and surgery textbooks with brightly colored stickers. They watched her practice her sutures before bedtime.
While in labor for 12 hours with her twin girls, now age 3, she studied for the microbiology part of the board exam.
“It kept my mind off the contractions,” she said.
While the internet is often discouraged among the Hasidim as overexposure to the secular world, Dr. Friedman secured the rabbi’s permission to buy a laptop and get internet service installed to access medical information and study guides that fellow students shared on social media. She got a smartphone for college-required apps on surgical procedures.
She also obtained rabbinical approval to drive the family car herself, but her husband continued to drive her out of their immediate neighborhood, then hop out and walk home, to avoid upsetting her Orthodox neighbors.
She continued to wear her wig during surgeries, but Rabbi Kohn agreed she could replace the traditional Hasidic head scarf with a surgical cap and wear scrub pants covered with a disposable surgical gown.
Shaking hands with male colleagues was still discouraged, but the rabbi agreed that accidental and necessary contact with male doctors during surgery was permissible, as was looking them in the eye during medical discussions.
When students began practicing osteopathic manipulations on one another in large classes, Dr. Friedman secured a female partner and wore full clothing instead of shorts and a sports bra like other female students.
Rabbi Moshe Krupka, executive vice-president of the Touro College and University System, called Dr. Friedman a “poster child” for Touro’s emphasis on supporting particular needs of students from diverse backgrounds.
But Dr. Friedman’s biggest supporter was Rabbi Kohn.
Last June, he died from Covid-19 at age 69.
In September when her youngest child was born, Dr. Friedman honored the rabbi who encouraged her medical school dream by naming her son after him: Aharon.
“The last thing he told me,” she said, “was, ‘Don’t quit.’”
