Vitali Voskoboinik’s bright blue eyes sparkled behind his glasses as he sat in his sunny Pacifica apartment. At 79, the Holocaust refugee looked full of life; he laughed and smiled, introducing himself first in Russian, then in Hebrew, and then in English.

One would never guess that just a few months ago he was bedridden, unable to breathe independently or speak, and on the brink of death from a severe case of Covid-19.

“To me, this is a miracle,” said Lena Asadov, who helped care for Voskoboinik as administrator of South San Francisco’s Angel Palliative Care and Hospice, Inc.

Asadov said when she had last seen him, Voskoboinik could barely sit on the edge of his bed without collapsing, his body and lungs extremely weakened from months of illness. On July 26, he stood to greet her, and he later walked down to the garden of his home at Terrace Senior Housing — two accomplishments that no one was sure he would be able to achieve.

While Voskoboinik is not yet able to resume his two-mile walks to the Pacifica pier, he has made a remarkable recovery — a feat Asadov credits to Voskoboinik’s fighting spirit and his daughter’s perseverance.

Voskoboinik was born in 1941, on a train headed to Uzbekistan as his mother was escaping Nazi-occupied Ukraine. He never met his soldier father and only knew him through a series of letters his parents exchanged before his father was killed in the war. Voskoboinik grew up in the Soviet Union, where he met his wife, and together they moved to Israel. They lived there for 20 years before coming to America in 2014.

Voskoboinik passed down his fighting spirit to his only daughter, Yulia Nedzvetski, who advocated day and night for her father after he got sick in January.

Voskoboinik’s symptoms began with a cough and difficulty breathing. His condition worsened rapidly, and after six days on antibiotics Voskoboinik was rushed to the ICU at Sutter Health Mills-Peninsula Center.

Once they had stabilized him, doctors estimated he had only months to live, Nedzvetski said. She refused to accept that prognosis. She had over 30 years of nursing experience in Ukraine, Russia, Israel and the U.S., as well as education in health care management and administration from Ariel University. But she also had something even more powerful: determination to get her father well again.

“I knew he would get better,” said Nedzvetski, who admitted to being so focused on his recovery she refused to accept that he was in critical condition.

Strict Covid safety precautions prevented her from seeing her father, except for a few times when she came to meet with doctors after she was vaccinated, but this did not stop her from dedicating her time and energy to his care. She left her job as a case manager at the VA and, with her two sons who live in Israel, set to work researching possible treatment options once doctors told her they had done everything they could, she said.

One treatment Nedzvetski suggested was proning, a process of carefully turning a patient in respiratory distress from their back to their stomach to help improve oxygen flow. Another was to use an ECMO machine, which pumps and oxygenates a patient’s blood outside the body, allowing the heart and lungs to rest. But Nedzvetski said she was told it was only for patients under 65.

“I came with three, four, five different treatment options and everything was a ‘no,’” said Nedzvetski. “It’s not something we do in the U.S., it’s not something we do for older people.”

Eventually she became so frustrated and desperate she began demonstrating outside the hospital, at one point holding a sign that read “Sutter, let the Holocaust survivor get the FDA approved medicine.” Although she was able to meet with the ICU director and speak with a roundtable of doctors and nurses, she said they would not approve the treatments she suggested.

Nedzvetski believes that families must advocate even more than usual for their loved ones, with hospitals overwhelmed with Covid patients and visitation restricted. She said such “limited access” has had a negative impact on patient care.

J. asked Sutter Health about Voskoboinik’s case but the hospital declined to comment.

Nedzvetski decided it was time to move her father back home and care for him there with help. But his condition was so dire — he was under sedation, on a ventilator and under constant medical watch — that as far as the hospital was concerned, he could not be discharged home safely.

“Hospitals are and were dealing with a lot during this time, and Yulia did her best finding every possible solution,” said Traci Dobronravova, director of Seniors At Home, one of the senior care services through Jewish Family and Children’s Services.

Nedzvetski utilized the help of Brigit Jacoby, Russian bilingual senior care manager at JFCS, who connected her with chaplain Bruce D. Feldstein of Jewish Chaplaincy Services at Stanford Medicine. He helped communicate with the hospital and contacted dozens of agencies about caring for Voskoboinik at home, but almost all saw his medical condition as a costly liability.

“When you get into the world of experimental treatments there are a lot of protocols you have to follow, and his case fell outside of that,” Feldstein. “It really looked like he would not have made it, [and] it is heart-wrenching when there’s a situation where you believe they should be able to help but they can’t.”

Then Nedzvetski found a compassionate ear at Angel Palliative Care and Hospice. “I really felt for them,” Asadov said. “As a Jewish person who was also born in Ukraine, I just knew I needed to do everything I could to help.”

Asadov said the transition from the ICU to home was extremely difficult, and that moving a patient on a ventilator to home hospice is not common. Nedzvetski said Sutter agreed to discharge her father home under the condition that she get instruction at the hospital on how to use all of the necessary medical equipment.

Asadov and the Angel Palliative Care and Hospice team helped Nedzvetski turn her home into a makeshift ICU room, complete with a hospital bed, ventilator, feeding tube and other medical supports. Nedzvetski said the agency was there whenever she needed assistance, and that one nurse, Lora Lemenov,  even left her own birthday celebration to come help.

Once home, Voskoboinik was given stem cell treatment by a private physician and three days later, according to Nedzvetski, her father began to recover.

Within the month, Voskoboinik was breathing independently. As his condition improved, Angel Palliative Care and Hospice recognized that his care goals had changed and he was in need of rehabilitation services. They were able to safely graduate him from home hospice to a rehabilitation plan with Pacifica Nursing and Rehab Center. He was discharged back home in mid-July.

Asadov hopes that Voskoboinik’s story will help change the stigma around hospice care, and make people aware that the goal is to provide comfort and improve patients’ quality of life, even if it turns out to be their final moments.

“Everyone is scared of the word ‘hospice.’ They hear that and think ‘that’s it, this is the end.’” said Asadov. “But for him, hospice wasn’t the end of his life. It was a new beginning.”