8/24/04

When you do things you don't mean to do
Or, the philosophy of Elul.

In this month preceding the Jewish High Holidays, when questions of responsibility and (lack of) deliberation come to the fore, a recent paper by two Australian philosophers is worth a look.

The authors attempt to justify our intuition that deliberative and non-deliberative acts should be morally evaluated in different ways. On their way there they suggest four classifications of human actions, "agency," in the language of philosophy. In deliberative agency, we reflect on what we ought to do. In conscious agency, we are aware of what we are doing, though not deliberative. Automatic agency involves a "reduction of the experience of doing," for example, as in over-learned actions like driving a car, in which one is fully conscious in general but not specifically conscious of the action itself. Automatistic agency, by contrast, involves a class of conditions in which one is not fully conscious of what one is doing, either "globally," involving the whole body, as in trance states, sleep walking, etc., or "locally," as in anarchic hand syndrome.

Is one to be held morally accountable only for deliberative acts? The answer is more complicated than a simple "yes." However, about the strong connection between accountability and deliberation that most of us intuitively know to be true, the authors say
"Even if deliberation (or the opportunity for it) were to correlate perfectly with moral accountability, we would want to know why this was so. One possibility is that deliberation is important in its own right. While this is a possible position, it seems implausible to us."

To this layperson it seems very plausible, especially this month. It is our reflective decision to act rightly which makes our right action traceable to us, our own unique moral creation.

8/23/04

A Mountain That One Cannot Fall Off
Bob Rosenthal, a poet and a fellow member of Town and Village Synagogue, had a ceremony this past Shabbat marking his adult bar-mitzvah. In his speech (below), Bob explains what it means to be an adult bar-mitzvah, how he became more observant, and his own continuing spiritual struggle as part of a community.

Today I am a family.

I am a family that gives comfort to one another. A family that meets for minyan. A family that prepares food. A family that visits the sick. A family that buys books for each other. A family that gathers on cold nights to learn the words of sages. A family that comes to your home when you grieve.

Today completes a vow I made in 1963 when I became 13. I vowed to someday become a bar mitzvah. Although synagogue life and Jewish home practice were unknown to me in my childhood, I experienced twinges to learn what Judaism was about. But I forgot about that vow. It was the vow ten years later that my new father-in-law, Aaron, made me give while we slipped under his dining room table. It was Seagram’s VO that put us there. He made me promise that my children would be more Jewish than I was. This was an easy promise to keep. Kids were not on the horizon. Again that vow was forgotten till kids did come and my wife said, “Let’s look for Hebrew schools.” I finally decided to come into this synagogue and found Kabalat Shabbat. I loved all the divine mumbling. The language was a family of sounds that tribally resonated and held me to their sway. Hit-or’ri Hit-or’ri -- “Awake and arise,” we sing to open Kaballat Shabbat in “L’kha Dodi.” Isaiah’s visions of Jerusalem clothed in splendor from today’s reading greeted me on my first visit to a service! I employed an oft-used method of learning called osmosis. I soaked up tunes and customs, and slowly made inroads into Hebrew and doing mitzvot. I have joy to be among family. Thank you -- all of you: Cantor Postman, Rabbis Siebert and Sosland, Teachers Pollack and Green, holy prodders Nauen and Oliver. I am grateful to my birth family who has traveled from afar and to my found family who is always here for me. And there is one someone who led to me her father’s challenge, and led me to this shul and bore us children who preceded me to this bima -- I could love no one if I did not love Rochelle Rose so.

As I began to feel the desire to read Torah and contemplated the possibility of becoming a bar mitzvah, I hesitated because of anger over my lack of Jewish education. However, as Jean Luc Goddard wrote in his recent movie Elegy for Love, “Sometimes we outlive our problems.” Today is my 54th Jewish birthday. My solar birthday is in the dog days of summer. Everyone is somewhere else. But the 4th of Elul is an appointment everyone has to keep. The Shofar blows and the time has come. Time to awaken the peacemakers in the family of who we are. Isaiah proclaims, “I am he I am he who consoles.”

The portion of Isaiah we read today is the fulcrum of the seven haftorot of consolation. The month of Elul has begun and heralds the high holidays in the next moon. Last month, Rochelle and I were hiking in Acadia National Park. We chose a cliffside climb. When we reached the point where the path could no longer hug the mountainside, there were iron rings pounded into the cliff to ascend to the next level. I thought of my bar mitzvah preparation as I grabbed onto the first ring. I realized that Torah learning is like climbing a mountain that one cannot fall off. Elul is the time to start that deep hike through your current life -- you step into the tenacious mud of hurts you’ve inflicted and sins you’ve committed. You climb the uneven path of worthy actions and love given and love received -- still you must go further along the sheer cliffs to reach a spiritual height. There is always a spot on that trail where you have to climb a ladder of rings pounded into the cliff. If you look down to the mess of existence you might not step up on the ring. Hand over hand, foot over foot, you can pull your self up. Those rings that support you and enable you are acts of contrition, the feeling of prayer, and earnest desire to live up on the heights.

Isaiah parallels this effort. His immediate view is the near end of the exile in Babylonia. He must ready the minds of the people Israel to let the suffering and pain of abuse fall away and return to Zion empowered and free. He recounts the horrors that befell us. We were made to drink the Cup of Reeling. We were made to lie down so that the other nations could trample across our back. Uri Uri -- Awake awake -- Isaiah calls out those words I heard at Kabbalat Shabbat. Shake off the dust and arise. He presents the wondrous picture of Jerusalem: “Awake Awake clothe yourself in strength, o Zion; array yourself in robes of splendor, O Holy City of Jerusalem!” And at the close he commands Israel -- Suru Suru -- Turn aside, Away -- Back to Zion. No longer are Israelites the pavement to be trod upon -- now they march with the Eternal leading the way and the Eternal following to catch up any stragglers.

This is what families do; they catch up the stragglers. I feel like I have been a straggler and I have not been left behind. This congregational family has kept its arms outstretched to me for almost a score of years. Making it to morning minyan has worked its slow appeal on me. Recently I started to take care of the yahrzeit plaques in the sanctuary. Lighting little lights and meeting the congregation’s families of blessed memory each week creates fresh constellations to keep us whole and vacate loneliness. It’s important to feel the myriad of ways we act as a family to support each other. Now the task is not just to catch up but also to lead. And help others who desire to find the path that leads to the trail, which becomes a climb. Does that climb end in glory? No, it starts with glory! Helping us to find the path are the prophets.

We just read in Shoftim: “The Lord God will raise up for you a prophet among your own people, like myself; him you shall heed.” (Deu. 18:15) This statement follows the restrictions on the occult arts. The need for communication with the Eternal and the need to get answers about what will happen will instead be provided by prophets. The Israelites elevated the prophet far higher than other ancient peoples. The prophet is one who will communicate God’s words. Moses reminds the people that they asked not to hear the actual voice of the Lord lest they die. God is pleased and states that he will raise up prophets: “I will put My words in his mouth and he will speak to them all that I command him.” (18:18) Jeffrey Tigay points out that the Prophet’s primary role was to speak on “all matters of national life: “Their role reflects the unprecedented seriousness with which Israelite religion believed that God and not the king was the true sovereign, and that human kingship was a man, and institution, established by prophetic mediation and hence subordinate to prophetic authority.” (Tigay 177)

The Lord has given the words and given us the path. “I have put My words in your mouth and sheltered you with my hand.” (Is 51:16) The age of pure prophecy is over. But, as Isaiah says, his Godly words are now in our mouths. This is the glory of the synagogue experience. God’s words are in our mouths. This means that new prophecy is not completely absent from our lives.

The adjective prophetic is also used to describe the ability to see inner truths before others do. Midrash says, “The dream is an unripe form of prophecy.” It is human to dream and human to carry the raw material of prophecy within us. I dare say we could use some old-school prophets to rebuke politicians and the body politic without concern for opinion polls. Prophets have never been popular. Another midrash says that Jeremiah was chosen to prophesize before he was conceived. He objected to the Holy one. “What prophet ever came before them whom they did not seek to slay? When you set up Moses and Aaron over them to act in their behalf, did they not wish to stone them? When you set up curly-haired Elijah over them to act in their own behalf, they mocked and ridiculed him, saying, ‘Look how he frizzes his locks, this fancy-haired fellow.’”

So too would a modern prophet be received. For twenty years, I was secretary to Allen Ginsberg, a poet widely described as prophetic. Today on my way to shul I saw his face hanging from the lampposts. I was not hallucinating -- there is a huge arts fair in the East Village inspired by his poem “Howl.” “Howl” has prophetic content in the classic sense. Look to the admonition of the Moloch section. Ginsberg equates the ancient Canaanite fire god to whom parents sacrificed children to the cannibalistic, money-based machinery of our age. In cadence and message, as terrible as Lamentations, Ginsberg wrote: “Moloch whose mind is pure machinery! Moloch whose blood is running money!” Norman Mailer called Ginsberg “the bravest man in America.”

But Ginsberg never claimed to be an agent of a holy voice. He was a human voice of candor. As the ancient prophets did, he placed his messages in the language of the common person. We read the prophets for they are not mysterious. They paid the human price of their gift and burden. We honor them by chanting and contemplating the comfort and the challenge they still provide. For us, the first step of teshuvah is the bravest. Unripe dreams are within us all; the voices of prophets are on the street waiting to be heard. Our rabbis say: Ever since the Temple was destroyed, prophecy was taken from the prophets and given to fools and children.”

*

I am part fool and part child. I am the shlub in the back and these are my words:

We are on the road to Zion but there is no road
We are praying for directions but hear only our own voices
We suffer faults and the chains that bind us to them
Yet footfalls follow footfalls through the echoing night
The smallest match struck in the darkness
is a mighty illumination
So bright we must cover our eyes as with the Sh’ma
Listen for daybreak’s blasts
There is so much behind you
There is no reason not to go on -- to the summit
You will find a part of you already there
Patiently waiting to see your face

Shabbat Shalom
What makes a good blog, 2.
Politics and the English Language: 2004 Update
"[English] becomes ugly and inaccurate because our thoughts are foolish, but the slovenliness of our language makes it easier for us to have foolish thoughts."

On rereading Orwell's essay I am struck by its relevance to political blogs on the wacky left and nutty right.

[A] mixture of vagueness and sheer incompetence is the most marked characteristic of modern English prose, and especially of any kind of political writing. As soon as certain topics are raised, the concrete melts into the abstract and no one seems able to think of turns of speech that are not hackneyed: prose consists less and less of words chosen for the sake of their meaning, and more and more of phrases tacked together like the sections of a prefabricated henhouse.
Such prefab phrases and unexamined concepts, repeated ad nauseum in the blogosphere, are called memes, as if technospeak redeems cliche.

[On meaningless words:] In the case of a word like democracy, not only is there no agreed definition, but the attempt to make one is resisted from all sides. It is almost universally felt that when we call a country democratic we are praising it: consequently the defenders of every kind of regime claim that it is a democracy, and fear that they might have to stop using that word if it were tied down to any one meaning.

[. . .]

In our time it is broadly true that political writing is bad writing. Where it is not true, it will generally be found that the writer is some kind of rebel, expressing his private opinions and not a "party line." Orthodoxy, of whatever color, seems to demand a lifeless, imitative style. The political dialects to be found in pamphlets, leading articles, manifestoes, White papers and the speeches of undersecretaries do, of course, vary from party to party, but they are all alike in that one almost never finds in them a fresh, vivid, homemade turn of speech. When one watches some tired hack on the platform mechanically repeating the familiar phrases -- bestial, atrocities, iron heel, bloodstained tyranny, free peoples of the world, stand shoulder to shoulder -- one often has a curious feeling that one is not watching a live human being but some kind of dummy: a feeling which suddenly becomes stronger at moments when the light catches the speaker's spectacles and turns them into blank discs which seem to have no eyes behind them. And this is not altogether fanciful. A speaker who uses that kind of phraseology has gone some distance toward turning himself into a machine. The appropriate noises are coming out of his larynx, but his brain is not involved as it would be if he were choosing his words for himself. If the speech he is making is one that he is accustomed to make over and over again, he may be almost unconscious of what he is saying, as one is when one utters the responses in church. And this reduced state of consciousness, if not indispensable, is at any rate favorable to political conformity.

One could add a number of terms from today's politiblogs to Orwell's list of mechanically repeated phrases, but I'll leave that as an exercise for the reader.

Among many other reasons, bloggish self-promotion is exasperating because it fails to realize that its vaunted objectivity (if it does say so itself) and hair-trigger journalism is undermined by prose which ranges from puffed-up to callow. No one bothers to critique most blogs because no one expects them to be written in anything more than a staccato smirk. If editing is the sign of a grown-up genre, no prizes for guessing the median mental age of politibloggers.

8/19/04

In which I am both a negligent father and a happy reader of blogs

The first, because I gave my daughter both Ebola and the common cold.

The second, because Alina Adams, friend of ours, ice-skating expert, and writer of both romances and mysteries, turns out -- not surprisingly -- to be an entertaining guest blogger as well. Welcome to the dark side, Alina.

8/18/04

Housekeeping

Two readers have already sent me a few blogs they would like me to take a look at -- thanks, KH and EQJ. If anyone has found a blog they think is well written, let me know. (I would prefer to know about blogs that are not already among the most popular. I've already broken this rule with Dooce, but she writes too well to be ignored.)

Words Without Borders is a translation journal run on a shoestring grant by a team of selfless editors. In the new issue, devoted to religious literature, you can find three new translations of mine of Yiddish poems by Glatshteyn, Tseytlin, and Lyesin.

Next week I'll be at the Yidish-vokh, and thereafter I'll be trying to cut away everything from my draft that doesn't read like a dissertation. So I crave the Readership's indulgence as I enter what is called in Blogland a "hiatus." (Why we don't call it a "break" I dunno. Not dignified enough, I guess.) Or, at least, less frequent posting.
Riverboat philosophizing

I went to a wedding in Chicago. One of the pre-wedding events was a cruise along the Chicago River with an architecture expert as guide. Halfway through the cruise, my baby started screaming. (Perhaps she took offense at the guide's aesthetics.) I took her downstairs to the bar to calm her down, and there ran into my friend the groom himself, with his baby. Our two daughters commenced applying their mouths to every available surface, and the two of us started talking. My friend is a philosopher, and I am a philosophizer, so we get along well.

One of the questions we were talking about was this: What does it mean to hope, to have a certain sort of confidence that everything will work out all right? More specifically, there are two parts of this question we were ruminating on.

What does it mean to say "everything will work out all right"? Clearly the meaning of the phrase depends on the context, but in general, there are two sorts of things we could mean: a general sense that the world will not suffer major cataclysm or disorientation, and a narrower confidence that one's immediate interests (life, liberty, maybe property) will be preserved. Let's take a prominent worry these days, that terrorists may mount another major attack in New York sometime during, say, the next twenty-five years. (Insert appropriate "God forbid" here.) If I say, "The terrorists will attack," and you say, "Everything will work out all right," you could mean either (a) the general fabric of society will not collapse (e.g., the terrorists will not win; martial law will not reign on the streets of Manhattan; our copies of The Cat in the Hat in Yiddish will not be carried off by looters); or (b) one's friends and family will not be killed or maimed.

In less extreme circumstances, I think, one tends to mean (b) -- that is, the narrower result will be a positive one, suitably modified to the worry at hand. For example, take my dissertation. (Please!) When your Host's wife says, "Everything will work out all right," she does not mean that I will find professional satisfaction in some other field even if, say, my committee doubles over in laughter at my defense and uses my thesis as a wrapper for fish-and-chips. She means that I will finish, and my career will properly progress. But as the stakes are raised and more serious worries are confronted, our definition of "all right" needs to be recalibrated.

So let's consider again the case of a terrorist attack. The attack will happen, in all probability, and people will die. (Again, God forbid.) Is it morally proper to hope in such a situation? Our intuition is yes, because such large-scale confidence (called bitokhn in the Jewish tradition; see below) is something most people have, if only because it'd be impossible to get through the day without it. But how can we hope if we know that someone (though not necessarily us) will suffer? How can we legitimately say "everything will be all right"?

Roughly speaking, if we consider the possible realization of our worst worries, we need to ask whether the resultant world is predominantly "all right" or not. If our worst worries are realized and the world that results is somehow "all right," how does this square with our intuitive definitions of "rightness"? (This might be connected to a larger question. Given our intuitive sense that the world is not an awful place, how do we understand the frequency of suffering? [This is also a theological question, of course, but since the question is interesting whether or not God is involved, I'm not going to talk about Him here. I'm sure He'll understand.]) If the resultant world is not "all right," how can we justify the hope that most of us manage to sustain?

There are Jewish correlatives to most of these problems. (I like what Baraita had to say recently on the subject of Hebrew and Aramaic terms in one's blog, so I'm going to use the English equivalents.) According to the Talmud, after death (it's not entirely clear to me when), one will be asked a series of questions about the conduct of one's life. One of them is "Have you hoped [or: Did you hope] for salvation?" (What's meant here is something like the Messianic age, although, of course, the commentaries differ.) There are other often-cited phrases: "This too is for the good," and "Everything that God does He does for the good." The Jewish approach matters not because the afterlife, or the world to come, or God's goodness, elides the question of evil, but because that question is important whether or not we believe in God, and for the same reasons -- namely, the possibility that our worst fears may come to pass, which might undermine our hope.

(Just to put your mind at ease, we did not talk about these things at the wedding. We drank wine and sang; some of us danced. I don't dance, but it was fun to watch.)

8/12/04

The twelfth of August

At least thirteen prominent Yiddish writers were executed on August 12, 1952, among them Peretz Markish, Leib Kvitko, Dovid Hofshteyn, Itsik Fefer, Dovid Bergelson, and Der Nister.

Russian Death
Leyb Kvitko

Russian death
is all deaths.

Russian pain
is all pain.

How is the world's heart now?
Its suppurating wound?

Ask a little child.
Ask a Jewish child.

1919
(my translation)

8/9/04

What makes a good blog?
My favorite blogs, 1.

Obscenity is refreshing, and when I say "obscenity" I mean taboo words in the context of well-aligned, clearly written prose, not words of four letters in every sentence. I had a long-running discussion with a college friend about my fear that true obscenity was disappearing: if everyone uses those words, where's their power to shock? Are f and s and a no longer to be the first words excitedly looked up in a new dictionary, or Googled in an idle hour? (Or perhaps racial slurs are the new cuss words?) If we've forgotten how to blush, who now knows to keep the fire in check so she can let it out to scorch the invaders in the hour of battle?

Then I click over to Dooce, and I am cheered by the highs and lows of the English language. Dooce is a narrator whose real name is Heather Armstrong. She is an ex-Mormon, a new mother, a Web designer, and a blogger. Little about the character Dooce makes her a great figure of fascination intellectual or spiritual: she's no Prince Hal, or Holden, or Emma. She's a quick-witted cynic, a whiskey-swilling junk-food-chomping mamma like thousands of others.

But there are a few things about Dooce which do set her apart and make her writing something to savor in small doses. First is what she rejected: Mormonism. This experience of the religious life, and the constant, bemusedly tolerant but disapproving presence of her family, gives her something to push against. It also gives her access to the Biblical and fundamentalist registers of speech which are not available to many bloggers. (In a recent post, she used the phrase "hot forks of displeasure." "Hot displeasure" is from the King James Version of the Bible, and I would love to know if that's where she got it. Incidentally -- not that Dooce would know or care -- this is from the Psalm that Jews recite at Tachanun.)

Second is her swearing. She does it in every post, but with such flexible power that I envy her willingness to be so foulmouthed in public. Obscenity is cathartic, and the combination of something as earthy as a good cuss word with the tender juiciness of Leta's cheeks -- well, that's something any restaurant critic would dine on with satisfaction.

Third is her psychological (and pharmaco-psychiatric) distress. I wish Heather Armstrong all the best, a speedy exorcism of her mental demons and a positive attitude for her to have and hold all the days of her life, amen. But such mental health can be death for a diarist, and I am guiltily glad, oh, so glad!, that Dooce has her up and down days.

Fourth, as mentioned, is Leta ("Her Screamness Who Screams A Lot All The Time Every Day With The Screaming") Armstrong, Dooce's daughter. Every post has at least one suspenseful moment: when will she start bleating? And when? Will Dooce freak out? How much? And in whose company?

Fifth is her drinking. A shot of whiskey's on me if we ever meet.

Now all of these qualities do not redeem Dooce's every failing. A blogger is not a novelist. She is not grappling with larger themes on the sprawling canvas of World and Life. She can be as insufferable as any new mother who doesn't know when to stop sharing her pictures. I'm glad she loves her husband, and (since by her account he is stable, considerate, attractive, a responsible father, and gainfully employed) he seems like a great guy to have around. But he's not the main attraction, so, if you please, Ms. Dooce, keep your kvelling to a minimum. And many's the entry that repeats something we've heard many times before.

But that's like criticizing a box of chocolates for having too much chocolate. Dooce is to be joyfully consumed in regular doses, like York peppermint patties -- or Maker's Mark.

8/8/04

Put your kayak down for a minute, we're late for shul!

Here is the information you requested about davening at the Religious Services Centre of the Olympic Village in Athens.

Saturday morning services begin at 8 o'clock. Please be on time.

You are also welcome to bring your own translations into Romaniote.

Thank you for your attention.


What would military intervention in Darfur look like?

That's the topic of an article in the New Republic by David Englin. He points out that apart from the no-fly zones and the safe areas necessary to protect aid workers and make their mission possible, any military force should be prepared to confront a well-trained and -equipped Sudanese army.
Good news from Sudan
(or, at least, the end of some bad news)

From: ProMED-mail
Source: Reuters News online, Fri 6 Aug 2004 [edited]

Ebola Hemorrhagic Fever in Sudan Declared Over by WHO

The outbreak of the deadly Ebola virus in southern Sudan, which infected 17 people and killed 7, appears to have been halted, the World Health Organization (WHO) said on Friday 6 Aug 2004. A WHO official said the outbreak, first reported in Yambio country of Sudan's Equatoria province in May 2004, would be officially declared over on Sat 7 Aug 2004, 42 days after the death of the last person confirmed infected by the virus.

The incubation period for the disease, whose origin is still unknown despite years of research, is 21 days, and the United Nations agency says an outbreak can be considered over when no new cases have been reported for twice that length of time.

Ebola hemorrhagic fever, which in its worst form causes massive internal bleeding and is one of the most deadly diseases in the world, was first identified in the Sudan in 1976, but has claimed most victims in the Democratic Republic of Congo and Uganda.

Although largely confined to tropical regions of Africa, it has also been reported in rain forest areas in the Western Pacific. The most virulent of its 4 known [genotypes] occurs in the Congo where, in the first known outbreak in 1976, 88 percent of the 318 reported victims died, and in 1995 it killed 81 percent of 315 infected people. Over the last 2 years in the Congo, it killed between 75 percent and 89 percent of all victims, a total of 199, in 3 separate outbreaks.

But death rates in Sudan, which has its own [genotype] and where there had been 2 other outbreaks before 2004, have been much lower, averaging around 50 percent of victims.

A large outbreak caused by the Sudanese [genotype] in Uganda in 2000-2001 affected 425 people but only about half, a total of 224, died. The only other significant outbreaks have been in Gabon -- another country with heavy tropical forest cover.

Health officials say there is still no known cure for the disease which is spread through body fluids, including blood. In 1995 it killed many doctors and nurses in the Congo outbreak. The WHO says its effects can be contained by prompt mobilization of local communities and the strict isolation of victims from physical contact with other people.


8/6/04

"Words are not involved in this"
(another poem by Larissa Szporluk)

Yellow, Singing at Night

the bird, wound-up,
looks almost like a lemon being shot,

the piston in its body
pumping back and forth into a blur,

like a tide that won't retire,
but hovers in remembrance of its high,

or a legendary bottle,
wrenched with genius, in the sand

where mussels secrete
amethyst tones, and the very thin rain

is a wall falling loose
at the crypt, and the song in the throat,

not rendered to stir,
stirs somehow, like a trick-maneuver

of fate, reminding him,
the boy whose palm it rivets in,

that words are not involved in this,
nor life, nor aim.
The politics of obesity and Medicare

A good summary by Jon Bonné of MSNBC points out that the much-ballyhooed change in Medicare policy amounts to somewhat less than a hill of beans in treatment coverage. The upshot, it turns out, is that a lone sentence will be removed from the Coverage Issues Manual (which details what is covered by the agency): “Obesity itself cannot be considered an illness.” No treatments will be explicitly added to the manual as eligible.

But here's a strange twist. There is, in fact, one treatment for obesity which is up for consideration. Not the friendlier, cheaper, possibly more effective (and certainly more sensical, from a public-health standpoint) anti-obesity treatments called diet, exercise, and nutrition, but fantastically expensive gastric surgery! Bonné writes:

The Medicare Coverage Advisory Committee, which recommends what the agency should pay for, may consider bariatric surgery this fall. But the agency has not scheduled discussion of other, less drastic treatments, such as nutrition counseling and structured weight-loss programs, though Tunis told MSNBC.com those treatments could be considered if the agency is asked to review them by outside petitioners.
Stranger still, the technical assessment (TA) mentioned in the article, a solid review of the epidemiologic evidence ("Diagnosis and Treatment of Obesity in the Elderly"), actually focuses on such treatment programs, which try to encourage voluntary weight loss. To quote the TA:
Obesity therapies with good evidence for improving health outcomes in the elderly incorporate both dietary and behavioral components; therefore, we consider these modes jointly here. All successful studies included exercise and used intensive counseling protocols. Effective interventions typically used diets based on reduced caloric intake, often in the setting of low-saturated-fat and low-cholesterol intake goals. . . . Weight loss showed clinical utility, particularly for cardiovascular-related benefits such as oral glucose tolerance testing or diabetes incidence.
Which "outside petitioners" got bariatric surgery on the agenda while treatment programs are not? Do the obesity groups prefer one treatment to another, and why? I would hope that the relevant petitioners (maybe I'll find out who they are) will approach the bar and ask that public health be covered before surgery.

8/4/04

Obesity and Medicare

It was recently announced that obesity treatments will now be eligible for Medicare coverage. I remember reading a number of objections to this decision, both in the blogosphere and elsewhere, though I can't find them now. One of the most plausible objections, phrased in the form of a defensible argument, goes something like this.

1. Obese people are obese (at least in part) by virtue of their own free will.
2. If these people became obese of their own free will, it is likely that anti-obesity treatments will be less effective, since the patients are not behaving in a way that would reduce their obesity.
3. Less effective treatments should not be covered by Medicare.

This is, I think, a utilitarian argument (though very rough and underdeveloped). There is a certain, limited amount of money available for health-care expenditures, so using some of it on less effective treatments is inadvisable.

Another argument goes like this:

1. Obese people are obese (at least in part) by virtue of their own free will.
2. This means that their obesity is (at least in part) their own fault.
3. Medical care should not be provided to those who harm themselves.

I can't see any way to defend this second argument, though it is also underdeveloped. In fact (and this shouldn't come as any surprise), I think physicians have a positive moral duty to heal and not to try and establish the fault (or lack thereof) of their patients.

Both arguments, though, have to come to terms with the following objection. How does one differentiate between personal decision and outside factors in the etiology of disease? It would be even more complicated to apply such differentiation (were it possible) to rationing of medical care.

To put it in more concrete terms: which of the following diseases make a patient more or less "blameworthy"? Cirrhosis of the liver; AIDS; obesity; lung cancer; heart disease; trauma sustained in an automobile accident (with a seat belt? without a seat belt?); etc., etc., etc. Keep in mind that these are some of the most common causes of morbidity and mortality in the U.S.
(Another way of going about it is to ask the question: are there other government programs which encourage patients to stop unhealthy behavior? At what point would a patient become ineligible for help in quitting smoking?)

This train of thought is inspired by a post over at Close Range. I'm not a philosopher (although I do read and enjoy philosophy), and these thoughts lack rigor. But maybe Marc can give me some advice.

8/2/04

John Kerry on Darfur

His Plan for America says the following about Darfur (pp. 33-34):
We must also work with the United Nations and Africa's regional organizations to address Africa's persistent, disproportionate share of the world's weak, failing states and chronic armed conflicts, and promote sustainable economic development. We support extension of the African Growth and Opportunity Act, which provides a door to a brighter future for many of the continent's poorest countries. We will also support effective relief efforts when there is a humanitarian crisis--particularly at this moment in Darfur, Sudan, where genocide is underway.

Although Kerry does use the word "genocide," there's no indication he would do more than what Bush is doing: relying on the U.N. to gum the Sudanese government into submission with its toothless resolutions. In particular, this paragraph bespeaks a deafening absence of readiness to help with an international peacekeeping force. Add to this Kerry's hasty promises to pull the troops out of Iraq, and isolationism comes to mind.

8/1/04

What makes a good blog?

The post-game analyses of the DNC blogs have been made elsewhere, so suffice it to say that (a) most of them were banal; and (b) a select few were worth reading. It comes as no surprise that the most valuable convention blogs were those written not by amateurs, but by people with at least some experience thinking and writing about politics; I'm thinking here about Mickey Kaus and Oxblog. David Adesnik, on Oxblog, points out, reasonably enough, that blogs are useful if they share with the reader a certain store of expertise. (That's why Andrew Sullivan didn't need to go to the convention. He knew what he was looking for, and helped me find the weak spots in Kerry's speech that I overlooked even though we both watched the same thing on TV.)

That's one criterion that can be used to assess a blog: usefulness. A blog can provide the interested reader with an entree to liberal-hawkish (or Christian-rightish) politics, linguistics, Jewish academia, cooking, Holywood gossip, Torah, or any one of a number of spicy, tangy, or wonky subfields.

But most people, shocked by the new, tend to ignore the fact that blogs are also (primarily?) a literary medium, stuck midway between the essay and the epistle, awkward despite its shiny newness and still trying to find its own way to eloquence. That is, a blog can be worthwhile even when it's not backed by expertise, and the je ne sais quoi which confers this worthiness is something old-fashioned folk call good writing.

A civic-minded citizen of the blogosphere should gird his or her loins to become the Michiko of the blogs, wielding a sharp red pen to sort out the reading matter from the packing material. (Note that literary quality is separate from blog popularity. Any fool can see that Instapundit has the most readers in the universe, but your fool here still fails to understand how anyone can bear up under his constant, uninflected staccato.)

Such a critic would ask a few basic questions. Which blogs are written with more than a modicum of style, energy, innovation, intelligence, worldliness, refreshing obscenity, plot-driven suspense, or colorful characters? Who manages to stick their identifiably quirky nose above the unending blizzard of daily posts required of a committed blogger? Who has created a memorable literary personality, or a set of concerns that manage to challenge and infect the reader? If the entire blogosphere were to disappear tomorrow, whom would we miss?

A blog critic would review a different blog every week. They could sing the praises of an already well-known blog, or pluck a gem from obscurity and hold it up to the light of public acclamation. No, I don't want to play the role of Kakutani. I'm not Micheeky enough. But maybe I can start with writing about those blogs I like a lot, and why I like them -- and that might in some small way encourage more thorough blog criticism done on a wider scale by more popular blogs.

More on this later, dear readers, if you'd find it interesting. (If so, let me know!)
The Dead Leader and the Living Father

Naftali Gliksberg writes in Haaretz:
The death of Moses in the desert is the embodiment of the paradoxical
relationship of the people Israel and the Land of Israel. In order to enter the
Land one needs the faith of Abraham, a faith that perseveres even in
opposition to all reality and human logic. But in order to exist as a people one
needs a leader like Moses - the seeker of revelation, the
rational actor according to a system of laws, the leader who didn't enter the
Land.

4.5 million gallons of water a day . . .
for 67,000 KJ residents

That's what's envisioned for a controversial pipeline which would divert water from New York City's Catskill Aqueduct. (The project is hotly disputed by neighboring communities, but it's probably the only thing supported by both the KJ village government and the dissident KJ Alliance.)

Get the facts and figures from another excellent article by the Times Herald-Record's Chris McKenna.

One of the more interesting tidbits:

The village has asked Congress for $20 million to cover much of the
cost.