Taking off
This coming Friday will be the third where I leave the hospital early to observe Shabbos. I don't do this without mixed feelings. Observing Shabbos is one thing when one is a tradesman and puts down the tools of one's trade (or picks them up) on one's own recognizance. But the modern workplace, where one is part of a team (or a cog in a machine, depending on how you look at it) is something else again. One's actions affect others. In fact, entire chapters of Jewish socioeconomic history have been written on the turmoil which ensued when Jewish factory owners (never mind the non-Jews) collided with the Sabbath observance of their Jewish workers.
The fact that I have been able, more or less, to pursue my Sabbath observance without undue harm to my career or earning power says not so much about my religious asceticism or Will to Frumkeit, and more about the benefits accruing to me by virtue of my class (by birth) and the expenditure in my education invested by my parents. The fact that hyper-rigorous Sabbath observance has become the norm of the American Orthodox community, by the same token, says a lot about the economic success of that community.
But that's by the way. What I wanted to point out is that the issues in my case (that of a medical student) are slightly more complicated. Most folks in my vast readership (no longer the Daily Dozen, but certainly not yet the Daily Century, either) know that saving a life, in Jewish law, takes precedence over the Sabbath. (This statement is rough; there are many exceptions; but the general idea is valid.) I'm just a student, and not involved (yet) in saving any lives, so one might think that I could leave early with a light heart. But an inner doubter asks: isn't it possible that the extra clinical exposure, available to me if I worked Shabbos, is necessary to train me to be the best life-saver I can be?
Possible, but not actually the case, I think, in the current system of medical education, or at least the one I'm part of. The inner doubter raises an important point, though. After some stage of one's medical education, the activity of medical care must be construed as some sort of gross life-saving even if one is not actually saving lives at every moment. Otherwise medical practice for the Shabbos observer would be impracticable and a shayle would have to be asked every minute of every Saturday. That is to say, once I become a resident, I will have to act like a doctor -- cause I'll be one. And doctors can't get out of working Saturdays if they are the primary caregivers for their patients.
There are, I know, residency programs which do not require the students to work on Shabbos. How this functions I don't know; perhaps the patients are helpful enough to get sick Sunday through Friday?
Qualifications, hems and haws, and corrections to this are sure to follow.
2/27/05
Why I Can Daven At All Those Cool Ortho Shuls on East Broadway
. . . only until my daughter is old enough to daven
Naomi Chana explains it all.
. . . only until my daughter is old enough to daven
Naomi Chana explains it all.
2/25/05
The Boy Knows the Truth
Isaac Bashevis Singer (1904-1991)
First printed in the Yiddish journal Di Tsukunft, October, 1972. Reprinted in Di Tsukunft, October, 2004, on the 100th anniversary of Singer's birth. The Tsukunft editors point out that the story has not been included in any anthology in Yiddish, and has never been translated. I'll try to translate a paragraph at a time, whenever I have the time. Expect the translation to be finished, oh, never. Still, it can't hurt to start.
When Reb Gavriel-Takhne became the Klintover rebbe on the death of his father, he told his attendants that he would not receive women. It was true that his own father and grandfather, and many other rebbes, like Reb Sholem of Belz and Reb Khayim of Sanz, did receive women, but he couldn't compare himself to those righteous men. They were angels; he, Gavriel-Takhne, was a man of bodily needs. His blood boiled in him. In the middle of prayer inappropriate thoughts would attack him like locusts. Fasts and cold mikvahs didn't help. The evil inclination spoke to him without any scruples: anything goes, get some while you still can. From anguish the rebbe bit his nails to the quick. He pounded his head with his fists, tore his sidelocks, called himself an evil man, disgusting, a sinner. He looked for advice in religious works, but it turned out, strangely enough, that an evil spirit had attached himself to him. How ridiculous! Young men visited him to learn how to be God-fearing; scholars copied his words of Torah; he taught Talmud daily to yeshivah students; was ashamed before other people more than before God . . .
"This is a world of falsehood, anyway," said the rebbe to himself. Here, in the world of demons, everything was backwards. Countless times Reb Gavriel-Takhne had wanted to call together those close to him and tell them the truth: he couldn't be a leader of Jews. But the rebbe knew that as soon as he took off the spodik and the felt coat, he would immediately come under the Devil's control. The way things were, at least, he hadn't progressed to any actual sin.
He kept having the same thought. A man like him, Gavriel-Takhne, is ashamed before other people more than before God.
The rebbe would look into "The Beginning of Wisdom" and think about Rahab the prostitute; he would study the Zohar and lust after Avishag the Shunamite and Queen Esther. It said in works of Kabbalah that new personalities would spring up between Adam and Eve, Jacob and Rachel, David and Batsheba. In this case, they meant souls, not bodies. But as soon as the rebbe fell asleep, the bodies of those righteous women would reveal themselves to him naked. He would cavort with them like a he-goat. They'd sing different songs and uncover their shame. The rebbe got up trembling.
"Help, please help! I can't take it any more!"
The rebbe had a wife, a descendant of the Roptshitser rebbe, Menukhe-Alte. But as much as he was a man of lust, she was someone of whom it's said "even her pregnancy and giving birth are in holiness." He, Gavriel-Takhne, is tall, broad, with the voice of a strongman and the appetite of an animal. At fifty-seven his beard was still as red as fire, without a thread of gray. He had all his teeth. He could crack walnuts with them. One time, during a fire in his courtyard, Gavriel-Takhne tore locks open with his bare hands, carried out whole cases of holy books. He grabbed Avigdor the sexton, who had passed out from the smoke, and carried him down two flights of stairs. Then the rebbe went out to the well and for two hours straight drew buckets of water which the firefighters used to put out the fire.
Isaac Bashevis Singer (1904-1991)
First printed in the Yiddish journal Di Tsukunft, October, 1972. Reprinted in Di Tsukunft, October, 2004, on the 100th anniversary of Singer's birth. The Tsukunft editors point out that the story has not been included in any anthology in Yiddish, and has never been translated. I'll try to translate a paragraph at a time, whenever I have the time. Expect the translation to be finished, oh, never. Still, it can't hurt to start.
When Reb Gavriel-Takhne became the Klintover rebbe on the death of his father, he told his attendants that he would not receive women. It was true that his own father and grandfather, and many other rebbes, like Reb Sholem of Belz and Reb Khayim of Sanz, did receive women, but he couldn't compare himself to those righteous men. They were angels; he, Gavriel-Takhne, was a man of bodily needs. His blood boiled in him. In the middle of prayer inappropriate thoughts would attack him like locusts. Fasts and cold mikvahs didn't help. The evil inclination spoke to him without any scruples: anything goes, get some while you still can. From anguish the rebbe bit his nails to the quick. He pounded his head with his fists, tore his sidelocks, called himself an evil man, disgusting, a sinner. He looked for advice in religious works, but it turned out, strangely enough, that an evil spirit had attached himself to him. How ridiculous! Young men visited him to learn how to be God-fearing; scholars copied his words of Torah; he taught Talmud daily to yeshivah students; was ashamed before other people more than before God . . .
"This is a world of falsehood, anyway," said the rebbe to himself. Here, in the world of demons, everything was backwards. Countless times Reb Gavriel-Takhne had wanted to call together those close to him and tell them the truth: he couldn't be a leader of Jews. But the rebbe knew that as soon as he took off the spodik and the felt coat, he would immediately come under the Devil's control. The way things were, at least, he hadn't progressed to any actual sin.
He kept having the same thought. A man like him, Gavriel-Takhne, is ashamed before other people more than before God.
The rebbe would look into "The Beginning of Wisdom" and think about Rahab the prostitute; he would study the Zohar and lust after Avishag the Shunamite and Queen Esther. It said in works of Kabbalah that new personalities would spring up between Adam and Eve, Jacob and Rachel, David and Batsheba. In this case, they meant souls, not bodies. But as soon as the rebbe fell asleep, the bodies of those righteous women would reveal themselves to him naked. He would cavort with them like a he-goat. They'd sing different songs and uncover their shame. The rebbe got up trembling.
"Help, please help! I can't take it any more!"
The rebbe had a wife, a descendant of the Roptshitser rebbe, Menukhe-Alte. But as much as he was a man of lust, she was someone of whom it's said "even her pregnancy and giving birth are in holiness." He, Gavriel-Takhne, is tall, broad, with the voice of a strongman and the appetite of an animal. At fifty-seven his beard was still as red as fire, without a thread of gray. He had all his teeth. He could crack walnuts with them. One time, during a fire in his courtyard, Gavriel-Takhne tore locks open with his bare hands, carried out whole cases of holy books. He grabbed Avigdor the sexton, who had passed out from the smoke, and carried him down two flights of stairs. Then the rebbe went out to the well and for two hours straight drew buckets of water which the firefighters used to put out the fire.
2/21/05
Imperfect Understanding
Gregg Easterbrook, in his Daily Express column at The New Republic [I think this is the link, but it seems to be broken right now], says there should be fewer languages. In presenting his claim, he manages to conflate a number of issues while misunderstanding them. There are too many inaccuracies and howlers to go over individually, but we'll start with the main ones:
"The fewer the tongues, the more easily societies communicate." This is an argument by assertion. Easterbrook does not understand that we have both a global English-language culture and, at the same time, many minority languages which may or may not correspond to political entities. For example, all countries involved in the recent war in Iraq communicated in English among themselves, while their citizens speak languages other than English. Surely Easterbrook does not maintain that these countries would have "communicated more easily" if only all of their citizens spoke English. (Presumably our colonial mother, the United Kingdom, spoke something other than English in the late eighteenth century; otherwise we would not have had so basic a miscommunication as a war.)
Furthermore, not every minority language is an "indigenous language." Easterbrook is laboring under the misconception that there are two kinds of languages: global powerhouses, like English, and minority languages spoken only by the primitive inhabitants of an isolated territory. But there are many sorts of non-global languages, ranging from national vernaculars (Ukrainian, Belgian) to state-supported languages(Irish, Frisian) to stateless languages (Yiddish, Romani).
"For citizens of the developing world, speaking a top ten language opens doors to a better life." No one denies that English, or any other language of global commerce, is a route to economic success. This is trivial. There are two questions here: (a) how one is to define economic success. One can always make more money. Is it really true that all other languages besides English (or Mandarin) should be jettisoned as long as speaking them reduces one's income by some non-zero amount? Secondly, (b) how is one to define "a better life"? This is the non-trivial question which cannot be answered in daily-express fashion.
"Multiple languages arose because throughout history, many groups of people lived in isolation, interacting only with others like themselves." I've read this sentence a dozen times and I'm still not sure what it means. Does it mean that, ideally, there would only be one language, but that due to "many groups of people liv[ing] in isolation," multiple languages sprung up? (In that case, Easterbrook's knowledge of sociolinguistics stopped at the Tower of Babel.) But we know that many languages, if not all, arose precisely out of a process of contact and exchange between different groups. This certainly describes the genesis of English, Spanish, and Yiddish, and I bet lots of other languages too. Even the Romance languages (which Easterbrook might be thinking of) arose out of contact between Latin and coterritorial vernaculars, not out of inbreeding. I'm not sure what languages Easterbrook was thinking of when he wrote this sentence (if "wrote" is the word). He probably thinks that the indigenous languages he blesses with his disapproval somehow blossomed ready-made from the earth, without contact with any other language. This isn't true either.
"[. . .] when a rare language dies out, the culture it served can continue, just in some other tongue[.]" I admire Easterbrook's confidence, but I disagree. Cultures change when they are translated. Such translation is not a sin, and is not to be avoided -- it's necessary, after all, to help Jews understand what is said in the Yiddish most of them no longer speak. But this does not mean that all of Yiddish culture is readily translatable into English. Translation does not mean continuation.
"And of course if members of a small-language culture want to work to keep their tongue in use, that's great, so long as they know a major language as well." Now he tells us this, in the third-to-last paragraph? O editor, where is thy saving pencil?
Gregg Easterbrook, in his Daily Express column at The New Republic [I think this is the link, but it seems to be broken right now], says there should be fewer languages. In presenting his claim, he manages to conflate a number of issues while misunderstanding them. There are too many inaccuracies and howlers to go over individually, but we'll start with the main ones:
"The fewer the tongues, the more easily societies communicate." This is an argument by assertion. Easterbrook does not understand that we have both a global English-language culture and, at the same time, many minority languages which may or may not correspond to political entities. For example, all countries involved in the recent war in Iraq communicated in English among themselves, while their citizens speak languages other than English. Surely Easterbrook does not maintain that these countries would have "communicated more easily" if only all of their citizens spoke English. (Presumably our colonial mother, the United Kingdom, spoke something other than English in the late eighteenth century; otherwise we would not have had so basic a miscommunication as a war.)
Furthermore, not every minority language is an "indigenous language." Easterbrook is laboring under the misconception that there are two kinds of languages: global powerhouses, like English, and minority languages spoken only by the primitive inhabitants of an isolated territory. But there are many sorts of non-global languages, ranging from national vernaculars (Ukrainian, Belgian) to state-supported languages(Irish, Frisian) to stateless languages (Yiddish, Romani).
"For citizens of the developing world, speaking a top ten language opens doors to a better life." No one denies that English, or any other language of global commerce, is a route to economic success. This is trivial. There are two questions here: (a) how one is to define economic success. One can always make more money. Is it really true that all other languages besides English (or Mandarin) should be jettisoned as long as speaking them reduces one's income by some non-zero amount? Secondly, (b) how is one to define "a better life"? This is the non-trivial question which cannot be answered in daily-express fashion.
"Multiple languages arose because throughout history, many groups of people lived in isolation, interacting only with others like themselves." I've read this sentence a dozen times and I'm still not sure what it means. Does it mean that, ideally, there would only be one language, but that due to "many groups of people liv[ing] in isolation," multiple languages sprung up? (In that case, Easterbrook's knowledge of sociolinguistics stopped at the Tower of Babel.) But we know that many languages, if not all, arose precisely out of a process of contact and exchange between different groups. This certainly describes the genesis of English, Spanish, and Yiddish, and I bet lots of other languages too. Even the Romance languages (which Easterbrook might be thinking of) arose out of contact between Latin and coterritorial vernaculars, not out of inbreeding. I'm not sure what languages Easterbrook was thinking of when he wrote this sentence (if "wrote" is the word). He probably thinks that the indigenous languages he blesses with his disapproval somehow blossomed ready-made from the earth, without contact with any other language. This isn't true either.
"[. . .] when a rare language dies out, the culture it served can continue, just in some other tongue[.]" I admire Easterbrook's confidence, but I disagree. Cultures change when they are translated. Such translation is not a sin, and is not to be avoided -- it's necessary, after all, to help Jews understand what is said in the Yiddish most of them no longer speak. But this does not mean that all of Yiddish culture is readily translatable into English. Translation does not mean continuation.
"And of course if members of a small-language culture want to work to keep their tongue in use, that's great, so long as they know a major language as well." Now he tells us this, in the third-to-last paragraph? O editor, where is thy saving pencil?
2/15/05
Why there aren't (m)any blogs by third- and fourth-year medical students
Or: What's the recommended treatment for a blogger hiatus?
In case you haven't guessed, I am spending a lot of time doing other things than blogging, mostly experiencing various varieties of humiliation and quasi-pedagogic force-feeding. Some interesting learning and patient contact in there, too. Stay tuned for coming articles and for blog posts at irregular intervals.
Or: What's the recommended treatment for a blogger hiatus?
In case you haven't guessed, I am spending a lot of time doing other things than blogging, mostly experiencing various varieties of humiliation and quasi-pedagogic force-feeding. Some interesting learning and patient contact in there, too. Stay tuned for coming articles and for blog posts at irregular intervals.
2/9/05
The riv-haleshonot made local
More Tales from Down Under on the LES.
[Scene: A kosher bakery. Two Jewish men are leaning on the counter and talking to each other in Yiddish in confident, ownerly fashion.]
One of the women behind the counter, to another woman: They can talk to each other in Yiddish, but we're not allowed to speak Spanish!
ZShB [in Spanish]: They don't let you speak Spanish?
[He is ignored.]
*Riv-haleshonot (Hebrew): Language war (literally, "quarrel"). A phrase usually referring to the often-strained relations between Hebraists and Yiddishists in the Diaspora and the Land of Israel.
More Tales from Down Under on the LES.
[Scene: A kosher bakery. Two Jewish men are leaning on the counter and talking to each other in Yiddish in confident, ownerly fashion.]
One of the women behind the counter, to another woman: They can talk to each other in Yiddish, but we're not allowed to speak Spanish!
ZShB [in Spanish]: They don't let you speak Spanish?
[He is ignored.]
*Riv-haleshonot (Hebrew): Language war (literally, "quarrel"). A phrase usually referring to the often-strained relations between Hebraists and Yiddishists in the Diaspora and the Land of Israel.
2/7/05
Sowing nostalgia
Loisaida stories, 1.
[Scene: Interior of a small store on a street near ZShB's new apartment. The very apotheosis of disorder. Shelves covered with dust, bits of recognizable leathery Judaica -- mezuzot, tefillin, etc. -- and other various merchandise. There's another store, somewhat less dusty and more ordered, down the block, but your narrator is not in a hurry and has chosen to wander on in here as well. At the counter in the front sits an old Jew in his seventies or eighties, with a white beard and a slanted, black "Litvish" yarmulke. His name is Rabbi E.* An open Talmud lies a few feet away. The conversation, of course, is in Yiddish.]
ZShB: Two havdalah candles, please.
[There's a pleasant conversation about ZShB's employment, marital status, and number of children. He is welcomed to the neighborhood.]
ZShB: Didn't there use to be a seforim ["Hebrew" book] store around here?
Rabbi E: Yes, but it closed last year.
ZShB: [Momentarily forgetting that he just went into another Judaica store a few blocks back] Is yours the only store around like this?
Rabbi E: Yes! [bangs fist on table] I'm the only one who sells good, kosher mezuzot and tefillin!
*He has more than an initial, obviously.
Loisaida stories, 1.
[Scene: Interior of a small store on a street near ZShB's new apartment. The very apotheosis of disorder. Shelves covered with dust, bits of recognizable leathery Judaica -- mezuzot, tefillin, etc. -- and other various merchandise. There's another store, somewhat less dusty and more ordered, down the block, but your narrator is not in a hurry and has chosen to wander on in here as well. At the counter in the front sits an old Jew in his seventies or eighties, with a white beard and a slanted, black "Litvish" yarmulke. His name is Rabbi E.* An open Talmud lies a few feet away. The conversation, of course, is in Yiddish.]
ZShB: Two havdalah candles, please.
[There's a pleasant conversation about ZShB's employment, marital status, and number of children. He is welcomed to the neighborhood.]
ZShB: Didn't there use to be a seforim ["Hebrew" book] store around here?
Rabbi E: Yes, but it closed last year.
ZShB: [Momentarily forgetting that he just went into another Judaica store a few blocks back] Is yours the only store around like this?
Rabbi E: Yes! [bangs fist on table] I'm the only one who sells good, kosher mezuzot and tefillin!
*He has more than an initial, obviously.
2/3/05
Shampoo, soap, and psychiatry
Feigning Sanity at Bellevue, my second article in the Medicine Mensch series.
And here it is in full:
MEDICINE MENSCH: Feigning Sanity at Bellevue
By Zackary Sholem Berger
February 4, 2005
My first rotation as a medical student is psychiatry, that branch of medicine that patrols the border between sane and insane. But as is well known to any observer of human behavior, the sane are sane up until the point when you start looking at them with an analytic eye. Then everyone seems to need treatment, doctors and students included.
At 9:15 every morning, our psychiatry ward has a "community meeting," a chance for everyone — patients, doctors and staff (the "community") — to thrash out problems that are relevant to life on our unit. A sociologist would have a wonderful time here. Everyone sits in large, colorful, uncomfortable plastic chairs, like booster seats for grownups. We're reminded daily that at the meeting, personal issues are out of bounds. But without fail, one of the patients always starts with the question, "When do I get out of here?" Or, "Quiero irme ya." ("I want to leave right now.") (The meetings are translated into Spanish.) "That's a personal issue," a staff member always answers, "but we can try to discuss it generally. We're only talking about community issues now."
(On the other hand, our staff meeting is a freewheeling chance to bitch and moan in the most personal of terms. Without coming to blows and, miraculously, without psychotropic medication, the issues are somehow solved, helped by the powerful motivation of getting enough work done by lunchtime.)
But let's get back to the first meeting. What does the "community" complain about? Someone gets tea instead of coffee at lunch, or vice versa. The meeting room (normally the patient lounge) hasn't had its floor washed in days. One of the patients won't take showers. "Hey, where's the shampoo?" Men are using women's bathrooms. And so on. If this list of problems sounds familiar, it's because they show up at all stages of life whenever people stay in close proximity: in the suburban home, summer camp, resort, homeless shelter or Elderhostel. We all have the same problems when staying three to a room.
Even in an emergency, the sickest mental patients have more in common with us than we might like to admit. A couple of weeks ago, I spent midnight to7 a.m. at Bellevue Hospital's Comprehensive Psychiatry Emergency Program — the psychiatric emergency room. The orientation packet emphasizes a number of safety precautions: Never be alone in a room with a patient; always have an exit route in mind; don't promise a patient, even in the name of politeness, anything that you can't deliver. From these caveats, I imagined a cross between a cellblock at Alcatraz and a chaotic thrill ride of the insane. (Never mind the prime rule of medical-student safety, on any ward, psychiatric or not: Get out of the way as fast as you can; someone larger than you knows exactly what to do in this situation.)
I saw five or six patients, and of those, only one needed urgent psychiatric care. Why did the others come to CPEP that night? It was rough outside, rainy and cold, with a brisk wind off the East River — not a good time to be kicked out by your mother because you've had a fight with her new husband. It also wasn't the best night (from another patient's point of view) to have taken a bus to New York from Michigan to "hang out with some friends" who turned out not to be so hospitable.
The attending physician on call that night decided that none of these other cases could be admitted. There were those who didn't have psychiatric problems at all, and just wanted a warm bed for the night. Others were indeed mentally ill, but not sick enough to stay in the hospital. Some fell into both categories. It's not trivializing the plight of the mentally ill to say that the daily lives of the sane are also ruled by institutions that cannot admit just anyone; the problem of limited resources is a general one. (Have you ever tried to find an apartment in the city, or get your kid into school, or find a job?) Even so, I kept asking myself the question: Shouldn't there be an institution that is ready to help these people, no matter what the cost? And here's the answer: Yes, and you're working in it. But you still can't do everything.
The next morning at 9:15 I did my little bit, filling in as a Spanish translator because a couple of people were out sick. Among other things, I helped make sure everyone understood an important fact: how packets of sweetener are distributed at lunch and why. Life on the wards, like life outside, is measured in shampoo and sugar.
Feigning Sanity at Bellevue, my second article in the Medicine Mensch series.
And here it is in full:
MEDICINE MENSCH: Feigning Sanity at Bellevue
By Zackary Sholem Berger
February 4, 2005
My first rotation as a medical student is psychiatry, that branch of medicine that patrols the border between sane and insane. But as is well known to any observer of human behavior, the sane are sane up until the point when you start looking at them with an analytic eye. Then everyone seems to need treatment, doctors and students included.
At 9:15 every morning, our psychiatry ward has a "community meeting," a chance for everyone — patients, doctors and staff (the "community") — to thrash out problems that are relevant to life on our unit. A sociologist would have a wonderful time here. Everyone sits in large, colorful, uncomfortable plastic chairs, like booster seats for grownups. We're reminded daily that at the meeting, personal issues are out of bounds. But without fail, one of the patients always starts with the question, "When do I get out of here?" Or, "Quiero irme ya." ("I want to leave right now.") (The meetings are translated into Spanish.) "That's a personal issue," a staff member always answers, "but we can try to discuss it generally. We're only talking about community issues now."
(On the other hand, our staff meeting is a freewheeling chance to bitch and moan in the most personal of terms. Without coming to blows and, miraculously, without psychotropic medication, the issues are somehow solved, helped by the powerful motivation of getting enough work done by lunchtime.)
But let's get back to the first meeting. What does the "community" complain about? Someone gets tea instead of coffee at lunch, or vice versa. The meeting room (normally the patient lounge) hasn't had its floor washed in days. One of the patients won't take showers. "Hey, where's the shampoo?" Men are using women's bathrooms. And so on. If this list of problems sounds familiar, it's because they show up at all stages of life whenever people stay in close proximity: in the suburban home, summer camp, resort, homeless shelter or Elderhostel. We all have the same problems when staying three to a room.
Even in an emergency, the sickest mental patients have more in common with us than we might like to admit. A couple of weeks ago, I spent midnight to7 a.m. at Bellevue Hospital's Comprehensive Psychiatry Emergency Program — the psychiatric emergency room. The orientation packet emphasizes a number of safety precautions: Never be alone in a room with a patient; always have an exit route in mind; don't promise a patient, even in the name of politeness, anything that you can't deliver. From these caveats, I imagined a cross between a cellblock at Alcatraz and a chaotic thrill ride of the insane. (Never mind the prime rule of medical-student safety, on any ward, psychiatric or not: Get out of the way as fast as you can; someone larger than you knows exactly what to do in this situation.)
I saw five or six patients, and of those, only one needed urgent psychiatric care. Why did the others come to CPEP that night? It was rough outside, rainy and cold, with a brisk wind off the East River — not a good time to be kicked out by your mother because you've had a fight with her new husband. It also wasn't the best night (from another patient's point of view) to have taken a bus to New York from Michigan to "hang out with some friends" who turned out not to be so hospitable.
The attending physician on call that night decided that none of these other cases could be admitted. There were those who didn't have psychiatric problems at all, and just wanted a warm bed for the night. Others were indeed mentally ill, but not sick enough to stay in the hospital. Some fell into both categories. It's not trivializing the plight of the mentally ill to say that the daily lives of the sane are also ruled by institutions that cannot admit just anyone; the problem of limited resources is a general one. (Have you ever tried to find an apartment in the city, or get your kid into school, or find a job?) Even so, I kept asking myself the question: Shouldn't there be an institution that is ready to help these people, no matter what the cost? And here's the answer: Yes, and you're working in it. But you still can't do everything.
The next morning at 9:15 I did my little bit, filling in as a Spanish translator because a couple of people were out sick. Among other things, I helped make sure everyone understood an important fact: how packets of sweetener are distributed at lunch and why. Life on the wards, like life outside, is measured in shampoo and sugar.
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