The argument from flawed design
[Corrected from an earlier version based on comments. Thanks to my bar-plugta.]

The argument from design begins with the observation that the universe is so intricately complex that only a builder could have created it. The only such builder is the Builder.

An offshoot of this argument is the Intelligent Design theory, which Hirhurim pointed out should better be called a religious philosophy. According to this so-called alternative to evolution, the details of biological systems require a Designer to assemble them all just so.

The problem with both the Intelligent Design philosophy and the argument from design is that complexity need not be explained by a Designer. But the problem of imperfections in the world's design is also relevant. Part of the idea of "complexity" inherent in the Design Argument (and the famous watch metaphor) is that the world's intricacy is necessary to its functioning, in the same way that a complicated mechanism underlies the way a watch works.

An "intelligent design" biologist (to the extent that one exists) would not credit evolution for regulatory proteins and their interlocking complexity. Rather, he would say that this is an instance of special creation, since nothing so complicated as protein-kinase molecular biology could have arisen by chance, even over millions of years.

But the complexity of biological systems is riddled with irregularities and imperfections that weaken the watchmaker metaphor and make us ask the question: what sort of designer would include them? Regulatory proteins can be hijacked by viruses or can malfunction through environmental insult. Even to some nephrologists I know, the kidneys seem like jerry-rigged, hopelessly complicated organs. And if the fine-tuned electrical conduction of the heart goes haywire, you can forget about the ventricles acting as pacemakers on their own. They're likely to conk out altogether, which is deadly to the organism.

Why would God build such imperfections into the system? The test for justifications of God's moral actions, as I think Paul van Inwagen touches upon in one of his lectures, is their narrative plausibility. (The well-known and ancient argument "I believe because it is impossible" can't help us in distinguishing between competing plausible accounts of God's actions.) If we compare the theory of evolution to the theory of special creation of biological systems, the second option presents us with questions that are very difficult to answer: if God specially created molecular biology, why couldn't He (or She) have done a better job? Why doesn't our heart work better? Why are we bipedal when it causes such pain over increased lifespans?

On the other hand, believing in both God and evolution provides a satisfying narrative. God created a system which is higher-order than even humans themselves, a mechanism which governs life in its complexity. This does not gainsay our moral responsibility or particularist relationships with God. Evolution and the Torah are not mutually exclusive. Rather, evolution (so to speak) is a construction more appropriate for the perfect Builder than imperfect special creation.

In other words, the argument from design assumes that complexity requires a Designer. Since not every kind of complexity needs a designer, though, we need to limit the argument to those sorts of complexity which fit the bill. I think that the irregularities and inconsistencies of biological systems -- those which intelligent design advocates hold to be prime examples of special creation -- argue against such "Designing" with a capital D.

A question was raised in the comments: how can we assume that God would design a complexity comprehensible by humans? But that's the very nature of designed complexity! If we point to an irregularity-riddled complexity and say, "This requires a Designer," we are left with very puzzling, perhaps indefensible notions of how the Designer must act.

Turn it and turn it, for stuffing is in it
...דמליתא בה (?)

The plush Torah is pretty cute, but its smile is incongruous. Torah makes you happy, it could be argued, but I wouldn't call it sunny or friendly. If I were an Amalekite I would see the plush Torah in my nightmares. (Then again, if I were an Amalekite, I'd have plenty of other things to worry about.)

*If anyone can think of a good Aramaic translation for "stuffing," half of my kingdom is theirs.

What hath frogs wrought

The word צפרדע (frog, or, collectively, "frogs") is found in two places in Psalms. The order of the plagues dealt the Egyptians differs in Psalms from the recounting in Exodus. One traditional explanation for this (as suggested by the Radak, R. David Kimchi) is that the true order is represented in Exodus, so there's nothing lost by a change in the order in Psalms (which according to this understanding presumably differs for rhetorical reasons). The historical-critical explanation, not surprisingly, is that different traditions, or source texts, underlie the various recountings of the Exodus tale.

This all means that variances in Psalms (when compared to Exodus) should be looked at closely. In this week's parasha, here's how Egypt is affected by the frogs:

כז וְאִם-מָאֵן אַתָּה, לְשַׁלֵּחַ: הִנֵּה אָנֹכִי, נֹגֵף אֶת-כָּל-גְּבוּלְךָ--בַּצְפַרְדְּעִים.
Exodus 7:27 And if thou refuse to let them go, behold, I will smite all thy borders with frogs.
כח וְשָׁרַץ הַיְאֹר, צְפַרְדְּעִים, וְעָלוּ וּבָאוּ בְּבֵיתֶךָ, וּבַחֲדַר מִשְׁכָּבְךָ וְעַל-מִטָּתֶךָ; וּבְבֵית עֲבָדֶיךָ וּבְעַמֶּךָ, וּבְתַנּוּרֶיךָ וּבְמִשְׁאֲרוֹתֶיךָ.
28 And the river shall swarm with frogs, which shall go up and come into thy house, and into thy bed-chamber, and upon thy bed, and into the house of thy servants, and upon thy people, and into thine ovens, and into thy kneading-troughs.
כט וּבְכָה וּבְעַמְּךָ, וּבְכָל-עֲבָדֶיךָ--יַעֲלוּ, הַצְפַרְדְּעִים.
29 And the frogs shall come up both upon thee, and upon thy people, and upon all thy servants.'

ב וַיֵּט אַהֲרֹן אֶת-יָדוֹ, עַל מֵימֵי מִצְרָיִם; וַתַּעַל, הַצְּפַרְדֵּעַ, וַתְּכַס, אֶת-אֶרֶץ מִצְרָיִם.
Exodus 8:2 And Aaron stretched out his hand over the waters of Egypt; and the frogs came up, and covered the land of Egypt.
ג וַיַּעֲשׂוּ-כֵן הַחַרְטֻמִּים, בְּלָטֵיהֶם; וַיַּעֲלוּ אֶת-הַצְפַרְדְּעִים, עַל-אֶרֶץ מִצְרָיִם.
3 And the magicians did in like manner with their secret arts, and brought up frogs upon the land of Egypt.
ד וַיִּקְרָא פַרְעֹה לְמֹשֶׁה וּלְאַהֲרֹן, וַיֹּאמֶר הַעְתִּירוּ אֶל-יְהוָה, וְיָסֵר הַצְפַרְדְּעִים, מִמֶּנִּי וּמֵעַמִּי; וַאֲשַׁלְּחָה, אֶת-הָעָם, וְיִזְבְּחוּ, לַיהוָה.
4 Then Pharaoh called for Moses and Aaron, and said: 'Entreat the LORD, that He take away the frogs from me, and from my people; and I will let the people go, that they may sacrifice unto the LORD.'

Let's compare Psalm 78:

מה יְשַׁלַּח בָּהֶם עָרֹב, וַיֹּאכְלֵם; וּצְפַרְדֵּעַ, וַתַּשְׁחִיתֵם.
45 He sent among them swarms of flies, which devoured them; and frogs, which destroyed them.

"Them" refers here to the Egyptians, I think.

The question is: which destruction is meant? The emphasis in Exodus is on the frogs' unstoppable fecundity, not on their destructive power. Rashi, commenting on the word "destroyed them" (ותשחיתם) in the verse in Psalms, says שומטין את ביציהם, "they [the frogs] took away their [the Egyptians'?] eggs." The reference is unclear to me, and I bet he's referring to a midrash I can't find right now. Perhaps Rashi is making an association with the root ש.ח.ת "destruction," which is known to Jews in the phrase השחתת זרע "[wanton] destruction of seed."

Perhaps it is the case (using a historical-critical approach) that the Psalmist knew of a different tradition, in which the frogs were not fecund but destructive. Rashi is combining their two effects, if I understand him correctly: since they were so multiplicative, they stole or took away the eggs of other creatures. Unfortunately, I'm still not clear on what Rashi means and whose eggs he's referring to. Any help here?

Prosperity = death?
This week's epidemiology abstract.

While mortality has decreased over the past century, superimposed on that decline have been occasional spikes. This study endeavored to confirm this observation by correlating economic with mortality indices in a statistical way. I haven't read the article yet, but the abstract piques my interest.

Increasing mortality during the expansions of the US economy, 1900–1996
Author: Granados, José A Tapia
Source: International Journal of Epidemiology, Volume 34, Number 6, December 2005, pp. 1194-1202(9)

Background In Western countries mortality dropped throughout the 20th century, but over and above the long-term falling trend, the death rate has oscillated over time. It has been postulated that these short-term oscillations may be related to changes in the economy.

Methods To ascertain if these short-term oscillations are related to fluctuations in the economy, age-adjusted total mortality and mortality for specific population groups, ages and causes of death were transformed into rate of change or percentage deviation from trend, and were correlated and regressed on indicators of the US economy during the 20th century, transformed in the same way.

Results Statistically and demographically significant results show that the decline of total mortality and mortality for different groups, ages and causes accelerated during recessions and was reduced or even reversed during periods of economic expansion—with the exception of suicides which increase during recessions. In recent decades these effects are stronger for women and non-whites.

Conclusions Economic expansions are associated with increasing mortality. Suggested pathways to explain this deceleration or even reversal of the secular decline in mortality during economic expansions include both material and psychosocial effects of the economic upturns: expansion of traffic and industrial activity directly raising injury-related mortality, decreased immunity levels (owing to rising stress and reduction of sleep time, social interaction and social support), and increased consumption of tobacco, alcohol and saturated fats.

Keywords: Economic conditions; macroeconomic factors; economic recession; unemployment; mortality determinants; age-specific death rates; causes of death; demography

A Herculean feat
To (unngggh) somehow use the power of the Bible (unnggh) without (arrgh) being religious! Whew!

Amy Davidson of The New Yorker and Ari Shavit of Ha'aretz hit upon a thing called The Bible as Literature. Strange but true!

Sharon talked about his own attachment to the land in your interviews with him. You said earlier that the settlers saw him as too secular. It’s a strange thing—he speaks about the land in Biblical terms, evoking Biblical figures, without ever being religious.

Sharon was a godless person, in a very profound way. He had no religion, no faith. When you look at the brutal chapters of his biography, you can say that there was something of the brutal secularist about him; this was the modus operandi of a person who’s really not God-fearing in any way. This is fact No. 1. Fact No. 2 is that he had a very strong sense of history, with a special attachment to the land, and a very strong Biblical memory—the Bible and the land came together in a potent fusion process within him. He was truly a nationalist romantic, in an almost scary way. The two sides seem to be contradictory, but, if you look at the history of Zionism, you see that there is not that much of a contradiction. For the early Zionists, the Labor-movement Zionists, history replaced God, and the Bible replaced both the Talmud and the Orthodox way of living as a Jew. History was the God of the Zionists. The idea was to bring the Jews—who, in the old Zionist terminology, had lived outside of history—back to the family of nations, the theatre of nations, where there is peace and war. This was the great thrill of the founding fathers of Zionism. And, in the same way, the Bible, being taken and read as the book about Jews living in this land, with a real, physical life as a nation, cultivating the land, defending the land—this was very powerful for the young Zionists and the young Sabras of Sharon’s generation. He took it perhaps to a bit of an extreme, because he was a person of extremes, but this intimate relationship with the land and with Biblical legacy and tradition actually goes well together with the godless dimension of his personality, and, in many ways, makes him the last of this early line of Zionists; we are not going to see any more of this type in the future.

Entsiklopedia haYehudit

This appears to be a free, readily searchable compendium of information about (traditional religious) Judaism taken from already published sources. In Hebrew.

O-bashing, continued
Third in an ever-more intermittent series.

I don't think boys younger than bar-mitzvah age should ever wear suits. It makes them look like Little Lord Fauntleroy or pint-size members of the Mob. Yet this appears to be de rigueur in many of my neighborhood Charedi shuls. Is the Shtetl, as imagined by Orthodox ideologues, populated by suit-wearing nine-year-olds?

(A Shtetl, thus capitalized, is a magical, mythically pious place, which even in the modern age harbored no doubt, heresy, or heterodoxy. Some very important Orthodox rabbis, whose naivete in this matter is charming, have quoted works of Yiddish literature [literature! that's imaginative writing, folks, whose relationship to reality is -- at its closest -- beside the point!] as a faithful historical record of what life in the Shtetl must have been like. Cf. R. Soloveitchik in Halachic Man, part 2, with a long footnote quoting I.L. Peretz, and, I believe, R. Aharon Lichtenstein referencing Sholem Aleichem, though I can't find the Lichtenstein text right now.)

But these are aesthetic criticisms, and can easily be refuted. ("Why, I find suit-wearing nine-year-olds deliciously heartwarming!")

This installment address a broader fault of Orthodoxy, viz.: the inability to admit (or, better, face the fact) that great rabbis of the past were often wrong in many ways. I'll take two examples in summary form. (These are examples I've encountered recently in my own Torah study, which means they're more interesting for me to blog about than rehashed and well-known sources [e.g. misogynistic sayings from the Gemara]).

In the tractate Eruvin of the Babylonian Talmud, page 59a (ערובין נט. תוספות ד"ה ותחומין דרבנן, for those of you following along at home), the writers of the Tosefot talk about whether certain classes of people are believable as witnesses for certain classes of ritual law (eruvs, kosher slaughter, setting aside of the challah). Their argument concludes: "If searching for chametz were a Torah-level requirement, women would not be believable [as to their testimony that such a search had been properly completed], even if they're directly involved in the task, because searching for chametz requires punctiliousness and great care. Therefore [in this case] one should worry about women's laziness more than in another case. That too is the meaning of the Jerusalem Talmud, [where it is said that] women are not believable with regard to searching for chametz, because they are lazy and search only the most minimal amount."

Now, I can't say that I'm surprised at such a statement. Misogynistic statements in the Gemara are a dime-a-dozen (as are legal innovations for the benefit of women, albeit with lesser frequency). Nor is this Tosfos a vital pillar of Jewish thought or law (though women's "unfitness" as witnesses has been a long and, actually, quite sordid chapter of halachah). (It's a very interesting Tosfos, of course, as most of them are, but not for its misogyny. I think this Tosfos might hint that "bedikas khomets" is more akin to "Pesach cleaning" than a modern-day halachist would admit.) The reason I bring it up here is that I can guess exactly how an average Orthodox rabbi would respond to it: with apologetics. Perhaps "Oh, we don't pasken like Tosfos here" (I don't know if we do or not), or "This is a metaphysical truth about women's innate capacities" or even "Who are we to criticize Tosfos"?

Here's the most cogent and satisfying way to read the statement of Tosfos with regard to women's laziness: It's wrong. Case closed. This doesn't mean that I'm arrogant, or reject the authority of Torah, or think I know more than the Baalei Tosfos. It doesn't even mean that I eat pork chops with a side of cheescake on Yom Kippur. It just means that sometimes rabbis are wrong. We gay-loving, jeans-wearing, Debbie Friedman-singing Conservative Jews certainly have our faults (hint: only one of those three activities is a sin in my book, and it's not being gay), but we can respect rabbis while calling them on their mistakes and not get tied up in knots about it.

There's a second example I'll give. It's shorter. According to halachah (the Rambam, at any rate, and I believe the Shulchan Aruch and the Remo as well; consult your local rabbi if you're brave enough to talk to her about it!), you're not allowed to have sex during the daytime or by the light of a candle. Why's that? A longish discussion in tractate Niddah of the Babylonian Talmud, starting on 16b, comes down to this: there's an angel (or demon, pick your translation) who deals with conception, and she's only active at night. Now this Gemara is not wrong, exactly. It's a convincing and consistent implication of a magical state of affairs. Unfortunately, I don't believe in the Gemara's magic. What do I do about it? Again, I could wax apologetic (it's a metaphorical apperception of a metaphysical truth! it's a guard against overpromiscuousness in the married couple! it's a segule for exciting lovemaking!), or I could say: I understand (or at least I think I do), and I don't agree. Case closed.

Elie Wiesel's Night
was written in what language?

This article in the Times (which discusses discrepancies among various translations) doesn't name the language of the original until the seventeenth (!) paragraph. (No prizes for guessing which language.)

What did you eat that summer?

Diarrheal Illness Detected Through Syndromic Surveillance After a Massive Power Outage: New York City, August 2003.
Am J Public Health. 2005 Dec 27
Marx Ph D M P H MA, Rodriguez M P H CV, Greenko M P H J, Das M P H D, Heffernan M P H R, Karpati M D M P H AM, Mostashari M D M Sc F, Balter M D S, Layton M D M, Weiss M D M P H D

Objectives. We investigated increases in diarrheal illness detected through syndromic surveillance after a power outage in New York City on August 14, 2003.

Methods. The New York City Department of Health and Mental Hygiene uses emergency department, pharmacy, and absentee data to conduct syndromic surveillance for diarrhea. We conducted a case-control investigation among patients presenting during August 16 to 18, 2003, to emergency departments that participated in syndromic surveillance. We compared risk factors for diarrheal illness ascertained through structured telephone interviews for case patients presenting with diarrheal symptoms and control patients selected from a stratified random sample of nondiarrheal patients.

Results. Increases in diarrhea were detected in all data streams. Of 758 patients selected for the investigation, 301 (40%) received the full interview. Among patients 13 years and older, consumption of meat (odds ratio [OR]=2.7, 95% confidence interval [CI]=1.2, 6.1) and seafood (OR=4.8; 95% CI=1.6, 14) between the power outage and symptom onset was associated with diarrheal illness.

Conclusions. Diarrhea may have resulted from consumption of meat or seafood that spoiled after the power outage. Syndromic surveillance enabled prompt detection and systematic investigation of citywide illness that would otherwise have gone undetected.

Circumcision made normal
As discussed by polemicists.

In the new issue (January 19th) of the New England Journal of Medicine, David L. Gollaher of the California Healthcare Institute reviews two histories of circumcision: Leonard B. Glick's Marked In Your Flesh: Circumcision From Ancient Judea to Modern America, and Robert Darby's A Surgical Temptation: The Demonization of the Foreskin and the Rise of Circumcision in Britain. (Glick's book was reviewed some time ago in the Forward by Jay Michaelson.)

The NEJM review isn't available on-line yet, but here are some quotes:

Although circumcision has a long and interesting past, its historiography has suffered from a lack of objectivity. Most books and articles on the subject have an agenda, either to advocate the practice as an effective, preventive health measure or, more commonly, to attack it as genital mutilation that violates the rights of children. The books by Leonard Glick and Robert Darby are firmly in the anticircumcision camp. These authors aim to use historical analysis to strip circumcision of its medical and cultural legitimacy by exposing the myths, erroneous beliefs, and bad science that have been used to promote it.

Glick, an anthropologist with a medical degree, describes himself as "a scholarly activist" who belongs to "several organizations dedicated to ending all forms of genital injury to male and female children throughout the world." His tone is that of one who has seen the light, as he puts it, "that male infant circumcision is medically unnecessary, harmful to normal sexuality, and ethically unjustifiable." Marked in Your Flesh is less a historical narrative than a polemic. . . .

[. . .] Although [Glick] states that modern scholarship has overturned received wisdom about the authorship and provenance of the Torah, he treats the account in Genesis of Abraham as a historical record. This treatment is not trivial. Many Jews, Christians, and Muslims believe that God appeared to Abraham and told him to cut his foreskin, and that the failure of Abraham's descendants to do so thousands of years hence violates a sacred covenant. Such a belief is a matter of religious faith, however, not of documented history.

[. . .] On this topic [how circumcision came to be a widely accepted procedure in American hospitals], Glick presents few new sources or fresh insights. [. . .]

Perhaps one third of Marked in Your Flesh is devoted to reviewing the medical debate about neonatal circumcision. Professional journals have published thousands of papers about whether circumcision leads to a lower incidence of urinary tract infection, cancer, and sexually transmitted diseases. A balanced reading of the record suggests that circumcision carries both benefit and harm. It prevents rare penile cancer, but occasionally it seriously injures a baby. The American Academy of Pediatrics Task Force on Circumcision reviewed the medical literature and reported in 1999 that "existing scientific evidence demonstrates potential medical benefits of newborn male circumcision; however, these data are not sufficient to recommend routine neonatal circumcision.

The task force saw the ambiguity in the data on the health benefits of circumcision. This ambiguity only increases when one learns, for example, that in July 2005 French and South African AIDS researchers halted a large, randomized, controlled trial of adult male circumcision to reduce the incidence of AIDS after early results showed that men who had undergone the procedure had a dramatically reduced risk of contracting HIV through intercourse with infected women. Much more research is necessary, which may not bear out this result. But while reading Glick's book, one senses that the idea of benefiting from circumcision is inconceivable to him. This unwillingness to suspend the belief that circumcision is an unalloyed evil weakens Marked in Your Flesh and limits its explanatory power.

Keeping it real
(not by Mark Strand)

In a field
I'm not one of
the cows.
This is
always the case.
For all x not equal to me
I am not x.

When I walk
I don't stay still
and always
the air moves in
since gas is infinitely
compressible.

We all have reasons
for moving.
I've been
kicked out by my girlfriend.

A crown of thorns at Thorn Farm

If you're curious as to the meaning of אטד in this week's parshe (its only appearance in the Chumash) you might do worse than look at this Wikipedia article (in Hebrew, I'm afraid). Remember though that the Ivrit meaning of the word is not the same as its Biblical meaning. Don't forget the midrash which explains the curious name of the place at which Jacob was mourned (Thorn Farm, or גורן אטד) by saying that the descendants of Esau, Ishmael, and Keturah festooned his casket with crowns as a farm is ringed with thorns.

Join the club

Will someone please help this man before his second thoughts about utensil-submersion become dangerous?

Permissible criticism, or O-bashing part II
Second in an intermittent series of friendly, well-meant criticism.

What do we talk about when we talk about what's wrong with Orthodoxy? A commenter on my previous post suggested that what I'm trying to do here is a "tit-for-tat" in response to Avi Shafran's Moment article "The Conservative Lie." I hope not. Shafran's argument can be summarized as follows: Conservative Judaism claims that it adheres to halachah. However, Conservative Jews and their leaders are predictably lenient, lax in observance; and cavalier about the importance of halachah to their movement. These facts show, says Shafran, that Conservative Judaism is a failure.

I doubt Shafran's interpretation of the evidence. But even taking these claims at face value, Shafran is only applying Orthodox criteria to the Conservative movement, finding the two don't match, and exclaiming, "See! Conservative Judaism is a failure!" It is a failure in Orthodox terms, but these terms are not the only valid ones. Conservative Judaism's approach to halachah is multi-faceted, and Conservative Torah scholars do not speak with one voice -- that very fact makes it very difficult to say how halachah plays a role in Conservative Judaism. (The same could be said about Orthodox or Reform Judaism, as far as that goes.) That Conservative Jews are lax in their observance, or even that they do not recognize the importance of halachah, is a problem to be solved, not an indictment of Conservative Judaism. Laxness of observance and halachic ignorance have afflicted Judaism forever. They might even be the status quo.

Shafran understands halachah according to its ultra-Orthodox interpretation: strict constructionism. But Conservative Judaism can be (and, I think, tries to be) both halachic and lenient. This dichotomy is unfathomable to Shafran, but does not make it any the less true.

The reason I'm rehashing Shafran's old essay is to try and make a stab at what I have to do to criticize Orthodoxy in useful ways. A commenter on my last post suggested that I should not judge Orthodoxy by Conservative standards. Certainly not. But, on the other hand, I can't judge Orthodoxy by Orthodox standards, for two obvious reasons: first, I'm not Orthodox; and second, because Orthodoxy might be too various to define usefully. A possible way out is sociological. Clearly, Orthodoxy plays a necessary role in Jewish society. (Not the only necessary role, or the most authentic role, but a necessary role. I make this claim because it's defensible.) If we can figure out what makes Orthodoxy necessary, and (further) point out where Orthodoxy is departing from this necessary role, this might be a useful beginning for outside criticism of Orthodoxy. In short: not to criticize Orthodoxy for what can't be by its very nature, but for what it should be and is departing from.

Maybe I've set myself too hard a task, because there's not just one necessary function which Orthodoxy performs. Let's try anyway. One definite function of Orthodoxy is to present itself as a uniquely authentic, traditional Jewish religious culture. I'm using the term "present itself" not to be snide, but to recognize that Orthodoxy is mythic (in the positive sense of myth popularized among Conservative Jews by Neil Gillman), fervently believing in its own authenticity. Whether or not that authenticity is unique is not germane to our present discussion. What matters is that Orthodoxy itself is unique by its belief in that authenticity. It's a self-creation through mythogenesis.

Call this the Myth of Religious-Cultural Authenticity. The hyphenate is important, because it's the subject of my first criticism -- which, like much else I'm saying here, is not original. Today's Orthodox Judaism is in danger of ignoring the "cultural" half of its motivating authenticity myth, and focusing exclusively on the "halachic." Not that Orthodoxy should (God forbid) change its fervent adherence to its own halachic standards (though what those standards are, how they're articulated, and how they're actually observed, is a fascinating, fraught, and ultimately very confusing terrain). But halachah to the exclusion of culture can drain Orthodoxy of what makes it convincing and meaningful not just to its followers but to its non-Orthodox observers: a central myth of traditional living as carried through the generations. (Alan Brill wrote about this in scholarly fashion in an article in Edah, which I discussed here. Also here, here, and here.)

I'd like to suggest that the sector of Orthodoxy which is managing to preserve both ends of the authenticity myth is the Charedi (and in particular the Chasidic) sector, and that modern Orthodoxy, though it is well-nigh tangent at times to my own Conservative Judaism, is most susceptible to this over-halachization I'm criticizing here.

Obviously, this is all a footnote to Rupture and Reconstruction.

Ebony and Ivory

Why can New York, the center of some universes, produce nothing better than the mealy, tasteless black-and-white cookie, a baked good I keep trying in vain hopes of being proven wrong, while it is Baltimore (a city I have nothing against, and in whose direction epidemiologists pray three times daily) which has given rise to the Queen of Cookies, the Chocolate-Topped? What say you, O Chocolate Lady?

Metzitzah b'peh and neonatal herpes II

Steven I. Weiss (aka Canonist) is on the case. Here's a comparison he makes:

On this issue, if we take the number of metzitzah b'feh procedures per year of 2,500, and assume one infection for those infants per year (which for whatever reason seems to be a number that everyone feels comfortable tossing around), we can compare that 1/2,500 ratio to that of the population generally. Of the roughly 120,000 New York City births per year, the Department of Health says there are roughly 30 infections, or 1/4000. So if all those numbers prove out — which for infections generally, infections in metzitzah b'feh cases, and number of procedures per year have a lot of valence — there's a difference in likelihood that could be somewhere between 33% and 50%.

This is a pretty good first try at a non-technical comparison of the incidence of neonatal herpes in the MBP population and New York as a whole (disregaring Canonist's terminology, which isn't what I'd use). But for an accurate, epidemiologically valid comparison, beyond nailing down the numbers as specifically as possible (Agudath Israel has an interest in exaggerating the frequency of metzitzah, for example), one would have to find a control group which is as comparable as possible to the MBP population. Ideally, that would be an ultra-Orthodox group which doesn't perform MBP. I haven't looked for differential neonatal herpes rates by religion or ethnicity, but I doubt those are followed up on by the Department of Health. A more likely tack is to find a zip code heavily populated by non-MBP Charedim and find the incidence of neonatal herpes within that area.

Taking Weiss's comparison as the best we've got, there's one thing that must be said upfront: Neonatal herpes is underreported. The question is whether the underreporting is differential, i.e., whether MBP parents (or their pediatricians) underreport neonatal herpes more than, less than, or with the same frequency as non-MBP parents (i.e. parents city-wide excluding those performing MBP). I have no idea what the answer is, but engaging in complete speculation, I would imagine that (a) the MBP population, like most Charedim, are "plugged in" to perinatal care to an extent greater than their socioeconomic status would predict, and thus (b) they would tend to report cases of neonatal herpes greater than other parents in the city, by and large, so that (c) underreporting would be greater among New York parents as a whole in comparison to MBP parents. This would overestimate any reported difference in incidence between MBP and non-MBP births.

I think there would be some interesting research here. More important than that, though, is what the DOH is doing to encourage reporting of neonatal herpes and the minimization of MBP.

Silence

Haven’t been through cataclysm, haven’t lived to see redemption,
Haven’t carved through simple moments to the bottom of their motion.
I don’t know how I’ve gotten through the day-to-day,
Not that this should hint at any courage or ennui.

No leaf bears a script. No earth-turn vibrates song.
No locust shaves a symphony from roadside corn.
Life is all that unifies, cell-in-body pulse.
There's no perfect zero. Should I add a shaky plus?

I ask the stones and pavement, stifling air, electron-work,
Tonguing waves and frozen moon, desert-wet and winter-choke:
I ask for one full full-stop, one moment ringing silence.
They call each to another and their speech is fluent muteness.

The resident at rest?
Saving lives: the Sabbath as a normal workday.

MEDICINE MENSCH: Good Shabbos, I'm Off to Work
By Zackary Sholem Berger

People outside the medical field don't understand the process by which beginning doctors are trained. Were I to start this column right off and say, "I'm interviewing for residencies now" (which happens to be true), many reading this would scratch their heads, wondering when, if ever, I'll finally finish my schooling. Let me explain.

Medical school is only the first step. A medical school graduate (which I will be this May, God and registrar willing) will get an M.D., but at that point the degree is only good for hanging on a wall, getting a nonclinical job or applying for further training. Any physician who wants to practice with a state license needs to undergo such training — in other words, a residency.

Residents are apprentices in the guild system that medicine still preserves: uniforms, vocabulary and work hours all set the doctor apart. To what extent these vestiges can be shed, without disrupting the core of the physician's identity, is a discussion that has lasted the past few decades. Uniforms (the white coats) haven't been abandoned, and medicalese is a thriving dialect. But my work hours as a resident will not be the same as the chain-gang days of old, when young doctors would stagger to and from the hospital — uphill both ways — at either end of a 36-hour shift. New York's "405 regulations," passed in the 1980s, placed restrictions on residents' total work hours and required minimum rest periods. These guidelines have now been adopted nationally, so that hospitals must now keep closer tabs on how long their residents work.

Work hours of a different sort will play a role in my decision of where to spend residency. (I'm in the middle of applying to residency programs in the subspecialty known as primary care, but I haven't yet come close to deciding where I want to be. What follows are just general principles, not pros or cons of any specific program.) The issue is this: Should I work on the Sabbath?

Most people's first response is: "But I thought doctors could work on the Sabbath." Without getting pedantic about the halachic or exegetical details of the principle, it's true that "saving a life sets aside the Sabbath," as does (broadly speaking) the treatment of a dangerously ill patient. But does doctors' work always entail saving lives? And are there Jewish reasons outside of Jewish law that might make it preferable for Jewish doctors to work on the Sabbath?

A resident doctor working in the hospital on the Sabbath does not spend all 25 hours, from Friday night to Saturday night, nimbly plucking the gravely ill from the mouth of death. Some of the time is spent dealing with busywork ("Sign this!" "Send that!" "Answer that intrusive page!"), while much of the rest is spent talking to patients, other caregivers and family members about matters that, while necessary, do not mean the difference between life and death. Not everything that a doctor does during a shift is lifesaving. This is a message reinforced by the changing work hours of medicine: If doctoring is a job like any other — with shifts, overtime and holiday bonuses — why shouldn't doctors get a regular weekend, or at least one day out of seven predictably free? In other words, the Jewish legal realities of the practice of medicine (the Sabbath "work" of the doctor is more often than not something less than lifesaving), coupled with the economic and family desiderata of the young doctor (it's nice to have some regular time off), has encouraged the development of the Sabbath-observant residency program in which residents work the same number of hours as their peers, but switch off their Friday-Saturday calls to others.

This development might be taken as a sign of the salutary tolerance that American institutions demonstrate for traditional Jewish observance, something that wasn't true in our grandparents' or even our parents' generation. I don't exactly disagree with this assessment; I find these programs to be quite attractive, and I'm applying to several of them.

But there's a downside here: Gaining your soul — not having to work on the Sabbath — might mean losing the world. Part of being a doctor is the relative cushiness of the profession itself, with its good salary and societal esteem. But part of being a Jewish doctor is something different: striking a balance between God's law and human law; between death, which might strike at any time, and the call to a life of rest and contemplation, which must be obeyed one day in every seven, lest it be snowed under by the detritus of the everyday. It's like being a religious Jew: Part of keeping the commandments is knowing when not to keep them, seeing where the boundaries are and when they might (or must not) be overstepped. How can you know what it means not to eat nonkosher food if you've never seen it on a menu? Spiritual concentration requires the rigorous exercise of contact with the nonspiritual; isolation can encourage a religiosity that does not allow itself contact with the outside world.

In short, being a Sabbath-observant resident might be the best of both worlds. But I'm not sure if a Jew is supposed to allow himself that.

Chicken soup and gefilte fish, preferably in vacuum-packed containers suitable for opening in trayf, unsanitary call rooms, may be sent, general delivery, to doctor@forward.com.

George in the News

The Jewish Telegraphic Agency published a breaking news item about George der Naygeriker.

Oy, baby.
Two sweet.

This post will be of interest to people who have a DVD player and use it to brainwash their child with multicolored Jewish images.

OyBaby was a fun, fluffy, undemanding DVD. It was catchy from start to finish. OyBaby 2 manages to be both frumer (more gratuitous/unconvincing/sentimental references to the tradition) and more goyish (less Hebrew, more bad English translations).

This does not mean, of course, that my daughter is not fixed to the spot whenever I put the disc in the player. I enable her addiction. And anything that pleases my daughter short of firecrackers, a chainsaw, or a pork chop is still a wonderful gift. Thanks to the aunt who gave it.

Interesting epi abstract of the week
Courtesy of your friends at the American Journal of Epidemiology.

[No comment from me, since I know nothing about this area of research. But I couldn't resist posting this.]

Association of Body Mass Index with Suicide Mortality: A Prospective Cohort Study of More than One Million Men

Patrik K. E. Magnusson 1, Finn Rasmussen 2,3, Debbie A. Lawlor 4, Per Tynelius 2,3 and David Gunnell 4

1 Department of Genetics and Pathology, Uppsala University, Uppsala, Sweden
2 Child and Adolescent Public Health Epidemiology Group, Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden
3 Division of Epidemiology, Stockholm Centre of Public Health, Stockholm, Sweden
4 Department of Social Medicine, University of Bristol, Bristol, United Kingdom

The authors investigated the association of body mass index (BMI) with suicide in a record linkage study based on the Swedish Military Service Conscription Register, the Population and Housing Censuses, and the Cause of Death Register. The cohort studied consisted of 1,299,177 Swedish men who were conscripted in 1968–1999, had their BMI measured at age 18–19 years, and were followed up for as long as 31 years. A strong inverse association was found between BMI and suicide. For each 5-kg/m2 increase in BMI, the risk of suicide decreased by 15% (95% confidence interval: 9, 21). The association was similar when subjects with mental disorder at baseline were excluded from the analysis. BMI-suicide associations were similar in relation to suicide deaths occurring in the first 5 years of follow-up (hazard ratio for each 5-kg/m2 increase in BMI = 0.84, 95% confidence interval: 0.73, 0.96) compared with associations 10 years after baseline (hazard ratio = 0.87, 95% confidence interval: 0.79, 0.96), indicating that weight loss as a consequence of mental illness does not explain the BMI-suicide association and that factors influencing BMI may be causally implicated in the etiology of mental disorders leading to suicide.

Some healthy O-bashing, part I
Or: Friends don't let friends wreck their train.

There's a certain sort of sermon that's regularly given these days in Conservative synagogues, judging from my experience and that of a highly non-random sample of friends and acquaintances. The rabbi explains that despite the grave errors and benighted ways of Orthodoxy, he would never think of engaging in "Orthodox bashing."

Now, there's certainly a sort of Orthodox bashing which I don't want to engage in. I love Orthodoxy. Some of my best friends, etcetera. I think it's one of many authentic sorts of Judaism. (Not every sort of Judaism is authentic -- yes, I know the very word "authentic" is problematic, but I'm not going to go into that yet.) I don't want to be nasty about Orthodoxy and I certainly don't want to accuse its practitioners of anything but the healthiest and most Jewish of motives.

But I do think that bashing, done in a good-humored, respectful, and well-foundedly productive way, can be useful both to the bashee and the basher. For the sake of accuracy, perhaps, I should use another word rather than "bash," but then I wouldn't get as many people's attention. And people who have been reading this blog for a while know that bashing is not what gets done here. I could call it instead "criticism," but that's a boring word. What's a blog for if not for the judicious use of inflammatory prose?

So I think it's high time for some well-meant, well-reasoned, not unlearned Orthodox bashing. What I'm going to try to do here, over the next few days, should put you in mind of a response in Moment magazine a few years ago to the now-infamous Conservative Judaism is Wrong article by (I think it was) Avi Shafran. A Conservative rabbi wrote that Shafran's criticism was dead on, and should be accepted by the Conservative movement (at least partially) -- but, at the same time, Orthodox institutions should receive their share of healthy criticism.

I feel compelled to engage in this sort of criticism because I see Orthodoxy tearing itself apart. Its train is about to come off the tracks and explode in a fireball -- at least, ideologically speaking. And if this won't happen, something even worse could still come to pass: namely, that Orthodoxy could enjoy further sociological success (more yeshivot, more kollel students, more blat gemore learned every day, more Orthodox Jews) while continuing to be wrong in crucial, foundational ways.

Proof to come.

Update: I'm grateful to the link from On the Main Line. If I don't have a new bashpost up before Shabbos, please forgive me. I do mean to continue very soon. One response to the comments: if you refrain from criticizing group X on the basis of its defining characteristics, you make any interesting or far-reaching criticism pretty much impossible, no? That is, I don't think it makes much sense to say, "Fine, criticize Orthodoxy as much as you like. Just don't criticize those things about Orthodoxy which make it Orthodox." I take it that one of the points of criticism is to articulate a vision of group X which is at variance with group X's view of itself. No?

Hanukkah Dinner Theater

We just got back, quite late, from a trip to Arkansas (on which more later). I lit Hanukkah candles, which I set up in such a way so that they're facing our outside window and perpendicular to the air conditioner. (They're Sabbath-type mini-candles, with a metal disc at the bottom of the wax.) Though the AC isn't on, the slight breeze blowing through its apertures has been blowing the wax away, very slowly, from the burning wicks, so that the lights stand in the center of a waxen runway, like spotlights in the snow, or a marquee for the premiere of "This Is Hanukkah."