Three and a Half Jewish Philosophers

ZSB: Is there a risk of the religious life?

Hilary Putnam: There’s always the risk of fanaticism. I spend part of every year in Israel at Tel Aviv University. There, the conflicts of certainties are appalling; that’s beginning to be the case in the U.S.

More in the Forward, where I interview Putnam about his new book, Jewish Philosophy as a Guide to Life.

America's Next Top Health Policy Problem

James Knickman, the unassuming and friendly health-policy analyst and CEO of the New York State Health Foundation, talked to our class of third-year primary care residents on Tuesday as part of our health policy course. Here is his list of the Top Ten Health Policy Crises.*

Solutions received by Monday at 7pm will get a free piece of apple-and-honey.

1.The lack of affordable and accessible health care for all Americans.

2. The need to develop methods to decide when to pay for emerging modalities and pharmaceuticals.

3. The need to move resources into prevention and public health.

4. The need to move resources into primary care.

5. How do we care for an aging population?

6. How do we expand physicians' use of evidence-based treatment approaches?

7. Great disparities across ethnic and income groups.

8. Malpractice!

9. Dental care.

10. The lack of health-care professionals.

*Okay, he didn't say "crises," he said "topics." But "crises" is more fun.

"Diagnosis of exclusion"

A zillion years of medical and graduate school, and nearly three years of residency, and I still don't understand what it means when people say that such-and-such is a diagnosis of exclusion. Any diagnosis is a diagnosis of exclusion!

Often, I think, people use that phrase as a retelling of the widespread myth that psychopathologies can't be diagnosed through testing. ("Anxiety is a diagnosis of exclusion.") Or a claim that only laboratory tests or imaging matter, not the history or physical. ("Hepatorenal syndrome is a diagnosis of exclusion.")

The next time someone calls a diagnosis a D of E, by gum, I'm going to ask them just what they mean.

Jewels of Elul CXVIII: A Month of Dreamers that Feels like a Year

with apologies to Craig 'N Co.

Since I have a lot of money, people are always sending me their crazy ideas. And I have to take them home on the train. I fall asleep and dream . . . dream of long vacations, plush terry-cloth robes, little bars of soap you always steal and then feel obscurely guilty about (unless you steal from the minibar, in which case you dream about credit-card bills in the mail and some meaty guy stomping through your front door with a large stick). When I wake up from my dream, I'm at the last station stop and the janitor has to sweep me out of the car with his broom. I wander outside and can't find the bus stop. Scared, I take a taxi.

That's my dream. To some people, it's trivial, stupid, a little cheap. But then I give them some money, and the word "cheap" is never mentioned again. The word "dream" is thrown around a lot, mostly by me. The prophets of Israel, I read, used to dream. Their dreams are full of sprouting sticks, rattling bones with ill-fitting skin heaving themselves reluctantly to their resurrected feet, women eating their newborns. Not Elul stuff at all.

When I think how far I have come, and how much money I have, I thank whatever gods may be for my dreams. I might write them down in a book someday. Dreams do come true!

Well that's all right then

Worried whether your favorite presidential candidate will defeat the other party's lying traitorous scum and save our nation this November? If you care about health policy, don't worry about it. Neither man's plan has a pig's chance at a barbecue of getting anywhere near passage.

Welcome to the hekhsher tzedek community, Orthodox Union!

Or: happy Elul!

So when will the OU withdraw certification entirely from Rubashkin's? When the case goes to court? When a conviction is handed down? When the sentence is served? How many "weeks" will this take? 1? 2? 6? 12? 52?

And why does there need to be a change in management? After all, these are just goyish legal structures we're talking about (ערכאות של גוים). "The law of the land is the law" is just Conservative liberal halachah, right?

Maybe there needs to be another trip to Iowa, company-paid. Make sure one of the rabbis involved "knows some Spanish." Look, the cafeteria is awful clean!

The Art of the Improbable

Today I voted for Paul Newell and Daniel Squadron. Nothing like casting your lot with the losing team! (And speaking of losing...)

* * *

You know what's useful? Reading political news.

Fresh fish for sale!

From there to here
From here to there
New Yiddish fish are everywhere!

Now available:
Eyn Fish Tsvey Fish Royter Fish Bloyer Fish
One Fish Two Fish Red Fish Blue Fish by Dr. Seuss
Yiddish translation by Sholem Berger
978-0-9726939-3-6
$15 + shipping (and tax in NY State)
yiddishcat.com

Don't forget:
Di Kats der Payats, The Cat in the Hat by Dr. Seuss, in Yiddish--$15
George der Naygeriker, Curious George by H. A. Rey, in Yiddish--$18
Colorful alef-beys poster by Stephen Cohen--$12

The futile slow code

I was involved in a slow code recently. (I won't say where, or when, or with whom.) They are slippery and repugnant. Rarely can any of the parties involved say with satisfaction or complete clarity when, or by whom, the slow code was suggested or agreed to. It is a substitute for an honest discussion of options with the patient and family, and it is a legal minefield.

Remind me not to get involved in them again ... when I have a choice in the matter.