When I wrote my previous post, I was not aware of the meta-analysis from 2009 by Myung et al. in the Journal of Clinical Oncology. (A meta-analysis uses statistical techniques to classify and then pool results from a number of studies.) The work by Myung et al. needs some detailed discussion, but it presents some findings which bear consideration: first, that in the subgroup of studies they considered which were of higher quality, there is a positive association between any cell-phone use (compared to rare or never use) and brain tumors both benign and malignant. Second, there is a significant association, in all studies which consider cell-phone use of 10 years or longer, between that length of use and brain tumors.
There are some caveats here. First, the "high-quality studies" are all chips off one larger study, i.e. done by the same group of researchers - and the lower-quality studies are all from another larger study. This means that there haven't been too many separate groups studying this topic recently in a scientifically legitimate way. Second, all the studies considered in this meta-analysis (23 of them) are case-control studies, which for various reasons are often considered more susceptible to bias than cohort studies, in which groups of subjects are followed for the development of brain tumors. Thus the biases I talked about in my previous post still apply.
Since the associations are small, susceptible to bias, and only in a subgroup of available studies, I would say the jury is still out.
Even when the jury comes back from sequestration (cell phones turned off, I guess), my general impression from my previous post holds true. I would not make any individual change in lifestyle, much less any public policy decisions, based on these weak-if-true associations, just because there are so many things in this world (even confining ourselves to our individual and public health) which are more important to worry about.
"Are we going out this evening?" he asked.
"Yes," said the Fireman, lighting the fire and making a lot of steam.
Goldberg looked cross. "It is my Sabbath," he said, "my day of rest. I do not want to go out on the Sabbath."
Goldberg's friend Patel the Locomotive chimed in. "Please do not make Goldberg go out on Saturday," he said.
The Driver pulled the lever, and Goldberg began to pull away. "Oh no!" he cried. "We are going out. I will have to travel beyond the inhabited boundaries of Sodor."
Patel shouted, "Help! Somebody help Goldberg!"
Another friend of Goldberg's, Peng the "Old Warrior," shunted a car onto the track that Goldberg was traveling on. There was a tremendous noise.
The Fireman shook his finger at Goldberg. "I am very cross that you are not going out today," he said. The Driver agreed.
"I am sorry," said Goldberg.
Garbage, A.R. Ammons
Letter from Iceland, W.H.Auden & Christopher Isherwood
A Poetics, Charles Bernstein
Der Geyer, M. Boraisho
The Ring and the Book, Robert Browning
Don Juan, Lord Byron
Watercolor Women/Opaque Men, Ana Castillo
Points for a Compass Rose, Evan S. Connell
The Bridge, Hart Crane
South America Mi Hija, Sharon Doubiago
The Song of Hiawatha
The Odyssey, Homer
Anathemata, David Jones
Dizner Tshayld Harold, Moyshe Kulbak
Fungi from Yuggoth, H.P.Lovecraft
Idylls, Jonas Mekas
Pale Fire, Vladimir Nabokov
Collected Works of Billy the Kid, Michael Ondaatje
The Same Sea, Amos Oz
Eugene Onegin, Alexander Pushkin
Testimony, and Holocaust, Charles Reznikoff
Golden Gate, Vikram Seth
Paterson, William Carlos Williams
Deepstep Come Shining, C.D. Wright
A, Louis Zukofsky
Many readers will be put off by the lines about mum and dad "fuck[ing] you up." Should they be, or not? What are the lines there for?
Whence the coastal shelf?
The last lines are more revealing than others in the poem. Tell us why you would rather not procreate.
To be charitable, the article did make me go and look up the literature, so that's not a bad thing. In short, however, the Times treatment is irresponsible and fear-mongering.
First, let me remark that the Times article mentions by name a refereed study of cellphones in humans only in the 14th paragraph. And it neglects to mention the multiple studies which have shown no connection.
Now, let's consider the INTERPHONE study referred to in the Times piece (it's one of these with the fake acronyms). It showed no connection between cell phone use and cancers, when all brain cancers are taken together. Now, it's reasonable for them to analyze different cancers separately, since they are of different severity and prevalence. It's not questionable in itself that they looked at an effect on gliomas. However, this effect was not significant. Only when they looked at cell phone use for 10 years or longer did they find an association with gliomas.
Several caveats - screaming sumo-size caveats - were not mentioned in the Times piece. (A science reporter presumably would have read the article.)
1. As far as I can figure out from reading the article, it's a secondary analysis. There was no a priori hypothesis that cell phone use for 10 years would be associated with glioma. Post hoc analyses are suspect - as you know - since data mining is biased. How many associations were fished through and discarded before this positive one was found? There is always a probability of a false positive, so if there were twenty post-hoc associations (properly consigned to an on-line appendix, pace the Times's conspiratorial mutterings), the chance of one positive finding is 5% - just by probability.
2. The association itself is not statistically significant! This is mentioned nowhere in the Times article, but the authors of the study themselves make haste to note this up front, in the abstract - which makes them responsible. I would not call this a hook to hang anyone's hat on.
3. The INTERPHONE study is a case-control study. A big question in any study of this kind is how we are to judge the accuracy of the cases' self reporting. People with cancer are understandably eager to find a cause, and might recall cell phone use out of proportion to the controls. Such recall bias is hard to control for.
4. Even if recall bias is controlled for, the correlation between recollected number of cell phone calls and the actual number of cell calls is not perfect. Heavier cell phone users tend to overestimate the number of calls they have made. In addition, the correlation between subject recall and their actual exposure to electromagnetic frequency is not airtight either.
5. Let's say the effect is real (which I very much doubt by reason of the sumo caveats just mentioned). (This would contradict another case-control study done on the very relationship between gliomas and cell phone use, in 2005, which was negative.) How high should this putative danger even rank on our public-health agenda? Gliomas are rare.
To quote a 2004 study in the journal Cancer (first thing I could Google): "The incidence rate of central nervous system (CNS) tumors in 2000 was 6.7 per 100,000 persons as reported from the Surveillance, Epidemiology, and End Results (SEER) registry and gliomas account for approximately 51% of all CNS tumors.". Let's say then 3.5 per 100,000 people. or 10,000 cases a year, more or less. Horrible cases to be sure. If cell phone use increased this number to 20,000 cases a year that would be a tragedy, but a tragedy comparable to the million deaths caused yearly by malaria?
6. In toto: bullshit.
Update: but see some second thoughts here.
We'll start with the first. This includes everyone who writes in Yiddish who is not Chasidic. For lack of a better word, we'll call them secular Yiddish writers, though their ideological, religious, and cultural sympathies run the gamut from the settler poetry of Velvl Chernin to the loud radicalism of songwriter Daniel Kahn. They are the heirs to the literary tradition of Eastern Europe and America, what was Yiddish literature with a capital L: a social phenomenon complete with newspapers, journals, books, printers, publics, writers, controversies, scandals, sex, and violence.
For secular Yiddish writers, nearly all of that has fallen away. Traditional venues, things still published on paper, can be counted on the fingers of one hand. There's the newspaper: the Yiddish Forward. There are the two or three literary journals. There is about a book, maybe two or three books at most, published a year. There is the Internet, certainly providing community - or the illusion of community - and a way for writers and readers to interact. But this cannot substitute for a community of people who spend their lives and make their living writing and reading. At this point, the number of people who make their living writing Yiddish in the secular community is about a minyan: the number of people on staff at the Yiddish Forward.
This does not mean that individual writers are not still producing individual works worth reading, or that the few literary institutions that still exist in the Yiddish secular world are not valuable. The Yiddish Forward, polished to a high literary sheen by Boris Sandler, has few parallels among Jewish publications anywhere - except perhaps the cultural pages of Israel's Haaretz in Hebrew. I suspect that some readers find it difficult to understand its mix of politics, culture, and academic analysis, but won't admit it. Gilgulim, a literary journal in Paris, is lovely (and I hope will come out for many more issues). Afn Shvel, the journal of the League for Yiddish, has been transformed into a modern publication, beautifully laid out and with a variegated content. It looks like the 21st century's last gesture towards the relevance of print in Yiddish.
There are a number of writers still working in Yiddish, though it's hard to know exactly how many - probably a hundred or so. Which to mention is an interesting question. In a healthy, king-size literature, like English, critics try to predict things: which writers will turn the great ship of written language in some unlooked for direction? out of all the abundance, what is worth reading? The first question is irrelevant to contemporary secular Yiddish literature, since the greatest ship of all is the daily language use of the ultra-Orthodox. We are gnats on it. The second question is irrelevant for other reasons. If you wanted to, you could easily afford to buy every single new book published this year by secular Yiddish writers. But let me name-check some loves of mine: anything published in Gilgulim; the strict, erudite, and tightly edited reviews of Mikhail Krutikov in the Forverts; the prolific post-Holocaust yearning of Alexander Shpigelblat; the monumentum aere perennius of Avrom Sutzkever, may his poetry be for a blessing.
The editors asked me to address some particular questions of contemporary secular Yiddish literature. They want to know what the challenges are. The challenges of writing in Yiddish! I don't know if writing in a language without readers is harder than writing in a language almost without fellow writers. But then they gave me an excuse to answer another question: is there communication between Chasidim and secular writers?
Chasidim: our brothers and sisters who create a literature merely by virtue of speaking a language daily and expressing themselves in writing. An enviable writing, as natural as breathing. But most would never call what they write literature, since they don't believe in aesthetics and know that secular literature is viewed by most in their community with suspicion.
So much of what is worth reading in Chasidic literature is written by anonymous hundreds who post at great length on a number of message boards. They write in a variety of genres and though I don't think much of what's written there is worth reading, it has the virtue of life, slippery and unmediated. There are a very few writers who write literature with a capital L - the blogger Katle Kanye is the most widely known of them, though there are others (such as Pinchas Glauber) who are on a similar level.
Do the secular and the ultra-Orthodox have something to say to each other? I read them, but they (with some exceptions) don't read me, and have never heard of me. There is no incentive for a Chasidic writer to read a secular writer, unless they want to benefit from a secular esthetic and the variety of topics available to it. That would be strange indeed - but stranger things have happened to Jews and Yiddish. Why shouldn't some of the strange things be blessings?
If I could imagine a work of literature in Yiddish, what would it be? An epic poem about today's Chasidim, written in Chasidic Yiddish, perhaps. Or a sprawling novel of contemporary Jewish life (about either sector, ultra-Orthodox or secular) written by an observer "on the other side." More than likely, though, the coming Yiddish classic will be written in a genre not even on my radar, outside my dyadic model of contemporary Yiddish culture. I look forward to it.
Here's where the definitions of art and science matter, though. The margin here is too narrow to contain a detailed discussion of where these two bugbears embrace and where they face off, fangs bared.
Read more: http://blogs.forward.com/the-arty-semite/132823/#ixzz14JZhcs6W
But not so fast, Utility Man! It's all about how the utilities are calculated. What happens when the shelter gets bigger and better? Now it's a school, with
[...]classes from kindergarten through sixth grade, as well as a library, a cafeteria and an outdoor auditorium. The plan is to expand it one year at a time until it is a high school as well.
I plan to post the English article at some point.
Twenty years ago there were four American universities with Yiddish programs: the Jewish Theological Seminary, Harvard, Columbia, and UCLA. Now there are more than a dozen. From Michigan to Maryland, from Chicago to Santa Cruz, students are learning about Yiddish literature and culture. Interest in Yiddish is growing even as its speakers (outside Charedi enclaves) continue to decline in numbers. But interest in the topic of Yiddish does not translate into a stable foundation for teaching the language, which makes some scholars nervous about the future of Yiddish scholarship.
Then the decision comes. When there is no bright flash before the burst bulb, when there is no flat tire to the thinking machine, when do we throw it away?
This is not stupid.
But whenever Berger writes about Yiddish as a language - well, see my "friend's" twitter feed @yiddishseuss. Yiddish isn't spoken by anyone anymore, except for the Holocaust survivors. Oh, and the Chasidim, among whom it is "booming" and a "lingua franca," whatever those are supposed to mean. And Yiddish has a "lilt" and a "kvetch." If anyone wrote about another language the way J. Berger does (say, about African American English or Spanish) he/she would be rightfully run out of town on a herring-draped rail.
And the whole *tone* of the piece, such cluck-cluck-cluck and automatic nostalgizing, got on my nerves. Yes it is sad, but the bookstore is failing because organizational and economic support is lacking, not because J. Berger's parents failed to speak Yiddish with him. English bookstores are failing all over this great land of ours too.
Cluck-cluck-clucking won't help much. Finding a warehouse, setting up a real Web site, and donating some dough will. Can I do these things? Prolly not.
Here and the there are together-together
and to swim reaching depths the ray bends itself downward.
Scythe is connected to stalk. This is how,
like violin player is one with the sound.
That's how the was is enbrothered with still,
that's how a woman and man are enlimbed.
--from Yiddish: Z.Sh.B.
If you can't make it to our program WWGD? [What Would Glatshteyn Do?] An Evening of Yiddish Poetry you can watch it online at the exact time of the event, Sunday, August 1 6:00 PM - 7:45 PM (EST). Go to bowerypoetrylive.com.Zackary Sholem Berger, Gitl Schaechter-Viswanath, Josh Waletzky
POETS AND SONGWRITERS:
David Botwinik, Leyzer Burko, David Fallick, Samuel Marder, Charles Nydorf, Mindy Rinkewich, Elinor Robinson, Yefim Vinnitsky, Gershon Weiss, Jennifer Goodman Wolloch
Albert Rosenblatt, Yaira Singer, Wojtek Tworek, Sheva Zucker
Don't miss the Yiddish poetry event of the millenium!
I keep comparing Balto. and NY. with regard to poverty and racial segregation. Can you point me to a good academic treatment of this topic? E.g.: Manhattan is segregated by income, obviously, but is it segregated by race when income is controlled for? And what is more influential in explaining Baltimore's neighborhood patterns, income or race?I found her answer interesting.
It sounds like you're more interested in empirical evidence than theory (?), but I know more about the theory (and I think the theory is actually more interesting) so I'll start there. The classic debate about urban poverty, race, and segregation is represented by William Julius Wilson on one side, and Douglas Massey on the other. As I understand it, Wilson argues that segregation is at root a structural economic issue, not just a racial issue; Massey argues that segregation is caused primarily by racial discrimination. This debate is still simmering because - obviously - race and income segregation are so heavily intertwined that controlling for one of the other is exceedingly challenging, and even if you somehow distinguish between the two factors you still haven't really explained the black ghetto.
Wilson's first foray on this subject: The Truly Disadvantaged (1987) - also has a recent book out called More Than Just Race
Massey's response (with Denton): American Apartheid (1993)
Good survey of the literature on the causes of inner-city poverty: Chapple and Teitz, "The Causes of Inner-City Poverty: Eight Hypotheses in Search of Reality"
Empirical evidence: I don't know of a good overview or study that anyone considers definitive. A lot of the literature is historic (particularly now right before the new Census data is released). Rather to my surprise I did not find any interesting looking case studies about either Baltimore or Manhattan but maybe I didn't look hard enough.
I was interested to note that when I searched WorldCat and my favorite urban planning database (Urban Studies and Planning: A SAGE Full-Text Collection), most of the empirical studies seemed to be by public health or education folks. See two citations below that look interesting, but are old. The problem with using 1990 or even 2000 data is that we think so much as changed - i.e. the suburbanization of poverty, gentrification of the inner-city, immigration. If I run into anything else I'll let you know.
Coulton, Claudia J., Chow, Julian, Wang, Edward C., Su, Marilyn, Geographic Concentration of Affluence and Poverty in 100 Metropolitan Areas, 1990, Urban Affairs Review 1996 32: 186-216 (link)
Osypuk, Theresa L., Galea, Sandro, McArdle, Nancy, Acevedo-Garcia, Dolores, Quantifying Separate and Unequal: Racial-Ethnic Distributions of Neighborhood Poverty in Metropolitan America, Urban Affairs Review 2009 45:25-65 (link)
Sulmasy presented what he calls the traditional tripartite view of EOL decision making, each part of which suffers from significant defects. The top of the pyramid, the optimum, is customarily held to be the living will (LW). However, living wills are both too vague ("no heroic measures") and too specific ("CPR but no counterpulsation"), involve interpretation of texts, and aren't done by most people anyway (current living-will rates are about 15%, per Sulmasy).
The next best choice is held to be substituted judgment (SJ). Sulmasy pointed out that SJ (a) places significant psychological pressure on families, with attendant sequelae; (b) is difficult to instruct family members in, because its meaning is not really clear; and (c) isn't what most people, when asked hypothetically, want to happen when they're non compos mentis anyway.
Sulmasy pointed out - interestingly enough - that the legal pedigree of substituted judgment goes back to English law, when questions like "What happens when a crazy person inherits a bunch of money?" or "Can a lunatic be made to donate a kidney?" had the courts looking to SJ for answers. (The case law had names like A Lunatic, but I can't remember the references. The big Columbia Law reference which got the SJ ball rolling in the 70s is here.)
Then at the bottom of the heap is Best Interest of the Patient, which no one likes because it's (a) paternalistic and (b) difficult to discern (Sulmasy didn't give (b), but I think it's obvious).
Sulmasy made the point that while LWs are supposedly optimum, everyone acts like Substituted Judgment is better.
So what's the better model? Consider the patient as a person, says Sulmasy, and think of the authentic values of that person. Then take into account, further, the clinical facts of the case. Then, keeping in mind the real interests of that person in light of their values and the facts of the case, try to come to a decision which respects all of those.
This is where my paraphase probably falls flat. But the key here that Sulmasy emphasized is (a) the neo-Aristotelian nature of his enterprise, i.e. emphasizing full flourishing; and (b) the skepticism of Sulmasy towards "Western, liberal" thinking which values autonomy above all else.
A story by Chaim Grade (yes, her husband) excerpted in this week's Yiddish Forward doesn't seem all that interesting from a narrative point of view, or innovative stylistically, but it's lovely writing all the same.
Here's the first sentence.
אונטער די קאַלטע שטיינערנע געוועלבן פֿון קלויז ישן זיצן זקנים בײַ דעמבענע שטענדערס.
Unter di kalte shteynerne gevelbn fun kloyz yoshn zitsn skeynim ba dembene shtenders.
Under the cold stone vaults of the * the old men sit at oaken *s.
Kloyz yoshn is a macaronic phrase, yoshn meaning - of course - old in loshn-koydesh, and kloyz being a smallish prayer- or study-house. "Old study house" doesn't get at it, because yoshn is part of the name here, not an adjective. Maybe Old Study House, but that seems like we're talking about a Society of Friends meeting place. Venerable? Ancient? Neither of those work.
Shtender - that's a common Jewish, or at least Yeshivish word. I think that when Grade is talking about the skeynim (old men, for lack of a better translation) sitting at the shtenders, he doesn't mean the podiums that people daven at, but rather the bookstands that rest on a table. "Bookstands" doesn't sound right, though.
But Beinart never mentions that Lieberman’s party won only 12.5 percent of the vote.Right-o! Only 12.5 percent. Because that's . . . wait a minute! That's a significant proportion of the population! Voting for a racist demagogue! (Sorry! A "populist.")
More (if you care) here. From the always entertaining Commentary.
Well, maybe. But that's the problem of the screen. If their number is 8, we put them in the Diabetes box. Then we "know" that we need to get their A1C at 7 . . .
But why do we know that? The evidence isn't so great that 8, say, is all that much worse than 7 with regard to clinical outcomes in an asymptomatic patient without evidence of micro- or macrovascular disease. Yes, if the number were 9, 10, 11, 12, then the answer becomes more and more definite, but you're going to start seeing symptoms somewhere in that range anyway.
[links to come, I hope]
He said There must be some mistake.
I sang the suffering servant song.
He licked my heel with flicking tongue.
He said I'd rather be a staff.
He crawled away and hissed So long.
I don't know what I'm doing wrong.
I wonder if the Sabbathian (that's the person who can operate within Shulevitz's permissive, suggested boundaries) has a better answer to the question than the Sabbatarian (that's a more law-bound Sabbath observer, like me). The Sabbathian can say: if you're bored, that's the point! Boredom is something modern people try to escape from, while the Sabbath reminds us that boredom is the absence of things that should not be there anyway. We should not be buzzed and pinged, and their absence should leave space for a mysterium tremendum, not a grande ennui.
But - on the other hand - maybe the Sabbatarians have a better answer. If the Sabbath is boring - well, that's your fault! (Im davar reik hu - mikem: if it's an empty thing, whose fault is that?) The point of the Sabbath is finally eschatological, not sociological. There can be societies which are just, pure, and balanced, and wholly secular, without any need whatsoever of some artificial day of rest. (Indeed, secularists in America and Israel might legitimately scoff at Shulevitz's Rousseauvian naivete.) But no society - on the mystical Jewish view - can have the piece of eternity which the Sabbath affords. Only eternity itself, which is entirely Sabbath.
If you are mystical enough, that eternity could be vouchsafed even if you are on Blogger and Twitter and all the rest of them all the time. As long as you have a direct connection Upstairs.
How can the wise child ask for the reason behind a Biblically ordained law? It does say in the Bible, "He gives his sayings to Jacob, his laws and ordinances to Israel." There are cases in which one does not understand the reason behind a practice, but by the very practice itself one comes to know the reason nevertheless. Thus is matzah without a taste [טעם]* - so that it can fade into the background, leaving the eating of the matzah itself as the reason. Similarly, the last food eaten at the Seder should be matzah.
*This word can also mean "reason." - ZB
with stubby beaks like sparrows,
resting places for gazes. Tomorrow
I'll make final edits and post, broadcast
to all my readers. Exact directions cast
a net of goals and safety. Last
night we mourned, drank, and fought.
Who died: it could be anyone. I ought
to tell you more and show you what I've brought.
What gives? How can someone with high blood cholesterol levels for 30+ years end up with clean arteries, if indeed there is any causation between blood cholesterol levels and plaque accumulation. ... Perhaps actual blood cholesterol levels have no cause of heart disease on their own a-priori. And, if any of these crazy hypotheses are true, then how can a health system prescribe drugs like statins so casually and routinely to anyone with cholesterol over 230? This is particularly true, when the long term side effects of such drugs must still be unknown.
Lots of questions -- some scientific, some health-plan political... But mainly I am looking for just straight talk on this whole cholesterol/heart disease issue.
You ask a lot of good questions. Let me paraphrase them for ease of presentation.
1. How do statins help in heart disease - through lowering the cholesterol level or some other mechanism?
It's not clear - this is one of those topics where the pendulum of the literature swings back and forth, and I can't say that I've followed every swing. Some hold that statins lower cholesterol, cholesterol causes heart disease, and that's it (though all the details of what the worst cholesterol particles actually are, and how they work their deadly magic, are yet to be fully worked out). Others think that statins are "pleotropic" - i.e. they work in multiple ways, e.g. by reducing inflammation.
2. How could you have high cholesterol and still have clean coronaries?
It's quite possible. I would imagine pretty common. That's why one of the biggest statin-related controversies hasn't really hit the lay press yet. It's all about when to give the medicines. Should everyone be on a statin if their cholesterol is above a certain level ("treat to target," or what I think of as the "statin in the water" approach), or should a statin be used only if a patient's risk of coronary artery disease is above a certain level ("tailored treatment")? A recent study in the Annals of Internal Medicine supports the latter, but no one really does this yet since the guidelines of the major doctor groups favor the former.
3. How do I know if I need to take medicine for cholesterol?
One way to think of it is this: statins lead to a reduced risk of coronary artery disease. Great. But this only matters really if your ABSOLUTE RISK, before statins, is something that you, or your doctor, are concerned about. If your 10-year risk of heart disease is 1%, and the statin reduces it to 0.1%, that's a 90% risk reduction, but maybe you don't care about a 1% risk. (I might not.) One way to calculate your risk is the Framingham risk calculator.
4, Do clean coronary arteries on a coronary CT scan (i.e. a low calcium score) mean I can't have blockages in the heart arteries?
1. Woman faints.
2. The doctors can't figure out what's wrong with her.
3. Bad Doctor says it's all in her head:
A neurologist in New York carefully examined her and her now thick chart and pronounced definitively that there was nothing wrong with her and that she should try to relax and maybe take up yoga.4. Good Doctor notices a few key features and makes the diagnosis:
Ledereich watched as the patient calmly sat up. “I know what you’ve got!” he told her excitedly. Her sudden collapse looked as if a switch had been thrown and all her muscles just turned off. Ledereich realized that although it looked like syncope, it wasn’t; she hadn’t actually lost consciousness. What she probably had, Ledereich told her, was something called cataplexy, and that meant that she also had narcolepsy.So far so good. But the treatment didn't cure the attacks:
But for reasons that neither the patient nor her doctors understand, after about six weeks, [the fainting spells] returned. At first, just occasionally. Then almost daily.
Thereafter she is left to do (more or less) what the Bad Doctor suggested: integrate her new diagnosis into her life.
The patient has learned to cope with her unusual condition; she no longer drives. And when she feels the warning signs, she tries to alert those around her to tell them not to worry. She’s part of a small community, andby now, most know her well enough not to call 911.
There are implications left unexplored here. First: that diagnoses can be partially but not entirely therapeutic. As Up To Date says about cataplexy, "these symptoms are often improved by medications." Often, but not always.
Second, that so much hinges on how the diagnosis is conveyed. Bad Doctor indicated that the woman affected with cataplexy "should just relax" - an abrupt and unhelpful direction, but not, for all that, unfounded. There is a connection between anxiety and cataplexy (and other sleep disorders) remarked upon in the literature.
Finally, a question is left unanswered (and unasked) at the end of the piece. What does the patient know that she has? Does she identify with her diagnosis of cataplexy in a way in which she wouldn't identify with a diagnosis of anxiety or other psychiatric disorder? Does the partial failure of GBH to treat her cataplexy at all detract from her trust/confidence in the diagnosis? In short, what does the patient think of all this?
The below isn't mine. It's an excerpt from an article Why Live Without Writing by a famous German poet I've never heard of called Durs Grunbein, translated by Michael Hoffman and printed in the newest issue of Poetry. Except there is no such person, Durs Grunbein. There is a person "Durs Grunbein" whose "u" has an umlaut, but I don't feel like putting it in.
In his diaries, Hugo von Hofmannsthal brings up the story of a German officer in China who, following the Boxer Rebellion, participated in a penal expedition:
The officer sees a line of men sentenced to death, standing in a field. With his sword the executioner goes from man to man. There is no need for his assistants to tie or even to hold down any of them; as soon as it’s the next man’s turn, he stands there with feet apart, his hands gripping his knees, his neck stretched out, offering it to the blade. One of the last in line, still some way from coming due, is completely immersed in a book. The officer rides up to him and asks: “What’s that you’re reading?” The man looks up, asks back: “Why are you bothering me?” The officer asks: “How can you read now?” The man says: “I know that every line I read is something gained.” The officer rides to the general who has ordered the execution, and begs him for the man’s life for so long that he gets him off, rides back with the written acquittal, shows it to the officer in charge, and is allowed to go and take the man out of line. Tells him: “You’ve been acquitted, you’re free to go.” The man shuts his book, looks the officer in the eye, and says: “You have done a good thing. Your soul will have profited greatly from this hour”—and he nods to him, and sets off across the field.
would universal coverage make people tangibly healthier? You betcha.but says something else even more important:
there are other ways to save thousands of lives that are much more cost-effective than expanding health insurance coverage. We systematically neglect these other opportunities.
all knowledge left unwritten with martyrs
jokes that float to the edge of the glass
and pop, forgotten.
I speak ritual
for the controlled explosions
fusing life and death.
A thousand words from everyone,
each singing and dancing,
a little drop
in my labyrinthine neuroscape.
To be the Yiddish poet of the State of Israel, winner of the Israel Prize and institutionally supported by no less than the Histadrut and Zalman Shazar, is no mean accomplishment, at a time when a commitment to “the negation of the Diaspora” and the negation of its mother tongue were standard procedure.
Read more in Tablet.
Read more at KevinMD.
Progress doesn't march along, it sort of limps, gets lost, finds its way again, and lies down for a nap on occasion.
2. Female etrogging.
3. Giving tzedakah while under the influence of X chromosomes.
4. Studying Torah . . . while female!
5. The tallit was too cute.
6. Singing. Singing is just bad. All singers should be arrested a priori.
7. Mitzvot are disruptive in general to the status quo. All the more so when done by women.
8. Arrest them all! Let Ovadiah Yosef sort them out.