Let us get what we want
And let us want the right thing.

Or what's a New Year for?

A gut, zis, gebentsht, and adjective-rich yor.

Crawling on the mountains
Shimon Adaf

You'll see,
my leaving will become my return to you.
Otherwise what's the meaning
of crawling on the mountains, the high stones
the stacks of wheat exhaling shadowy gold
into the night.

translation from the Hebrew: ZShB

To the Googler of "poem about milkshake"
We aim to please.

Working on it. But it might take me a while (what rhymes with "slurp"?).

Why did it happen?
Poem/שירה as witness.

[T]he song answers those who say "Why did all this befall us?"
--Ibn Ezra on Deuteronomy 31:19. (My translation. Loose, how I like it.)

The stick

When you finally got blood from the hard stick
You spotted the backflash (pulsating, red)
And said Thank God. The woman's legs and arms
Were everywhere; you were in the middle
Holding her down while wielding
A butterfly in the other. You stuck her and she bled.

You thank the Rock of Moses that she bled
And not you. He took a stick
To strike the rock, unwilling
To try his luck with persuasion. God read
This as rebellion. Here the test of mettle
Is not getting stuck. Fuck! you cry, and hold her arms

Again. Can she please quit moving her arms?
She's used and used. Most of her life she's bled
High, or been sick, or in the middle
Of other people's lives. Now she's screaming. Stick
It out or shut up, you could say. It's for your own good. Red
Is what you want from her. Would you help us? Are you willing?

You promise her a Snickers and she's willing.
Her drugs are stamped on her arms.
Her lips and nails are painted careful red.
Her AIDS showed on a blot of what she bled.
Moses lashed out with his stick
When he wasn't out front, but in the middle.

But that wasn't what you were thinking in the middle
Of multiple stabbings and wheedlings.
You'll send the labs. You'll treat. Will it stick?
Is Bellevue just another scar on her arm?
I'm sorry if you want suspense: you stuck, she bled,
She shrieked and thrashed, the gauze turned red.

Moses, stick in hand, didn't know he erred
Till God denied him. Force: it feels like meddling
To those on divine peaks away from blood.
But we down here see in the scars and whealing
Proof indirect that what we teach our arms
Is strength, not just intention. A stick

Read as a resting staff is idle; wielded
With strong arms is a try at mettle.
We bled her to cure. She was a hard stick.

Death and its complications

Jewish Ethics and the Care of End-of-Life Patients. Edited by Peter Joel Hurwitz, Jacques Picard, and Avraham Steinberg. KTAV Publishing House, Inc., in association with The Institute for Jewish Studies, University of Basel, Switzerland.

End-of-life decision making is now often left to specialists. This book presents their deliberations in a way meant to be accessible to the layperson. It is a dissection, perhaps over-specific, of general questions that many of us will face when we and our families get old and sick: when is the right time to die? What are the right criteria, and who decides?

Orthodoxy finds in the classic texts, Talmudic passages as well as later decisors, not just guiding principles but specific legislation, with one overarching conclusion: that every moment of life is to be actively preserved, even at the price of decreased quality of life. Every end-of-life decision is to be met with the same standards, and nearly every deliberation can find its relevant source in the classical texts. If the circumstances of terminal illness are different today, and death can be drawn out over long weeks of desperation and indecision, this should not divert our gaze but focus it even more intently on the principles that matter. On the other hand, Reform thinkers have pointed out for years that such texts are open to multiple interpretations – generalizations are risky, and every case should be considered according to its unique circumstances.

This book, in short, presents a canonical spectrum with familiar opposite ends: the Orthodox insistence on the eternal relevance of Talmudic passages (even to vastly changed modern circumstances) whose interpretation can change only glacially, and the classical Reform deconstructive approach to Jewish law.

A second question has to do with the many treatments which are given to (or foisted upon) the terminally ill. When the time comes to die, when there is nothing more to be done (or when what is being done is clearly inhumane or futile), how can we decide what to turn off? How can we stop impeding death without actively causing it – or is there a difference? In this book, the bioethicist Vardit Ravitsky considers Israel's new law concerning the terminally ill, which has something important to say about these matters.

The best-known element of this law is a technological compromise. Some explanation is in order. Many thinkers recognize a distinction between the hastening of death in the living patient (forbidden) and the removal of impediments to the death of a terminally ill patient (required). In other words, life must be maintained -- but death, once unavoidable, cannot be artificially kept at bay. This distinction, important in traditional Jewish law, is sometimes so unclear as to appear a contradiction.

These terms have been connected to a corresponding pair in secular bioethics: withholding treatment versus withdrawing treatment that has already been given. The claim is made that withdrawing treatment, once given, corresponds to "hastening death," while withholding treatment, in terminal illness, is just refusing to place an impediment in the path of a dying patient.

Here enters the technological compromise: a timer connected to a respirator. The timer converts a treatment continuous in time (and thus one impossible to stop without "withdrawing") into a "discrete" sequence of decisions whether to continue the use of the device -- that is, whether to "withhold" or not.

Ravitsky's analysis helps us understand why such a halachic-technological compromise is necessary. If the distinction between "withdrawing" and "withholding" were of ethical import, the timer -- designed to circumvent it -- would be an instance of deception. However, Ravitsky agrees with the position of the current Western bioethical literature, that this distinction is erroneous. There is no real difference between withholding and withdrawing. Therefore, "timers may be perceived as devices that enable individuals to overcome an emotional difficulty in order to do what is ethically right. They thus become an appropriate and clever way to bridge the gap between the desired moral outcome (death with dignity and respect for individual autonomy) and a cultural atmosphere (grounded in religious tradition and ingrained values) that does not allow renunciation of the distinction."

That is, Israel is confronting, albeit on a larger, public-policy scale, exactly what American Jews confront - a conflict between moral outcome and religious tradition. The editors have performed a valuable service in collecting thoughtful essays discussing this conflict from various points of view. It's another question whether laypeople -- who don't like to discuss death -- will pick up this book.

Has the bulb burned out on your Enlightenment?

Over at Gil's, they're still debating if it's okay to read books at YU.

Primeval compassion

. . . When the time has come for the renewal of the world, primeval compassion is awakened[.] Since the creation of the world was without any awakening on the part of humanity but only on the part of God, when that primeval compassion was awakened, the enslavement of Joseph and the slavery of our ancestors were annulled. It is thus favorable that every year the compassion of Creation awakes, as the Baal Shem Tov said in commenting on [a verse in Psalms]. Let there be light always keeps the world in existence. Therefore, when this compassion is awakened every year, and God is desirous, it is favorable for the people Israel.

--the Mei HaShiloach, aka R' Mordkhe Yoysef Leiner of Izhbits, on parshes Emor (my translation)

"And God is desirous"*: is this contingent?

*ולכן כשנתעורר בכל שנה זה החסד וחפץ השי"ת אז הוא ניחא לכלל ישראל.

False dichotomies
0 + 0 = 0.

Friend Becca in a recent Shefa post makes some points that I would like to reiterate - so let me do just that by cutting and pasting. (What my friend Lobachevsky calls "research.")

Apropos of Ariel's article (which I first read about from a Jewschool postin g about it) & responses to it:

[W]e should avoid false dichotomies & zero-sum perceptions both here & in general. There are plenty of other popular & pernicious ones--the one that comes first to my mind right now is:

outreach/less-affiliated enagement vs. inreach/core group engagement

but one could also consider (some of which we've discussed here before):

• egalitarian vs. traditional/halakhically serious
• GLBT-friendly vs. traditional/halakhically serious
• committed to social justice vs. committed to halakha
• welcoming to families of mixed religious backgrounds vs. committed to Jewish continuity
• encouraging of alternative structures for meeting Jews' needs (esp. young Jews' needs) for community ( e.g. independent minyanim) vs. committed to the USCJ and its member organizations (including synagogues)
• intellectual vs. social
• study (text) vs. ritual (action)
• respectful of others' practices & beliefs (among Jewish denominations; with regard to others' religions) vs. committed to one's own practices & beliefs

Whenever we treat one of these groups as "our side" and the other as "the enemy"--and ignore that these groups in fact are not separable except by ignoring all subtlety, complexity, and nuance--we all lose.

Concrete benefits to disseminated intelligence

Apropos of nothing (except perhaps my few days at the Yiddish Week which I am very much looking forward to) , I should say that Wikipedia is a fine thing. At least in this regard: the article on Yiddish, a few months ago just as laughable as anything you'd find in the lay press, is now something I can actually refer people to. Shkoyekh to those who are working on it!

Do Not Reconsider, II

On the whole it's a salutary thing for all health care workers to think about their patients' wishes when it comes to resuscitation and intubation. But selection bias is a killer. What I mean is that doctors start getting curious about DNR/DNI orders when their patients get very sick. Since no one thinks to ask about these orders when the patients are relatively healthy, you could be forgiven for thinking that on occasion these orders, rather than a way in which a hospital interprets a patient's wishes, are an acceptable method of declaring medical futility. But that's a big problem - you don't want these categories to be mixed up. (And, of course, any competent doctor would I'm sure be horrified at any suggestion that this is what she's doing, since - in fact and in law - there's a lot that can be done in terms of medical treatment that has nothing to do with resuscitation or intubation.) The solution, of course, is to have everyone's DNR and DNI status stamped on their foreheads the minute they're seen by their first doctor. Not only is this not happening, I even wonder if it could. If informed consent is laughable in its practical execution, what more can one expect from DNR/DNI?

My PhD thesis

In a short and snappy six pages.

In memory of August 12, 1952
An untitled poem.

* * *

I put on the darkness
Over my head, my arms, my feet . . .
I walk around in a big black tallis
With tattered black edges trailing
Clawing at black walls.

Black infinities drag after me
Tangled together with distance.
Worldly emptiness is open to me
And there I step on
Black wandering maids.

I’m walking in my crown:
Black heights springing from me
Black distance stretching from me
Black earth away from me
And from all sides
Black horses jumping on me!

Peretz Markish
1917

In the Imager

That irresistible attraction you feel is not the result of your spiritual striving; rather, you forgot to take off your yarmulke clips before loading Mr. Richards into the MRI.

Curriculum mori
...if my Latin is right.

Two or three courses in medical school could be usefully replaced by a course on death. We never learned much about it - its epidemiology (who dies, why, and when), its public health (how it can be prevented), its signs and symptoms in the hospital (how to know someone is dying), and, sometimes most important, how it's to be dealt with when nothing much can be done to prevent it. Who do you talk to? How do you approach a family of someone who's died? (Not all of them are "grieving," so I said it another way.) What will be your reaction? Who can you talk to?

It's one of the big subjects which we're supposed to learn on our own.

Less whiny

This blog is now three years old, more or less.

And I made it through the first month of residency without making a complete fool of myself. Barely.

Not the ones dead

It's not that we become used to death, it's that there's no halfway point where we have to struggle with it. We never learn how to express our horrors and hopes. We sit in the call room, most of us just out of college, not even knowing which questions to ask, or whom.

Shabbat and the residency: a rabbi advises

One posek I asked (I'm not going to say who it is, but you can probably narrow down the alternatives) said this:

If it were possible for all observant Jews to work in a shomer shabbos medical facility, it would surely be nice. I, however, do not believe that it is forbidden to work in a non-shomer shabbos facility. Do your best to avoid hillul shabbat, but when it must be done, do it be-shinui unless it is a case of pikuah nefesh or safek pikuah nefesh.

Irregulars of the Lost Ark

Newish: my review of Cecil Helman's book of prose poetry. (And if you don't like my review, here's another.)

The earth will be devoured by the sun

Ten billion years from now. That’s what they say.
Come on! Let’s think about what can be done.

It’s true, we’ve had an enviable run
Although it might not always seem that way.
Have you read how the ancients saw the sun

As a capricious god? You wanted none
Of that in school – now bend your knees and pray.
Surely there’s something more that can be done!

I guess that you could take a loaded gun,
Abduct professors of astronomy,
Demand solutions to the giant sun

That’s engulfing all our neighbors, first one
Then anoth – Look, the moon’s been swept away
By fire’s tides. Before destruction’s done

Let’s clutch our sides and laugh: It sure was fun
To be alive in those few heady days
Between the core of earth and molten sun,
Between our wishes and what can be done.