Charged with punishment: the Artscroll

Marc Shapiro, the Modern Orthodox historian, has an erudite, wide-ranging, and entertaining post over at the Seforim blog (thanks to S.); the conceit here is that Shapiro is trying to find mistakes with Artscroll. Buried in the middle is a nugget which points up (to me) why even Modern Orthodoxy can be difficult to understand.

Shapiro wonders how to translate אדון עולם, i.e. the first two Hebrew words of Adon Olam: "eternal Lord" or "Lord of the world"?

[ . . .] I was pleased when I found the perfect example of an Arscroll error, and this in a prayer that we all know well, Adon Olam. What do these words mean? To answer this, most people will open their Arscroll siddur. Artscroll translates, “Master of the Universe”. This, or similar translations (e.g., Lord of the Universe, Master of the World) seem to be standard. Yet for a while I was convinced that the proper translation was “Eternal Lord.” After looking at the song as a whole, and seeing how it speaks of God’s eternity, it appeared clear to me that this is what the first two words mean.

Agreed! And refreshing (thought I) to see recognition in Orthodox circles (okay, recognition by one Orthodox writer) of a text's plain meaning.

But it was not to be. In Shapiro's words:

A few weeks ago I received a letter from R. [Meir] Mazuz[, a Sefardi scholar], and well, let’s just say that I won’t be trying to impress people any more by pointing out that Artscroll has mistranslated Adon Olam. To begin with, R. Mazuz insists that Adon Olam is identical with Ribbono shel Olam. As for my point about “olam” never meaning “world” in the Bible, he writes:

זו דעת החוקרים האחרונים שעולם בתנ"ך פירושו נצח, אבל חז"ל לא הבינו כן

As proof for this he refers to Berakhot 54b

כל חותמי ברכות שבמקדש היו אומרים: עד העולם. משקלקלו הצדוקין ואמרו אין עולם אלא אחד התקינו שיהו אומרים מן העולם ועד העולם

At the conclusion of the benedictions said in the Temple they used at first to say simply, “forever.” When the Sadducees perverted their ways and asserted that there was only one world, it was ordained that the response should be "from world to world” [i.e., two worlds].

He also called attention to a passage in Sanhedrin 58b where the verse in Ps. 89:2, עולם חסד יבנה, is understood not as “forever is mercy built,” but as “the world shall be built up by grace.”

As I said, I am forced to conclude that in this case Artscroll gets a pass.

This is very frustrating! R. Mazuz seems to believe that the interpretations of Chazal trump pshat, even when other readings are more plausible and even (in this case) when the piyyut in question is post-Biblical, not to mention post-Talmudic! It feels weird, like Shapiro is being yanked back into line by the unseen hand of Orthodoxy.

Meaningless directions

If you have occasion to compose or think about your living will (and I hope you will soon), please do not include the phrase "heroic measures," which means nothing at all - or, rather, many different things to different people. One person's heroism is another's medical routine. If you would rather not be resuscitated (i.e. have your chest forcibly compressed and undergo electric shock), then say so. If you would rather not have a tube down your throat to aid in breathing, say that. If you would rather people not do "too much," decide what that means to you, and write that down - and tell the person you would like to make health care decisions for you if you cannot. Don't count on people understanding what you write unless you are painfully detailed and inescapably clear.

Presenting the second-year resident
Now in a magically supervisory capacity.

Said the cattle thief: it's time to take stock.

The intern is a snake devouring its own tail. The second-year resident ("R2" is the quasi-robotic nickname) is still chewing at her tail but is also keeping an eye on the tail-devouring of other snakes, with helpful comments all the while. "Open the maw a little wider! Fangs into the tail like you mean it!" And the hot sand all around, with the Georgia O'Keefe-ish carcasses. And the whistling of passing trains.

The meaning of the allegory: I still sometimes don't feel like I know what I'm doing, even with years and years - I mean, fourteen months - of medical experience under my belt. I know for a fact, more abstract than concrete and more intuitive than learned, that it is better to say "I don't know" than to invent a probably-misleading principle on the basis of limited information. But the latter is what I see people doing all the time around me, and whenever I say "I don't know," I still feel guilty and weak.

Some of this is due to lack of confidence, which will be repleted steadily until my graduation, at the end of my third year of residency. Some of this is due to epistemological uncertainty. I don't know what it means to know about medicine, and at times I'm not sure that everyone else does either.

Let me qualify: there are many models of what it means for a doctor to know something, but none of them covers all the situations that we encounter. "Evidence-based medicine" (one model) is a misnomer, because the "evidence" is population based, while much medicine is done person by person. There are many other jerry-rigged epistemologies, lizards skittering up and down the hospital hallways between the feet of housestaff. "See one, do one, teach one" - sure, but what is "seen" and "done" depend very much on how one is taught. Diagnostics is an epistemological minefield: take into account all your probabilities (Bayesian and otherwise), but you must still walk into a patient's room with at least two or three layers of information and attempted diagnoses made by other people in the hospital who have seen the patient first. Seasoned diagnosticians often cannot explain how they arrive at the correct diagnosis; on the other hand, autopsies (of a previous generation; these days they're rarely done) indicate that diagnoses are wrong about a quarter of the time.

The epistemologic dissonance par excellence is between doctor and patient. The doctor knows the patient's sick, and the patient doesn't believe this at all - or vice versa. The patient knows what's going on in her body, but the doctor needs to do another test to find out - because he says he doesn't know yet. You can say that this is because doctor and patient subscribe to different epistemologies (biomedical vs. traditional, quantitative vs. narrative, or what-have-you), or you can say that neither doctor or patient knows how they know things, or thinks about it much at all. (Meta-epistemology? You came to the right place.)

Now I'm a second-year resident, with more time to think about how I (don't) know what I (don't) know. This is precisely the time when I am supposed to start conveying my knowledge to those one step below me: the interns. (Many of whom, in terms of raw medical facts and figures, know more than I do anyway.) It's appropriate that I don't feel like I know how to do this.

Perhaps I'm thinking about this all wrong. Medicine (or, to term it more appropriately, health/sickness/wellbeing) is based not on knowledge but faith. Induction is a leap. The sun will rise tomorrow because we've seen it done so for our entire lives and heard stories about its constancy. Doctors and patients alike put themselves in the hands of their combined trust: standing at the foot of the mountain or at the door of the hospital.

Yiddish Week 2007
Reflections, 1.

I'm back from the Yiddish Week. The strangest thing is how normal we all are, we fringe Yiddishists, all the flavors of (mostly American) Jewry represented: the usual Reconservadox spread plus a Charedi couple; secular folks; old and young; couples with jelly-smeared kids. And it feels like (maybe?) that there are slightly more people with kids and 2o-somethings among us. On the one hand, speaking Yiddish should be normal for those American Jews that do so. It should be a choice on the menu with the respect due it - by no means the only one, but definitely a possibility. On the other hand, ideologies that seem normal are tame. We don't want to be stamp collectors, do we?

You look so drawn

Satisfactory Comics has a blog!

Fuftsik Sent and Madona
Yiddish rap in the Jewish state.

Check out this article in Yediot Acharonot. I haven't heard the sound files yet. (Thanks to reader MJ for pointing this out.)

Update: As usual, I'm about three to four months behind the curve -- the disk came out in May. I just listened to some clips. Lipa it isn't, just saccharine frumification of perfectly good music. (Why would you need an ultra-O version [track 5] of La Isla Bonita?)

(Speaking of Yiddish and Madonna, the new issue of Afn Shvel has a great article by Marc Caplan on Ms. Ciccone Ritchie and her practice of Kabbalah.)

Incrementalism versus single-payer health care reform
Different routes to the same solution.

Cross-posted to Clinical Correlations (with some edits there)

Health insurance positions: The obvious imperfections of our current health care system have inspired a number of solutions. They can be organized into two broad categories, incremental or single-payer. Each of these solutions is advocated by a single-issue lobbying group. National medical organizations support these solutions in greater or lesser measure.

Advocacy groups: Physicians for a National Health Program provides information about the benefits and practical implications of a single-payer health care system. The list of members of its advisory board includes their organizational affiliations, but (as its name indicates) the group is composed of physicians, not medical organizations or professional societies.

Incrementalism is represented by the National Coalition for Covering the Uninsured, a broad-based coalition of a number of organizations, including the AMA, the American Hospital Association, the American Public Health Association, the American Academy of Family Physicians, pharmaceutical companies, insurance companies and other organizations. Given the divergent range of interests and philosophies represented by this list, it's no surprise that the NCCU's plan involves a number of less wide-reaching improvements in the current system, including transparent pricing; personal Medical Savings Accounts; and the expansion of public programs to cover the very poor.

Professional organizations: Many medical organizations act as both professional societies and as advocacy (i.e. lobbying) groups. Their "home" positions may in many cases differ from their compromise positions hammered out in coalitions with others. The American College of Physicians, on its Web site, advertises its support for the Health CARE Act, a proposal which would increase federal matching funds to those states expanding Medicaid coverage to all those beneath the federal poverty level, and which would also provide increase federal funding to those states which increase coverage for uninsured children.

For its part, the American Medical Association "will strongly advocate for incremental measures to expand coverage," and in keeping with this advocacy is a member of the HCCU. In the long term, says its Web site, it will continue to push for the adoption of a market-based plan to expand coverage, "relying upon incentives and voluntary approaches." Similarly, the American College of Surgeons endorses universal access to care "within our current pluralistic health care system," i.e. to be incremental in the pursuit of change, with some features being implemented on a state by state basis. The ACS further emphasizes that "reducing health care costs [through improving information technology] is much more desirable than containing costs by rationing care."

Compared to other professional organizations, the American Academy of Family Physicians is full-throated in its advocacy of a plan to ensure health care coverage for all. On its web site, it lists those services which should be covered for all who reside in the United States (a relevant distinction in these days of proposed immigration reform). Assured services with no co-payment include prenatal/maternity care; well baby/child care; evidence-based childhood and adult immunizations; and evidence-based periodic evaluation and screening services. Other assured services, including outpatient physician services and outpatient prescription medications, would require 20% co-payment. The AAFP is also the rare organization which specifies a funding mechanism: a national, broad-based tax. Under the AAFP plan, coverage would be rationed by a "resource-based relative value system."

Differences and similarities: The differences in advocacy positions - taken on their own and as participants in coalitions - of the American professional medical organizations remind practicing physicians, and especially physicians in training, that the current health-care system can justify various solutions. Advocacy can also be modified in coalition for the sake of practical lobbying.

Personally, I think a single-payer system is the only solution that would fix the gaping inequities in our system -- but I also realize that there are many ways of getting there. PNHP might better fit idealists, and NCCU, realists, but they have a goal in common: reducing the numbers of the uninsured. Perhaps the coalitions can themselves coalition to put the problem of the uninsured higher on the agenda of the 2008 elections.

Mr. Hales and his medical husbandry

"The first person to measure blood pressure was Stephen Hales, an English clergyman of creative genius, who in 1708 directly connected the left crural artery of a horse to a 9-foot-tall glass manometer using brass tubes and a trachea of [a] goose." (from McGee, Evidence Based Physical Diagnosis)

Our Son Leaves His Fifty-Inch Plasma-Screen TV
Behind Because There Will Be
No Room in the Dorm

The remote control is eight inches long
with a display that I never understand
no matter how many times
you explain it: "Dad,"
you said, looking not at me
but the flitting basketball
and the neon cheerleaders,
"it's universal." So it
is. Then why is it only your Mom and me
who have to stare
at this blank Buddha
in our living room?
Its four sides
four years
times forty
thousand
dollars.

The narrative voice is bliss

At times the Gemara gets so intoxicated with its own line of thought that it just goes right ahead and ignores the Mishnah.

(d)(5) hold on a minute!
In this week's New England Journal of Medicine, Wendy Parmet provides legal justification for my inchoate worries. (More about the author.)

Many important questions remain [regarding quarantine and detention for tuberculosis control]. First, courts have not decided how long someone may be held before a hearing is offered or what procedures are necessary in the event of a mass quarantine. Courts have also not yet decided what probability of risk justifies short-term or long-term detention. Nor have they clarified what evidence is needed to determine that a person is or may be infectious or how infectious a person must be to justify isolation. Most critical, courts have not explained what must be shown to conclude that a patient is noncompliant so that detention is the least restrictive alternative. In tuberculosis cases, courts have upheld detention when a patient has failed, like [Andrew] Speaker, to follow medical advice. But they have not considered how forcefully that advice must be given or what, if anything, the government has to do to facilitate compliance. [. . .]

Compulsory isolation and quarantine alone cannot stop the spread of XDR tuberculosis. Moreover, excessive reliance on compulsory measures can lull the public into a false sense of security and at the same time prompt people who are at risk to do exactly what Speaker did — run. Fortunately, most persons infected with tuberculosis want treatment and have no desire to infect others. When clinicians and health officials work with patients and have their trust, most will cooperate. By ensuring that coercion is used only when less restrictive alternatives will not work and with due regard for the rights of those detained, the law can foster public trust, minimizing the need for compulsion and laying the groundwork for the comprehensive and costly control programs needed to prevent the spread of XDR tuberculosis and other contagious pathogens.

Dr. Zauberberg
Or: How I learned to stop worrying and believe in the (d)(5) hold.

I'm now rotating. (Of course, we're all rotating together, being on the Earth and all.) I'm currently working on the Chest Service of Bellevue Hospital. "Chest" means "lung" which means (at least for most of our patients) tuberculosis. There are lots of lung diseases, but the most common ones (pneumonia, asthma, COPD [emphysema and bronchitis]) get thrown in the same big barrel as all the other medical conditions, spread out among all the other medicine teams on the regular wards. This particular ward I'm on now is limited to the tubercular.

It is a Manhattan version of the Magic Mountain. There are New Yorkers of unexotic ethnicity (Puerto Rican, say) who have AIDS; there are Asian immigrants who have had the misfortune to contract drug-resistant TB; there are the elderly and demented from Coler-Goldwater, who are exiled from their residence until their cultures come back negative, no acid-fast bacilli swimming redly past the eyepiece.

And then there are those who are under arrest, under Article 11.47(d)(5) of the New York City Health Code. In other words: they have TB, and they can't or won't either take their medications or modify their behavior so as not to pose a risk of contagion; they have been warned, and now they are shut in. They are under (d)(5) hold.

This is justified by public health necessity, which is defined by the New York City Department of Health. On a case by case basis, the DOH balances the danger of contagion, the necessity of treatment, and the contingency of private circumstances.

I wish I had something wise to say here, something which would precisely trace this intersection so we could see it as clearly as pathologists see the offending acid-stained bacilli. All I can do - as usual - is ask myself questions while I immerse myself in the work the system requires of me in the name of the patients.

I've been thinking all day of the word "misprision," but I'm sure it's not as foreboding or relevant here as it seems.

The GH-2
A validated two-question happiness screening instrument.

1. In the past two weeks, have you felt hopeful, exuberant, happy, joyful, or energized?

2. In the past two weeks, have you felt pleasure from things which ordinarily give you pleasure?

If the answer to either 1. or 2. is "Yes," proceed with the full nine-question happiness screening questionnaire.

Queasiness of summer

Pressed in our book of estimations
a crumbled leaf.

The minimum gain through loss -

The first word my bell learns
is were-I.

A Louisvillian's dubious claim to fame

Crystal Meredith? Went to school with her.

Not that I agree with her suit.

What it's like to be an intern
A week before I unbecome one.

Resident: Says "Let's get a quick [arterial blood] gas."

Intern:
1. Sighs inwardly.

2. Goes and finds
a. a little syringe with some heparin in it so that the blood doesn't clot
b. some alcohol swabs
c. a Ziploc bag
d. another little syringe for a second try
e. needles to stick with

3. Goes into the patient room, lays supplies at bedside. Says: "I'm sorry, I need to get some blood from you."

4. Realizes that he has forgotten
a. Gauze
b. Some ice in the bag

5. Raises up the bed so he doesn't break his back.

6. Finds the pulse.

7. Gives the patient a considerate and well-meaning count-of-three.

8. Sticks the patient.

9. Doesn't get it on the first try [return to step 5], or the second, or the . . . ha! Gets it on the third try.

10. Holds gauze on the sticking point till the bleeding stops.

11. Takes the bag up to the lab.

12. Knocks on the door. Shouts "Hello?" Hears an echo.

13. Pages the person he's looking for.

14. Hands in the blood.

15. Waits by the computer, refershing the lab results page about twenty times till the results come back.

16. Hustles back to the resident with slip of paper in hand. "The gas [huff, puff] is seven point [whew] two three . . ."

Resident [absentmindedly]: "Hey, thanks! Yeah, I thought that's what it would be. Listen, can you just get some quick cultures off this guy -- and then guaiac him?"

What about stupid versus dumb?

Sage advice heard in the ER today:
"It's much better to be smart than intelligent."

I am distraught!

Gertel's closes tomorrow.

I will eat for comfort.

Justice, justice, shalt thou eat

A blog about the "social justice hechsher." (Hat tip to S.B. of Louisville.)

Avraham Burg: chauffeured hypocrite
And partial prophet.

Yes, Burg is a paragon of self-righteousness ("so attached to Zionism," wrote a commentator in Haaretz, "that he drove around with a chauffeur paid for by the Sochnut years after he left its employ"), but he makes many thought-provoking points about problems afflicting Zionism. (English here.)

NB: I don't at all agree with his misguided political analogies, and I don't think Israeli society is basically violent. But I do think Zionism suffers from weaknesses, and few other Zionists (or ex-Zionists) besides Burg are pointing these out with such uncompromising clarity.

Difficulty naming objects
. . . in English, maybe.

Neurology consult's note (about a Spanish-speaking patient of mine): "The patient has some difficulty naming objects. He calls eyeglass lenses 'crystal.'"
In other words, he calls eyeglass lenses cristal.

Random booksightings

I saw some interesting books at BEA. I also learned that asking politely "Do you have any samples?" will work only if (like my wife) your badge bears the name of a major book publisher, or if you are leadng a three-year-old by the hand and you are looking at children's books.

I saw:

Fotografiando las matematicas (a gorgeous album with depictions of "integral," "solid," and other concepts)

a volume of addresses by Sir William Osler, put out by Duke UP, of interest only because it demonstrated a tendency to hyperannotate a work which is actually not all that worthy of interest (e.g. the reader is informed helpfully that "Nicotine, Bacchus, and Aphrodite" refer to the vices of smoking, alcohol, and sex, respectively)

a book of problems in number theory from the training manuals of the Math Olympiad team from the U.S.

some fascinating Spanish-language poetry

Lineas Urbanas, a slim collection of essays in Spanish about New York City

a facsimile hardcover edition, pocket-size in all but width, of Les Fleurs du Mal with illustrations by Matisse

. . . but no Judaica, because I didn't get over to where it was

TB, Airborne
Traveling XDR class.

Now the truth can be told: if I were the other night intern, I would have been taking care of the phthisic traveler a few days ago. Even though I didn't have the pleasure of putting on a mask and going into his room in Bellevue (sorry, "a New York hospital," as the first Times article coyly put it), I feel compelled to provide some information about a question we're all wondering about: how easy is it to get tuberculosis on an airplane?

You can't do that experiment. (Though it would be fun!) What does the literature say? Google Scholar gave me links to two articles. One of them talks about TB transmission from an infected crew member to his colleagues. The other, by Kenyon et al., is titled "Transmission of Multidrug-Resistant Mycobacterium tuberculosis during a Long Airplane Flight." We read in the abstract: "In April 1994, a passenger with infectious multidrug-resistant tuberculosis traveled on commercial-airline flights from Honolulu to Chicago and from Chicago to Baltimore and returned one month later. We sought to determine whether she had infected any of her contacts on this extensive trip."

In brief, their findings were as follows:

1. The researchers managed to get in touch with 802 fellow passengers, or about ninety percent of the people on the airplanes the woman traveled on -- a commendable effort.

2. Of these passengers, twenty-nine tested positive on the "TB skin test." Twenty-two of these had previous risk factors for tuberculosis, which means it's impossible to tell in this case (since the passengers weren't followed beforehand) whether their skin tests were positive before they ever took that flight.

3. Of the seven without previous risk factors for TB, six were on the longest flight the passenger took (a nine-hour jaunt from Chicago to Honolulu). They all sat in the same section, and four of them sat within two rows of the passenger.

The authors conclude, "The transmission of [the TB organism] that we describe aboard a commercial aircraft involved a highly infectious passenger, a long flight, and close proximity of contacts to the index patient."

How does this article relate to the now-famous globe-trotting lawyer? The kicker here is that the woman in the article was "highly infectious". To wit:

The index patient was a 32-year-old Korean woman, who according to relatives was taking no antituberculous medication but had previously been treated for tuberculosis — twice as an adolescent in Korea and once within the past two years in Japan — with unknown medication. She arrived in Honolulu in April on a tourist visa and was reportedly coughing and lethargic while staying with friends (Household 1) for five days. She then flew from Honolulu to Chicago and from Chicago to Baltimore, where she remained with friends (Household 2) for one month. Members of Household 2 reported a worsening of her symptoms, including progressive cough, lethargy, shortness of breath, fever, night sweats, and the eventual onset of scant hemoptysis. In May she returned to Honolulu, flying from Baltimore to Chicago and from Chicago to Honolulu. Eight days after returning to Household 1, she had an acute episode of hemoptysis, described as consisting of approximately 1 liter of bright red blood. Hospital evaluation revealed extensive pulmonary disease (Figure 1), and her sputum was highly positive (3+) for acid-fast bacilli and was culture-positive for M. tuberculosis. The patient died of pulmonary hemorrhage and respiratory failure five days after being hospitalized.

She died of TB shortly after the flights in question, and was highly infectious when she flew. Contrast this with the patient in this week's story, who has so-called "active" tuberculosis (the organism is in his blood) but does not appear to be either symptomatically ill or highly infectious (the amount of TB-causing organism in his sputum is low).

Was quarantining the passenger in this most recent case (or, rather, attempting to quarantine him) the right thing to do? Probably, since he is infected with so-called XDR (extremely drug resistant) TB, which is associated with a higher mortality rate. It's best to be on the same side, even though it's probably unlikely that anyone he traveled with got infected.

(However, I'll take the opportunity to mention that many organizations (schools and the like) use the TB skin test indiscriminately, without assessing their members' risk factors for TB, their infectiousness if they do test positive, and the resultant small likelihood of transmission even if they are infectious.)

When I pray for certain sick people

it's not that I don't want other sick people to get better. Of course I'd like all sick people to get better.

So why not pray for all of them?

There are time constraints.

If you had infinite time, and knew everyone's name, would you include the names of all the sick in your prayers?

All the sick I know (of) personally. The farther away a sick person is from my personal knowledge, the less strength my prayers have. The less I really want them to get better. Or: the less often I think about them. It's a complicated relationship, if I were to think about it more precisely: not just the strength of wanting, not just the frequency of wanting, but the intensity with which the person's condition occupies my attention. The difference between home and another place.

Ideally, you would wish with equal strength for everyone to get better.

I think so.

You recite traditional Jewish prayers, which ask for the sick to be healed "among the other sick of Israel." Do you generally include non-Jews in this prayer?

Not generally. I don't know if that's because I know fewer non-Jews than Jews, because I tend to actively seek out (names of) Jews to pray for, or because I find it more congenial to include Jewish names in a Jewish prayer.

"More congenial" is a pretty term for racial exclusion.

Why don't we pray for the entire world? Why do we stick to our people, to our mythic ancestors, to our Jewish God? Because there's a power to specificity. If there were a strong prayer, embedded in a particular poetic idiom, which embodied a wish for the cure of the entire world, at once, without regard to any divisions at all . . . I can't imagine such a prayer because each prayer has its own preconceptions. Everyone wishes from somewhere, has their own family to yearn from. There is no universal person.

Why not write that prayer? Why not be that person?

There are cultural constraints.

An Intern's Lexicon
Version 1.0
Descriptive only. Not prescriptive, endorsed, or reflective of these terms' actual scholarly or humanistic meanings.

A-stick (v.) to draw blood through puncturing the radial artery.

Baseline: at baseline (adj.) Describing a usual or healthy state before arrival in the hospital or before some insult or incident. "His baseline mental status is poor."

Code: 1. (v.t.) To attempt to resuscitate a patient. (n.) An attempted resuscitation. 2. (v.i.) To undergo an attempted resuscitation. 3. (v.i.) To die after an unsuccessful attempted resuscitation. 4. full code (adj.): Someone who is to be resuscitated in case of cardiopulmonary arrest. Opposite of DNR.

Cute: (adj.) Possessed of some attractive or positive attribute. Used of older patients. "That patient of mine in the step-down is so cute! He sits there with his blanket, reads the paper, and asks me how I am when I pre-round on him in the morning."

Dispo: (Short for "disposition.") (n.) Plans for discharge, or a patient's destination upon being discharge. "She's hanging out, waiting for dispo."

DNR: Short for Do Not Resuscitate.

Fail: (v.) (paradoxical reverse construction) To be unsuccessfully treated by a medication. "That gomer failed Vanc[omycin], so we put him on Imi[penem]."

Female: (n.) Woman.

Fix: (often jocular) (v.) To treat, especially acutely. "Your list is so small!" "I fixed everybody."

Gome: Short for "get out of my emergency room." Originally used in House of God, now generally used. n. An older, chronically ill, demented patient. -- Gomey (adj.)

Hang out: (v.) To stay in the hospital while no longer acutely ill. "Anything going on with Mr. Smith?" "He's just hanging out."

Ins-and-outs: Measurements of intake and output on the part of the patient.

Jeopardy: (n.) A backup system whereby certain residents are called in when others become sick or otherwise unavailable.

Male: (n.) Man.

Mental status: (n.) Cognition.

Psych issue: (n.) Psychiatric, psychological, or emotional complication. More generally, any expression of feeling.

Resp (v.) : Short for "respire." To breathe at a certain rate. "The patient is resping at 36."

With it: (adj.) Able to converse; interactive. "He was with it when he came into the hospital

Say It In Chabon
Or: Der yidisher polislayt-unyon.

The newest, baroquest Jewish novel is one I won't be reading -- not because I am opposed to it on principle but because my complexes will get in the way of any purely literary experience. To explain we have to turn the clock back to 1997 (or sometime before), when Michael Chabon happened upon the sublime little volume Say it In Yiddish, a book that provides practical phrases for the traveler to Yiddish-land. The notion of a country whose inhabitants might use Yiddish in daily life captivated Chabon with its otherwordliness, and -- so inspired -- he wrote a whimsical essay for the Library of Congress magazine Civilization about such a land (with, it bears mentioning, the requisite Ben Katchor illustrations for a Yiddish reverie).

Thus ensued a kerfluffle in the tiny on-line Yiddish world, or, more precisely, a flame war (which I took part in) on the Yiddish e-mail list Mendele, most neatly summarized by Chabon's response to his critics (thanks to Leizer Burko of yiddishland.googlegroups.com for digging this up):

Date: Sun, 29 Jun 1997 10:05:37 -0700 (PDT)
From: Michael Chabon <mchabon@earthlink.com>
Subject: Weinreich's phrasebook

I am hesitant to wade into this fray, but the recent assertion by Mr. Mordkhe Shaechter [7.025] that "the author of that article has already apologized to B. Weinreich" compels me to step in. I have been following the recent exchanges over my article in Civilization ever since an interested party began forwarding them to me last week. They can, as far as I can tell, be divided among those who got it, those who most decidedly did not, and those, like Mr. Turkel [7.024], who feel qualified to comment without having read the article at all. Since I can neither speak nor read Yiddish in any but the most rudimentary fashion, I don't know what Mr. Adam Whiteman had to say.

People who get the piece recognize, first of all, that a book which explicitly advertises itself, on the cover, in capital letters, as a PHRASEBOOK FOR TRAVELLERS, naturally, logically, and commercially implies the existence of a country to be travelled to. A country. An entire nation. Not a neighborhood like Crown Heights. Not the annual meeting of a Yiddish language society or a Folksbeine. No one takes a Chinese phrasebook for travellers to Chinatown or a Chinese New Year's Parade. Even if someone might, such certainly would not be the imagined market for a series of traveller's phrasebooks.

This inherent implication is the central pillar of my ruminative essay (not a book review, not an analysis of the current state of Yiddish). There is a phrase given in the book, with Yiddish translation: Where can I get the boat/ferry to --------? My essay simply tries to imagine different ways to fill in that blank (that is, to imagine a place where one takes a ferry either to or from a country whose principal language is Yiddish). _Now._ Post 1958, when the book was published. Not in the twenties during some shortlived Soviet republic. Not in Israel shortly after its founding. But now, when the book, with its series of useful phrases for visits to auto mechanics and airline ticket offices, is still apparently very much in print. Where, in 1997, could you go that it would behoove you to know how to say, in Yiddish, "Which way to the casino?"

The second thing people who get the piece recognize, I think, is that however many people are still reading, speaking, and enjoying Yiddish, and however many young people are taking up the study of the language--however vital is the spirit of Yiddish revival--something has been lost. Something immense and profound. I don't know anything about Mendele and its ways. Perhaps this statement will bring the wrath of the entire subscribership down upon me. But I believe it. If this causes some of you to pity me, or shake your heads, or even wish, with Mr. Turkel, to excoriate me, so be it. There is no nation to take the Weinreichs' little phrasebook to; for every other language in the series, such a country exists. That difference saddens me.

In the course of a recent, and personally frustrating correspondence with Ms. Beatrice Weinreich, I did express my apologies to her--but not, as Mr. Schaechter seems to imply, for what I wrote. I stand foursquare behind every single word of that essay, without apology. What I regret is the hurt feelings and grief that my words evidently brought to a woman whose work I respect. It was a harsh blow to her to discover that someone thought her phrasebook was, among many other things, and in the saddest way, funny. (I gather from this list that I am not entirely alone in thinking so.) I have tried to explain to Ms. Weinreich that she, like some members of this list, had misinterpreted both the spirit and the letter of my essay. I love Yiddish. I love being Jewish. I love language and humor. All of these inspired my writing. The desire to hurt, offend, or insult Yiddish scholars and lovers of Yiddish did not make up even one atom of my motivation. My only desire was to report faithfully how the book made me feel, and the fancies it conjured in my imagination.

In her initial letter, and in her subsequent, generally unmollified reply to my reply, Ms. Weinreich argued, as have some members of this list, first of all, that the book could be useful for trips to Crown Heights or Williamsburg, for example; and second, that it might come in handy in Israel, or perhaps would have come in handy in Israel at an earlier time in the book's life. My principal rejoinder to these arguments has already been made: a phrasebook for travellers implies a country whose principal language is that of the phrasebook. Sure, there are, or could be, exceptions to this. There could be a phrasebook for travellers in Romany, say, that might be useful under certain conditions, or one in Latin that might at some time have come in handy in the Vatican. With regard to Israel, and the argument that there were or are many Yiddish speakers there who, as Ms. Weinreich attempted to convince me, felt or feel at sea in a land of Hebrew, I fail to understand how they would have benefited from an English-Yiddish phrasebook. Yiddish-Hebrew, perhaps. As for the English speaking traveller, if I had been going to Israel in 1959, say, I doubt I would have chosen an English-Yiddish phrasebook to be my companion.

AIl this is, however, completely beside my point. I wasn't interested in writing about whether this book was, or could be, useful; it is evident to anyone not blinded by sentiment or passion that such a book is, in a practical sense, all but useless. What interested me was imagining another world in which a Yiddish phrasebook for travellers would have an obvious referent, one with the official passports, customs agents, airlines, and ferry companies that play such a prominent (and, to me, poignant) role in the phrase book. The more I thought about, and imagined this country, the sadder I felt at its absence, a sadness which --for me, the only person I ever claimed to be speaking for--no amount of extinct Soviet republics, Chasidic neighborhoods, and Yiddish preservation and renewal societies will ever completely abate.

I'm sorry if this angers, hurts or irritates some people, or everyone who reads this post. I'm sorrier still for anyone who can't see the humor--the heartbreaking, wistful, uproarious humor--in the book. But I don't regret a word of what I wrote. On the contrary, Mr. Schaechter.

Michael Chabon

And from such an exchange, it turns out, came the impetus for The Yiddish Policemen's Union.

Ten years after the mini-dispute, I, like Bina Weinreich, remain unmollified. I see the humor of the book (which has acquired near-classic camp status in some circles), and I appreciate the whimsy of Chabon's take, but ("blinded by passion or sentiment," perhaps) can't overlook his mistake: the assumption (so American-Jewish! so confidently ignorant!) that only languages with a country have a useful function, that only official state languages have any business arrogating to themselves any practicality (except for the two non-state languages of Romany and Church Latin [!]). That's an ignorance that even a brilliant prose style can't wash away, and whimsy can't cover up.

Here I am, still blinded in Yiddishland.

Elinor Nauen on Roberta Oliver

I promised Roberta that I wouldn’t say she was brave. I promised Roberta I wouldn’t say she “fought the good fight.”

Well, RO, I lied. I am going to say that to the end she stayed considerate, gallant and gorgeously courageous. Part of that was her usual modesty: She never said “why me?” She believed she’d had a good run, and she was at peace.

But Roberta was, of course, far more than her cancer or her death.

Our friendship began about 10 years ago, when I was just starting to get involved at Town and Village. We’d both been invited to a dinner, where I didn’t really know anyone. (To appreciate this anecdote, you have to know that I’m originally from the Midwest.) So, we were at this dinner, and she was telling a story, rattling along a mile a minute: TWO miles a minute.

And I said, Hey slow down, I can’t understand what you’re saying, you’re talking so fast.

And without missing a step, in that 1940s wisecracking-dame voice she had when she was still a smoker, she said, What, they can’t listen so fast out there where you come from?

A couple of years later, I happened to drive her and her son to Binghamton when he started college. What I remember most about that trip is the way she talked about Torah. Her infatuation (as someone called it), her joy in and mastery of the technical details, her passion and commitment inspired me to want what she had. If I am a halfway decent Torah reader, it’s in large part because Roberta “tortured” me—by which she meant that she refused to let me or anyone else do a sloppy job, not if she could do anything about it. She was endlessly patient in listening to me and many others practice our reads—and she never missed a mistake.

Roberta would be the first to say she didn’t have a beautiful voice, but when she leyned, her voice was radiant. Radiant and beautiful, out of love.

She loved being Jewish. She loved kirbys and The Gilmore Girls and salami. She loved shopping—and returning everything she bought the next day. And she loved her kids. How many times we would be on the phone and she would say, gotta go, it’s Paul. Or, It’s Katie! She lit up each and every time she said their names. How tender Paul and Kate have been under the recent stressful circumstances. How much I admire them—and their mother for raising two such wonderful young people. As well as Roberta’s magnificent mom Sarah, who started it all.

Roberta gave the best gifts, not only because she was generous, but even more, because she paid attention to her friends and knew what would please us. She was organized—I don’t know how the morning minyan will manage gala ads and the summer beach outing and daily Torah reads without her. She was fun and a good dancer.

But like any friendship worth its salt, ours was mostly a day-in day-out accumulation of listening, talking, hanging out. It’s not anecdotes or witticisms I will miss about Roberta, but the everydayness of our friendship. The privilege of her love and friendship.

Roberta (Rivka bat Avi v'Sarah), ז"ל

My friend Roberta died Wednesday night. She used to read Torah every week at our shul. She was careful with every word, every last trope -- and she never failed to bury an excellent reading of hers under a mountain of self-criticism the minute she came back to her seat ("I completely missed that zakef gadol!"). She demanded a good keriah from herself and others. She would fume and mutter under her breath when the gabbaim were not doing their job with the more error-prone.

She had been sick for a while; she wasn't old at all. Her mother will be at her shivah. And this is what I'm thinking: זו תורה וזו שכרה? -- this is the reward of the Torah?

Me and Jerome G.
Making your doctor better.

Jerome Groopman: "Because we doctors see so many people, thinking in the moment, we have to use shortcuts. If lay people become educated about how we think, with a few appropriate and directed questions, they could help us think better. They should ask, “Could this be anything else?” or “I’m worried this is something serious.” That is the genuine partnership."

See my Q&A in this week's Forward with the author of How Doctors Think.

Disclaimers apply
And modesty! Lots of modesty.

It's not that I really think I'm the best overall Jewish or Israeli blogger, but you might as well vote for me, since someone was nice enough to nominate me. (Please also vote for In Mol Araan as best food blog and Katle Kanye as best non-English blog. All nominees in these categories here.)

Happy birthday, Itzik!

I had fun at Itzik Gottesman's 50th birthday party last night, held at the Yiddish Artists and Friends club on East 7th Street. (He's the assistant editor at the Yiddish Forward, also an ethnologist and many other things besides.) The music was great, the dancing -- well, I tried to, a little bit, and then realized it was way too complicated for me. Let me say something else about the klezmorim: you should go buy The Broken Tongue, Daniel Kahn's CD of Yiddish-klezmer-funk (or, as his band's site puts it: "Alienation Klezmer Bund = Radical Yiddish Song + American Gothic Folk + Punk Cabaret + Klezmer Danse Macabre = Verfremdungsklezmer Bund."). Also, Adrienne Cooper's daughter can wail the guts out of a song. (I know she has her own name; someone told me but I forgot.)

While I'm mentioning Itzik, you should read his article in the Forward from a couple of weeks ago about how the Forverts is adapting to the changed (i.e. mostly Chasidic) Yiddish landscape.

Avrom Sutzkever: the blog
Not by him but about his work.

First post, with my translation of "Ode to the Dove" (part I).

Earlobes

On Leviticus 14:14, Rashi (or the Rashi found in many chumoshim my chumesh) uses a word קנארפעל knarfel to gloss תנוך אוזן earlobe. I have no idea what kind of word this is. I don't think it's Yiddish, unless it's a weird rhoticizing way of spelling קנאפל knafl heel ("heel of the ear"?). If anyone knows, that would make me less mystified, and would save me the effort I'm currently expending in trying to look it up. (Ideally I would find a reliable critical edition of Rashi which includes the "Yiddish" glosses, but I don't know where that would be.)

Update: The lobe thickens. I followed S.'s advice and just spent way too much time browsing Google Books (thanks for nothing!). Jerold Frakes' Early Yiddish Texts 1100-1750 (see page 1 in Google Books) includes a few pages on the Yiddish and Tsarfatic glosses found in Rashi. Leviticus 14:14, and knarfel, are not among them. I guess then that whatever manuscript my bal-chumesh was working from either (a) had a later addition of this super-gloss, or (b) the publisher just stuck it in. I have yet to look at the printed Rashi manuscripts available through JNUL.

A conversation with a taxi driver

Driver: What language are you speaking to your daughter? Is that Dutch?

Me: Close! It's Yiddish. A Jewish language. Say [noticing Driver's accent], where are you from?

Driver: The Congo.

[. . .]

Driver: I love the Jews.

Me: Oh . . . !?

Driver: My King is a Jew.

Me: (thinks) Congo. Does Congo have a king? I know something awful is happening in Congo right now but I don't remember what. Was "Belgian Congo," right? Was there a king then? Belgian Jews? (says) King?

Driver: My King, who I love.

Me: (light dawns) Oh . . . Jesus?

Driver: Yes. I think the Jews are wonderful. You are so good with money!

Me: I wish I was.

Driver: You are born smart. You are blessed.

Me: Um . . . thanks!

Yiddish junkets

Brandeis, or . . . Birobidzhan?

Hamiltonians
are sometimes funny.

Thinking about thinking about medicine
Rx: Think better.

I recently had the opportunity to interview Jerome Groopman for the Forward on the occasion of his new book, How Doctors Think. I hope the Q&A will appear soon. Meanwhile, enjoy this discussion in Slate which is rather less polite and chummy than ours was. Perhaps I should have said to Dr. Groopman what I was thinking, which is: Research on the patient-doctor interview has been accumulating for the past twenty-five years; why are mainstream MDs discovering it only now? (It's also interesting that the Slate discussion does not touch on doctor-patient communication at all. Groopman: doctors need to be trained better! Sanghavi: systems need to be more effective! But, guys, getting the patient to tell the doctor what the problem is? This is simple? This is done to perfection inside the office?)

Annoying Hebrew slang
Courtesy of Eurovision, Teapacks, and Iran.

I recently heard Israel's entry to the Eurovision song contest, a Teapacks song called Push the Button (video, lyrics). It's a good thing the lyrics are available on-line, because I can't understand the words to most songs in English, much less in rapped Hebrew. I think I learned a new word:

שוטרים וגנבים מתרוצצים עלי
והם קופצים עלי, מתקרצצים עלי

Shotrim veganavim mitrotzetzim alay
Vehem koftzim alay, mitkartzetzim alay

This is translated somewhere as "Cops and robbers run all over me / And they're jumping on me, getting on my case." I didn't know the word מתקרצץ, but judging from chat groups it means something like "annoy, suck up to, give too much attention to, glom onto" (e.g. כשחיפשתי דירה בבית הסטודנט, התקרצץ אלי איזה זקן -- "when I looked for an apartment in the student house, this old guy started getting in my face"; or המלצר ששירת אותנו התקרצץ עלינו בצורה דביקה במיוחד -- "the waiter who served us glommed onto us in a really sticky way").

Where does it come from? My father read to me over the phone from Milon Slang Makif, Comprehensive Dictionary of Slang, by one Rosenthal, which connects it to the word קריצה, meaning "winking, blinking." (Interesting that the Milon defines the reflexive - hitpa'el - as "to be annoyed," while on the basis of Internet usage, and from the Teapacks song, the hitpa'el functions here as an intensifier - to annoy.) Presumably קרצץ is formed by duplicating the last letter of קרץ. (Google doesn't know much about קרצץ.)

Rosenthal's Milon Slang Makif connects the word to קרציה tick. (Thanks to Balashon and an anonymous commenter for corrections.)

And k-r-tz (קרץ) is a well-known root from Tanach and modern Hebrew. In modern Hebrew it means "blink" (as mentioned above), but Rabbinically and Biblically the word also encompasses "pinch, cut; snap [the fingers]". Here's where I should get off the train and let Balashon, with his greater knowledge and fuller bookshelves, drive the etymology forward. Or is that backward?

Liberal "Torah Judaism"
Much as I hate the term.

Is there "da'as Torah"? Are there scholars lay, rabbinic, or talmid-khokhemdik who immerse themselves in the Torah so completely that their system of reference is different from others'?

This is plausible -- with a caveat. These learned Jews aren't to be found just in the ultra-Orthodox streams of Judaism which have popularized the term. Even liberal Jews can have daas Torah. It's just that their -- our! -- Torah is different (cf. "seventy sides/faces/tongues/languages to the Torah").

After the blood and the lamb: beets

I welcome your envy: among the guests at our second seder was Ms. Chocolate Lady, with escort Mr. Lady-to-be. She made us chocolate mousse which is quite possibly the best thing I have eaten ever. Even tastier than the Jewish madeleine, I mean the afikoymen.

She also made us some beets, and I brought them for lunch to work today, a big tupperware that I meant to eat only half of. Big mistake, thought I, as I opened the plastic bag and saw a pool of beet juice on the bottom - now I'll have to eat up the whole thing so it won't leak into my backpack on the way home. So, worried about beet overdose, I started in. And they were delectable. There I sat, waiting for my patients to arrive, tie untucked into shirt, slurping up huge tasty beet hunks with trusty chunks of matzo. I was a beet-scarfing animal. I was a beet plague. I finished it all and I wanted more.

Lucky the door was closed. And I sanitized my hands before examination.

Meritorious mothers
From Solomon Schechter, Aspects of Rabbinic Theology, chapter 12.

The Zachuth of the pious ancestry may generally be described as the זכות אבות (the Zachuth of the Fathers), but the term Fathers is largely limited in Rabbinic literature to the three patriarchs, Abraham, Isaac, and Jacob, God's covenant with whom is so often appealed to already in the Bible. The Rabbinic rule is, "They call not Fathers but the three (patriarchs), and they call not Mothers but four" (Sarah, Rebecca, Rachel, and Leah) [1]. The last statement with regard to the Mothers suggests that there is such a thing as the זכות אמהות (the Zachuth of the Mothers). This is in conformity with the Rabbinic statement in reference to Lev. 26:42 regarding God's remembering his covenant with the patriarchs, that there is also such a thing as the covenant with the Mothers [2]. In another place, they speak even distinctly of the Zachuth of the Mothers, "If thou seest the Zachuth of the Fathers and the Zachuth of the Mothers, that they are on the decline, then hope for the grace of God." [3] And it would even seem that they would invoke the Zachuth of the Mothers together with the Zachuth of the Fathers in their prayers on public fasts prescribed on the occasion of general distress [4] . . .

[1] Berachoth, 16b. See, however, D.E.Z., ch.1, where they speak of seven Fathers who entered into a covenant with God. In Sirach (heading to c.44), the expression Fathers is even more extensive.
[2] T.K., 112c.
[3] See Jer. Sanhedrin, 27d, and Lev.R., 36,6. Cf. commentaries, and see also Cant.R., 2,9.
[4] See Pseudo-Jonathan to Exod. 18:9 and Mechilta, 54a. In our liturgy, the invocation of the Zachuth of the mothers is very rare. A Piyut (hymn) by R. Gershom b. Judah, recited on the eve of the New Year, has a reference to the covenant of the Mothers.

Adventures in Toddler Bilingualism
Superfluous plurals.

My Yiddish- and English-speaking* 3-year-old, while playing blocks with me:

Du bist a boyer! ("You're a builder!")
Ikh bin a boyer! ("I'm a builder!")
Mir zaynen beyde boyersn! ("We're both builders'n!", i.e. with the plural form boyers and an added plural suffix-n)

*She also sings a lot of songs in Mandarin, but I don't think she can generate a sentence.

Who cut the khreyn?
And other Passover questions.

I'm thinking about the following questions during this Pesach season. You are invited to roll your eyes at them, ignore them, discuss them, think about them, or suggest your own.

1. Does it matter whether the Exodus story is historical?

2. How can one story (the Exodus) yield contradictory interpretations - e.g. the Jews are God's chosen people, yet the Jews were deserving of extermination in the desert?

3. Did the Israelites do anything to make themselves worthy of redemption - or was it all Moses'/Aaron's/God's doing?

4. What is the connection of chametz to Passover?

5. Can one people redeem another, or is that unwanted interference in the internal affairs of another nation?

6. If God chose the Jews, what did God choose them for?

Halachah Is Not Esthetics
An article in Makor Rishon.

Looks interesting, but I haven't read it yet:

The traditional halachic principle which prohibits "a mitzvah done through sinning" is not all-encompassing. According to a distinction made by the Rabbis of the Talmud, it goes into effect only in the most blatant of circumstances.

I know what your problem is
You're two stents!

I have the sinking feeling (maybe it should be "clotting") that the bare-metal vs. drug-eluting stents debate* is going to be our decade's version of dietary epidemiology: small effects, multiple studies, uncertain conclusions of doubtful clinical relevance. (For example, the latest NEJM-published meta-analysis looks at a four-year follow-up. I really hope our patients with stents live longer than that.)

*Short version: Vessels in which bare-metal stents are inserted tend nevertheless to fail (close off again) after a short time. Stents which elute drugs avoid this first problem but have recently been associated with an increased risk of thrombosis (clotting). Of course, whether these first two statements are true is also open to question . . .

Schaechter z"l: toiling without sentimentality
"What motivated him was the desire that Yiddish should receive the respect of any other language."

Brian Zumhagen talked about him today on WNYC (audio, transcript).

* * *

An evening of remembrance and Yiddish learning

on the shloyshim of Dr. Mordkhe Schaechter z"l

Sunday, March 18th, 5:30 P.M.

at the Workmen’s Circle / Forward Building,

45 East 33rd Street

between Madison and Park Avenues

in New York City

The speakers:

David Braun, Harvard University

Marc Caplan, Johns Hopkins University

Paul Glasser, YIVO Institute for Jewish Research

Rakhmiel Peltz, Drexel University

David Roskies, Jewish Theological Seminary

A few Yiddish songs especially meaningful to Dr. Schaechter will be

sung.

Primarily in Yiddish.

Take the 6 train to East 33 Street,

or the D, F, N, R train to West 34 Street.

On and Off the Bima

Nice if unsurprising article in the Times about adopted Chinese girls turning bat mitzvah, but please!

“That was my hope when I started her in day school,” Ms. Nealon said, “that when she got up on the bimah” — the lectern where the bat mitzvah girl reads from the Torah — “she would feel like she had the right to be there.”

Sic! Look, you're The New York Times, the only de facto Jewish newspaper some New York Jews ever read. Get the lingo straight, wouldja?

(For reference, the bimah is the platform. The lectern is called the amud. It's called other things too, but I bet no one calls it the shtender in the shuls mentioned in the article.)

On second thought: it could just be that the Times is using lectern in another sense, namely to refer to said platform. If this is the case, they would probably call the reading stand a podium.

Where have you been, Moses?
Look, we made you something. With your brother's help.

This year Parshes Ki Siso (Ki Tisa) almost makes me want to cry. The children of Israel made a mistake born of desperation and fear - they didn't know when Moses was coming back down the mountain. (Rashi says it was all because of a scheduling mixup, whether 40 days included the following night.) What were they supposed to do? And the worst of it is, their sin is a real sin, which shouldn't be blamed on the mixed multitude. They did it (we did it), and are to be blamed, but our reasons were understandable. We were scared and hopeless.

It feels like all the stories I'm hearing from my patients, now that I know enough to ask about depression, suicidal thinking, drug and alcohol abuse, but don't yet have enough experience to see my help taking effect -- or the problems are too deep-rooted for me to help at all. It's like screaming at the train that's about to hit a stalled truck.

Promise
Glyn Maxwell (from his book Nerve)

I made my child a promise, so a weight
was passed to her. I saw how carefully

its power was handled, that it lit the thoughts
around it, and I felt it warm her talk

and urge the hours along. Since I, like you,
no longer know a word like that, the light

she gained was lost to me. It didn’t mean
I’d let her down—I didn’t—but I seemed

to be aligned with those who might in time,
as if I’d somehow set coordinates.

Poem Stuffed into Ziploc Bags With Hamentasch and Raisins
aka shalekhmones doggerel 2007. Hebrew and Yiddish doggerel here.

Esther was greenish. You know that, honey?
It makes me squeamish but she's better than money.

She could have been silent, let the whole thing pass
But the Queen kicked the can of Ahashuerus.
Esther was greenish . . .

Beauty's in the eye, buck stops at the throne
Esther couldn't save us had she slept alone.
Esther was greenish . . .

World Leaders, Jewish and Non-Jewish, Send Purim Greetings
From the United Synagogue, Spam Division, Propaganda Subsection.

President George W. Bush
The White House
WASHINGTON -- Following are remarks that the President made for the press regarding the Festival of Lots, which falls on Saturday night, except when it doesn't.
"I'd like to thank the Prime Minister of Israel for alerting me to the very real danger that exists from President Haman of Persiran. We would admit defeat, and the terrorists would win, if we did not bomb the bastards back to the Stone Age the minute after the megillah is read at my friend Joseph Lieberman's synagogue Kesher Israel."

Prime Minister Vladimir Putin
The Kremlin
MOSCOW - Following are remarks the Prime Minister made to his wife before he turned his face to the wall and fell asleep. Some content has been censored.
"I would like to congratulate my Jewish friends on being so devilishly clever as to defeat the nefarious Central Asians. My friend Rabbi Lazar of the warm, friendly, welcoming, and messianist Jewish group Chabad tells me that only one lesson can be learned from the Scroll of Esther: we would be in very real danger if we did not bomb the Chechnyan bastards back to the Soviet Age the minute after I finish this bottle of vodka."

President Moshe Katzav
Beyt Ha-Nasi
JERUSALEM - Following are remarks made by the President to an attractive staff sergeant who brought him coffee this Wednesday.
. . .
On second thought, never mind.

Rabbi Avi Shafran
Spokesman of the World Conference of Grand Jewish Orthodox Charedi Rabbinical Rebbes
SOMEWHERE IN BROOKLYN. QUEENS MAYBE? MONSEY? I FORGET. ANYWAY. - "Since 'the glory of the princess is within doors' and Esther deserves her modesty, the coming Artscroll/Super Charedi (TM) edition of the Megillah will change Queen Esther's name to 'Mister Mister.' While we're at it, 'Mordechai' sounds gay; his name we're changing to 'Mendel.'"

Professor Arnold Eisen
Chancellor of JTS
UPPER WEST SIDE, PARTICULARLY INCONVENIENT TO ANY TRAINS YOU MIGHT EVER WANT TO TAKE. WHY COULDN'T THEY HAVE PUT IT NEARER MIDTOWN? - "First of all, Avi, quit making jokes about what the 'TS' stands for. That's just immature. Second, I'd like to wish an anthropological, sociological, and philosophical Purim to all my constituents. I am pleased to release the results of a comprehensive poll recently taken of the Conservative movement's leadership when they were having lunch together at Katz's. [They were eating the tuna salad. Jeez, you people are so frum!] 50% of the respondents (N=1) agreed with getting shiker-faced on Purim, while another 50% (N=1) held that sugar intoxication was preferred. Another 50% (N=1) wondered when he could finally retire to Jerusalem and join an Orthodox shul. Steve, oh Steve Cohen! Why don't these numbers add up right?..."

Rabbi Elliot Dorff
Professor of Partial Homosexual Heterim
UPPER WEST SIDE, I MEAN THAT'S WHERE HE WORKS, BUT FOR HIS SAKE I HOPE HE LIVES SOMEWHERE ELSE - "I'd like to wish my gay friends an enjoyable Purim. But not too enjoyable."

Informed consent
Notes for a talk

Mr. C. is a 55-year-old Spanish speaking man with abdominal pain that has migrated from the epigastrium to the right lower quadrant of the abdomen. You are asked to “consent” him for a CT scan of the abdomen. Your Spanish is good enough to talk to him, but Mr. C. does not ask any questions, even when you repeatedly press him on the matter. He keeps saying, “Whatever you say, doctor.”

More here.

My favorite gay-and-lesbian teshuvah

It took me this long to read Rabbi Gordon Tucker's teshuvah? It's as if all the questions and problems I have been having, all the points I have been fumbling after (and wasting precious bandwidth on, inelegantly and ineloquently, in this blog) have been encapsulated and justified. Go read. Let's talk. Dov W., are you out there? Come challenge.

Choni the Furrow-maker
A.k.a. the Plasterer. Or the Roof-smoother.

All these are alternate translations of חוני המעגל, generally known in English as Choni the Circle-Drawer. Listen to this particularly satisfying explanation of his name, from an article by Dr. Israel Rosenson.

There is a similarity between the עוגה (ugah) in this story and the עוגיות (ugiyos), round furrows around trees, mentioned in the laws of the intermediate days of festivals. "Irrigation ditches are watered during the intermediate days . . . but furrows are not made for vines" (Mishna Moed Katan 1:1).

According to this, Choni stands in the middle of the circle like a tree in the midst of its furrow-circle . . . to emphasize the dependence of a man's strength on his Creator.

Dietary epidemiology strikes again
The interesting epidemiological abstract of the week. Do you believe it?

Keep in mind that dietary patterns are devilishly hard to establish (never mind corroborate). (I talked here about the problems of dietary epidemiology. Michael Pollan debunked the whole field in a brilliant essay in the New York Times Magazine a few weeks ago.) Also, keep in mind that factor analysis is susceptible to subjective, nay idiosyncratic, notions of how factors should be defined. Nevertheless, this is an interesting abstract, particularly with the suggestion that a "Mediterranean" diet (olive oil, veggies) is associated with country of origin but not associated (negatively or positively) with diabetes.

Dietary Patterns and Diabetes Incidence in the Melbourne Collaborative Cohort Study
Hodge et al.
American Journal of Epidemiology 2007 165(6):603-610

The authors investigated the association of dietary patterns and type 2 diabetes in a 4-year prospective study of 36,787 adults in the Melbourne Collaborative Cohort Study (1990–1994). A total of 31,641 (86%) participants completed follow-up, and 365 cases were identified. Four factors with eigenvalues of greater than 2 were identified using the principal factor method with 124 foods/beverages, followed by orthogonal rotation. Variables with factor loadings having absolute values of 0.3 or greater were used in interpreting the factors. Odds ratios for diabetes incidence across quintiles of factor scores were computed by use of logistic regression, adjusting for age, energy intake, family history of diabetes, country of birth, and other factor scores. Factor 1, characterized by olive oil, salad vegetables, and legumes and by avoidance of sweet bakery items, margarine, and tea, was associated with country of birth but not with diabetes. Factor 2, characterized by salad and cooked vegetables, was inversely associated with diabetes. Factor 3, characterized by meats and fatty foods, was associated with increased diabetes risk. A range of fruits loaded strongly on factor 4, which showed little association with diabetes. Avoidance of a dietary pattern including meats and fatty foods, as well as adherence to a pattern including salad and cooked vegetables, is recommended.

The Emperor of Yiddish Words
Schaechter z"l, from 72nd Street to Bainbridgevke.

Mordkhe Schaechter, a linguist, lexicographer and rebbe of secular Yiddishists, died February 15. He was 79.

I became attracted to Yiddish when I was growing up in Louisville, Ky. Sitting in the back of Ms. Donsky’s German class, I often encountered Schaechter’s name while stumbling through week-old issues of the Forverts. On the basis of these references, I came to imagine a one-man Yiddish empire, an Academy of the Yiddish Language, publishing books, issuing edicts and deciding issues of style from a Yiddish Palace perched high in the mountains of Eastern Europe.

Read more in the Forward.

And you shall bind them (2)

A few days ago I talked about Rabbi Michael Broyde's prediction of the Conservative movement's imminent demise. What interested me were two throwaway statements: (1) "halachah is binding" (implying that this statement is unquestionably true for everyone, in the same way, at all times), and (2) American Jews can be divided into those who believe (1) is true and those who don't.

Comes a recent post by Jonathan Woocher on the Conservative e-mail list Shefa which nicely addresses point 2. So I'll quote it here in its entirety. Two points: although Broyde was trying to classify the whole of the Jewish community, Woocher talks here about the difficulty of defining the Conservative movement. I think the same difficulties apply to either, which is why I'm citing this. Second, the poster thinks it would be problematic for the Conservative movement to define itself based on behavioral criteria. I agree with this, probably for same reason as the poster. Indeed, it would be curious if behavioral criteria were not part of the C. movement's self-definition (such criteria being an essential part of halachah) - but only a part, since if it were the whole definition we would be a movement dedicated to self-policing and ruling people out rather than in.

I believe that part of the difficulty in addressing questions of denominational identity, boundaries, etc., is that there are multiple dimensions of what we might mean by, say, “the Conservative movement.” We might be talking about the movement’s 1) ideology (and, of course, none of the movements has a single, coherent ideology, but rather at best a set of ideologies with certain common elements); 2) program (different than an ideology; this is what it actually focuses its collective energies on at any given point in time); 3) institutions (synagogues, seminaries, USCJ, RA, etc.); 4) people (not just the public figures, but the people one encounters or encountered in the past in shul, school, camp, etc.; and/or 5) style (as with ideologies, movements do have multiple styles, but the “styles” of Conservative and Reform Judaism are generally fairly distinct). My observation is that what attracts individuals to a particular movement may be any of these (singly or in combination). So, one may well be ideologically “Reform,” but have a social network largely made up of Conservative Jews and prefer a service with more Hebrew.

There is a natural and understandable inclination to believe that ideology should be the trump card in this deck. This would lead to saying, e.g., that if you don’t believe in the normative authority of Halakha (leaving aside for the moment what we understand Halakha and its normative authority to be), you really don’t belong in the Conservative movement. However, it’s not clear to me that we should privilege ideology in this fashion, especially since it is an arena in which multiple positions coexist. So, unless one is prepared to set either strict ideological boundaries (how would we enforce these?) or – even more problematic – behavioral boundaries (which is where this thread began: questioning whether those who do not follow “normative Conservative practice,” e.g., not eating non-Kosher food outside the home, should have their opinions counted on an issue like gay ordination), I’m afraid we are stuck with an ambiguous movement in an ambiguous world.

I, for one, am comfortable with this, since the alternative would in my view be far worse, namely a movement constantly checking its tzitzes. I would not find this a very appealing landscape on which to take my Jewish journey.

Happy 100th, Wystan!

This is always worth hearing -- not his best poem (or his best reading), but one of my favorites.

Should not have been a talmid-khokhem

I am trying to express my appreciation of Schaechter (as everyone called him) in a limit-yourself-to-800-words sort of way. Meanwhile, a thought from today's shiva call, where someone quoted a frum acquaintance of the deceased. "It's a pity [Dr. Schaechter] wasn't a Torah scholar," the acquaintance supposedly said, "because he was so medakdek [punctilious]."

Two possible responses: no, he shouldn't have been a Torah scholar, because then he wouldn't have been what he was. Torah scholarship is not so destitute, nor the Jewish world of intellectual endeavor so narrow, that every talent must be yeshiva-fied. We have minds aplenty and lots of problems to work on, from the nature of God to the proper number of bird sacrifices - to questions of language preservation and standardization.

In fact, Schaechter was a secular Jew. Some friends and I (they are academic Yiddishists who devote their life to the language and literature) are discussing his passing over e-mail, and one pointed out that our subject line (borekh dayen emes, "Blessed be the True Judge"), while an appropriate and natural response for some of us, is not appropriate for Schaechter. He was many things in his appreciation of the Jewish people, but religious he was not. He was a secular Yiddishist, an ideology with its own powerful advantages, blindnesses, and failings, not to be lumped into our own personal categories, no matter how much we are beholden to them.

Second is that being medakdek (הקפדה, דקדקניות) is not what I think of as necessary for a Torah scholar. Encyclopedic knowledge, certainly; exactitude, yes; but above all an inspired creativity. But creativity is a dirty word in some circles.

Mordkhe Schaechter olevasholem

Dr. Schaechter, the linguist, teacher, editor, lexicographer, and (for lack of a better word) rebbe of Yiddishists everywhere, has died. The funeral will be tomorrow.

Update: The Times obituary.

The first Valentine’s day

was Valentine’s last --
his head bid on by an apothecary.
A cut-rate martyr.
The last thing in his head (save the blade)
a tavern:

close, smoky, ringing with soldiers’ serenades to others’ wives
while in a darkened corner
he brooded over a wine-stained tabletop
carved with pairs of small crosses: Valentine’s
illegal young marrieds,
contra legem imperatoris.

He’s under the deepest coldest
dirt in Rome. On that spot, now, a couple stands,
kissing each other breathless,
waiting and forgetting
for the light to change -- hot blood and

no head.

And you shall bind them

Rabbi Michael Broyde wrote in the Jewish Week that Conservative Judaism is dying. Sad, don't you know, to see pure Jewish souls lost to the likes of Ramah and JTS. And it's all because we embraced the homosexuals and uprooted a clear "Sinaitic prohibition". (If, on the other hand, we had created a "Sinaitic prohibition" where none existed before, that would be okay. But I digress.)

Now, the bulk of the article is founded on the same mistaken premise beloved by Orthodox demagogues everywhere: that "Jewish law" is by definition what Orthodox rabbis say is Jewish law. Thus Conservatism does not follow Jewish law because (wait for it) Conservative Judaism is not Orthodox.

The author, I remind you, is a professor of law at Emory.

But even apart from this intellectual heavy lifting he does say something interesting:

The truth is that there is a grand divide in the Jewish community worldwide between two groups: those who think that Jewish law (halacha) is really, truly, binding and those who do not.

There are two implied propositions here:
1. Jewish law is binding.
2. Jews can be divided into two groups: those who think 1. is true and those who think 1. is not true.

What does it mean for halachah to be "binding"?

With "binding" in English we generally refer to a legal decision or agreement which the party or parties have agreed to follow beforehand, as in the phrases "binding contract" or "binding arbitration." An individual or body issues a decision on a contested point of law or procedure; the party must act according to that decision on pain of negative consequences.

Halachah is different. In some cases, a person presents a question to a rabbi on a certain matter, the rabbi renders a decision, and the person then acts according to that decision. This happens in a minority of occasions, even in Orthodox communities - thus I don't think that this what Rabbi Broyde is referring to in his characterization of halachah as binding. Rather, he is more plausibly referring to the body of halachah as binding.

Leave aside for a moment how we should define the body of halachah, because this is where R. Broyde and his Conservative colleagues differ. The problem is, for understanding "bindingness," that the situation of the Jew following halachah is different from the legal subject obeying a legal decision. For one thing, the source is not clear. Theologically speaking, the Source is clear, but halachah is many-layered, many-authored, and oftentimes internally contradictory. Thus, unless one asks a particular rabbi for a particular decision at that particular second, there are many particular elements of "Jewish law" one could hew to, or not. Even a given halachic question can be differently framed depending on how the "body of halachah" is understood.

The above is not to say that Jewish law is not binding. Of course I think it is! Merely that it is not enough, true, or convincing to say that "Jewish law is binding" means "I look in the Shulchan Aruch and I do what it says." The fact that I can disagree with one halachic source and agree with another makes any such characterization difficult.

In fact, given that halachah is so multi-faceted and non-unitary, it is no wonder that minds much greater than I have defined the bindingness of halachah as contingent on the existence of a community which sees halachah as binding! Thus we're right back to where we started, unless R. Broyde is of the opinion that "halachah is binding" means "Orthodox Jewish practice is binding."

Why all this throwing words around? Because if we are to divide American Jews into groups based on who thinks Jewish law is binding, it would help to get a handle on what this proposition actually means. Let's imagine we've done that (though we haven't), and return later to the issue of what American Jews think - even more complicated than the definition of "binding"!

Frost-off
You vant I should stand outside vit my horse looking at de snow?

Translation fans might be interested in Katle Kanye's Yiddish version of Stopping by Woods on a Snowy Evening, and my attempt inspired by his. There have been several earlier translations of the poem into Yiddish, but I can't find any of them right now.

The teaching of Jethro

We're familiar with the organizational content of the advice given to Moses by Jethro (Jithro, Yithro, Yisro(y), Yitro [is that why the rabbis say he has many names?]) - an management system, with leaders for various strata of the children of Israel. Something I was reminded of this year was the religious-educational content of Jethro's advice. This is Moses's explanation to his father-in-law of his approach:

14 And when Moses' father-in-law saw all that he did to the people, he said: 'What is this thing that thou doest to the people? why sittest thou thyself alone, and all the people stand about thee from morning unto even?' 15 And Moses said unto his ather-in-law: 'Because the people come unto me to inquire of God; 16 when they have a matter, it cometh unto me; and I judge between a man and his neighbour, and I make them know the statutes of God, and His laws.'

Jethro's preface to his words of advice bespeaks a different emphasis.

20 And thou shalt teach them the statutes and the laws, and shalt show them the way wherein they must walk, and the work that they must do.

Unfortunately, the translation (JPS 1919) betrays us somewhat here, for in the original, the same word (וְהוֹדַעְתִּי, וְהוֹדַעְתִּי) is used in Moses's explanation ("make them know the statues of God, and His laws") and in Jethro's ("shalt show them the way wherein they must walk"). The root implies knowledge, understanding, and a host of other things. But what 's most important is what M. and J. choose to convey: the laws versus the way wherein they must walk, codification versus (presumably moral) instruction. The dispute is an old one. Jethro's argument for the usefulness of teaching in time management is no weaker for being implicit: if you show the pople where to go, they might be less likely to bother you in the future with picayune concerns about law and custom.

In medical terms: talk with the patient while she's in front of you rather than just telling her what to do. You might help her self-improvement and save yourself time in the long run.

The football news you expect
From the sports blog you trust.

The score in this year's Super Bowl was 29-17. Both numbers are primes! This has happened twice before, in 1980 and 1970. I will guess that this is precisely as likely as one would expect this sort of thing to happen by chance. That, or it's a divine sign of maddening ambiguity. God's like that.