"U- Maryland has had the biggest commitment to Yiddish as a language anywhere in a hundred-mile radius," says Harvey Spiro, president of Yiddish of Greater Washington, which organized a letter-writing campaign. "We're not a particularly political organization, but this kicked us in the gut."Umm...I think Johns Hopkins is near the University of Maryland, no? And they have a great Yiddish teacher.
12/28/09
More mourning for Yiddish
I don't want anyone to lose their job teaching Yiddish at the University of Maryland, certainly not Miriam Isaacs, but it would increase sympathy if people quoted in newspaper articles would be careful not to say things like this:
12/24/09
Authenticity as aesthetic (or: what is coherence and integrity?)
In the Forward, Jay Michaelson says that "the myth of authenticity has got to go." In the liberal circles that he and I travel in, this claim isn't all that surprising or challenging. I believe he's mostly talking to those of us whose subconscious, when asked to provide the image of an archetypal Jew, summons up a fundamentalist of our time or a prehistorical figure - anything but one of our own hyphenated, conflicted kind. But the hyphenations and conflicts, say Michaelson, are part and parcel - perhaps even the most admirable element - of Judaism. Most of what we value is transient, and always in flux.
What should we pursuing if not this myth? Michaelson gives several rephrasings of what I presume is meant to be the same idea: whatever religious, literary, or cultural form "speaks to the depths of what it is to be human," "get[s] to what matters" or is "resonant." Finally, though, he comes down to the core of his alternative definition: "a personalized notion of authenticity measured by integrity and individual coherence." I don't know what that means, but let's say for the sake of argument I pretend to. I can think of two problems with this.
First, coherence is a cousin of consistency, the hobgoblin everyone loves to hate. There's a reason for that: we all know complete bastards who are thoroughgoing and consistent in their personal behavior. What resonates with them, unfortunately, is nothing the rest of us would touch with a 10-foot pole. I suppose this is why "integrity" makes an appearance, but that's a slippery fish itself, and Michaelson owes us a more rigorous definition.
The second problem is that Judaism, for all its flux and change, is not predominantly a collection of individual non-interactors, each (with integrity and individual coherence, naturally) pursuing their own direction: a Brownian-motion people. Things get popular and define, in large measure, the majority of the Jewish community. So American Jews like "bagels and not jahnoon" because there are more Ashkenazic Jews than other varieties. Similarly, "Joseph Caro’s legalistic Shulchan Aruch" beat out his radical, mystical “Maggid Mesharim” because the former became popular and frequently referred to while not the latter. It's not complicated: people seek community. As sociologists (most notably Arnold Eisen) have pointed out, the majority of American Jews light Chanukah candles and make some sort of Passover Seder even if they don't know or care about the halachic or historical underpinnings of the holiday.
The problem, in short, is that whatever Michaelson's aesthetic (for that's what it is - and I mean that as a believer in the importance of aesthetics), there will still be practices and assumptions regarding Judaism which the majority of a certain community of Jews adopt. Unless "internal Jews" like him find a way to convince the rest of us what exactly he means by that coherence and integrity, we will be left out of his aesthetic. I don't know whether that would be more to his or our detriment.
What should we pursuing if not this myth? Michaelson gives several rephrasings of what I presume is meant to be the same idea: whatever religious, literary, or cultural form "speaks to the depths of what it is to be human," "get[s] to what matters" or is "resonant." Finally, though, he comes down to the core of his alternative definition: "a personalized notion of authenticity measured by integrity and individual coherence." I don't know what that means, but let's say for the sake of argument I pretend to. I can think of two problems with this.
First, coherence is a cousin of consistency, the hobgoblin everyone loves to hate. There's a reason for that: we all know complete bastards who are thoroughgoing and consistent in their personal behavior. What resonates with them, unfortunately, is nothing the rest of us would touch with a 10-foot pole. I suppose this is why "integrity" makes an appearance, but that's a slippery fish itself, and Michaelson owes us a more rigorous definition.
The second problem is that Judaism, for all its flux and change, is not predominantly a collection of individual non-interactors, each (with integrity and individual coherence, naturally) pursuing their own direction: a Brownian-motion people. Things get popular and define, in large measure, the majority of the Jewish community. So American Jews like "bagels and not jahnoon" because there are more Ashkenazic Jews than other varieties. Similarly, "Joseph Caro’s legalistic Shulchan Aruch" beat out his radical, mystical “Maggid Mesharim” because the former became popular and frequently referred to while not the latter. It's not complicated: people seek community. As sociologists (most notably Arnold Eisen) have pointed out, the majority of American Jews light Chanukah candles and make some sort of Passover Seder even if they don't know or care about the halachic or historical underpinnings of the holiday.
The problem, in short, is that whatever Michaelson's aesthetic (for that's what it is - and I mean that as a believer in the importance of aesthetics), there will still be practices and assumptions regarding Judaism which the majority of a certain community of Jews adopt. Unless "internal Jews" like him find a way to convince the rest of us what exactly he means by that coherence and integrity, we will be left out of his aesthetic. I don't know whether that would be more to his or our detriment.
12/16/09
ABBA in Borough Park
Social scientists rethink the relationship between Chasidim and modernity.
Sometime in 2001, if you were a Chasidic woman in Borough Park, you would have noticed a teacher's assistant who looked out of place at your daughter's school. You would have been familiar with non-Jews and non-religious Jews from their stores and magazines. But you would never have expected someone not quite right to be in your daughter's classroom. She was nice enough, an intelligent woman with a shearling coat who spoke a good Yiddish. But it was clear what she was not: a haymishe fro, a Chasidic woman. You went to the principal to voice your concerns. Could it be that outside influences had invaded your daughter's school so easily?
The woman was politely asked to work somewhere else, and she did. Once in a while you saw her in the community, though never again at that school. But who was she?
You heard from your friends that she was a Jew from a non-religious home, studying in a university to be some kind of professor. She was Ayala Fader, an anthropologist - and her subject was not an obscure group of hunters near the Amazon, but the Chasidim, and how Chasidic girls are raised to a particular kind of devotion.
* * *
Perhaps you have thought of Chasidim as a pre-modern, separatist sect, with their own strange costumes, quaint language, and deliberately different, even contrarian customs. But - according to a nascent body of work by researchers interested in contemporary Chasidim - you would be wrong. It is not how Chasidim avoid modernity which enables them to survive as a self-defined group, but how they negotiate with, cleverly re-interpret, and, in the final analysis, appropriate modernity as their own.
Fader (an associate professor of anthropology at Fordham University and author of the new book "Mitzvah Girls: Bringing Up the Next Generation of Hasidic Jews in Brooklyn" (2009: Princeton University Press) asks the same question about the Chasidim that you would: how can they participate only piecemeal in the surrounding world? Not, Fader says, because they are ignorant of its attractions or advantages, but out of religious and philosophical reasons: "they use the sense of their own authenticity, including a nostalgia for a lost, purer past in Eastern Europe, to make this historical moment just one more point in a redemptive narrative." Our superficially new modernity is just a repackaging of the same old Exile.
Many of the details of Fader's research have to do with raising Chasidic children, the "mitzvah girls" of her title. What is the special religious instruction tailored to Chasidic 5-year-olds? There is none: "these 'choices' [of daily life for children] are socialized in [Chasidic] kids through everyday interactions, not religious training." Fader spent hours and hours with her tape recorder, observing just what social interactions make up the Chasidic child: no, you can't draw a purple apple because apples aren't purple - even if the imagination would like to suggest it; no, you can't ask what the Mishnah is because girls don't learn about the Mishnah - even if you might be curious about it. When the proper choices are socialized by thousands of interactions with parents and teachers, they become second nature.
But conscious choices even in an area as rooted in the unconscious as language, also play a role in the self-definition of Chasidim. Sarah Benor, a sociolinguist at Hebrew Union College in Los Angeles, has written about the strategies used by Jews of different varieties to construct their version of Jewishness. Much as the Jewish English of American liberal Jews is not a distinct language, or dialect, but rather a repertoire of words and phrases consciously chosen for effect, Chasidic Jews flit between Englished Yiddish and Yiddished English to display their status to the outside world and mark their own status within their world.
Social interactions and language - somewhere on the border of conscious and unconscious activity - are important to the self-definition of Chasidim. But what about those elements of culture which people choose because they relieve the monotony? In other words: what about fun?
Asya Vaisman, a research fellow in Jewish studies at the University of Washington, recently defended her doctoral thesis at Harvard on the Yiddish songs and singing of Chasidic women. She tells a story from her research which shows that music, like language, helps define Chasidic separateness despite its porousness: "A Belz woman in London told me that her daughter was 'naughty' once and used songs by ABBA for the melodies in one Hasidic production." The headmistress had never heard ABBA, so she approved the songs. On its surface, the lesson of the story is clear: non-Chasidic culture (like ABBA) can only be allowed in if its provenance is hidden or denied. But the point might be even more subtle: as long as the maxims of cultural restriction are obeyed, the odd outside influence can slip through (and productively used) without undermining the foundations.
Today's researchers into Chasidic culture might thus be coming to a new consensus. Perhaps ten or twenty years ago, Chasidim were seen as a defiantly separatist sect, whose entire raison d'etre is a thoroughgoing opposition to modernity. Now Chasidim are seen (as Fader puts it) as creators of another, parallel modernity which communicates with our own. Only through understanding these dual modernities can we appreciate the importance of the niggun that comes from a secular Yiddish poem; the hairstyle which is "shtoddy" (fashionable) but not too much; the shifting from "Toyre" (with a Yiddish accent) to "Torah" and back again in order to "pass" as more or less modern.
Do Chasidim themselves see modernity as negotiable? R., a Yiddish journalist with a day job in finance, said via e-mail, "There are good and bad sides to modernity like anything else. I think a Chasid can extract the good elements from modernity: (relative) openness to other schools of thought and a readiness to change one's worldview, in the framework of traditional observance."
Katle Kanye is a Chasidic blogger. In contrast to R., he is skeptical about the modernity of Chasidim. "Modernity is fine. It keeps the house warm, you can use it to fly to see the rebbe a few times a year, view a menorah lighting from seven thousand miles away, visit the best doctors. If that's modernity, why not? But the fact that these discoveries didn't come about by themselves but are the fruit of free-thinkers including Darwin, Hume, Mill and other heretics - this the Chasidim don't understand and don't even recognize. When a Chasidic graphic designer sits with Coral or Photoshop and creats beautiful graphics, he might be so holy that he uses the Internet only for earning a livelihood. Then go explain to him that his art began with the painters of naked ladies in the Met, and he'll tell you that's not art, that's lust with a tie on."
Katle Kanye puts his finger on a weakness in Fader's depiction of Chasidic life as more in parallel with than in opposition to modernity. If we strip away everything that makes modernity a unique historical movement (the focus on the individual, the search for newness, the innovation in every sphere of life even to the extent of the abandonment of formerly universal truths), then what are we - or the putatively modern Chasidim - left with besides the name?
Nomi Stolzenberg, a professor of law at USC, is looking closely at these contradictions in the context of Kiryas Joel, New York - a town which has remained a predominantly Chasidic enclave through its inhabitants' creative, even contradictory, use of the principles of liberal democracy. How does a modern, liberal, secular political/legal regime enable Kiryas Joel to survive? It would not be a surprise if Stolzenberg's answer ends up having a lot in common with the findings of Fader, Vaisman, and Benor: Chasidim make use of modernity as they finesse its significance.
Recently I got a phone call from a Chasid, who asked, "Can you tell me what I should read to introduce myself to secular culture?" He was adamant that he did not want to leave his community, but only wanted to know what books to read to get exposure to "other ideas." After learning about Chasidim and modernity, I now want to know: is he seeking to become more modern, more Chasidic, or both?
Sometime in 2001, if you were a Chasidic woman in Borough Park, you would have noticed a teacher's assistant who looked out of place at your daughter's school. You would have been familiar with non-Jews and non-religious Jews from their stores and magazines. But you would never have expected someone not quite right to be in your daughter's classroom. She was nice enough, an intelligent woman with a shearling coat who spoke a good Yiddish. But it was clear what she was not: a haymishe fro, a Chasidic woman. You went to the principal to voice your concerns. Could it be that outside influences had invaded your daughter's school so easily?
The woman was politely asked to work somewhere else, and she did. Once in a while you saw her in the community, though never again at that school. But who was she?
You heard from your friends that she was a Jew from a non-religious home, studying in a university to be some kind of professor. She was Ayala Fader, an anthropologist - and her subject was not an obscure group of hunters near the Amazon, but the Chasidim, and how Chasidic girls are raised to a particular kind of devotion.
* * *
Perhaps you have thought of Chasidim as a pre-modern, separatist sect, with their own strange costumes, quaint language, and deliberately different, even contrarian customs. But - according to a nascent body of work by researchers interested in contemporary Chasidim - you would be wrong. It is not how Chasidim avoid modernity which enables them to survive as a self-defined group, but how they negotiate with, cleverly re-interpret, and, in the final analysis, appropriate modernity as their own.
Fader (an associate professor of anthropology at Fordham University and author of the new book "Mitzvah Girls: Bringing Up the Next Generation of Hasidic Jews in Brooklyn" (2009: Princeton University Press) asks the same question about the Chasidim that you would: how can they participate only piecemeal in the surrounding world? Not, Fader says, because they are ignorant of its attractions or advantages, but out of religious and philosophical reasons: "they use the sense of their own authenticity, including a nostalgia for a lost, purer past in Eastern Europe, to make this historical moment just one more point in a redemptive narrative." Our superficially new modernity is just a repackaging of the same old Exile.
Many of the details of Fader's research have to do with raising Chasidic children, the "mitzvah girls" of her title. What is the special religious instruction tailored to Chasidic 5-year-olds? There is none: "these 'choices' [of daily life for children] are socialized in [Chasidic] kids through everyday interactions, not religious training." Fader spent hours and hours with her tape recorder, observing just what social interactions make up the Chasidic child: no, you can't draw a purple apple because apples aren't purple - even if the imagination would like to suggest it; no, you can't ask what the Mishnah is because girls don't learn about the Mishnah - even if you might be curious about it. When the proper choices are socialized by thousands of interactions with parents and teachers, they become second nature.
But conscious choices even in an area as rooted in the unconscious as language, also play a role in the self-definition of Chasidim. Sarah Benor, a sociolinguist at Hebrew Union College in Los Angeles, has written about the strategies used by Jews of different varieties to construct their version of Jewishness. Much as the Jewish English of American liberal Jews is not a distinct language, or dialect, but rather a repertoire of words and phrases consciously chosen for effect, Chasidic Jews flit between Englished Yiddish and Yiddished English to display their status to the outside world and mark their own status within their world.
Social interactions and language - somewhere on the border of conscious and unconscious activity - are important to the self-definition of Chasidim. But what about those elements of culture which people choose because they relieve the monotony? In other words: what about fun?
Asya Vaisman, a research fellow in Jewish studies at the University of Washington, recently defended her doctoral thesis at Harvard on the Yiddish songs and singing of Chasidic women. She tells a story from her research which shows that music, like language, helps define Chasidic separateness despite its porousness: "A Belz woman in London told me that her daughter was 'naughty' once and used songs by ABBA for the melodies in one Hasidic production." The headmistress had never heard ABBA, so she approved the songs. On its surface, the lesson of the story is clear: non-Chasidic culture (like ABBA) can only be allowed in if its provenance is hidden or denied. But the point might be even more subtle: as long as the maxims of cultural restriction are obeyed, the odd outside influence can slip through (and productively used) without undermining the foundations.
Today's researchers into Chasidic culture might thus be coming to a new consensus. Perhaps ten or twenty years ago, Chasidim were seen as a defiantly separatist sect, whose entire raison d'etre is a thoroughgoing opposition to modernity. Now Chasidim are seen (as Fader puts it) as creators of another, parallel modernity which communicates with our own. Only through understanding these dual modernities can we appreciate the importance of the niggun that comes from a secular Yiddish poem; the hairstyle which is "shtoddy" (fashionable) but not too much; the shifting from "Toyre" (with a Yiddish accent) to "Torah" and back again in order to "pass" as more or less modern.
Do Chasidim themselves see modernity as negotiable? R., a Yiddish journalist with a day job in finance, said via e-mail, "There are good and bad sides to modernity like anything else. I think a Chasid can extract the good elements from modernity: (relative) openness to other schools of thought and a readiness to change one's worldview, in the framework of traditional observance."
Katle Kanye is a Chasidic blogger. In contrast to R., he is skeptical about the modernity of Chasidim. "Modernity is fine. It keeps the house warm, you can use it to fly to see the rebbe a few times a year, view a menorah lighting from seven thousand miles away, visit the best doctors. If that's modernity, why not? But the fact that these discoveries didn't come about by themselves but are the fruit of free-thinkers including Darwin, Hume, Mill and other heretics - this the Chasidim don't understand and don't even recognize. When a Chasidic graphic designer sits with Coral or Photoshop and creats beautiful graphics, he might be so holy that he uses the Internet only for earning a livelihood. Then go explain to him that his art began with the painters of naked ladies in the Met, and he'll tell you that's not art, that's lust with a tie on."
Katle Kanye puts his finger on a weakness in Fader's depiction of Chasidic life as more in parallel with than in opposition to modernity. If we strip away everything that makes modernity a unique historical movement (the focus on the individual, the search for newness, the innovation in every sphere of life even to the extent of the abandonment of formerly universal truths), then what are we - or the putatively modern Chasidim - left with besides the name?
Nomi Stolzenberg, a professor of law at USC, is looking closely at these contradictions in the context of Kiryas Joel, New York - a town which has remained a predominantly Chasidic enclave through its inhabitants' creative, even contradictory, use of the principles of liberal democracy. How does a modern, liberal, secular political/legal regime enable Kiryas Joel to survive? It would not be a surprise if Stolzenberg's answer ends up having a lot in common with the findings of Fader, Vaisman, and Benor: Chasidim make use of modernity as they finesse its significance.
Recently I got a phone call from a Chasid, who asked, "Can you tell me what I should read to introduce myself to secular culture?" He was adamant that he did not want to leave his community, but only wanted to know what books to read to get exposure to "other ideas." After learning about Chasidim and modernity, I now want to know: is he seeking to become more modern, more Chasidic, or both?
12/8/09
How liberal Jews can be as successful as Chasidim
I'm a modern Jew, trying to live in a way both authentically Jewish and culturally liberal. I enjoy ubiquitous technology and freedom of thought. My daughter can be a rabbi, a scholar, an artist, or something else entirely, unfettered by restrictions. But are we modern, liberal Jews still going to be around in a few decades? If my granddaughter will still be a Jew, what kind of Jew will she be?
The Hasids hold up their allegiance to their way of life, and none other, as an answer to these questions. No, I am not an authentic Jew. My Judaism is endangered by modernity. Liberal women are led astray by their freedoms. My granddaughter will be without any particular ethnic identity at all.
As a proportion of the Jewish community, liberal Jews are decreasing and fundamentalist groups (including Hasids) are growing. They spill over into neighboring communities and their towns (like Kiryas Joel in upstate New York) split at the seams. I worry they might be right. Perhaps liberal Jews are doomed to extinction.
Is there a way we can hold on to what we believe in and not be washed away by the surrounding culture? What can the Hasids teach us about being Jews in modernity, and is there anything about their techniques which we liberal Jews can learn from?
I've asked this question of myself time and again, because I am fascinated by Hasidim. I am by turns attracted and repelled by a Jewish group succeeding beyond all expectations despite predictions a few decades ago of their imminent demise, while motivated by ideologies that are in large measure strange and forbidding to me.
I feel a kinship to them for two reasons: one, they are Jews, and like them I am religiously observant (though in a way they don't recognize as observant); and two, I speak Yiddish. Because of this kinship, I have spent time with and developed meaningful friendships -- and some adversarial relationships -- with a number of Hasids, read a considerable amount of their contemporary literature, and devoted quite a bit of thought to the question of what liberal Jews can learn from Hasidim. I have done this while trying (in my Yiddish writing) to defend liberal Jewish ideology to Hasidim.
Wouldn't it be wonderful if liberal Judaism's ideologies and cultural institutions were to enjoy success and relatively ensured longevity, just like the Hasids, while keeping to our own liberal, Jewish values? At times I have thought that we should emulate Hasidic success by copying Hasidic strategies As a strange contemporary Jewish type - the Yiddishist - I have thought that we should, like the Hasids, retreat into an isolated community and talk Yiddish to each other. And I have thought that that might also be a solution to the difficulties of the other Jewish ideologies I identify with. If Conservative Judaism is most successful in scattered enclaves outside of New York (mostly college towns), why not found a Conservative enclave in the middle of nowhere? If we care enough about what we believe in, shouldn't we be willing to retreat behind the walls to keep out what will wash away our way of life?
The reason why this wouldn't work is obvious. We liberal Jews are modern, and we find value in that. Every interaction between Jewish and non-Jewish culture is not a source of anguish but the normal material of our life. It would be weird for us to choose to interact only with Jews, even if they were liberal Jews. That would take away our modernity.
So we can't build walls - or rather, if we are to be consistent with our ideologies, we can't. What should our survival strategy be? We can't set out to win the demographic war, as our lifestyle doesn't lend itself to strategic procreation. Perhaps (as many contemporary Jewish organizations seem to believe) we should make Jewish life as attractive as possible. Let's send young people to Israel, and maybe on the way to their paid vacation they will find meaning in Zionism. Let's try and create entertaining Jewish events which will pull in the disaffected and unaffiliated.
Such a strategy, however, becomes caught up in itself. If we are always reaching out with a Jewish liberal modernity, when do we start reaching in? What is it, after all, we want to preserve?
This is the most important lesson the Hasidim can teach us, even if we are unwilling or unable to build walls. Their way of life is successful, picturesque, rich, and in many ways meaningful, but its approach is one we cannot take. It is not for the obvious reasons that we are not Hasidic, and their ideology is not ours - that goes without saying. It is because of what their success teaches us about how movements can work: in spite of, not because of worries about survival.
I feel a kinship to them for two reasons: one, they are Jews, and like them I am religiously observant (though in a way they don't recognize as observant); and two, I speak Yiddish. Because of this kinship, I have spent time with and developed meaningful friendships -- and some adversarial relationships -- with a number of Hasids, read a considerable amount of their contemporary literature, and devoted quite a bit of thought to the question of what liberal Jews can learn from Hasidim. I have done this while trying (in my Yiddish writing) to defend liberal Jewish ideology to Hasidim.
Wouldn't it be wonderful if liberal Judaism's ideologies and cultural institutions were to enjoy success and relatively ensured longevity, just like the Hasids, while keeping to our own liberal, Jewish values? At times I have thought that we should emulate Hasidic success by copying Hasidic strategies As a strange contemporary Jewish type - the Yiddishist - I have thought that we should, like the Hasids, retreat into an isolated community and talk Yiddish to each other. And I have thought that that might also be a solution to the difficulties of the other Jewish ideologies I identify with. If Conservative Judaism is most successful in scattered enclaves outside of New York (mostly college towns), why not found a Conservative enclave in the middle of nowhere? If we care enough about what we believe in, shouldn't we be willing to retreat behind the walls to keep out what will wash away our way of life?
The reason why this wouldn't work is obvious. We liberal Jews are modern, and we find value in that. Every interaction between Jewish and non-Jewish culture is not a source of anguish but the normal material of our life. It would be weird for us to choose to interact only with Jews, even if they were liberal Jews. That would take away our modernity.
So we can't build walls - or rather, if we are to be consistent with our ideologies, we can't. What should our survival strategy be? We can't set out to win the demographic war, as our lifestyle doesn't lend itself to strategic procreation. Perhaps (as many contemporary Jewish organizations seem to believe) we should make Jewish life as attractive as possible. Let's send young people to Israel, and maybe on the way to their paid vacation they will find meaning in Zionism. Let's try and create entertaining Jewish events which will pull in the disaffected and unaffiliated.
Such a strategy, however, becomes caught up in itself. If we are always reaching out with a Jewish liberal modernity, when do we start reaching in? What is it, after all, we want to preserve?
This is the most important lesson the Hasidim can teach us, even if we are unwilling or unable to build walls. Their way of life is successful, picturesque, rich, and in many ways meaningful, but its approach is one we cannot take. It is not for the obvious reasons that we are not Hasidic, and their ideology is not ours - that goes without saying. It is because of what their success teaches us about how movements can work: in spite of, not because of worries about survival.
What does this mean? Take two examples of successful, relatively recent (in historical terms) Jewish ideologies. Zionism was not predicated on the notion fhat the Jewish population of Eastern Europe would be nearly exterminated in the Holocaust. To be sure, many Zionist thinkers predicted that Diaspora Jewry was untenable, but as a general matter this claim has proven to be unfounded (the American Jewish community is in no danger of extinction). The success of Zionism has to do with the success of the ideology: Jews constructing a modern Jewish state in the Land of Israel. Whatever its flaws, that country does exist, thanks to Zionism. The ideology has succeeded. Even if Jewish communities around the world thrived, and Israel were comparatively small and insignificant in terms of Jewish life, its success would still be significant.
Similarly, Hasidism as a culture is not merely a means to an end of survival. Hasidim have large families and live lives of chosen isolation because they believe strongly that their observance of strict Jewish law is the only way to God's approval. If, through some demographic or historical quirk, this caused them suffering or disappearance, they would still feel this way. Their ideology - by their lights - would still be a success.
So I come to the conclusion that my worries aren't wrong, necessarily (maybe modern, liberal Jews are bound to decrease in numbers), just misplaced. If we believe that contact with non-Jews and a wide variety of ideas is beneficial to us, if we think that a spectrum of Jewish practice and culture is valuable, and if we own up to these ideologies with confidence, we can be free of the relentless demographic drumbeat which our own worries and the worries of our institutional demographers pummel us with. We can be confident, modern, liberal Jews, in other words, and succeed by doing what we believe in, whether or not our communities and adherents grow by leaps and bounds. We can be as successful as the Hasidim even if we can never be fruitful and multiply, or be as picturesquely isolated, as they are.
12/2/09
What bridges the gap between evidence-based medicine and the patient?
Under the withering barrage of recent guideline changes, doctors and patients alike have raised their hands in surrender. It seems like guideline group after group have changed their recommendations to say (more or less) the same thing: "[name of screening test here] should be discussed with the patient according to their risk profile."
We used to think that population studies ("big-E epidemiology") would provide us with the tools to fix health care. The drill of empirical science would become the Swiss Army knife of evidence-based medicine.
But something got in the way: inconveniently enough, that something is the patient.
A patient is not a population, but a unique individual with a one-of-a-kind combination of characteristics. So how to apply the population findings (or even the evidence-based recommendations) to the individual? As Karla Kerlikowske says in the latest issue of the Annals of Internal Medicine ("Evidence-Based Breast Cancer Prevention: The Importance of Individual RIsk"): "We urgently need risk models with better discriminatory accuracy . . . that can accurately identify individuals at all levels of risk."
So that's one way of bridging the gap. But there's another way which is just as central: making sure the patient is informed enough (about their own desires, even - about their own priorities) to make them a partner in decision-making. Because how can evidence-based medicine leap the gap from the journal to the bedside without the patient taking hold of it themselves?
We used to think that population studies ("big-E epidemiology") would provide us with the tools to fix health care. The drill of empirical science would become the Swiss Army knife of evidence-based medicine.
But something got in the way: inconveniently enough, that something is the patient.
A patient is not a population, but a unique individual with a one-of-a-kind combination of characteristics. So how to apply the population findings (or even the evidence-based recommendations) to the individual? As Karla Kerlikowske says in the latest issue of the Annals of Internal Medicine ("Evidence-Based Breast Cancer Prevention: The Importance of Individual RIsk"): "We urgently need risk models with better discriminatory accuracy . . . that can accurately identify individuals at all levels of risk."
So that's one way of bridging the gap. But there's another way which is just as central: making sure the patient is informed enough (about their own desires, even - about their own priorities) to make them a partner in decision-making. Because how can evidence-based medicine leap the gap from the journal to the bedside without the patient taking hold of it themselves?
Subscribe to:
Posts (Atom)
