What a commentary means

We read Ecclesiastes (Koheles) this past Shabbos. Some read it (or heard it read) in a synagogue, others read it out loud to a two-year-old while she ran around the house babbling to herself. To each their own.

I read it from the Biblica Hebraica Stuttgartensia. When I'm studying part of the Tanakh which I find obscure, or full of impenetrable vocabulary, I often go to the BHS to find which variations in the Masoretic texts might explain a difficult word. This is one difference between, say, BHS and the traditional commentators. The latter explain why the text is the way it is. Historical-critical study of the Bible, on the other hand, often tries to suggest enmendations which help make better sense of the text. (The two sorts of commentary overlap, of course -- traditional commentators often suggest enmendations, though in a different language than modern critics; and Biblical critics for their part often use a literary approach which owes a lot to their traditional forerunners.) To put it very broadly: the BHS is critical while traditional commentary is aesthetic.

But is this really the case? Any resolution suggested by the BHS to a difficulty it points out must be judged on an individual basis. Some of these suggestions (based on alternative manuscripts and words in Akkadian) I can nod my head at and understand passively, but can't criticize with a firm base of knowledge, since Biblical criticism isn't my day (or night) job. On the other hand, when BHS makes a suggestion about the plausibility of one reading over another, I can say yea or nay more confidently. Then we're in the realm of aesthetics, where I feel more equipped with appropriate criteria.

In Ecclesiastes 1:15 it's said (King James translation) "That which is crooked cannot be made straight: and that which is wanting cannot be numbered." In the original: מעות לא־יוכל לתקן וחסרון לא־יוכל להמנות. On the last word (le-himonoys), which means "to be numbered," BHS says: "prp להמלות (cf bBer 16b)". In BHSese, this means "It has been proposed that the alternative reading "cannot be replenished" is more plausible; compare the reference in the Babylonian Talmud, Berachot 16b."

Now, once there, you won't find any reference to Ecclesiastes. This is what you'll find (from an on-line version of the Soncino translation):

WHEN TABI HIS SLAVE DIED etc. Our Rabbis taught: For male and female slaves no row [of comforters] is formed, nor is the blessing of mourners said, nor is condolence offered. When the bondwoman of R. Eliezer died, his disciples went in to condole with him. When he saw them he went up to an upper chamber, but they went up after him. He then went into an ante-room and they followed him there. He then went into the dining hall and they followed him there. He said to them: I thought that you would be scalded with warm water; I see you are not scalded even with boiling hot water. Have I not taught you that a row of comforters is not made for male and female slaves, and that a blessing of mourners is not said for them, nor is condolence offered for them? What then do they say for them? The same as they say to a man for his ox and his ass: 'May the Almighty replenish your loss'. So for his male and female slave they say to him: 'May the Almighty replenish your loss'. It has been taught elsewhere: For male and female slaves no funeral oration is said. R. Jose said: If he was a good slave, they can say over him, Alas for a good and faithful man, who worked for his living! They said to him: If you do that, what do you leave for
free-born?

The Hebrew of the relevant phrase above ("May the Almighty replenish your loss") is המקום ימלא חסרונך, where the noun for "loss" is the same as that in the Ecclesiastes verse, and the verb is the same as the one suggested by the BHS enmendation.

The question is: what criteria would one use to accept or reject this suggestion? The Talmud was not composed at the same time as Koheles, so what is the reference to the Talmudic tractate meant to show? We know that lashon mikra (the language of the Tanakh) and lashon Chazal (the language of the Talmud and associated texts) are not at all the same.

Perhaps the reference is merely meant to show that the phrase "חסרונות . . . להמלות" is plausible -- i.e. that it makes aesthetic sense. And in that sense, I'm convinced.

Giggle-inducing machzor translations
Grand Prize.

A gut kvitl!

(Meaning: I hope your happiness, prosperity, and general bounty of Divine providence, signed and sealed upstairs this past Yom Kippur, are efficiently processed by the Upper Yeshiva's bureaucracy and legislated into law come Hoshannah Rabbah.)

I just wanted to comment on how unfortunate it is that the worst poem ever and the worst ever rhyming couplet (below) are both in machzorim of the Conservative movement.

Please turn to page 351 in your gray machzor:

Bandits have pursued me, fast and fleet
But none pursue me faster than my own feet.

A close second place (not a couplet, but would you really want a second line to this baby?):

My soul, my heart, and every inward part . . .

A happy, doubtful New Year from Katle Kanye
Saith the Yiddish blogmaster [my translation; read the whole post!]:

I don't have any answers [to these doubts], and I won't find any answer during the many holidays whose threshhold we're on now. On the first day of Selichot I hopped up on the wagon, and I'm riding until the end of Simchat Torah. Not because I want something, and not because I'm afraid that if I don't I stand to lose something. I can't say that I'm a willing passenger, but my fate is to go along for the ride. I won't justify it to myself by saying that it's the right path, but I'm still not jumping off. This is my portion from all my labors -- to look on as my traveling companions drag big bags of the four species and whole sukkahs, seeing only what's going on in the wagon, and I'm traveling lightweight and keep wanting to look out the window. I want to see who's pulling the wagon and who's driving the horses, and they just want to open their baggage, because they're so sure that the wagon will keep on going whatever happens. Will I stay till the end of the trip? For now I'm just happy that I'm not being thrown off.

Get up!
Stand up for your rites.

MEDICINE MENSCH: Resetting the Spiritual Clock
By Zackary Sholem Berger
October 7, 2005

I've been getting up at five in the morning for the past two months. It would be nice if this new schedule granted me some insight into the human condition or the plight of the sick, but my observations are on a smaller scale.

A lot more people than you might think are up that early. On the way from my apartment building on the Lower East Side to my bus stop there's an unsavory-looking building that is shuttered during the day. When I stumble by at 5:45 in the morning, there's an improbably well-organized fruit stand out front, tables of oranges, apples and bananas under the streetlamps. The fruit seller is always wearing a T-shirt and shorts, no matter the weather. I say good morning to him, and to the MTA bus driver, but maybe it's the wrong thing to say — these people have been up for hours already and probably are ready to go to bed after their shift switch. "Sleep well" might be more appropriate. ("Sleep well" is something you never say to a medical resident, unless you're trying to taunt him.)

All the people getting to work at this hour can be divided into different subgroups, the most obvious being the 6 a.m. cell-phone talkers. (Who are they talking to? Other 6 a.m. cell-phone talkers, I guess.) There are those plugged into their iPods, the nurses chatting and joking away in friendly groups, and solidly built men in leather jackets carefully avoiding eye contact. Then there's the group of eccentrics you always find in the city: people mumbling to themselves.

I'm among the mumblers. According to Jewish law, there are times in the very early morning when it's just too early to daven. I can say certain prayers when I'm at home, certain prayers on the bus (when it's already slightly later, and the sun is scrambling into place) and certain other prayers in the chapel tucked away in one of the corners of the cavernous Long Island hospital where I'm now stationed. My davening is fragmented, and my morning feels that way too — something I start assembling at 5 a.m. and piece together, hour by hour, until I arrive at my destination and start my work day more or less a whole person.

The best way to describe davening, or, more universally, prayer, to those who don't generally engage in it is to say that it's a systematic stock-taking. Residents do this every day, when they visit their patients before they're expected to present them to the entire team. They pre-round, or round before rounding, making sure they're informed about what happened to their patients overnight and what these patients need during the new day.

More often than not, my mind drifts during davening, like someone walking down the street on the way to a familiar destination. I think about my day's responsibilities, what I'm going to eat for lunch, what I need to study. I manage to reduce thousands of years of stirring liturgical yearnings to a shopping list.

Then once in a while — or, more precisely, once a year — I start trying to pay attention to davening again, in the religious equivalent of getting up at five in the morning to go to work. A week or so before the High Holy Days, Jews begin to gather at ungodly hours to recite Selichot, impassioned vows of contrition and pleas for mercy on the part of the Almighty. The irony is that this liturgy is based on the piyyut, a medieval poetic form distinguished by its labyrinthine syntax and obscure biblical references. What happens, then, is this: A dozen or so half-asleep Jews mumble incomprehensible prayers with less than notable fervor, though in every minyan there's always the exception who makes a point of clenching his fists, staring at the ceiling and making other signs of overt piety. So what's the point of the poems? There might be one Jew in 50 who understands their content (English translations like Artscroll try their best, but end up sounding like a Brooklyn-accented imitation of "Masterpiece Theater").

But in this area (as in a number of others), it's not the content but the form that's important. Getting up early shocks the internal clock into a new and unfamiliar time zone. For the medical student, it takes this shock to move from everyday pursuits into the uncomfortable, cold and early-rising world of the hospital. You have to learn to pay attention to both your patients and the clock. For the Jew entering into a new year, getting up early can help realize the famous challenge of the shofar (as Maimonides understands it): "Wake up from your sleep!" Get up early to shock yourself into the new year. Get up early, or you might miss the shofar. And if you mumble your first prayers while you're still half asleep, you'll be perfectly understood not only by God, but by any medical student.

Zackary Sholem Berger hopes that in 5766 you never have to see the inside of a hospital — unless you work in one.

שמע קולנו

Hear our voice
but ensure us choice.

Burn evil from the earth
not error or accidents of birth.

With Your gall
tincture our will with shall.

כתיבה וחתימה טובה!
Leshone toyve -- Happy New Year to everyone.

Ashkenaz in Israel
An ideolo-blog.

Assaf Galay, the charismatic journalist and Yiddishist behind the "Hatenuah lezehut ashkenazit" (The Movement for Ashkenazic Identity), has a Hebrew blog that's well worth reading, though I can't say I agree with its post-Zionist slant.

(A)elul Aesthetics

"I'll ask one thing of God, one thing I'll request:
to dwell in God's house all my life;
to have a vision of God's pleasantness, to visit His palace."

A bit of Psalm 26, which we read during the month of Elul.

One could take the above verse to mean that we would like to be vouchsafed a vision of God through the merit of the commandments. The mitzvot would then be a ticket to the Palace, like an armband to a rock concert.

I think the point can be taken differently. God is pleasant. That is, God is beautiful, and during this time of year we would like to merit an appreciation of this beauty -- without unthinking anthropomorphisms or idolatrous projections, leaden fundamentalism or empty-headed laxities. The contemplation of the Divine should be a source of joy, not of confinement.

The health of China

Almost exactly a year ago, this blog mused about China's shifting burden of disease - the term epidemiologists use (hey, I guess I am one now) to denote what happens when a country becomes more developed (i.e. less poor), and different causes of death become more, or less, frequent. A fascinating issue of the New England Journal of Medicine includes an important study on that very topic. The abstract is below.

Background With China's rapid economic development, the disease burden may have changed in the country. We studied the major causes of death and modifiable risk factors in a nationally representative cohort of 169,871 men and women 40 years of age and older in China.
Methods Baseline data on the participants' demographic characteristics, medical history, lifestyle-related risk factors, blood pressure, and body weight were obtained in 1991 with the use of a standard protocol. The follow-up evaluation was conducted in 1999 and 2000, with a follow-up rate of 93.4 percent.

Results We documented 20,033 deaths in 1,239,191 person-years of follow-up. The mortality from all causes was 1480.1 per 100,000 person-years among men and 1190.2 per 100,000 person-years among women. The five leading causes of death were malignant neoplasms (mortality, 374.1 per 100,000 person-years), diseases of the heart (319.1), cerebrovascular disease (310.5), accidents (54.0), and infectious diseases (50.5) among men and diseases of the heart (268.5), cerebrovascular disease (242.3), malignant neoplasms (214.1), pneumonia and influenza (45.9), and infectious diseases (35.3) among women. The multivariate-adjusted relative risk of death and the population attributable risk for preventable risk factors were as follows: hypertension, 1.48 (95 percent confidence interval, 1.44 to 1.53) and 11.7 percent, respectively; cigarette smoking, 1.23 (95 percent confidence interval, 1.18 to 1.27) and 7.9 percent; physical inactivity, 1.20 (95 percent confidence interval, 1.16 to 1.24) and 6.8 percent; and underweight (body-mass index [the weight in kilograms divided by the square of the height in meters] below 18.5), 1.47 (95 percent confidence interval, 1.42 to 1.53) and 5.2 percent.

Conclusions Vascular disease and cancer have become the leading causes of death among Chinese adults. Our findings suggest that control of hypertension, smoking cessation, increased physical activity, and improved nutrition should be important strategies for reducing the burden of premature death among adults in China.

A Jew and a Cabbie

On the way to drop off some shipments of the new book (that would be George der Naygeriker, Curious George in Yiddish), I started chatting with the cabbie -- a Dominican, it turns out. I learned some stuff. First, my neighborhood (the Lower East Side) is not Dominican; the Latinos down here are from all over. (I had already known that the main Dominican concentration in the city is in Washington Heights, but a bakery, some soccer fans, and other manifestations had led me to the mistaken belief that the LES constituted a branch of the DR Diaspora.) Second is the interesting way he referred to my religious-ethnic affiliation:

Eres un americano judio, no?

Meaning:

You're a Jewish American, right?

Interesting, because no one would use this locution ("Jewish American") in English, at least not these days. (Not that it's inaccurate or suspect, just out of date.) So: is this the way Dominicans (habitually?) refer to American Jews? Was it an effort not to say something unintentionally offensive? Just this cabbie's idiolect? Inquiring bloggers seek Dominicanologists for explanations.

Medicine Monster
Time to find myself.

Medicine Mensch 9, in which I specialize, specialize, specialize.

MEDICINE MENSCH
Job Hunt: Choosing the Right White Coat
By Zackary Sholem Berger
September 2, 2005

I am 32 years old, and it's time to decide what I want to be when I grow up.

I do have things narrowed down somewhat: I want to be a doctor. But what kind? I don't have the luxury of thinking it over much longer. The time has come to apply to residency programs (the four-or-so-year stints of hospital-based indentured servitude marking the start of a doctor's career), and I need to decide on a specialty.

There are many different kinds of physicians. A Web site run by the American Medical Association lists more than 50 specialties, ranging from aerospace medicine to colon and rectal surgery. Each has its partisans and its detractors, but finally the decision is my own.

Many medical students ask themselves whether they should apply to one of the "lifestyle residencies" — specialties chosen because of desirable salaries or fewer demanding hours. There is a whiff of snobbery in this label. Medicine is, after all, still an attractive profession for many, precisely because it offers a comfortable living. Even those specialties that are not the highest paying certainly are no road to self-denial. By most definitions, doctors are still rich. Isn't lifestyle a reasonable criterion for choosing a career?

I won't even say which specialties are considered "lifestyle residencies," because the definition changes every five years. Each specialty, no matter how unpopular or looked down on at one time, is redeemed eventually through market forces. Take, for example, circus medicine (not a real specialty, as far as I know). It used to be that no one wanted to be a circus doctor, dodging screaming children all day and putting casts on unlucky trapeze artists. But the wheel of fortune turned, and some students discovered the attractions of the specialty. The pay is not bad, and the hours are reasonable: The shows are at regular times, and in between you can hang out with the Siberian tigers or do whatever else you want. Plus the popcorn's free. Suddenly it's a buyer's market, and circus showmen have more applicants than they can handle. How did circus medicine get more popular? The specialty didn't change at all, but more medical students discovered that they'd rather do something else during their residency than work 18-hour days.

Ideally, our passions and our needs would coincide. What we want to do would be precisely what we're trained to do, and a good bit of money would be made doing it. Sometimes, though, it works the other way: Money (and livable hours) point out a career to us that we wouldn't have thought of before. To go even further, there's nothing wrong with moneymaking as the chief criterion for one's choice of medical specialty or any other profession. The rabbis of the Talmud tell us to teach our children a trade, not a career. If our child can make a good living in something legal, nine to five, and completely dull, there is no reason (according to this strain of Jewish thought) for her employment to have a larger redeeming social value. Her redeeming value should come from her spiritual life, not her professional one.

But of course, work is more than work. It shapes our life. The stereotypes that medical students attach to various specialties are only partially untrue. Certain specialties are known to be impatient with abstractions, abrupt and unfriendly, while others are known for indulgent book-learning and a tendency toward long-windedness. Even if a doctor doesn't conform to these stereotypes when he enters these specialties, he might be brought more into line with them, both by working with his colleagues and by the particular kind of medicine for which these personalities make sense.

So instead of choosing a specialty (or a job) that makes possible the rest of your life, you can choose one that becomes your life. The rabbis were experts in choosing a "clean and simple trade," a profession that provided both sustenance and space for what they held to be life's most important pursuit: the study of Torah. But they didn't have as much to say about choosing careers that provide professional satisfaction, possibly because this wasn't relevant either to their historical moment or to their economic class. (The same rabbis also said, "The best of doctors are bound for hell." But that's a discussion for another time.) Later Jewish thought does see a place for intellectual and professional absorption in things other than Torah — a career for career's sake — as a worthwhile way to spend one's time.

The answer to all this is the punch line of an old joke: You're right, you're right and you're right, too. Someone who chooses a career (or a medical specialty) for the sake of personal satisfaction might find out years later, when it's too late, that his personal satisfaction depends not only on intellectual and spiritual sustenance but also on having time to spend with one's family as well as money to buy what one needs. But one who chooses a job that leaves time for the rest of life might discover that the rest of life feels boring without the stimulation of a demanding profession.

I'm still not sure what I'll be. Maybe I'll run off and join the circus to cure the age-old medical syndrome of big red noses and oversized feet.

Zackary Sholem Berger, a fourth-year medical student, accepts all well-meaning job advice at doctor@forward.com.

A yummy blog

Sit yourself down and have yourself a little something -- and, in the bargain, a window onto a delicious world of Jewish culinary aesthetics.

A poem by Shmuel Halkin
In memory of the murdered poets and August 12.

To the Newborn Child

For the newborn: bless him.
With his mother’s milk, may he drink in
The thirst to bear a lamp for all people,
But the light should also be for his own people.
When he discovers for the world a new star,
May it for his own people not get any darker.

[translation: Z. Sh. B.]

Tisha B'av reflections
Non-rigorous, unfleshed-out: what I had to say this evening at my shul.

In the fifteen minutes I have allotted to me, I’m going to definitively answer some small, easy questions. For example: why are we here? What is life for? And why are we not having any lunch tomorrow?

The houses of Hillel and Shammai debated whether it would be better if the world had not been created. It was decided that it would have been better had the world not been created, but since it has been, we must examine our deeds.

This raises several questions. Would it be better for whom had the world not been created? If we are talking about God, then we have to understand what God takes to be “good.” But it might be, that given a particular definition of what God thinks is good, then a creation without our world might be better than a creation with it. What would it take for our existence to make the creation worse in God’s view?

Let’s put it another way. What would God’s criteria for good and better be, if our world did not exist? If none of us were here, would there be any morality left? If no one were around to behave rightly or wrongly, what would God care?

If the very existence of people, and, in more specific terms, the Jewish people, is enough to guarantee the Almighty the existence of a certain sort of moral calculus, then we’re already a step ahead – we can be confident, in a strange sort of way, that it’s better off that we are here. But only if our actions represent that sort of moral calculus. Perhaps that doesn’t mean that everything we do has to be right and proper, only that we have to be thinking about it. It means that whatever happens in a world inhabited by human beings is of moral import. Suffering is not just what God visits upon us, it is a phenomenon which must be understood and related to God’s blessings.

There’s another way of understanding “it would be better if the world not be created.” “Better” – as understood by people. How would this make any sense? But think of the imperfections of the world that people visit upon each other. One might think that our imperfections are so manifold, our death-dealing so innovative, that pain would be eliminated by getting rid of the source: people. We all know the midrashim in which God, or God’s angels, regrets having created people. People, on occasion, regret having been created, not because they get a raw deal from God, but because they give a raw deal to each other. Better far, perhaps, not to be around at all.

Why am I talking about the disappearance, or death, of all humanity, on the eve of a very specifically Jewish fast day? We are not enjoined to mourn the evil that human beings visit on each other; we are commanded to weep and sing dirges commemorating the destruction of the Temple in Jerusalem. We’re not mourning the famines in Africa, we’re not mourning the attacks in London. We are not even mourning the tragedies, the unnoticed deaths that happen every day to people we know and love and people we’ve never met. In a larger sense, true, every tragedy is relevant to our fast days, just as every joy is relevant to our holidays. Both these sorts of days are reflections of the joy and pain in God’s creation.

Only in a larger sense, though. In a smaller sense, Tisha B’av, which is really a small day, one small, not widely observed day in the Jewish calendar, represents one small corner of the dark world’s tragedy, perhaps an attempt by the Rabbis, or by God the Arranger of History, to make things manageable. It is an attempt to connect one part of our myth (that is, the way we understand our history) to another part.

This mythic connection goes something like this.

What do Jews do during their life in this world?
We build and create, imitating God.
We built a Temple, imitating the relationship of Jews to non-Jews and Israel to the rest of the world.
We collaborated with God on the Torah, a system of myth and law imitating the way in which God created the world.

What happened on Tisha B’av?
Our creation in imitation of God was destroyed.
Our Torah was burned.

What do we do on Tisha B’av now?
We cease from building and creating. We attempt to reproduce death as nearly as possible. It is a Shabbat from joy.

What is the traditional wish on Tisha B’av?
That we see the Temple rebuilt.
Which means: that we experience redemption.
Which further means: that we live in a world imitating God’s creation.
We experience death in order to transform life.

Hospital Food
It's always lunchtime somewhere.

Here's Medicine Mensch 8. Dig in!

MEDICINE MENSCH: Doctor's Orders: Fruit Salad and a Cheese Sandwich
By Zackary Sholem Berger
August 5, 2005

Despite the superpowers previously described in this space, medical students are normal people. They need places to lay their heads, white medical coats to keep out the rain, and three meals a day. Since their time for breakfast and dinner is sacrificed to sleep, three meals often means only one: lunch.

What's for lunch, and where do I eat it? On the ground floor of the hospital I'm working in, there's a diner with the same wishful-thinking menu of other diners — many things can be ordered and some of them are even available. I eat there occasionally. That is, I go with some other medical students, order an iced tea and a fruit salad, and eat my kosher bread and cheese from a bag I hide under the table. No one throws me out, and the iced tea is good.

The fruit salad, in a securely-fastened plastic box easily opened by surgeons or other coordinated people, is the same that's available just next door, over the partition at the hospital's coffee shop. But there, rules are different, and the hospital's stern hierarchy is topsy-turvied. Attending physicians and patients' cousins alike wait in line to grab the attention of the blue-shirted guys who take orders, man the cash registers and bag coffees and tuna wraps with frightening speed, calling women mi amor and discussing soccer with each other in Spanish. A sign over the cash register explains enigmatically: "All Kitchen Items Cannot Be Ordered Express." In practical terms, this means that the blue shirts have complete control over what they pack up quickly and what they prepare in their own good time. I'm not sure how long it takes to become a regular in their eyes, but if I go there often enough and order a homemade iced tea, no sugar, I hope eventually they'll start to recognize me.

As you move upstairs, the options change. There are vending machines with sweet and salty snacks, from a company that either has a dark sense of humor or doesn't realize how many patients here are suffering from diabetes or heart failure. On the 12th floor there's a dining room with a cafeteria that I've never seen open, a phalanx of vending machines, and a row of microwave ovens; at lunchtime the place is packed with nurses speaking Tagalog, Chinese and Spanish. Outside, above the door, there's an inviting Dante-esque sign: "Patients Not Permitted."

This is because patients are expected to stay in their rooms, awaiting care. Their care, like everything else in this hospital, is dependent on the combined efforts of thousands. And when something goes wrong, such mistakes are discussed exhaustively over lunch. At morbidity and mortality conferences, mishaps are analyzed over bagels and coffee. In line at the coffee shop, people whisper about the surgeon who operated on the wrong leg. These days, hospital administrators are terrified of the survey commission that's about to come through town, flashing remorseless, efficient smiles and catching careless errors in every chart. Some mistakes don't cost anyone's life or limb — they merely make the patient's dinner late. But even this can be a serious blow. As one resident told us students, "The best way to piss a patient off is not to feed them."

A couple of nights ago I was in the E.R. A patient had been sent there with an unexpected heart problem after what he had assumed would be an uneventful checkup. I took his history, did a thorough physical, and then thought: What more can I possibly do for this person before the resident has time to come see him? I had already done his EKG, and I'd already apologized to him for the confusion in the E.R., which, to the untrained eye, is the natural state of the big-city emergency rooms. (That particular night, the air conditioning wasn't working, a dozen or so cops were guarding their charges and the guy in the stretcher next to my patient was screaming, more out of churlishness than pain.) I asked, "Is there anything I can do for you?" The man looked at me, thought a bit, and said tentatively (in Spanish), "Well, I'm awfully hungry."

It was a rare privilege to lay down a hot meal in front of this sick man. I didn't stick around to see whether he liked the spaghetti, or, after he finished, how he managed to get his tray off the stretcher while staying attached to his heart monitor. I was too busy getting up to the 17th floor, where I would tuck into a saag paneer and drink some mango lassi. It was 9:15 p.m., finally time for lunch.

Zackary Sholem Berger looks forward to breakfast and dinner, too. Medical-student recipes and tales of past mistakes are available at doctor@forward.com.

Growing out of all its shoes

This blog is now two years old (plus nine days or so). Big slices of cake with icing may be left in the comments.

Career decisions
by blog.

So I don't know if I want to be a primary-care doctor or a psychiatrist when I grow up. Any advice, opinions, or facetious remarks? (Talmudic references, or lehavdl quotes from Auden, are always appreciated, whether or not they're relevant.)

A stethoscope and a plausible manner doesn't make me a doctor
Or: I'm a conman and you're a moron.

Sample dialogues like this are really my main source of medical education.

Let's choose a new head
. . . and return to Egypt?

Concerned citizens of the Conservative movement would do well to look at this blog, with its blow-by-blow (or yawn-by-groan) account of JTS's search for a new chancellor. Sources tell me that the bylaws were changed just last week (more or less oligarchically) to include fewer academics on the selection committee. This means that an organizational non-entity will be chosen, one who will make Conservative Jews from Forest Hills to Jerusalem roll over as one and go to sleep. But if I ruled the world? David Golinkin, maybe. Perhaps a notable talmid-khokhem or Jewish academic scholar who happens to be a C. Jew. I didn't think Judy Hauptman would be interested in the job, but it looks like she's done some thinking on the subject. Is this a campaign editorial?

Medicine Mensch goes (Poly)Glatt
Number seven in a series.

Visiting Patients, With Dictionary In Hand
By Zackary Sholem Berger
July 1, 2005

Before I became a medical student, I thought I spoke Spanish pretty well. I spent six months after college researching minority languages in Spain and, after moving to New York, I've had many a friendly conversation with miscellaneous Spanish speakers I've accosted: random passersby from Puerto Rico, law students from Colombia, grocery packers from the Dominican Republic.

Having a conversation on the street or a chat in a café about politics or literature is one thing. If you don't understand a word, you can smile or nod and pick up from context what's going on. But say you've been called down to the E.R. to take a history and do a physical, and you find a drunk, toothless man in handcuffs gesturing frantically at something underneath his bed. If you could understand drunken, toothless Spanish a little bit better, it might not take you 15 minutes of sympathetic listening to understand that the man wants his cell phone (which the cops sitting nearby are not about to let him have).

The difficulty isn't simply a matter of decoding the speaker's register (someone from a different socioeconomic class can be hard to understand, even in one's native tongue), nor is it the fact that various dialects of the language are represented at any urban hospital. It's often the words themselves that make things hard. Like every other medical student, I have a command of several different kinds of medical terminology: the mind-numbing jargon of the scientific literature, the half-macho talk of rounds and last but certainly not least important, the normal words people use to talk in English about whatever's the matter with them.

It's this last kind of vocabulary that I lack in Spanish. I can talk a blue streak about genetic predispositions and infectious agents, about endoscopies and anesthesia — these are international terms, much the same in Spanish, English and many other languages. But lay language is different. I've already experienced a certain kind of linguistic blockage more than once. I've started a conversation with a Spanish-speaking patient, we've built up something of a rapport, she's complimented my Spanish, I've figured out why she's come to the hospital. Then, all of a sudden, I need to ask a specific question to narrow down the field of possible diagnoses. I use what I think is the right word, and one of two expressions appears on the patient's face: either outright incomprehension, or a polite glazed-over look that means, "I'm going to keep my mouth shut until I can figure out what the heck this nice doctor is saying." It's then that I have to search my dusty old neurons for a Spanish word I learned once, many years ago, or for a synonym that's used in the home country of this particular patient. During one memorable conversation, a patient and I sat through a long, awkward pause before she figured out that I was asking about her period.

Those familiar with the overscheduled life of the medical professional might wonder what's the point of trying to achieve "medical fluency" in Spanish or another foreign language. For most doctors it might be enough to master a minimal vocabulary, and the extra minutes spent figuring out the Colombian word for "tampon" or "leg splint" can more profitably be devoted to a more extensive history or exam of the other dozen patients that have to be seen today. It's also true that a translator is (usually) available. That's if one wants to take the legal route. Many doctors use the Spanish-speaking janitor, or the patient's sister who's waiting in the lobby; neither alternative would be applauded by medical ethicists.

It all depends on how the doctor sees her practice. If her task is to see clients who are visiting for necessary medical services, they probably can be more efficiently served (not to say "processed") with minimal communication. Many common complaints can be divined from the patient's presentation and demographic with only the bare outlines of a conversation. If this approach isn't warm and personal, it's certainly necessary when there are hundreds of patients to see in a week.

But since I'm still a medical student, I can still afford to let my personal tendencies influence the way I see medicine. I'm a person who doesn't mind sacrificing a little efficiency (or even a lot) to get a good conversation going with the person sitting in front of me. Will that make me a better doctor? Beats me, but I know I'll have more fun this way.

"You can't learn every language," a medical student friend of mine pointed out when she heard about my linguistic ambitions, i.e., trying to learn some Chinese. Many people at Bellevue know some stock Chinese phrases, but if I can avoid it I'd rather not storm into the hospital room of an 80-year old man and blurt out the Chinese version of "Did you piss today?" Most medical students wouldn't be caught dead asking an older person that question in English; clearly there must be another way to do it in Chinese. And I'm still trying to find the Yiddish speaker who doesn't assume that accented English will impress me more than mameloshn.

If you happen to speak English, I will make every effort to accommodate you once I'm a physician. Please realize, though, that since I'll be a doctor, my handwriting will be illegible — in any language.

Still a medical student, Zackary Sholem Berger has a bunch of dictionaries at home, but he never can seem to remember the word he needs. When he's a physician himself, he can have a medical student look everything up for him. Send him questions in the language of your choice at doctor@forward.com.

A new translation of Pessoa: a review

In the way of bloggers everywhere, I'm posting here a review of mine which was rejected by a journal.

Fernando Pessoa: Selected Poems
Translated by David Butler

Every translation of poetry should come with an introduction explaining the approach of the translator. David Butler does this with admirable forthrightness in his recent volume of selected translations of Fernando Pessoa: "I have resisted the temptation to tidy up the English syntax for the sake of readability. . . . The awkward syntax . . . of Pessoa's poetry is intended as a semantic corollary to his overwhelming sense of existential 'thrownness', and is ill-served by imposing definitive structures or meaning on the English." "A great advantage of a bilingual edition," continues Butler, "is that it is far easier for the translator to resist the urge to rewrite," since the original is available to the reader for easy comparison.

Thus on the one hand we can praise Butler for an important service: presenting the nearest English equivalents of Pessoa's existentially knotty Portuguese. But the translator of poetry has another responsibility (which does not necessarily exclude Butler's approach): creating poems in the target language. Translating a poem into Portuguese into a non-poem in English which respects the unclarity and strangeness of the original is a good deed of philology but not yet a poetic accomplishment.

First, though, to Pessoa. Anyone but the blasé Pessologist will warmly welcome a new selection of his poems, since some of it will be new to the average reader. The effect of his controlled and variegated confusion is that of someone thinking out loud, unsure about everything but his own unsureness: "I write in the midst/Of that which isn't to hand." Is this the modern predicament, or merely a modern version of that pain which we dismiss with the classification "the human condition"? Pessoa (this time under his own name and not one of his famed multiple-personality eponyms) has something to say about this ( p.39):

Autopsychography

The poet's a man who feigns.
He feigns so completely
That he comes to pretend pain
For pain that he actually feels.

And those who read what he writes
Feel also, in the pain they read,
Neither of the two that he had,
But only that which they don't have.

Thus, to entertain our reason,
Round and round in wheel-ruts
Revolves that clockwork engine
That is termed the heart.

The combination of cold mechanics and raw pain is invigorating, Larkin without the censoriousness. Pessoa implicates us in his poetry, a sort of imposter's game or dressing-up of feelings as other feelings – but the poet also points out time and again that only through such playacting do we see what might be true.

A short review of Pessoa would be as inappropriate as a one-page review of the work of Emily Dickinson. Here I'll just something about the translation. Though in agreement with Butler's theoretical possibilities, the reader might find it difficult to find anything poetical in his translations. From Butler's introduction, it seems that this might be what he wants, and the translations themselves seem to bear out this suspicion. The last lines of the poem above, for example, run this way in the original: "E assim nas calhas de roda/Gira, a entreter a razao,/Esse comboio de corda/Que se chama o coracao." The verb gira precedes the noun comboio; in Portuguese, as in other Romance languages, there is nothing particularly awkward or significant about this syntax. Preserving in English this Portuguese syntax ("revolves that clockwork engine") throws the reader off guard and does not allow her to finish reading the poem without thoughts of translation intruding into her attention. This is presumably not the sort of "thrownness" Butler has in mind.

One could go through these translations and quibble with a number of word and phrasing choices (for example, Butler tends to translate Portuguese basta as suffice, a word which in English is confined mainly to upper-register speech), but this is unfair. Translating Pessoa requires concentration and sensitivity, and by and large these are present in this edition. Indeed, these same qualities should be brought by the reader to every poem of Pessoa's represented here, a record of a personality nervously approaching and then withdrawing from the world:

That which pains me is not
What is in the heart
But rather those beautiful things
Which will never exist.

They are the forms without form
Which pass by, without pain
Being able to know them
Or love dream them.

They are as though sadness
Were a tree and, one by one,
Its leaves were to fall
Between the trace and the mist.