Monday, May 30, 2011

Dr. Moe, Dr. Larry, Dr. Alan

Med school came through for Alan.  Both kids went in my direction.  I didn't realize I was a good influence, or maybe I wasn't.  My kids inherited my diligence and tenacity, maybe a tendency to not take themselves or their talent too seriously.  More importantly though, for all my hard work, for all my tendency to complain about people and circumstances, I never belittled my medical colleagues except in a humorous way.  Same with patients.  Some can be pretty irritating but my willingness to let these annoyances proceed in stride probably made them wonder sometimes why I did not always treat them with the same placid manner.  Eventually they realized it is because I expected more of them than I do of patients.  Both kids rose to the occasion.

While I might have like to have more for retirement set aside than I now can, I cannot think of a more valid personal legacy well worth the financial consequences.

Friday, May 27, 2011

Purchasing Judaism

Went to the AKSE Board Meeting, the one where they discuss budget.  It is actually a rather thoughtfully constructed, particularly on the income side where predictability is usually not a whole lot better than my trying to predict glucose outcomes from the insulin decisions that I make.  They looked at what they actually took in and for the most part avoided the annual grandiose projections of what they might like to take in but probably won't.  The expense side is much more predictable and the opportunity of a part-time salary has mitigated the reality of spending more than we receive.  

Along with the budget came a dues increase of about 5%.  That would bring my obligation to a whopping $2625 annually, which is enough to make me wonder not only what I get for what is by far my largest tax-deduction not counting my upcoming professional liability tail.  I would also analyze the purpose of this expenditure and alternatives that give a similar or better return for a comparable sum.

One of the people at the Board Meeting asked rhetorically why the congregation exists and what its future might be.  I incurred the irritation of the President, something starting to get a little beyond the energizing mini-conflict from my perspective, by pursing that thought not in a rhetorical way but in its implementation to decisions, whether to make the unpopular choices that eliminate debt or to charge young members a nominal fee to give them a measure of ownership in the synagogue and avoid a major deterrent of a $2625 bill just as they reach age 30 and have to start spending on their kids.  Sometimes you give money away entirely for somebody else's benefit with no expectation of receiving any return, sometimes in gratitude for what you have already received, but most often to make a purchase for something you will get in return.  Usually when I write a check the category is clear.  My support of WashU Hillel is mostly one of gratitude, my monthly Jewish contributions are designed to be for somebody else's benefit with no strings attached and my credit card statement goes mostly to purchases for which I am the beneficiary.  Things like taxes merge all three categories, supporting schools that benefited me greatly at one time, snow removal that benefits me now, and research grants on esoterica that probably benefit nobody but the person receiving the grant.  But taxes define membership in America, Delaware, or municipalities and state sales or hotel taxes paid where I am not really a member perhaps gouge me unnecessarily or enable me to derive benefit in the places I visit which are reciprocated when others visit my places of citizenship.  The synagogue dues fall into a similar realm, providing a forum of Jewish advancement for me, a payback for all the friendliness that has come my way, and a daily minyan for those who hold that experience in higher value than I do.  The women of AKSE, who I think get much less from their membership than would be their just entitlement, get the same bill as me.  The young members do not, yet they also have a mixture of personal benefit, gratitude, obligations to others whose needs differ from theirs, and expectation of citizenship that should accompany membership.  I think the leadership is wrong to bypass some monetary contribution, however nominal, in exchange for what they receive, much as Medicaid and insurance companies have come to realize that co-pays of a minor nature reflect on ownership and responsibility for medical care that does not happen when people receive something without any requirement to contribute to outcome.

So is $2625 a justifiable purchase?  I certainly get less for myself than I once did.  My attendance on Shabbat morning has not only waned but there are times when my avoidance of being there is purposeful rather than a random consequence of the on-call schedule.  While the messages from the Rabbi have clearly reflected his professional growth since his arrival, moving from recycling of Hebrew school dalet class to looking up something in book about Ramban that I do not have and imparting Ramban's insight to me, it is still not quite the same as having facility with 3000 years of our mesorah to explore a topic of Torah from its seventy faces.  At least I am no longer bored but have learned not to engage him in conversation about his sermons.  However, in medicine and in Judaism it has been the ability to engage my teachers and extract knowledge and insight that they have but I don't that has allowed me to advance professionally and Jewishly in a fairly consistent way most of my lifetime.  If I purchase something for me with my dues, that is invariably the item of highest personal value but it has not been forthcoming.  My personal creativity is tolerated but not valued.  I see my inquisitiveness and my intellect as my most enduring Divine gift, the thing that drives me at work, in the exam rooms, teaching people and advancing myself Jewishly whether through Artscroll,, conversation with peers.  It is that give and take, that floating of ideas into the marketplace of possibilities that drives medical progress and advances Jewish mesorah.  I increasingly see that being consciously cut off at AKSE, to the point of no longer being a place where Judaism is advanced by exploring the wisdom and misadventures of what came before.  To the extent that I am purchasing citizenship, the last couple of years have been a sufficient disappointment to make me think that a competing purchase of another type might be better.  And then there are the other two elements, gratitude and need to support the benefit that others accrue though are of no particular value to me personally.  These are hard to get away from, though perhaps easy to replace.  My attachment to Wash U Hillel is permanent even though I was only there two years.  Penn's is permanent.  I owe the current group of students at least what the alumni afforded me.  I don't have that devotion to AKSE.  My sense is more that I paid dues for years, contributed skill for much of that time and received less than I put in, unlike Hillel where I put in bupkis and created an experience that carried forward forever.  Hakaras HaTov is a core value, and AKSE is entitled to some of that irrespective of the irritations that have come my way.  Same with services to others.  The people there need Kiddush, benefit from the Rabbi's mind more than I do, need minyanim, need education.  Even if I do not personally advance from these things others do.  Then again, people need these things everywhere and the advantage of a monetary economy is its portability so I can take part of that $2625 and enable a different cadre of individuals to have these things that benefit them without benefiting me personally.

As I approach Shabbos, Memorial Day, the increasing Days of the Omer that I did not count this year for the first time in a while largely out of a sense of hypocrisy for towards the people who do yet fail to advance their character for their effort, and the end of AKSE's fiscal year, it is hard to dispel my impression that $2625 to AKSE is not a good investment in Judaism for me for sure and probably not for the Jewish public.  The more I analyze this the more convinced I am both intellectually and emotionally that it would be better to simply disaffiliate from any synagogue as my father did at my age, also spurred by an assessment of financial value.  He needed the money for other things.  I am fortunate enough to still be earning a significant salary with the vigor at age 60 to do the things that justify it.  Redirecting that sum in a more purposeful way needs to be considered and probably implemented.  I would like to take 40% of this, about $1K and dedicate it to Jewish advancement for Irene and me, then take the other 60% as three $500 donations for the advancement of others.  There are no shortage of destinations for this money to places that fulfill this mission far better that what I have seen come out of AKSE in recent years.  It is a disappointment in some ways, as there are still friendships and gratitude there but it is not a prudent investment in optimal Judaism.

Wednesday, May 25, 2011

Board Meeting

My attendance at AKSE Board Meetings has been largely a complete one, as has my attendance at its committee meetings and at Beth Shalom activities before that.  I am hard pressed to think of any I skipped primarily because I didn't want to be there, finding them irritating or an undue depletion of time.  At many of them I've been something of a space occupying lesion but I've always shown up, sometimes at some inconvenience to myself.

I find myself undecided on whether to attend tonight's session.  It may be decided for me by a plethora of consults that keep me late at the hospital but looking at the agenda, mostly budgetary planning.  I've been there before, or to some extent this comes up in a minor form with the financial report each month.  Most of the big budgetary items are set.  There are staff payroll costs which dominate the numbers, maintenance of the building comprises the second category of expense, and most other stuff is relatively diddle.  There is not of discussion as to how well the big ticket items enable the mission of the synagogue as an institution but a lot of discussion on whether to save $500 on postage costs.

The income side may be more complex.  It is harder to predict than the expense side, the retrospective review invariably being wrong and too optimistic.  Yet the people who create the income side, primarily the members, are the very ones who need to be served on the expense side where the discussion never quite includes how well you serve them.  It is hard to think of budgeting as a fundamentally abstract concept, much like basic science, which then gets translated to reality.

From my own perspective, there are spheres of concern and spheres of influence.  On this I have little of either.  The cynical me realizes that for the most part a herd mentality prevails, which may be good since you don't want to be doing radical things with the money of congregants who are change and risk averse but who are at least astute enough to realize that uninterupted progression of current trends will have its day of reckoning.

So what would I, as a sage lurking under the rocks, recommend.  Just like I have a tendency to take patients at their word, I would take the task force at its word and proceed down the path of single clergy.  Without getting into a discussion of the attributes that single Rabbi ought to have, the best way to economize is to do the work yourself and hire expertise that you do not have.  Some of us can fix our own cars, some need an experienced person to change the oil.  Some paint our own rooms or mop the floors, others hire painters and cleaning crews.  Some of us who did not know how to paint or scrub even rise to the occasion and learn how.  The opportunity to make that transition plopped into the congregation's lap without even having to contend with contentious contract renewal or denial discussion next year and the leadership failed to take advantage it.  I think we need a certain amount of reliability on having a ba-al tfiilah and the expertise of a Torah reader.  The price of a hired prayer leader, both an economic one and a lost opportunity one to engage the congregants and have them advance skill and rise to a need, seems inordinantly high for what we get in return.  A school of AKSE's size should be a one or two room schoolhouse with a payroll to match.  The progress of its alumni in parlaying what they learned there into more sustained adult Judaism should be tracked as part of the duties of the school staff for the purpose of upgrading the program over time and if the results are superior to anyplace else, which they are likely to be, then to using that as a source of product differentiation that allows us to recruit members.  That would be a form of budgeting with a purpose.

Do we need a building that big?  It is part opportunity, part albatross.  On one hand, the proceeds from sale could provide enough interest to enable the congregation to live within its means.  On the other there is a clear attachment of the membership to the physical structure and a willingness to support it so that element of expense seems purposeful.  Rental of space with the building has gone nowhere.  The options would be to either set aside the project or hire a seriously professional consultant who knows how to market space.  And now we are out of big ticket items.

On the income side, the word on Bingo remains a work in progress.  While I do not think this is the optimal business for a synagogue, the majority does and it could be a source of revenue.  When all is said and done, the income side depends on membership, how well the current members are served and how well policies and experience attract or deter potential members.  The task forces were too inbred to think beyond themselves and their own needs with a result that reflects this.  They had an opportunity to capture other perspectives through the focus group but this had roughly the same impact as the paid consultant whose guidance never got implemented.  There aren't too many ways to enhance membership.  One would be to deal with the Women Thing.  There are ways that can bring women closer to parity and there are folks like me who thrived on Hillel environments which must accommodate diversity, often by enabling parallel offerings.  My hero Rabbi Jim Diamond took a steadfast position that all students at Wash U and Princeton had a stake in Jewish life around the campuses and he will provide the resources to fulfill it.  AKSE had one minor foray into this with its monthly Mechitza minyan and a second foray with the Women's Tefilah Group.  Neither fulfilled its potential and if I have any seriously negative clergy evaluation comments, it would be not prioritizing these two opportunities to advance the Jewish experience irrespective of whether the people are eager to be advanced.  Not doing this for the Mechitza minyan enabled Ritual Talibans to undermine more mainstream progress on the Women Thing.  Not doing this for the Women's Tefilah Group gave tacit or maybe even overt confirmation to the community that the Rabbi does not care about the engagement of women in his congregation to the extent that other opportunities are available for them elsewhere and that women who are really committed to their own advancement need to take their families to those places instead of AKSE.  The other opportunity for advancing membership in places where mechitza or other forms of gender policy place women in a disadvantageous position involves providing a valued service ranked higher in importance than mode of worship.  This can be community involvement open to women, but most congregations of all creeds offer this.  Orthodox Judaism has a uniqueness of high level analysis of Judaism and opportunity for engaging in tradition.  Most successful Orthodox congregations that have attracted substantial non-Orthodox membership have done this through the educational route.  That means capturing college experiences which created a fondness with most people and not recycling Hebrew school which is usually the source of Jewish disdain and youngsters emerge from parents making their Jewish decisions to the college years where people make their own way.  AKSE is still recycling Hebrew school as its standard. 

Again, that is how budgeting becomes purposeful, looking at what is not yet provided that could be to make the offerings more attractive on the income side and investing on the big ticket items to accomplish this purpose on the expense side.  Unfortunately there is not a lot of incentive to think of money as the means to the congregation's purpose.

Wednesday, May 18, 2011

Paper Everywhere

We did some semblance of cleaning for Pesach as we do every year.  Unfortunately this time it meant removing remnants of my now non-existant office transported to my living room to someplace else so that the carpet cleaners might purge Chametz.  Some things went to the storage center I rented but most went to the family room or hall.  As we get four weeks into the Omer ever more quantities of mail and magazines and newspapers have arrived, not to mention cardboard containers that still have some food in them.  My kitchen table has no visible surface.  My desk at work does not appear much better.  I had to dig out the netbook from under a pile of stuff including forms that I was supposed to fill out but haven't yet.

Paper never quite ends but at least it can be sorted into categories of importance or perhaps even urgency.  I'm not sure what happens to all the stuff that goes into the recycling bin which the trash collectors pick up every couple of weeks.  Definitely better than keeping all that stuff here.

Sunday, May 8, 2011

AKSE Comfort Zones

At heart, I am probably a Jewish Hellenist time shifted to the contemporary era but thinking in a parallel manner to our ancestors who discovered that not all beauty had to be internally generated and not all rules remain functional forever. Moreover, I'm a sucker for talent and things done well. To some extent, I find a measure of friendly conflict energizing, something characteristic of my subclinical ADHD self.  The Cantorial replacement committee brought a nice, talented young man for an audition this past shabbos.  He is a fine musician, a pleasure to listen to though not necessarily a delight to worship with.  I suspect his limitations as a reliable Torah reader will conclude his candidacy.  Personally I found myself passively taking in the Musaf Symphony but more personally engaged in the concluding prayers conducted very competently by one of the rare teens in attendance.

AKSE has a legacy of taking the easy way out, staying within the comfort zone of what was done before and paying a rather large and inexorable price for doing this.  There really is no reason to hire a ba-al tfiliah, though we do need a Torah reader of skill and reliability.  The young man concluding the prayers demonstrated this quite well.  His vocal skills more than met threshold, he certainly engaged me in the proceedings and his capacity to fulfill his Bimah assignment was more than ample.  Moreover, he developed this skill as a component of his Jewish growth at AKSE, which is what I think the core mission of the synagogue really ought to be.  We have capable members but very few of them enhanced their skills from the time they first arrived.  It is more comfortable to let the women set up Kiddush and gather for Junior Congregation worship than to push for parity, acknowledging that true equality must be denied them.  It is easier for Cafe Tamar to move outside its mission of showcasing AKSE people, opting instead to entertain them with semi-professionals, some probably not even Jewish, as its own talented people opt to take in that imported entertainment rather than endure rehearsal.  Last year's dinner made some money but it struck me as the Ghost of AKSE Past, survivors of the 1980's glory days occupying the tables, celebrating what once was and not really grappling much then or beyond with what might be.  On a more practical measure, most Torah aliyot I am invited to do are from the recycling bin of what I have done before.  I assume that the same principle goes for the other readers.  There is no incentive, indeed no expectation, that growth in skill needs to occur.  And then there is the coup d'grace, a Bylaws amendment indicating that rotation of officers no longer needed to occur, and it hasn't.  Committees from the Ritual Talibans to my Education Committee to a most inbred recessive-gene expressing Cantorial Transition Team, have the same people doing the maintenance of the core functions of the congregation but without the vitality that creates a vibrant future, which can only be had by moving past those comfort zones.  All of this is comfortable but it comes at the price of progress that can only be attained by challenging people to do some things that they can do but have not done yet.

I certainly do not run my exam room or my teaching rounds that way.  There is an expectation that patients will monitor their sugars, give themselves insulin and take responsibility for their care, even it they'd rather not.  My residents are exposed to science behind what they encounter clinically, even if they've rejected any interest in basic science.  And what I like most about Mercy has been the challenge to my intellect, ingenuity and energy needed to manage some very difficult medical problems that had previously languished.  That his how people really move themselves and others ahead.