Wednesday, September 28, 2011

New Year 5772

Rosh Hashana begins tonight.  I do not feel connected to it this year.  One year ago it marked the dividing line between closure of my practice and the first day on the new job.  This year Board Exams follow Yontiff.  I feel a little beaten down by the job, keeping long hours, looking for my next respite however brief.

I will not be attending AKSE services until Yom Kippur.  Irene took a particular liking to an independent egalitarian offering run by people who desire a better experience than what their congregation offers, or more accurately needs to cater to in order to keep a broad dues paying membership content.  I could use a couple of really good sermons.  My heart is just not into the themes of turnover and renewal.  Don't really need a new me, but some upgrades to the current me might be in order.

Friday, September 16, 2011

Shabbos Dinner

As the sunset times get earlier and before long Eastern Standard Time arrives, there becomes less of a window for my wife to prepare a Friday night dinner worthy of Shabbos.  That brings the task to me, generally done from 5:30-6:30 on Friday mornings but some preparation earlier in the week.  Meat, usually chicken but sometimes beef or even fish if I plan to go to Beth Emeth reform oneg shabbat where the good stuff is milchig, has to be defrosted on Wednesday or purchased from Shop-Rite Thursday night.  Mini-challot get defrosted on Thursday or purchased during the day on Friday.  Depending on the main course I will marinate the meat the night before.

For the most part the preparation is simple.  Usually chicken breasts or a dismembered chicken gets browned in a big pan, then seasoned and put in the oven while I prepare boxed couscous or rice.  Occasionally beef is on sale, so I will put stew meat into the crock-pot along with vegetables, rice or beans, spices and plug it in.  Once in a while flanken or short ribs goes on sale so that is prepared like the chicken.  Occasionally I will feel more energetic and obtain a pot roast, whole chicken or turkey breast which I prepare Thursday night.  A frozen vegetables get nuked in the microwave and Luigi's Pareve Water Ice makes for a suitable dessert.

Usually the dinner is simple, an end to an often arduous work week, a demarcation point, something worth a little extra preparation to do.  We avoid appointments that night other than maybe watching or recording Washington Week and in a prior era seeing what JR was scheming on Dallas.  Since I completed Kaddish, even attendance at Beth Emeth where I really like to hear what their Rabbi has to impart, is decided by what time I arrive home and what time they start that week.  No appointment to finish at a certain time.

I've also not been to AKSE's monthly shabbos dinner in a very long time.  While I admire the effort and intent of the people who assemble this, going there really amounts to keeping one more appointment, a place that I need to be at a fixed time.  My work week keeps me in contact with people who come to the exam room at a specified time.  I cannot escape from patients in the hospital, residents and colleagues tapping into my knowledge, irritation about some process gone wrong.  Shabbos is really an escape from that.  While my Rabbi's have tried to instill into my mindset the need to assemble with community that day, my fondest shabbat experiences really took place during my final two medical school years when I no longer had exams on Saturday morning and I could escape by myself for a peaceful evening.  I would plan dinner alone or occasionally splurge oh so very gently to walk to a vegetarian restaurant not far from my apartment for a special supper that I would be unable to prepare on my own.  Shabbos became an Island of Time with myself and later with my household, as it still is.  While divine intent was for it to go from sundown to sundown, I came to appreciate and anticipate a somewhat shorter break from the usual, as shabbos morning services bring another set of appointments and a return to a a public sphere, though with different players to separate it from the work week.  It is really about Me Time, Family Time, maybe a bottle of craft beer with a dinner that does not require scrambling for the final assembly and enjoyment.  And then maybe some Rabbi and God Time the next day.

Wednesday, September 7, 2011

Learning a Haftarah

AKSE had an interesting debate, or really discussion since in principle everyone was on the same page.  Our Cantor opted to depart with more than ample notice and we really could use the savings in salary.  Do we need a Cantor or do we need some or all the things the Cantor does?  What is the minimum purchase and should we do the minimum?  We do not have the capacity to get the Torah reading done by congregational volunteers.  That has been long established and therefore a reader is hired for most of the Cantor's scheduled vacations.  We already have a volunteer for shacharit most weeks and musaf when the Cantor wants to do shacharit instead.  Can we get two a week instead of one a week and can we cover the speicial times as the New Moon approaches each month or the yom tovim or rosh chodesh impose significant variations to liturgy?  And let's not even mention Shabbat Mincha where we have both a unique service and a Torah reading.  The word from people who assign the parts, which gives them great credibility is that we cannot.  This probably separates real Orthodox congregations where skill is abundant from the wannabes like us that promote the aura without really having the substance.  And so the decision was made to bring a real Hazzan aboard for Shabbat and Yom Tovim.  He began last weekend, a nice classically trained fellow from another era.  While I appreciate his talent, my enduring fondness for Jewish worship really developed amid the Hillel foundations that I attended, the epitome of grass roots participation where a threshold of competence was expected, show-off flourishes discouraged, and the ba-al tefilah varied from one week to the next as did the tunes imported from the various home towns.  As nice and adaptable as the new Cantor seems to be, I predict that those in attendance will tire of the experience in a relatively short time.

AKSE does have one remaining bastion of volunteers on its Bimah, the Haftarah readers.  Most people acquire the rudiments of skill through Bar Mitzvah preparation and given enough time the portion can be recycled many years later.  There are enough people, mostly alumni of the once grand Conservative congregations who can sight-read Hebrew sufficiently and have familiarity with trop to learn any Haftarah in a short time.  The cadre of readers has expanded, though rather slowly.

My latest assignment on this takes place the Shabbat after next, Isaiah Chapter 60, one of the Haftarot of Consolation following Tisha B'av.  The language seems rather difficult which challenges the fluency but it is these challenges that make the effort worthwhile.

Tuesday, September 6, 2011

Board Exams

An every ten year ritual, starting about four years ago with open book self-tests and this horrid thing called a Practice Improvement Module that started out as a legitimate assessment of how well or poorly I communicate with referring physicians but morphed into a series of complex work flow diagrams when my two secretaries and I were the only ones there to do work.  And now the exam.  The patients in my practice modules and on the last two exams don't resemble what I actually see most days.  I do not think I've ever seen a Fragile X Syndrome or a McCune-Albright "coast of Maine" cafe-au-lait spot.  I've been studying from practice exams written by various professors whose biases can be detected from the questions but at least I can extract the principles that I am expected to know from the questions.  Did well with the diabetic questions, stunningly poorly with the adrenal questions and somewhere in-between with the reproductive questions.

This is big business.  I paid about $1000 to enroll in the program, $120 for the review book published by the Endocrine Society, and the outlay for the review course will set Mercy Hospital back most of my contracted Continuing Education allotment.  The pass rate for Endocrinology is reported at 77%, the lowest of any specialty.

To be fair the American Board of Internal Medicine which sponsors this, it has moved ahead of the fraternity hazing of ten years ago.  There is legitimate educational content to the practice sessions, the people I've dealt with by phone have been responsive and professional, the Old Boys have been retired and replaced by a CEO from the American College of Physicians who at least has a sense that an annoying process needs to have some off-setting benefit.  Still the exam looms a month away as I continue to struggle with the review book and head off to the intensive review course in Cleveland in a few days.

Monday, September 5, 2011

Investing in Bingo

Many synagogues, including mine, have their financial challenges.  There is actually a literature on this, though my sense of the officers is that they really haven't explored this much, opting instead for a quest for fundraising which in a good year may add 5% to revenues though it usually comes with a significant financial risk to get that 5%.   Memberships make the place financially solvent, either in the form of dues or contributions beyond dues.  There is a limit, though, to how much of our own member funds we can wring out, so there is always an interest in getting income from other sources.  Synagogues and churches have rented space in their buildings.  Some have elegant catering facilities that generate a profit.  Some have public events.  Our officers opted for Bingo.  Without  getting into the propriety of this, which the Rabbi approved so it must be OK, its only direct purpose was to generate revenue with perhaps an unintended by important benefit of generating a rather strong group of volunteers dedicated to the project.  It was expected to lose money the first six months, which it did, to the tune of $8 K which required re-examination.

As AKSE projects go, this one seemed to be handled reasonably well.  People did their homework in advance, knew what to expect, analyzed trends, and expanded participation beyond the President's usual A-list people.  Will it ever make money?  What about serious money?  What about the value of having a project that members are committed to for its own sake?  Any indirect benefit to member retention?  My interpretation on these questions is mixed.  It can probably make some modest profit, about what a successful fundraiser would make.  

When all is said and done, there is still a budgetary deficit forecast this year and no serious intervention to erase that, let alone repay what is owed other than Bingo.  Until something else arises, break even with a measure of community development as a beneficial unintended offshoot needs to continue a while longer.