Thursday, August 8, 2013

Elephants in the Room

We all have them.  For the most part we don't exactly ignore them, as much as we might like to.  But we do not discuss them in a forthright way either.  We have them in medicine.  We have them in Judaism.  Yet there is a measure of Derech Eretz that keeps the items under wraps.  There is also a very legitimate fear of disruption that would inevitably occur if you fixed what needed to be fixed.  And there is a reticence to avoid victimizing some very nice but ineffectual people in the process from doctors who function above their level of skill to clergy who fail to inspire.  Whatever the benefits of revolution might be, somebody gets figurative beheaded in the process.  So we sidestep the discussions of computerizing medical care or we look to the future of what the Judaic experience might be without ever schecting the sacred cows that need to go to get it there.  We rationalize the decline of Federations and Synagogues over a generation from circumstances beyond the control of the organizations' leadership without acknowledging that the leadership has been engaged in a cloning experiment that begets more of what the desired public walked away from.

Somewhere along the way, my congregation needs to deal with bringing women ahead, the mediocrity of the worship experience, managing shrinking membership that is not going to reverse by bringing a personable Rabbi to the Bimah, unrealistic attachment that people have to what is there now to the neglect of what might be.

In my work world, you cannot keep looking the other way while residents discharge people without appreciating what the recipients of those patients will need to do on their behalf.  Not all loose ends and be tied together with a quick turf to somebody's office.  The office computers are diminishing medical care.  Expectations are put on primary doctors that exceed the skill of many and overwhelm those at the upper tier of knowledge who have to process though increasing volumes of people who are generally well without special provisions to isolate and focus upon the few who need more meticulous decision making.

So do I think formal Judaism and ordinary medical care are going to hell in a handbasket?  Well, not exactly, but I do think there is a day of reckoning where the status quo becomes unsustainable.

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