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Wednesday, June 26, 2019

Lost & Found Tables

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Yesterday afternoon I decided to attend afternoon minyan, which has largely depleted to a non-minyan, whoever shows up. only the Rabbi and me yesterday.  Our space sharing arrangement with the USCJ congregation may be contributing to it, as parking was s hard to come by even with a nearly empty building due to building maintenance that halved the already tiny parking lot and sadly, the need for protection from anti-semitic attack that limits access to the building.  For the most part, this isn't worth the trouble of going so people vote with their attendance.  Their Rabbi heard the buzzer, graciously interrupted what he was doing to let me in, and I agreed to stand near the door until services to let anyone else who came by inside if they did not appear dangerous. 

To the corner was the Lost & Found table for the Hebrew School, and in the rack a brochure for enrollment in their Hebrew School, which seems well attended.  The tuition of $1600 staggered me, as it meets only two days a week, but if you want a Bar Mitzvah you gotta pay.  Along the way, you also have to wear a tallit, as that either inside a velvet bag or alone was by far the most common item on the table.  There were gloves, mostly unmatched, something that looked like the cover you would put on your golf driver with a U of Maryland logo, some water bottles, only one rather attractive knit kippah that I think looked feminine but wasn't sure.  I would think that most kids only have one tallit and one carrying bag, they would only have limited places to leave it:  home, car in transport, or at the synagogue, and would notice that it was missing.  The cost would also prompt people to look for them.  But they were the most common unclaimed items.  Gloves are easily replaced and could be dropped anywhere as could water bottles.  And you really don't need to cover golf club heads.

Osher  Lifelong Learning Institute also keeps a Lost & Found table.  The enrollment there far exceeds the enrollment in Hebrew School, the tuition a small fraction of what the Hebrew School charges, though people go there only for the enrichment so it is harder to extort a high attendance fee.  Despite the large enrollment, the Found Table is much smaller.  Water bottles or insulated coffee tumblers seem most common.  People lose gloves, misplace their reading glasses, a pierced earring will fall off, they remove their wristwatch during a class and leave it on a desk.  I did not see any dentures or contact lenses.  Items of this type could be lost anywhere and, unlike dentures or contact lenses, none seemed seriously expensive to replace.  A few of the seniors who attend probably go to few other places but most visit restaurants, libraries, movies, and malls so the lost items could be anywhere.  It's easier to replace them than to pray to St. Anthony of Padua, the patron Saint for Lost Objects, for their return.

I wonder how much of our own archaeological conclusions are distorted by lost things that people never recover that are discovered on dig sites centuries later.  When we find these artifacts, we assume they were important reflections of how people lived.  They could be just as transient and expendable as our water bottles or even our talesim.  A risk of Type 1 error, no doubt.

Tuesday, June 25, 2019

Less Facebook

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My previous attempt control time spent on Facebook lasted less than four months.  It was my intent to not access more than three half days a week, one post of mine each time and maybe some shares and comments.  There's just a lot of stuff that interests me and an entrance way to the world of ideas just seemed insatiable.  But it was really more like the lure of the Sirens which sucked the Greek mariners into their whirl.  Odysseus had two solutions, one for his crew who he instructed to make themselves temporarily deaf by putting beeswax in their external auditory canals and one for him where he could discover what was so alluring but not get there since his crew was instructed to tie him to the ship's mast.  I already know what FB does.  Beeswax, or at least a firm access schedule would likely be more effective. 

I am a little puzzled as to why my rationing of the medical SERMO went so well but rationing Facebook failed.  I think I am attached to the people of FB and a few of the groups, something I do not have with Sermo.  I also can pre-screen FB participants, snoozing or ignoring or unfriending.  Sermo does not allow that.  The best I can do is recognized the name of the poster or make a judgment on the title and move on. 

Here's the latest ration attempt.  Look at notifications every AM and PM.  Read posts on days that are divisible by 4, shutting down once done.  Can share on that day only.

See if this works any better.

Tuesday, June 18, 2019

Ethnic Festivals

The Greeks and the Italians have been an annual hit locally, predating our move here nearly forty years ago.  There is a Polish festival which I have never attended.  Two attempts at Jewish display have occurred, a one time Jewish Expo at the Jewish Community Center which attracted a large attendance with vendors and Israeli displays and traditional food.  It was only intended as a one time event.  As these ethnic festivals are sponsored by churches, one synagogue attempted a Jewish festival which flopped/  It is very hard to do a Jewish Festival with the congregation located in a neighborhood that the Jews have long since abandoned for safety, no parking facilities to speak of, and most of all, the restrictions of Kosher which means the organizers have to decide whether to sell blintzes or hamburgers.  Kosher certified wine at the time was primitive and beer mostly Budweiser.   Israeli wine is now readily available, Israeli beer not really as the Israelis drink Danish Carlsberg.  And Friday night and Saturdays off limits.  It's never been attempted since.

That leaves us with Greeks the first week of June followed by the Italians the following week.  The Italians arrange shuttle buses and now charge an admission, but even if you eat nothing the tour of their church and the music from the podium is worth the evening out.  Italian cuisine is built largely around the pig and some crustaceans prepared a thousand ways.  People who eat these things give a thumbs up.  I eat dessert, baba au rum which is a little like babka, and luscious hand-helds with features of a cookie and a cake.    At one time there were stabbings reported each year and attempts to keep black young people and their children off the shuttle buses but I think an entrance fee screens the troublemakers better than either accepting the weapons or overtly discriminatory practices that got appropriate boos from those already seated on the shuttle bus.

After avoiding this outing for several years, I returned to a very pleasant evening.  The menu has expanded to reasonable vegetarian options.  Not nearly as crowded as I remember it.  Rain deterred some, entrance fee deterred some, parking arrangements not as easily accessible to the inner city fun seekers had its effect.  Police were there in significant numbers, including a forensics officer though no shootings or rub outs occurred.  We had a quick supper, walked around, went inside the church to hear a tenor with piano accompanist,  Left a $10 bill in their pushka.  Rain came in torrents so we huddled under a canopy, wife got dessert, and at a letup we headed to the shuttle, rewarded for our wetness with a spectacularly vivid rainbow on the way home. 

Good respite.

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Tuesday, June 11, 2019

Antisemitic Gay Pride

Image result for antisemitic gay prideGay Pride Week

While I've always looked at this as a civil rights application, I may be a minority.  Always could be challenged too, as the opinion has remained static but the experiences that reinforce them have not.  This week, what I perceive as civil rights has encountered a clearly antisemitic interface from within and external animus from people who are running out of groups to hate without reprisal.  I may be more of a centrist though probably not a good umpire if it means accepting the antisemitic components.

My own history arrives in packets, there being no ongoing reason to revile anyone or protect anyone.  The first exposure that I remember involved a few snickers among friends.  A junior high teacher had been unexpectedly suspended and amid rumor, homosexuality emerged as the reason.  Never confirmed.  He was never my teacher so I lacked any incentive to say he does his job well or that this is as convenient an excuse as any to remove a man who lacked professional skill.  I think he disappeared.  This being my teen years of the 1960's, out of site, out of mind.  Everyone I knew had some interest in girls though my crowd tended to begin dating more in college than high school.

I did not know any gays in college either.  Not that there weren't any but they escaped my attention.  As I proceeded onto medical school we had one effeminate professor who we wondered about but for all I know he was married with a family.  The subject never arose again.

One turning point came at about mid-residency.  I thought I would have to move out of university housing at the end of my second year.  In anticipation I scheduled vacation for the final two weeks of the contract year.  My expectation proved correct and I arranged for a new apartment to which we moved in June.  That left me with two weeks of vacation and my wife between the end of her visiting professorship and the start of her post-doctoral position.  At the time, airlines, whose fares were first being deregulated, started advertising bargains to the west coast so my wife and I agreed to take advantage of this.  We flew to Los Angeles, enjoyed the glamour of the entertainment industry and the mansions, drove along the coastal highway to San Simeon and to extraordinary scenery, settling in Berkeley which gave us easy access to San Francisco by public transit.  It was there, for the first time that I encountered openly gay male partners.  Some were effeminate with smooth faces, some make-up, attended hair but male clothing.  There were partners walking on the streets holding hands as I did with my wife.  In the restaurants the servers were similarly effeminate.  I had no emotional reaction, to my surprise, perhaps.  It was not quite like going to the zoo to look at biological specimens, more like visiting a foreign culture that I had read about but never actually seen.  Little did I realize that what would become AIDS was beginning in that place at that time.

As a VA hospital physician on the east coast, AIDS made its appearance in the mid1980's, a lethal disorder with opportunistic infections.  The VA had its share of gays, perhaps even more infected from shared hypodermic needles.  This now became part of history taking.  Yet, unlike San Francisco, had I seen any of them at the mall, none would stand out.  My role was clearly to treat infection and its end organ involvement so I really did not involve myself in much social history other than some drug abuse referral.  Not long after, I began fellowship.  There are some subtle endocrine features of AIDS but they are generally subordinate to the more dramatic infectious, pulmonary, and oncology events so I really didn't see any.

On to solo practice.  Even covering colleagues on the weekends, no AIDS, no visibly gay people.  It changed forever, though, when I signed up for a Facebook account.  I had read about this fad-like opportunity as a feature in the NY Times when visiting NYC for a weekend.  I jotted down the information on how to sign up, and did as soon as I returned home.  My attraction, as that of many others, was to reacquaint with the old friends from years back, mostly high school, a little college.  Many of us had been chums since kindergarten, separated by college, and never expected to contact each other at any subsequent event other than a high school reunion.  Facebook changed that in a week.  Within a short time I had sent a share of "friend" requests and received a similar share.  The service, once the high school was identified on my profile, would select out potential people who might be familiar and we would offer each other contact.  The flurry continued about a year, then hit a steady state with minimal additions, though some deletions for death or irritating political postings that appeared in excess.

One old friend, literally a fellow kindergartner, had achieved a distinguished career, including his name on the credits of some TV shows that I watched regularly.  He had some interesting educational experiences, retired from his primary occupation a little earlier than most of us, started a post-retirement business with equal enthusiasm, and had established household with a male partner which he maintained for about the same duration as my traditional marriage.  I had no reason over our entire childhood to detect any social difference between him and anyone else in our group.  He was still one of us, a schoolmate, a cub scout with his mother who took her turn as Den Mother still alive and functioning as she approached 90.  Instead of his name appearing on the credits, as his new business entered a popular niche, he would appear on the screen or as a guest in a widely trafficked location.

That was likely my transition point.  I would never do anything to hurt this kind, accomplished friend.  As AIDS moved from lethal to chronic and gay expanded from discrete outside a few metropolitan centers to a more open LGBT pride that we have now, the presence also moved from don't ask/ don't tell to something more contentious.  We have protected age, religion, race, gender in the workplace, housing and military.  Running out of people to look down upon never really happened, but the ability to deny them public access did, except for the gays.  Equal access and opportunity is something conceptual.  Steadfastly refusing to participate in any activity that would incur harm to a personal friend resets the position differently.  Torah is subordinate to Derech Eretz.  I miss enough of the mitzvot, that I can forgo any that might require me to harm a friend, let alone other people's friends.

Since my first visit to San Francisco, I've been there a few additional times, including once after reconnecting with my only known personal gay friend.  The community is still there and with steadfast support of a population that while mainstream would also never betray a friend.  These men, and probably women, seemed less visibly on visits there subsequent to my first time there.  I don't know why.  But they are no longer a curiosity.  They are people who contribute economically, engage in charity and in religion, probably shop at better stores than I do, take good care of patients if they are physicians, and advance science.  On behalf of my friend, who I would never harm personally, I would never harm these people collectively either.  Though for the same reason, I discourage antisemitism from any source, particularly one that diminishes itself by taking the position it did,

Sunday, June 2, 2019

Shavuot Approaching

Omer has reached its final week.  Shavuot can be a forgotten holiday, even a conflicting one for those with school kids who may be the only ones from their classes to miss recess or even a class trip on a glorious day, or maybe not.  Or even the Harvard Commencement one year.  There are no shofars, clergy in kittels, sukkahs, dreidels, or seders.  The yontiff ends its only ritual of a nightly Omer count. Time in the synagogue can be rather long with Hallel and Akdamut on the first day, Hallel, Ruth, and Yizkor on the second.  Anticlimactic to the daily upward count some might say.

But there is a tradition of dairy meals, some of the best options around.  We can eat blintzes any time but they are special now.  I have not made cheesecake in ages, it being easier and less expensive to buy one.  We have kugels.  Since the yontiff follows shabbos this year, shabbos should be milchig as in fish prepared in a way requiring some planning and effort.  A Fish Market Apple Walnut Pie or Macaroni and Cheese in the manner of Horny Hardardt.  Tofu might be worth a shot.  A quiche.  Maybe baklava or something Middle Eastern.  Not much ritual but the imprint of food and a seven week effort to get there bring the needed celebration to our communal start of Torah centrality which has endured.


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Friday, May 31, 2019

Disappointing Webinar

A good friend traceable to the Year Gimel hosts a project to promote the accuracy and meaning of scientific studies to a largely non-scientist public.  For the most part, science is the ultimate revelation of what you see is what you get, but it is open to its vagaries, not yet figured out, and adaptation to various non-science agendas from political policies to promoting drugs for doctors to prescribe.  And there have certainly been scientific frauds where real scientists alter results to look more important than they really are for secondary gain, usually promotion in the scientific workplace.  We can watch anti-vaxxers on TV or You Tube.  We have elected officials downplaying global warming, a form of Russian Roulette with our descendants and not that much benefit for us now.  Public visionaries don't seem to have the value that they once did, at least in America.

My friend pointed me to a Webinar on Climate Change, for which he and his organization take a great interest, one conducted by a reputable organization called the Union of Concerned Scientists.  There being no tuition for this and it occurring on an afternoon not otherwise occupied by appointments, I signed up and signed in at the appointed time.  My presence lasted 15 minutes.  I closed the Adobe connecting program, proceeded to my car and went shopping instead. 

Instead of discussing anything that required a modicum of scientific background, or even interest, they were discussing a piece of doomed legislation when what they really need is regime change.  There is science and there is agenda.  Impediments to science, be they elected officials or the shills with PhD's that sign aboard for career gain, need to be looked at as impediments to overcome.

The best way to do this is with voters figuring out that devaluing science is just one more of the global depravity that we watch on our daily screens.  Banging your shoe on the table with a "Nyet" Khruschev style doesn't bring credibility to the realities of global warming and its consequences or the best scientific evidence that causes our most astute scientists to think that way.  Creating alliances with others that have their own reasons for unseating some of our elected officials might. 

And we have rogue scientists.  PhD's who promote falsehood for personal gain are worthy of blackballing from the scientific community.  Assembling a catalog of these people and making an effort that they are unwelcome in any respectable scientific workplace might be a better project for ethical scientists to implement.

Science goes forward with objectivity and planning.  This seminar had neither.


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Tuesday, May 28, 2019

Hands Hurt

Pauciarticular arthritis.  That's what it's called.  Maybe migratory arthritis.  While the last recommendation I wrote for a resident's fellowship resulted in a Rheumatology match, my own knowledge of arthritic syndromes has taken a major dip over my professional career.

I can describe history.  There is chronic recurrent low back symptoms, classically transient lumbago that is self-limited and responsive to naproxen.  Occasionally my ankles will hurt transiently and I have had an arthroscopy of my right knee about 15 years ago.  All large joints, mostly axial.  No effusions and really no objective exam features of rubor, tumor, calor, just dolor.

This is different.  When I retired I committed myself to a treadmill session, two days on, one day off.  I did a good job until the next back layoff.  Like most things I will make excuses not to do, it gets done most reliably when done first thing in the morning, which I did through my cruise to Europe last fall and into the winter, back permitting.  Then I started noticing some stiffness in the mornings.  Hands were most prominent but axial stiffness as well, pretty much every morning until late morning.  Being retired, I could go on the treadmill any time so I rescheduled this for late morning or early afternoon, with decent compliance if not otherwise occupied at those times.  Other than the morning stiffness, I experienced no constitutional symptoms but had some intermittent carpal tunnel numbness in the expected distributions, always transient.

Earlier this week I awoke with my left ring finger bent.  It looked like a boutonniere deformity and relocated with a snap to its usual position when I gently forced it.  Flexion dislocated this proximal interphalangeal joint again, only to snap back with gentle force.  A few more times back and forth and it stayed in place with mild discomfort.  The following morning it happened again and this time all the proximal interphalangeal joints on my left except the thumb were sore.  Distal joints were fine.  The metacarpophalyngeal joints were stiff and there was slight tenderness over the PIP areas but no swelling or redness.  By opening and closing my fist the stiffness went away.  The right hand seemed only minimally stiff but no pain.  Later in the day I took two naproxen tablets, which would be a full strength prescription dose.  It felt better in the evening.  This morning my left hand is almost back to baseline with slight joint stiffness.  However, my right ring finger became overtly inflamed at the MCP and DIP joints with less involvement of the middle finger DIP.  The MCP and proximal phalanx were far more tender than the left hand ever was and my middle and ring fingers could not make a fist.  Cold water helped, a blue gel cold pack helped less, and two naproxen had less effect on my right hand than yesterdays pills did for the left.  What gives?

The antecedent stiffness suggests rheumatoid physiology but the very transient nature on the left makes me think of other things.  Just have to give the right fingers a few more days, then reassess.

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