Facetious Insignificance

A large part of what I like about halacha and Judaism is that things matter and nothing is to be treated lightly.  Our actions and deeds, the world and all its objects have meaning for us.  This is not necessarily to say that there is meaning out there to be discovered, as maybe we construct much of it for ourselves.  It is, however, a statement that everything should evoke a rational, ethical and emotional response from human beings.  More than anything, it a moral imperative to be serious and engaged with the world in such a way that befits our human dignity.

Any serious response involves making distinctions, putting things into categories and deciding priorities.  In the Jewish setting, this is embodied in commandments and custom but the ethical dimension may well evoke a less formal response in other cultures.  It is no less true than in any academic discipline where information is sorted, categorised and interpreted.  

Yet, too many people leave their rationality at the laboratory door, at work or in the academy, and take a ‘live and let live’ attitude to their lives outside.   It is the scientific categories and distinctions, for example, that really matter and everything else is plain vanilla by comparison.  And just like its corresponding ice cream flavour- why make a fuss about it?  With a twinkle in the eye and a shrug of the shoulder, any life-affecting obligation can be shook off:

‘Who cares what lifestyle I choose so long as I don’t harm anyone?  Morality is culturally relative and people can live as they please.  Why distinguish or categorise people or actions as that just excludes!’ 

This is not to say that no argument exists for relativism, libertarianism or excluding regulation from certain areas of your life.  It’s the way some people say with a look that tells you that it doesn’t matter a darn bit how you answer them.  The people for whom rationality is pointless because any distinction just doesn’t matter- to them.  Care-free people for whom any action is equal and every distinction irrelevant if it simply doesn’t bother them! 

This attitude in extremis- a failure to draw distinctions or let them impinge on you in any way- is a denial of one’s humanity.  It reminds me of a case in Oliver Sack’s The Man Who Mistook his Wife for a Hat about a patient who had a brain tumour and underwent a personality change, becoming complete superficial and uncaring:

Testing left-right discrimination was oddly difficult , because she said left or right indifferently…

‘Left/right. Right/left.  Why the fuss? What’s the difference?’

‘Is there a difference?’ I asked

‘Of course,’ she said, with a chemists precision.  ‘You could call the enanitiomorphs of each other.  But they mean nothing to me.  They’re no different for me.  Hands… Doctors… Sisters…’ she added, seeing my puzzlement.  ‘Don’t you understand?  They mean nothing – nothing to me.  Nothing means anything… at least to me.’

‘And this meaning nothing…’ I hesitated, afraid to go on.  ‘This meaningless… does this bother you?  Does this mean anything to you?’

‘Nothing at all,’ she said promptly, with a bright smile, in the tone of one who makes a joke, wins an argument, wins at poker…. Nothing any longer felt “real” (or “unreal”).  Everything was now “equivalent” or “equal”- the whole world reduced to a facetious insignificance

I’m not saying that those who don’t agree with examining the small things in life has a neurological disease but perhaps they are not fulfilling their true potentiality as a rational being.  Of course, what I like about Judaism may be what another hates.  This is what someone said was the best thing about leaving the religious-Jewish fold (http://daashedyot.blogspot.com/2010/08/better-know-kofer-sam.html):

The best thing... hmmm... maybe that you don't have to take everything so seriously. Every choice and action isn't considered such a major issue that you always need to be absolutely confident is the exact right thing to do

Now, whilst I certainly don’t believe in being confident that my actions are the exact right thing to do (in fact, I think halacha is about doing things even without that certainty), I certainly think my actions should be considered.  Whilst prohibitions or commands may be highly annoying, I’m not one for a care-free disposition and no-one can accuse me of treating things with a facetious insignificance.

Leeches Suck and ECT is Shocking

New Scientist had an intriguing article about Leeches and their use in modern medicine. Apparently, they are very helpful in preventing problems when limbs are reattached. They help remove excess blood that could be life-threatening, and also inject a chemical that prevent blood-clotting. Who would have thunk it?

These poor leeches, however, have a very disreputable reputation, and probably through no fault of their own. It is not as if leeches deliberately prey on human beings, hide in your cornflakes or wait on street corners for an unsuspecting vein to walk past. Who can blame a leech for not looking a gift horse in the mouth and gorging itself on blood until it is six or seven times its normal size? After all, humans in our decadent West gorge themselves on cupcakes until they are six or seven times their normal size!

Yet, one cannot blame someone who would be weary of the use of leeches as part of their medical treatment. For almost 2000 years they were used as a catch-all treatment by ‘doctors’ who may have killed more patients than they cured. This is nicely summed up from a scene from Blackadder:

Edmund: Never had anything you doctors didn't try to cure with leeches. A leech on my ear for ear ache, a leech on my bottom for constipation.
Doctor: They're marvellous, aren't they?
Edmund: Well, the bottom one wasn't. I just sat there and squashed it.
Doctor: You know the leech comes to us on the highest authority?
Edmund: Yes. I know that. Dr. Hoffmann of Stuttgart, isn't it?
Doctor: That's right, the great Hoffmann.
Edmund: Owner of the largest leech farm of Europe.
Doctor: Yes. Well, I cannot spend all day gossiping. I'm a busy man. As far as this case is concerned I have now had time to think it over and I can strongly recommend a [in chorus] course of leeches.
Edmund: Yes. I'll pop a couple down my codpiece before I go to bed ?

For much of the time, this proliferate use of leeches was based on the belief that our body was composed of four basic substances or humours (blood, phlegm, black bile, and yellow bile) that corresponded to the four Greek elements (fire, earth, air and water). Disease was caused by an imbalance of these humours and significant blood-letting could redress the balance.

Now that, post 19th Century, we do not believe in this theory, how come we still have leeches being used in medicine? Sure, it is not done on the basis of a discredited theory and it would be wrong to discard something just because of a chequered past, but is anachronistic nonetheless. After all, surgeons have great trouble preventing the leeches from straying and there is no guarantee that they will latch on and suck. Equally, if they know the combination of chemicals that stop blood-clotting why don’t they administer it in a different way? And if they don’t, why are we comfortable administering something we don’t have an understanding of?

The same goes for ECT (Electro-convulsive therapy), a commonly used technique in the 1940s and 50s, that passes an electric current through a patient and produces a seizure in the patient. It was used to ‘cure’ a large range of mental illnesses, often without the consent of the patient and sometimes was administered as a form of abuse. Yet, this is still in use today!

There are far more controls to its use, is limited to fewer illnesses, and is more monitored. Interestingly enough, in my psychology course, I learnt that the research shows that ECT is (slightly) more effective in treating schizophrenia than any of drugs currently available. Schizophrenia has a mainly biological rather than psychological cause, and passing current through the brain ‘does something’ to temporarily reset the brain. However, the ‘does something’ is not very well understood. Are we really happy to administer this when we don’t really understand it or its long-term effects just because it seems to work? Couldn’t scientific and medical funding be better directed elsewhere?

This is where the chequered past of a medical method comes in. After all, which modern scientist would a priori think of leeches or electricity as a great way to solve illness based on what we know? We only use it because of a direct link to a past where medicine was more barbaric. After all, the farm that breeds the leeches has been in operation from 1845, when the theory of humours was still believed. Given that it is the only licensed farm, Blackadder’s criticism of Dr. Hoffman of Stuttgart is prescient.

Of course, it’d be all worth it if we could make it up to leeches as a reparation for a history where we have abused their talents! Their life starts well being fed on sheep blood served in a sheep-gut condom. Yum! Alas, as soon as they are used, the surgeon drops the leech into a tub of alcohol and thrown into “Medical Waste”. Neither the leeches or the humans are being given the chance they properly deserve!