Posts Tagged 'Atul Gawande'

Good Life: Death and Chukkat

In Chukkat, this week’s Torah portion, we learn about the bizarre rite of the para adumma– red heifer.  It was a cow brought to the priests as a sacrifice, and its ashes were used for the ritual purification of Ṭum’at HaMet (“the impurity of the dead”), that is, an Israelite who had come into contact with a corpse. It does seems strange that some how the ash of one dead animal would deal with their fear of having come into contact with a dead body. The notion of a para adumma seems out of step with our lives. How do we make sense of this in the 21st Century?

I was thinking about this question when reading Atul Gawande’s  Being Mortal: Medicine and What Matters in the End. In his bestselling book, Atul Gawande, a practicing surgeon, has fearlessly revealed the struggles of his profession. Here he examines its ultimate limitations and failures – in his own practices as well as others’ – as life draws to a close. And he discovers how we can do better. He follows a hospice nurse on her rounds, a geriatrician in his clinic, and reformers turning nursing homes upside down. There he writes:

Medicine has triumphed in modern times, transforming the dangers of childbirth, injury, and disease from harrowing to manageable. But when it comes to the inescapable realities of aging and death, what medicine can do often runs counter to what it should.

In today’s day we have removed death from our lives. Even doctors, uncomfortable discussing patients’ anxieties about death, fall back on false hopes and treatments that are actually shortening lives instead of improving them. And we the families go along with all of it.

So while it is crazy to imagine how the para adumma removed the impurity of death from the Israelites lives, it seems even crazier that we have feebly tried to removed death itself from our modern lives. We might not find ourselves going to the Priest for a consult, but we should find people who show us how to have the hard conversations about death before it is too late. Gawande writes:

Our ultimate goal, after all, is not a good death but a good life to the very end.


Priority List: What Yitro Has To Teach Us This Year

Despite the fact that we are almost done with January, I feel that the year has just started. And yet some how my To-Do list is already too long with hardly enough checked off. How will I ever get through it all this year? But I do not feel alone. It seems that we all have too many things to do. Making lists help us structure and prioritize our time, but do the lists represent us? Do these to-do- lists portray our personal, professional, or organizational values? While we want to be accomplished, do we want to be identified just as the people who do the things on our lists? Is there a soul to our lists?

Wanting to check “write blog post” off the list I turned to Yitro, this week’s Torah portion. There we read about the receiving of the Torah and the Ten Commandments. Interestingly enough, there was a period in Jewish history when they wanted to read the Ten Commandments in the synagogue liturgically. This practice was rejected for fear that people would think that the entire teaching of the Torah was just this To-Do (or Not-To-Do) List. Surely these ten commandments are important, but what is their relationship to the other 603 commandments? Are these a list of priorities or values? If they are a list of values, how does the rest of the Torah spell out these values? And if they are priorities, does this really manifest the values of the rest of the Torah? Or more importantly how does a list speak to the soul?

This got me thinking about Atul Gawande‘s 2009 The Checklist Manifesto . Gawande points out that, while airplane pilots use checklists to ensure optimal outcomes, surgeons do not. While the surgeon might think that their education is beyond needing a remedial checklist, that is not the biggest difference. The biggest difference is if the surgeon fails the patient dies while if the airplane pilot fails he goes down with the ship. It is easy to distance yourself when you do not have as much invested in the outcomes. The book’s main point is simple: no matter how expert you may be, well-designed check lists can improve outcomes.

It is impossible for me to read Yitro without think about our beloved FJC’s Yitro Program for assistant and associate directors (ADs) of Jewish camps across North America. With the continued support of the AVI CHAI Foundation this program is running its third cohort. Yes, I love each cohort equally. In this program we are training these ADs to enhance the Jewish experience at their home camp. In short they need to explore the soul of their camps. As everyone knows these ADs have a crushing amount of work to do. Their To-Do-Lists would give most people apoplexy.  Together in this program we are doing the hard work of defining and elevating the soul of these lists.

Taking their example to heart I think it makes sense for all of us to review our lists for the coming year to ensure that our values and priorities are aligned. We all have a lot of work to do to live accomplished value driven lives.

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