Thursday, April 26, 2018

Dr. Sims' Legacy

Regular readers will know that that there are certain specific themes that surface again and again in my writing. The nature of heroism is one of them. And the specific relationship of the Jewish people to the Land of Israel, and particularly to Jerusalem, is another. But the single topic I believe I possibly have returned to the most times over these last eleven years of writing weekly is the question of the reasonableness of expecting an individual to transcend the beliefs that are considered ordinary and uncontroversial in his or her society, and in so doing to see the world as it truly is and to act accordingly. It sounds as though it should be the simplest thing in the world to look out at the world through your own eyes…and then to process and respond to what you are actually seeing and not what you’ve been told, in some cases even since childhood, that you see. In reality, however, it is not only a challenge, but—at least for some—among life’s most daunting, difficult tasks.
In that context, I have wondered how reasonable or rational it would have been for the world to expect a German child, every single one of whose authority figures at school, in church, and even at home was either a Nazi or a Nazi sympathizer, to condemn Nazism—and particularly Nazi anti-Semitism—as something depraved and debased, and to risk everything to save, say, a Jewish child facing deportation to the camps. I’ve written about slavery in antebellum America in that vein as well, and particularly about the way so many clergypeople, Christians and Jews alike, seemed almost weirdly incapable of transcending what everybody knew about race to see slavery as the brutal affront to human dignity that it seems to us so clearly to have been. And I’ve also written about the strange inability of so many Jews for so long—and we are talking here not about centuries but about millennia of persecution and endless exile—about their inability to see that they didn’t actually have to live in exile at all, that they could just as easily have made their way to Eretz Yisrael and settled there, that they could have claimed their rightful patrimony not by praying that it come to them via miracle or as a chapter in the coming redemption of the world, but actually by making it so through the labor of their hands and the sweat of their brow.

Clearly, it isn’t that easy to look around at the world, to take note of details that everybody knows to be true…and to reject them as absurdities without caring how that act of rejection might conceivably impact on you personally and on your place in society. Nor do you win any points for knowing better than people in past centuries with respect to propositions that the whole world has long since rejected! The challenge is to look at the actual world in which you live, to take note of its givens and its most (not least) normative beliefs and opinions, and then to have the moral courage to reject as false the propositions that seem to you personally not to be in harmony with what you actually see of the world when you look out at it through your own eyes and allow the matrices of your own working brain intelligently and morally to process what you see.
So these were the thoughts that came to mind as I saw the pictures in the paper the other day of workers removing the statue of J. Marion Sims from its pedestal on Fifth Avenue just outside of Central Park. I mentioned him in a letter last October when I was writing about the issue of whether statuary honoring Confederate war heroes should be removed or left in place. (Click here to revisit that discussion.) But I didn’t elaborate much on his situation, which is why I’d like to return to it today.

J. Marion Sims was, by all accounts, one of the great physicians of his day. Indeed, he is often acclaimed as the father of modern gynecology and as the personal innovator of any number of surgical procedures that have helped countless women, including the repair of both vesicovaginal and rectovaginal fistulas, twin problem that ruined the lives of countless women before he proposed a successful way to intervene surgically to fix them both. And if that—and all his many other achievements—were all there were to his story, his would be an uncontroversial legacy of medical greatness and his place in the pantheon of surgical and medical innovators would be uncontested.
The problem, however, is that, between 1845 and 1849 in Montgomery, Alabama, Sims developed his surgical technique to repair the kind of fistulas mentioned above by conducting experiments on slaves who were delivered to him by their owners to see if he could fix their problems. Three of them he personally named Anarcha, Betsy, and Lucy, and it was on them that he performed the bulk of the experiments that led him to the discovery of surgical techniques still in use today to assist women. And that leads to the question I would like to consider today: how shall we, sitting on the moral high ground more than a century and a half after the passage of the Thirteenth Amendment, judge a southerner in antebellum Alabama who didn’t see slavery for what it was?

It feels as though reasonable arguments could be made in both directions. On the one hand, these women actually were suffering from the problem Sims set himself to solving and, as noted, each was cured as a result of his efforts. On the other hand, Sims had no way to know if his experimentation would be successful and was, in effect, using these women as human guinea pigs to see how they would respond to various ideas he had about how to repair the various kinds of fistulas that so plagued women in his day. It was a long, unpleasant process for the women involved. Anarcha, for example, underwent thirteen different surgeries before her recto- and vesicovaginal fistulas were declared permanently and successfully repaired.
Also, none of the women was anesthetized before her surgery. (They were, however, given opium to address their pain after the procedures were completed.) To be fair, though, I should note that the 1840s were the very years in which the use of anesthetic drugs before surgery was first being introduced, and it was apparently not uncommon for doctors trained in an earlier era to resist their use. Indeed, when Sims later moved to New York to found the Women’s Hospital, he declined to use anesthesia on his (white, non-slave) patients too when he set to repair their fistulas surgically.

Sims’ own testimony regarding the crucial issue of consent is key. Writing in 1855 in the New York Medical Gazette and Journal of Health, Sims wrote as follows:

For this purpose [of therapeutic surgical experimentation] I was fortunate in having three young healthy colored girls given to me by their owners in Alabama, I agreeing to perform no operation without the full consent of the patients, and never to perform any that would, in my judgment, jeopardize life, or produce greater mischief on the injured organs—the owners agreeing to let me keep them (at my own expense) till I was thoroughly convinced whether the affection could be cured or not.
And so the water becomes considerably muddier. He claimed he had their consent. But what could that mean when the women involved were the property of their white owners, whom he openly writes “gave” the women to Sims to see if he could find a way to cure them? Was he lying about them giving consent? What could that even have meant? What he really said to them, no one knows. What would have happened if any of them had declined to proceed, ditto. But what we do know is that these were slaves, the human property of their white masters, and that they were given by those masters to J. Marion Sims for medical-surgical experimentation.

Was Dr. Sims a precursor of Dr. Mengele? That seems exaggerated—Dr. Mengele, who was not even a real physician (his title references his Ph.D. in physical anthropology from the University of Munich), conducted incredibly cruel experiments on innocents at Auschwitz and elsewhere, and was probably insane. Dr. Sims, on the other hand, was a real physician not at all unreasonably revered by many as the father of gynecology and as the individual, even today, the most responsible for solving the most terrible of medical problems specifically faced by women in his day. Clearly, Sims was unable to see slavery as the morally depraved institution it surely was and took advantage of black women “given” to him by their owners to further his work. And so we are left with a relatively simple question: does the fact that the doctor’s experiments were successful and led to tremendous advances in the care of women obviate the fact that the experimentation that led to those advances was done on un-anesthetized slaves who were apparently called upon to hold each other down during the experimental surgical procedures performed on them?
The City of New York has decided that it does not. And just a few days ago, the statue—in place across from the New York Academy of Medicine since 1934 and for two decades before that in Bryant Park—was duly removed and will be set up near the doctor’s grave in Green Wood Cemetery in Brooklyn.

It’s a difficult issue to resolve. All agree that the man did great good and that his work led to countless women being rescued from horrific ailments. All also agree that the path the doctor followed to that great good was morally flawed, and more than just slightly. And so we come back to the question I opened by asking: how reasonable is it, exactly, to condemn people ex post facto  for not seeing the world as we see it now, for not having the insight to transcend the things everybody just knows about the world and its institutions, for not being able to see what millions in his day also could not clearly see?

The world has changed considerably since I was a child. Attitudes towards gay people, towards the place of women in society, towards the place of racial minority groups in American culture, even towards animals in the zoo—all of these have undergone sea changes since I was a child learning about the world from my teachers and, because my parents taught me to respect those teachers, believing what I was told. Should I be condemned for not having had the maturity as a nine-year-old to see things more clearly than my own teachers, then my own parents? I bristle at the thought. But I also wonder what Anarcha, Betsy, and Lucy would say if the fate of Dr. Sims’ legacy were placed in their hands to determine. Ultimately, the decision really should be theirs to make. But given the impossibility of resolving the issue that way, I think the City of New York probably acted correctly in moving the statue to a position near Dr. Sims’ grave and taking it from its pre-eminent position on New York’s grandest avenue facing one of its pre-eminent medical institutions.

Thursday, April 12, 2018

Yom Hashoah 2018

The first Yom Hashoah was observed on December 28, 1949, a date chosen by the Israeli rabbinate not because it bore any connection to any specific Holocaust-related event, but because it corresponded to the tenth day of the Hebrew month of Tevet, a minor fast day that already existed and which, it was felt, could reasonably be co-opted to do double-duty both as a marker in the annual cycle of days connected to the destruction of Jerusalem in the 6th century BCE and also as a national day of mourning for the k’doshim who died as martyrs during the Second World War. The intended symbolism was clear enough—that if we survived the Babylonians and we survived the Germans, we can survive any onslaught directed against us—and was surely intended to inspire hope for the future of the State of Israel. But as Israel became a powerful nation defended both by a mighty fighting force and a formidable arsenal, the need to co-opt the Shoah as a symbol of hope for a national future for the State was destined to fade.
And so, although Yom Hashoah was observed on the tenth of Tevet again the following year, in 1951 the Knesset voted formally to establish the twenty-seventh of Nisan as Yom Hashoah instead. That date too had no specific connection to the Holocaust, but was considered a meaningful choice nonetheless because it fell squarely between Pesach, our annual festival of freedom, and Yom Ha-atzmaut, the day on which Israeli independence was declared in 1948. The message embedded in this date too was clear enough: that the establishment of Israel as a sovereign state was the only rational response to the Shoah, just exactly as the exodus from Egypt itself had once been the only possible solution to the enslavement of the Israelites. That, in my opinion, is a profound thought. But is it enough to motivate diasporan types such as ourselves to embrace Yom Hashoah not specifically as an Israeli holiday, but as a Jewish one as well?

It’s not like we don’t have alternate dates to consider. International Holocaust Remembrance Day, for example, was established by the United Nations in 2005 and scheduled for January 27, the day the Red Army liberated Auschwitz. Meant as a memorial day not only for the six million Jews murdered by the Nazis, but also for all the other victims of Nazi terror—including particularly the quarter-million mentally ill individuals euthanized by the German authorities, as well as the 200,000 gypsies, the 9000 gay men, and the uncountable other innocents murdered by the Germans and their willing henchmen. Surely, no sensitive Jewish soul finds anything objectionable in preserving the memory of all the victims of the Nazis, not solely the Jewish ones. But there too the message embedded in the choice of date is meant to teach a simple message, that just as the world acting in concert was able to defeat fascism even in its most brutally powerful version, so should it be possible for the world’s nations, were they only similarly to act in concert, be able to defeat the forces of darkness that threaten the peaceful future of the world’s peoples today. That too strikes me as a profound thought, and my general inclination to hold the United Nations in contempt does not really spoil the cogency of the concept itself. But my question here nonetheless remains the same: is that notion powerful enough to justify an annual Shoah memorial day not specifically as a way of embracing the possibility of peaceful co-existence among nations working together to create a world of free people, but as a way formally of responding personally as Jewish individuals to the annihilation of European Jewry and acknowledging the specific place the Shoah occupies and possibly always will hold in the consciousness of Jews the world over?
Maybe the concept itself is flawed. Memorial days are by their very nature inclusive, but is it really possible to include millions upon millions of people in a single gesture of recollective grief? I’ve just finished rereading Amir Gutfreund’s magnificent novel, Our Holocaust, which I found even more stunning the second time ’round. The book is remarkable in a dozen different ways, but the key element that it stresses over and over is how each single individual murdered by the Nazis was an entire universe—a whole world of culture, personality, and potential. Under normal circumstances, that is, of course, precisely how we do respond to the murder of a single child or of an adult: as a tragedy of indescribable proportions precisely because of the inestimable value of any human life.

When seventeen children were shot down in Parkland on February 14, Americans responded as one with a kind of national paroxysm of grief that has yet totally to abate. That felt and feels entirely normal. But during the summer of 1944, 12,000 Hungarian Jews were murdered daily at Auschwitz. How can the same language be used to describe the murder of little Etan Patz, of the Parkland seventeen, and of the 437,000 Hungarian Jews murdered at Auschwitz in the summer of 1944? And 437,000 is less than a twelfth of the total number of Jews killed during the Shoah. No wonder there is something overwhelming even about the concept of having a memorial day to honor their memory—as though loss on that level even could be conceptualized, let alone conceptualized successfully enough for a single day of mourning to pay anything more than cursory, formal honor to their memory!
One tentative solution comes from, of all places, Germany itself.

There’s no easy way to translate the German word Stolperstein. The verb stolpern means “to stumble” and is, in fact, a distant cognate of the English. A stein is a stone. A Stolperstein, therefore, is a stone in the road that you stumble over, that you come across and pause for a moment to look at. But these Stolpersteine are not just inconveniently placed paving stones, but rather part of a remarkable effort first undertaken in 1992 by the artist Gunter Demnig, who had the idea to memorialize the Nazis’ victims one by one by placing a marker in the street at each individual’s last known address.  
In the years since then, more than 67,000 such Stolpersteine have been set into the pavement all across Europe in more than 1,200 different municipalities. They do not solely mark the last known address of Jewish people, however—they honor the memory of all the Nazis’ victims, including Allied soldiers murdered by their German captors in flagrant violation of every conceivable standard of decency in wartime. In Germany, each inscription begins with the words hier wohnte, the German words for “here lived,” which are then followed by the name of the individual being memorialized in his or her own home setting. When the numbers of victims connected with a certain address was simply too great for single stones bearing the name of each—for example, when Demnig’s team wanted to memorialize the 1,160 mentally-ill individuals deported to their deaths by the Nazis from the train station in Stralsund, a picturesque town on the Baltic Sea, they came up with the companion notion of a Stolperschwelle, a “stumbling threshold” set into the ground beneath the train station’s front entrance through which the unfortunates were made to march on their way to the trains that took them to their deaths in Poland.

It’s all too much to fathom. I live in a normal world, one in which the trial of a nanny accused of murdering two children has been written up in the paper on a daily basis for weeks. People’s interest in that trial hardly needs justification because the murder of children is among the most horrific crimes imaginable. And yet…this is the same world, this one in which the nanny is on trial for the murder of two—this is the same world in which twenty-five hundred children in the Kovno ghetto were sent to Auschwitz on two consecutive days in March 1944.

Maybe Gunter Demnig has it right—the numbers are just too great to contemplate, let alone actually to conceptualize, and the only reasonable way to mourn is on a victim-by-victim basis: one man, one child, one woman, one address, one year of birth and another of death, one fate, one loss.
When Sam Solasz, the father of our fellow Shelter Rocker Mark Solasz, spoke at Shelter Rock on Thursday evening, he was one man telling one story. It was gruesome, to be sure. And although he personally survived, he was able to make it clear how little likely his personal survival was…and how atypical his fate when compared to the Jews of his hometown and the other members of his family. His was one story…and that was perhaps why it was fathomable: one man, one set of details, one story of survival. That the dead aren’t here to tell their story leaves us in an obvious quandary, but the idea in both cases is the same: the burden Yom Hashoah lays at our feet is not to nod mutely at some unfathomable number, but to find the courage to accept that each individual victim of the Nazis was the loss of an entire world, of an entire universe.  It feels almost as though the burden is too heavy for any of us to shoulder alone. But that is the whole point of coming together as a community on Yom Hashoah, of course: to bear what none of us could bear alone, to shoulder a burden none of us could carry alone, to mourn in a way that none of us could bear on our own as individuals.

May they all rest in peace, those with graves and those with none, those with surviving family members and those with none, those with Stolpersteine marking the homes they were forced to leave on their journeys to oblivion and those whose homes are as yet unlabeled…or forgotten and unknown.