A number of
interesting scientific studies were reported on in the press this week.
It was just this
week, for example, that Nicholas Bakalar wrote in the Times about a new study published
in the journal Nutrients that proved definitively that overeating, and
particularly the over-consumption of fats, leads to drowsiness. The study,
undertaken at the University of Adelaide in Australia, considered 1,800
Australian men and took into account many different kinds of data (including the
men’s eating patterns, their weight-gain and -loss statistics, their status as
smokers or non-smokers, their predisposition to suffer from depression, their
waist sizes, and their level of physical activity) to come to its riveting conclusion.
The results were impressive by any yardstick, but they were particularly
satisfying for me personally because, as it happens, I have been conducting a
similar experiment over the last forty or so years and, although my test group
was considerably smaller, my data—all of it, particularly when Joan wasn’t
home, empirically gathered by myself—has led me to precisely the same
conclusion as the one to which their study led them. I feel so validated!
And I knew I wanted to share that with you as soon as I read about their study! Vivat experimentiam scientia!
But the study that
I wish to write to you about, published in the scientific journal Heart (the
official journal of the British Cardiovascular Society) and also reported on in
this week’s Times, is more surprising and far more provocative. This was
a dramatically larger undertaking, one that analyzed data culled from the
medical records of over 180,000 men and women. It did not, however, involve the
testing or observation of actual patients, but was rather a kind of giant meta-study
that drew from twenty-three different anterior studies of patients in an
attempt to answer a question that I never thought even to wonder about: whether
social isolation and/or a personal sense of loneliness could possibly be a
meaningful predictor of future coronary disease or of a future stroke.
Social isolation
and loneliness are not the same thing exactly. In terms of the study, the
former term was used to denote adults who have few social relationships or
friendships, while the latter was used to describe people who are basically
unsatisfied and unhappy with the relationships they do have even if they are
not few in number. There is something inherently quirky about a study like this
because, there being no scientific way to test for either loneliness or a sense
of being isolated, the patients under study were labelled with either or both
those terms solely by virtue of their own self-definition: if patients
qualified themselves as being among the lonely or the isolated, then they were
considered to belong to that group for the purposes of the study. Their medical
histories, on the other hand, were a matter of medical record: the researchers took
no note of anecdotal evidence and depended instead solely on medical records or
death certificates for the data regarding the subjects’ histories of heart
attacks and strokes. So it was by its very nature a kind of a hybrid built on
analyzable scientific data and patients’ own sense of their place in the world.
There was no
divergence in the findings regarding men and women. That much was interesting
without being particularly surprising, but the results were, at least to me
personally, beyond arresting: self-defining as lonely or feeling socially isolated
appears to increase the risk of having a heart attack, angina, or of eventually
dying of heart disease, by 29%. The risk of stroke increases by 32%, almost a
full third. It is true, I should note,
that the researchers attached a caveat to the effect that it was a review of
observational studies and did not scientifically establish a medically-verifiable
link between loneliness or isolation on the one hand, and heart disease or
stroke on the other. But the data speaks for itself in a matter like this so
clearly that it’s hard—at least for a non-scientist like myself—to imagine that
it could be a mere coincidence that patients across the board—men and women,
old and young, healthy and infirm—who described themselves as lonely or
socially isolated were dramatically more likely to suffer from heart disease,
and that this increased susceptibility seemed unrelated to any other obvious
factors that might otherwise have put them in some different category regarding
their likelihood for future heart problems or stroke.
The researchers themselves
saw it the same way. In fact, the opening line of the introduction to the study
sums up in a particularly stark way the way the scientists who conducted the
study came eventually to understand their own data: “Adults who have few social
contacts (i.e., who are socially isolated) or feel unhappy about their social
relationship (i.e., who are lonely),” they wrote starkly, “are at increased
risk of premature mortality.” And not only is that risk real, they went on to
note formally, but it is statistically and scientifically comparable with
other, far more widely accepted predictors of future heart disease, notably carrying
too much weight and engaging in too little physical activity. So that sounds
pretty definitive to me: feeling friendless or forlorn is not only a heavy
burden to shoulder emotionally and psychologically, but has profound potential implications
for an individual’s heart health and longevity. There’s a folk saying preserved
and labelled as such in the tractate of the Talmud we’ve just finished learning
at Shelter Rock that reads o chavruta o mituta, which means “either
friendship or death.” Patrick Henry may have felt that living not-free was the social
or moral equivalent of being a dead person, but our ancients had a more
practical, apparently more medically correct notion: that living friend-free
and without the support of a warm, sustaining community is not merely comparable
to not being alive at all, it actually leads, or can lead, to an early
demise.
And that thought
brings me to take issue with one of the most famous passages in the Haggadah.
As you know, I’m usually a great one for maintaining a sense of ongoing
fidelity to the traditional text of our prayers. In Tzur Yisrael, we
maintained almost all the most traditional phraseology, altering the received
text here and there only to accommodate realities which seemed strange or even
wrong to ignore. And I feel the same way about the Haggadah—attempts to “fix”
this or that passage so as to make it conform more obviously to modern
sensitivities always seem to fall flat when I consider them closely and the
traditional text is almost always the one that speaks to me the most clearly.
But arguing for a
traditionalist approach to liturgy doesn’t mean that I invariably agree with
what I read. And I find myself at odds with one of our most famous passages
this week: the story of the four sons who relate to their parents’ efforts to
celebrate Passover so differently. I know most seder-attendees know the
passage by heart, but let’s revisit it just for a moment. The wise lad is the
one who asks all the right questions and he is appropriately rewarded for his
curiosity with warm approval. No issue there! The simple lad is the one who
takes note of the festival but can barely bring himself to formulate a coherent
question. His mah zot (“what is all this?”) couldn’t be less
eloquent, but he too is somehow rewarded for even his minor level of
inquisitiveness with an answer simple enough for anyone at anyone to
understand. No issue there either! Moving along, even the child who lacks the
wherewithal to ask any sort of question is treated kindly…but the contrary son,
the rasha, who excludes himself from the group is not to be treated
kindly at all. Instead, he to be dealt with contemptuously and taunted with the
possibility that, having taken himself out of the group in his own day, he
would surely not have been taken from Egypt had he been a slave there in
ancient times. And this, from a book that makes a special point of saying that all
Jewish people are called upon to imagine that they themselves were slaves in
the land of Egypt and would still be there had God not brought them forth with
a mighty hand and an outstretched arm. All…but apparently not him!
That seems harsh to
me. The lad is, after all, present at his parents’ seder table. He
observes what’s going on around him. His question, particularly in the Hebrew,
isn’t that different from the wise son’s…only he hasn’t come to the
point just yet at which he feels that he belongs to the group. He’s present yet
absent, involved yet aloof, included yet excluded, in yet out. In other words,
he’s standing on the wrong side of the threshold looking in, and tradition has
chosen to focus on the spot he’s standing on rather than the direction
he’s looking in. In a perfect world of my own making, such a young
person would be spoken to gently rather than harshly, kindly rather than with
the kind of acidulous contempt that will only make him feel even less a
part of the group he is being mocked for not feeling part of…or not enough part
of. To shove him even further away seems cruel or, at the very least,
counterproductive…and now I see that my sentiments are mirrored by scientific
research: the strength of community is not only satisfying spiritually, but the
sense of belonging that comes along with membership in any traditional Jewish
community is actually something that can lead to a long life. To turn a child
away because he’s not there yet is thus, at least potentially, to
shorten his life. To turn any people away merely because they feel disengaged
is, to say the least, counterproductive: the correct response to people who
feel disengaged is to engage them as though their very lives depend on it,
which they apparently do. O chavruta, o mituta indeed!
People occasionally
tell me that they’re not sure about retaining their affiliation with the
synagogue after their children are done with the Religious School and they’ve
made all the bar- and bat-mitzvahs they’re going to make. There are several
different ways that this thought is couched when it’s put to me, but my
response is always the same: what you get by belonging to a thick, rich, caring
community of like-minded co-religionists is that you get to belong to a thick, rich,
caring community of like-minded co-religionists. The twin specters of
loneliness and isolation will never haunt those who belong because the
traditional Jewish community is designed specifically to guarantee that no one
ever needs to feel abandoned or deserted. And because, ultimately, friendship
is at the core of community and serves as its defining feature: family is
blood, but community is amity. And that, it turns out, is not just important
because it leads to warm, fuzzy feelings about the universe. It’s important
because finding your place in a community of caring friends is one of the
things that staves of heart attacks, angina, and strokes. I might have said
that from the bimah in the past as a kind of rhetorical flourish
intended poetically to tout the advantages of affiliation. But who knew it was scientifically
true as well? It turns out my mother
was right—you really do learn something each and every day!
At Shelter Rock, we
foster communal friendship as best we can and that, more than any specific
service, is what we offer our membership: the chance to belong to the kind of
thick community in which people are allied by a sense of familiarity and
emotional intimacy, and in which no one ever needs to feel bereft or forsaken.
I suppose that truth visits us all in different ways at different times of the
year, but I myself feel it particularly in the course of our holidays when we
gather in the great sanctuary of the synagogue for Yizkor and as a community
find the courage and strength to face our own mortality by staring down the
past and the future as one extended, caring family of friends. Yizkor is about
our lost loved ones, obviously. But it’s also about the living, the people who
have come to remember and to mourn. The antidote for the kind of sadness
associated with grievous loss is not gain of any sort, but the strength of community
and the support engendered by the sustaining relationships community by its
nature fosters. The discovery that being part of that rich circle of friends
and neighbors also apparently staves off heart disease, thus extended our lives
meaningfully, only makes me feel prouder of my membership in our little shtetl,
our village in which none needs to feel lonely and in which despondency brought
on by social isolation is the fate of no one at all who wishes it otherwise.