Sign In Forgot Password

VOLUME 2, ISSUE 23

06/12/2020 05:39:56 PM

Jun12

Eve J Lowenstein (AKA Sidlow)

COVID and its Mask:
What a Plague has to say about Humility

If you could take a snapshot of a moment in time today and show it to the you of half a year ago, it would shock your comprehensive abilities. 

I was driving down Peninsula Blvd when I noticed the overhead traffic billboard flashing: COVER YOUR FACE IN PUBLIC. It occurred to me that if I saw that image six months ago, first thought would have been: Jihad! and Where's my hijab? But I would have been dead wrong. 

I was driving to hospitals in Brooklyn one morning and noticed EVERYONE wearing masks. I felt totes gangsta (my kids lingo for totally cool criminal) NOT wearing my mask in the car, as I appreciated my last moments of freedom to breathe before I had to don an N-95, an outer mask and face shield for work.  The whole experience puts me into hypercapnic coma: altered consciousness from inhaling my own bad breath in carbon dioxide stew for hours on end.  (Rich calls me Guzma (exaggeration) Woman for a reason!)  The sight of everyone masked vaguely depressed me, not only as a symbol of the flagrantly conspicuous and insubordinate virus we face, but also for its subliminal message:  A mask is a visible mark to mute yourself!  A mask implies: Cover your mouth: no one wants to see it! Cover your individuality, it is of no consequence.  Silence your ego: It's expression sickens others! 

Maybe you think: Wow, she gets all that from a mask?  So, what’s she high on?  Well actually: two cups of coffee. But allow me to explain: This very same morning’s drive to work, at a street corner near Kings County Hospital, I noticed a young woman dressed in neon red sneakers, shirt and matching red mask.  Most days I would appreciate seeing someone artfully coordinated as an expression of their spirit.  For those who know me, I too relish this outlet.  But this episode struck me in its ridiculous irony:  She took pride in looking put together and she almost did, except for the dissonant mask.  While I have in these last weeks seen some creative masks, they are overwhelmingly repulsive.  This big splotch covering half the face, like Neo’s disappearing mouth in the movie The Matrix, is deeply disturbing in its symbolic powerless depersonalizing humiliation.  A mask with visible muting evokes an instinctual reaction of disgust to a ubiquitous flaw of the human spirit:  Hubris.  Perhaps therein lies the reason certain world leaders will not wear masks in public. To wear a mask is to attest to a defect.   

In an age of talking heads and authoritative science, humility is scarce.  I think back to March 30th, when the news featured an Orthodox Jewish Physician in Monsey who claimed to have cured 100% of his 500 coronavirus infected patients with a hydroxychloroquine/azithromycin/zinc cocktail, such that none (0%) needed vents or hospitalization.  He offered other unbelievable predictions and misinformation.  Absolute success and perfectly rounded numbers were an immediate red flag for fraud.  I was embarrassed by implicit association for the chilul Hashem, but Rich, who has greater faith in ultimate justice being served in our lifetime, assured me that this Quackery would be revealed.  I just read an article that he is under investigation by a federal prosecutor. 

If you learn anything in this pandemic it is never to assume that loud is strong and quiet is weak.  After all, G-d gave us mouths that close and ears that don't.  To be SILENT and LISTEN (which, incidentally, share the same letters) should be our default.  But then, here am I talking on and on.…

To be fair, humility is a tough pill to swallow.  There is a glamour and comfort to absolutes, certainty and hero power.  People flock to gurus and love shows featuring unfathomable super-doctors, super-cops, superpowers. It's hard and humbling to stare doubt in the eye with acceptance, something COVID is challenging us with.

"Doubt is not a pleasant condition, but certainty is absurd." (Voltaire)            

In my world of medicine, the potential damage of overconfidence/ hubris has been studied and found to be the most common source of medical mistakes (diagnostic error).  This anchoring heuristic (bias) is also known as premature closure (a failure to consider alternatives after a primary diagnosis is reached).  This is also expressed in the saying in medicine: ‘A diagnosis is an intellectual catastrophe’. This means: if we feel we have arrived at a diagnosis, the sense of resolution and tension relief will naturally lead a physician to a relaxed cognitive position and prevent additional thinking and searching, which may result in missing another diagnosis at play. In fact, in medicine, not all patients have a condition that fits neatly into one diagnosis. They may have several that explain findings or a condition that doesn't even fit into our current paradigms; something new altogether, like COVID-19.  A few months ago, I could not have made a diagnosis of COVID toes on this unwell little patient.

"Genius diagnosticians make great stories, but they don’t make great health care. The idea is to make accuracy reliable, not heroic." (Don Berwick, Boston Globe, 2002)               

I have seen last month things I never saw before: A disease called Lupus first presenting as a blistering variant called Bullous Lupus.  The cases I have seen and read in the literature were unanimously in the context of already established severe Systemic Lupus disease of the kidneys, never de novo (new) in presentation.  Yet, I just saw my first ever Bullous Lupus presumably triggered by COVID infection in a patient with no prior Lupus detected.  COVID has reminded me that humility and doubt is a more honest and useful intellectual position than certainty.  

Incidentally, a good example and one of the earliest documented cases of premature closure in the Torah is Yitkchak's mistaken identification of Yaakov as Esav, based upon the limited evidence of hairy hands and a delectable goat meat disguised as venison.            

It is natural to prefer and feel reassured by certainty, with the implicit 'in control of all the facts.' But the dangers of such an approach becomes obvious when, for instance, one evaluates a child with injuries suggestive of child abuse.  With an awareness of something akin to Heisenberg's Uncertainty Principle of Quantum Mechanics, complete certainty is humanly impossible.  One must examine evidence, fully aware of our limited view on truth, and cautiously word an assessment on a subjective 'highly improbable to highly probable' spectrum of potential child abuse.  This is not a sign of weakness or stupidity, but rather, an honest and humbly reliable realism, well relayed in the statement:                 

"Seek out the company of those who are searching for the truth. But avoid at all costs those who claim to have found it." (from The Teaching Company's course: Myths of American History)

We Jews are no different in our yearning to reach for absolutes and complete truths in our Judaism.  But hubris can invade and poison our perspective on halachic practice: "Halacha is the way to reach a certain place, that place being morality and holiness. Too many Jews who travel the halacha have forgotten that it is only a way and not the place to which it is supposed to lead.  Whoever makes the way into an end in itself, is lost." (From The nine questions people ask about Judaism. Prager and Telushkin, 1986)      

We long for heroes and absolutes, but the human paradox, irony and tragedy is that only with a humble embrace of our limitations and inadequacies can we safeguard the truth and values imbued in our religious practice.

By: Eve J Lowenstein (AKA Sidlow)

Wed, August 12 2020 22 Av 5780