by Madhu Kaza

It’s cold outside. New York City is probably exciting as ever out there, but I’m staying in with my soup and my soup spoon and all of the spoons, with books listing this way and that on the shelves, socks and sweaters stuffed into drawers, stray paperclips on the loose, dust storms gathering behind the sofa and an African stone egg that's warming either under my pillow or somewhere under my bed. It would all be uneventful, except that I’ve been rereading Michal Ajvaz’s novel, The Other City.

The Other City begins with the narrator taking refuge from a snowstorm in a bookstore in Prague. Through a series of magical encounters that follow, the novel leads us into “the other city,” which exists as a shadow city just beyond the Prague that is known. The Other City is a labyrinthine and fantastical place where books turn into jungles, the alphabet becomes a virus, oysters attack cities, and fish battle inside glass statues. Through the layering and pile up of surreal imagery Ajvaz conjures a world that is wonderful and terrible, a place of awe.

Though it’s a strange place the Other City is not inaccessible or distant. Ajvaz insists that if we truly learned how to look and pay attention we’d find that we are right at the edge of otherness: “The frontier of our world is not far away; it doesn’t run along the horizon or in the depths. It glimmers faintly close by, in the twilight of our nearest surroundings; out of the corner of our eye we can always glimpse another world, without realizing it.” He notes that we overlook the nooks and crannies, the closets and the dusty spaces of our homes or between our homes where things are happening:

Even inside the space we regard as our property there are places that lie beyond our power, lairs inhabited by creatures whose home is over the border. We are familiar with the strange queasiness we feel when we encounter the reverse side of things, and their inner cavities which refuse to take part in our game: when we shove aside a cabinet during spring-cleaning and we suddenly find ourselves looking at the ironically impassive face of its reverse side, which stares into dark chambers that are mirrored on its surface, when we unscrew the back of the television set and run our fingers over the tangle of wires, when we crawl under the bed for a pencil that rolled away and we suddenly find ourselves in a mysterious cavern, whose walls are covered with magical, trembling wisps of dust, a cavern in which something evil is slowly maturing until one quiet day it will emerge into the light.

Ajvaz tells us not only that is there a world unfolding from the perspective of the spoons in a drawer, the backside of the cabinet, or the space between walls in an apartment, but also that encounters with this world can be frightening. “Every genuine encounter destroys our existing world,” says the narrator. What counts as a genuine encounter must be terrifying because it puts us in contact with the unknown; it makes the familiar strange.

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by Misha Lepetic

“Is it the media that induce fascination in the masses,
or is it the masses who direct the media into the spectacle?”
~Baudrillard

I usually buy my cigarettes at a corner store, on Manhattan's Upper West Side, that, not unusually for such establishments, also does a brisk trade in lottery tickets. Now, buyers of both cigarettes and lottery tickets are placing bets on outcomes with dismally known chances of winning. My fellow consumers are betting that they will win something, and I am betting that I won't (I also console myself with the sentiment that I am having more fun in the process). But in both cases, the terms of exchange are clear – we give our cash to the vendor, and buy the option on the pleasure of suspense, waiting to see if we have won. Beyond the potential payout, there really isn't that much more to discuss: the transactions are discrete and anonymous. And in the end, someone always wins the lottery, and someone always lives to a hundred.

I was reminded of the perceived satisfactions of participating in games of chance with hopeless odds after hearing a recent piece on NPR discussing quite the prize: a cool $1 billion dollars for anyone who nailed a 'perfect bracket.' In other words, the accurate identification of the outcomes of all 63 games of the NCAA men's basketball playoffs. Sponsored by a seemingly oddball trinity of Warren Buffett, Quicken Loans and Yahoo!, the prize is, on the face of it, an exercise in absurdity. But its construction is superb, and worth examining further, for reasons that have little to do with basketball, or probability, but rather for the questions it provokes around the value of information.

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by Kathleen Goodwin

There are many bitter and hopeless thoughts that have plagued me since the night that Wendy Chang took her own life in her Harvard dorm room in April 2012, just 34 days before she would have graduated. However, it wasn't until this past January, when Madison Holleran, a freshman at the University of Pennsylvania, committed suicide in Philadelphia, that I have felt compelled to organize these thoughts to understand what may have prevented these horrifically tragic deaths. Madison was a varsity track runner at Penn and was reported to have a loving family and many friends. She was also so remarkably beautiful that no news source reporting on her death could help but comment on it. Wendy and I were both part of a close-knit student organization and having known and worked with her, I can attest that she was among the most gregarious, creatively talented, and vibrant human beings I have ever encountered. The hundreds of Harvard students who attended Wendy's filled-to-capacity memorial service all voiced similar sentiments describing her uniquely magnetic nature.

In the immediate aftermath of Wendy's suicide, I blamed the environment at Harvard that seemed to value our accomplishments over our happiness. However, when I had my own episodes of anxiety and depression in the year following her death, it was the presence of my roommates, friends, and a few exceptionally helpful university administrators who prevented these issues from spiraling out of control. While I may criticize American colleges for not doing enough to support the mental health of students, I realize that colleges, including Harvard, offer an invaluable opportunity for development within what can be a supportive community. However, many colleges today are failing their students who grapple with mental health issues. Numerous require or compel students who admit to suicidal thoughts or serious mental illness to take a leave of absence, or even to formally withdraw. Most colleges claim that they are not adequately equipped to help students with mental illness and implicitly suggest that it is not their responsibility to provide resources to mentally ill students, especially when these may be diverting resources from students who are “well”. I argue that, on the contrary, it is the direct responsibility of these institutions to create a campus environment where students struggling with mental illness can be supported.

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by Dwight Furrow

I suspect most people would say “good taste” is an ability to discern what other people in your social group (or the social group you aspire to) find attractive. Since most people cannot say much about why they like something, it seems as though good taste is just the ability to identify a shared preference, nothing more.

But looked at from the perspective of artists, musicians, designers, architects, chefs and winemakers, etc. this answer is inadequate. It doesn't explain why creative people, even when they achieve some success, strive to do better. If people find pleasure in what you do and good taste is nothing more than an ability to identify what other people in your social group enjoy, then there is little point in artists trying to get better, since the idea of “better” doesn't refer to any standard aside from “what people like”. So it seems like there must be more to good taste than that.

Furthermore, good taste cannot merely be a matter of having a sense of prevailing social conventions because artists and critics often produce unconventional judgments about what is good. Instead, having good taste involves knowing what is truly excellent or of genuine value, which may have little to do with social conventions.

But philosophers have struggled to say more about what good taste is. David Hume, the 18th Century British philosopher, argued that good taste involves “delicacy of sentiment” by which he meant the ability to detect what makes something pleasing or not. In his famous example of the two wine critics, one argued that a wine is good but for a taste of leather he detected; the other argued that the wine is good but for a slight taste of metal. Both were proven right when the container was emptied and a key with a leather thong attached was found at the bottom.

Thus, Hume seemed to think that good taste was roughly what excellent blind tasters have—the ability, acquired through practice and comparison, to taste subtle components of a wine that most non-experts would miss and pass summary judgment on them. The same could be said of the ability to detect subtle, good-making features of a painting or piece of music. The virtue of such analytic tasting of wines is that the detection of discreet components can at least in theory be verified by science and thus aspires to a degree of objectivity. Flavor notes such as “apricot” or “vanilla” are explained by detectable chemical compounds in the wine. The causal theory lends itself to this kind of test of acuity since causal properties can often be independently verified.

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by Shadab Zeest Hashmi

You write of your country as if from a great distance.

Distance is journey’s squinting twin; it courts vision. My country, you will understand, came from vision’s egg. It came from a dreamer of journeys—a poet who entertained nightly the spirits of distant poets: Plato, Ghazali, Rumi, Hafiz, Goethe— sojourners all. What distilled from their vapor was the map of my country.

You can find black and white reels of the millions who made the journey into this dreamer’s land—on trains, oxcarts, on foot. Jour is day, and journey, the work wheel with dreams for spokes we turn daily.

The souring of his dream may also be seen best on a journey; myopic distance fusing radii surreptitiously, organically— vision brought into clear focus: New hay turning into gold— new sweat.

We learn to avoid shadows. We walk in the light cast by our own missteps.

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by Yohan J. John

“Little does my lady dream / Rumpelstiltskin is my name!” Rumplestiltskin, by Anne Anderson. Image from Wikimedia Commons

Of all the strange and wonderful fairy tales I encountered as a child, Rumpelstiltskin always struck me as the most peculiar. The story revolves around a girl who must spin straw into gold or face death at the hands of the king. A dwarf appears out of nowhere, and spins the straw into gold — for a price. On the first night he takes a necklace, and on the second a ring. On the third night the girl has nothing left to pay him with, and so the dwarf makes her promise to give him her firstborn child. The king's greed is sated after three days of gold-spinning, and he marries the girl. In due time the new queen gives birth to a child, and sure enough, the dwarf returns to receive his pounds of flesh. But the queen refuses, and tries to offer him some of her newly acquired riches instead. The dwarf agrees to give up his claim on the child, but only if the queen can guess his name within three days. Her guesses on the first two days fail. But then one of her spies returns with a strange tale. He came across a little cottage in the woods, in from of which he saw a dwarf prancing around a fire, singing a song that ended “Little does my lady dream / Rumpelstiltskin is my name!” On the third day the queen initially pretends not to know the dwarf's name. Finally she says, “Could your name be Rumpelstiltskin?” At this the dwarf flies into a rage, and stomps his foot on the ground so hard that a chasm opens up in the ground, swallowing the dwarf, who was never seen again.

As a child I found the dwarf's plunge into the subterranean void the most eerie element in the story, but in recent years I've been pondering another, perhaps deeper mystery. Why did Rumpelstiltskin's name have so much power?

Fairy tales notwithstanding, by the time I got to college I had come to think that names were mere conventions that had no intrinsic meaning or value. For all practical purposes, surely one label was as good as any other? Dismissing a debate on what to call something as “mere semantics” seemed to be an act of hard-nosed skepticism and realism.

But as I came to discover, naming involves much more than simply assigning a label to something that has already been identified. The act of naming is one of the central mysteries of human cognition — it is the visible tip of an iceberg whose depth below the surface of conscious thought we have only just begun to plumb. I cannot claim to have solved this mystery, but I'd like to present what I have cobbled together so far: a handful of puzzle pieces which I hope will entice the reader to join in the investigation. (Perhaps more puzzle pieces will turn up in future columns.) I've divided up the essay into four parts. Here's the plan:

1. We'll introduce two key motifs — the named and the nameless — with a little help from the Tao Te Ching.
2. We'll examine a research problem that crops up in cognitive psychology, neuroscience and artificial intelligence, and link it with more Taoist motifs.
3. We'll look at how naming might give us power over animals, other people, and even mathematical objects.
4. We'll explore the power of names in computer science, which will facilitate some wild cosmic speculation.

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by Paul Braterman

Scientific theories are antifragile; they thrive on anomalies.

Some things are fragile – they break. Some are robust – they can withstand harsh treatment. But the most interesting kind are antifragile, emerging strengthened and enriched from challenges. Whatever does not kill them makes them stronger. Science is as successful as it is, because science as a whole, and even individual scientific theories, are antifragile.

We owe the term “antifragile” to the financier and thinker Nassim Nicholas Taleb, author of Fooled by Randomness and Black Swan. Taleb describes his latest book, Antifragile; Things that Gain from Disorder, as the intellectual underpinning of those earlier works, since it formalises his earlier reflections. Antifragility is the true opposite of fragility. Unlike mere robustness, it is the ability to actually profit from misadventure. A porcelain cup is fragile, and shatters if dropped. A plastic cup, being robust, will not be any the worse for such an experience, but it will not be any the better for it either. Contrast the human immune system. Being antifragile, it is improved by stresses. Having been challenged by an infection, it will be primed to respond more effectively to similar challenges in the future, because it has learned to recognise the infection as an invader. There are deep connections between randomness, uncertainty, novelty, information, and learning, and natural selection in an uncertain world favours antifragile systems because they learn from experience.

Good safety systems are antifragile. Accidents will happen, and of their nature cannot always be foreseen, but each accident can be analysed retrospectively and procedures adjusted to anticipate similar challenges in the future. Moreover, experience shows that experience is more persuasive than foresight, even when the mishap itself has actually been foreseen.

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by Omar Ali

I have written before about the historical background of the Shia-Sunni conflict, and in particular about its manifestations in Pakistan. Since then, unfortunately but predictably, the phenomenon of Shia-killing in Pakistan has moved a little closer to my personal circle. First it was the universally loved Dr Ali Haider, famous retina surgeon, son of the great Professor Zafar Haider and Professor Tahira Bokhari, killed in broad daylight in Lahore along with his young son.

This week it was Dr Babar Ali, our friend and senior from King Edward Medical College; He was the assistant DHO (district health officer) and head of the anti-Polio campaign in Hasanabdal, who was shot dead by “unknown assailants” as he drove out of his hospital at night. Shia killing portals reported his death but it is worth noting that no TV channel or major news outlet reported on this murder. Such deaths are now so utterly routine that they do not even make the news.

This should scare everyone.

In 2012 I had predicted that:

“The state will make a genuine effort to stop this madness. Shias are still not seen as outsiders by most educated Pakistani Sunnis. When middle class Pakistanis say “this cannot be the work of a Muslim” they are being sincere, even if they are not being accurate.

But as the state makes a greater effort to rein in the most hardcore Sunni militants, it will be forced to confront the “good jihadis” who are frequently linked to the same networks. This confrontation will eventually happen, but between now and “eventually” lies much confusion and bloodshed.

The Jihadist community will feel the pressure and the division between those who are willing to suspend domestic operations and those who no longer feel ISI has the cause of Jihadist Islam at heart will sharpen. The second group will be targeted by the state and will respond with more indiscriminate anti-Shia attacks. Just as in Iraq, jihadist gangs will blow up random innocent Shias whenever they want to make a point of any kind. Things (purely in terms of numbers killed) will get much worse before they get better. As the state opts out of Jihad (a difficult process in itself, but one that is almost inevitable, the alternatives being extremely unpleasant) the killings will greatly accelerate and will continue for many years before order is re-established. The worst is definitely yet to come. This will naturally mean an accelerating Shia brain drain, but given the numbers that are there, total emigration is not an option. Many will remain and some will undoubtedly become very prominent in the anti-terrorist effort (and some will, unfortunately, become special targets for that reason).

IF the state is unable to opt out of Jihadist policies (no more “good jihadis” in Kashmir and Afghanistan and “bad jihadis” within Pakistan) then what? I don’t think even the strategists who want this outcome have thought it through. The economic and political consequences will be horrendous and as conditions deteriorate the weak, corrupt, semi-democratic state will have to give way to a Sunni “purity coup”. Though this may briefly stabilize matters it will eventually end with terrible regional war and the likely breakup of Pakistan. . Since that is a choice that almost no one wants (not India, not the US, not China, though perhaps Afghanistan wouldn’t mind) there will surely be a great deal of multinational effort to prevent such an eventuality.”

Unfortunately, it seems that the state, far from nipping this evil in the bud, remains unable to make up its mind about it.

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by Holly A. Case

Demonstration in Budapest in support of CEU, April 9, 2017

On Tuesday of last week, the Hungarian parliament passed a law that seeks to drive the Central European University, founded in 1991, out of the Hungary. Many articles and op-eds have been written condemning the law, and declarations of support have come from Hungarian universities and student unions, scores of universities and scholarly organizations in Europe and the US, and from CEU students and alumni. Demonstrations and solidarity events have taken place in Budapest, New York, London, Lisbon, Friedrichshafen, St. Petersburg, Warsaw, Saarbrücken, Amsterdam, Barcelona, Paris, Bucharest, Mainz, Vienna, Berlin, Cluj, Stockholm, Heidelberg, Zagreb, and Prague. Members of the European Parliament, as well as US and European diplomats and statesmen have criticized the law, all to no avail. The governing party in Hungary, Fidesz, with Prime Minister Viktor Orbán at its head, remains unmoved.

Somewhere in between all the domestic and international support and the Hungarian government's attacks on CEU is the actual place and the people who have studied or worked there. What follows is a series of anecdotes about an educational institution in the heart of Europe like no other, one that has no obvious forerunners or successors. The child of a euphoric moment in the region's history (1989), CEU has since grown and changed, but has also transformed the many people who have passed through it.

1996: The Conference (by yours truly, no affiliation with CEU)

I first visited CEU in the spring of 1996. A friend of mine and I had come up from the town of Szeged for a conference. We met the other participants in a cafeteria-like setting at the brand new Kerepesi dormitory on the outskirts of Budapest. The conditions for language surfing were ideal. Everyone had a few, it seemed: all the former Soviets knew Russian, all the former Yugoslavs knew…well, that language that they all spoke (the name of which was a plaything in that cafeteria, but a minefield outside it; the war in Bosnia had barely ended). Plus there were the displacement stories, like Leonid, a Russian-speaking Jew from Moldova, who also happened to speak Bulgarian as well as that language, thanks to friendships and a love interest from Serbia.

I gave my conference presentation on absurdism in Polish and Hungarian literature. While the cafeteria conversations had unfolded in numerous languages, the conference proceedings were all in English, which was rough for many of the participants who had only been learning the language for a short time. After my panel, a group of us—myself, a Croat, a Latvian, a Hungarian, and Leonid—were standing in the lobby when someone commented on how good my English was. "How did you learn it so good?" he wondered. Before I could tell him it was my native language, the Latvian spoke for me, waving a hand dismissively: "You know how it was, the borders were changing so quickly."

We burst out laughing. The collapse of multi-national states, the fall of the Berlin Wall, and the end of the bipolar world order: the borders had indeed changed very quickly.

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ASSIGNMENT

Only Muslim in the workshop,
I went on about the President’s
Shocking and Awful on Iraq,
civilization’s cradle,
bombed back to the Stone Age
for non-existent nukes
sold by capitalist gunrunners.

I am a witness, I said,
I must howl: In every well
in Baghdad a rafiq is weeping
while long black coats
(with gas masks)
huddle at the Wailing Wall,
as if prayers could halt smart bombs.

“Rhetoric, not lyric,” my peers echoed
Yeats. “Argue with yourself not others,”
the adjunct professor said, “A warhead
rising from its silo was over the top.
Nike stockpiling kneepads was sick.
Not ars poetica.”

By Rafiq Kathwari, winner of the Patrick Kavanagh Poetry Award 2013.

by Ahmed Humayun

Saudi King Abdullah

Earlier this month Saudi Arabia decreed that the Muslim Brotherhood, the Middle East's dominant Islamist party, was a terrorist organization. This is the latest move in a series that demonstrates Riyadh's profound fears about the challenge posed by the Arab uprisings to the Sunni ruling status quo, and especially to its self-appointed role as the arbiter of Sunni Islam. The Saudi designation says less about the character of the Muslim Brotherhood and more about its own embrace of an all-out eradication strategy meant to vanquish, rather than accommodate, the aspirations of populist Islamist activism across the region.

Contemporary states tend to apply the ‘terrorism' label selectively. Pakistan distinguishes the good Taliban, who are perceived to protect the state's interests in Afghanistan, from the bad Taliban, who attack the Pakistani state and are therefore described as terrorists. Saudi Arabia too condemns groups that target it, such as Al Qaeda and its offshoots, while remaining a critical sponsor of a dizzying array of militant factions around the world.

In the case of the Muslim Brotherhood, the charge of terrorism is particularly inapplicable. The Muslim Brotherhood renounced violence decades ago. Unlike violent extremist groups like Al Qaeda it does not preach that Arab rulers are apostates whose un-Islamic rule must be toppled through war and subversion. It denounces terrorist attacks, supports electoral democracy, and preaches political engagement—rather than terrorism and insurgency—as the method of advancing change.

Saudi antipathy towards the Muslim Brotherhood is not therefore due to any genuine fear of terrorism. The real threat is the political and ideological challenge posed by the Brotherhood's potent mix of Islam and politics. The Saudi model of governance uses religion to command absolute submission to rulers, disdains meaningful elections or transfer of power, and promotes a depoliticized citizenry. Through its enormous petro power it propagates the same Islamic order abroad, funding reactionary clerics, organizations and institutions across the Muslim world. An alternative way of construing Islam and politics is a deep internal threat to the legitimacy of the regime and a provocation to its monopolization of global Islam.

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by Debra Morris

In this part of the essay I'll draw out some possible consequences for the contemporary Democratic Party of a distinctive brand of partisanship exemplified, as I suggested in Part 1, by my grandmother, the woman known all my life as “Morris.” She is a true Texas type: the Yellow Dog Democrat. To be sure, she has always been more Lady Bird than Ann Richards in demeanor—proper, clean-living, quietly capable; disarmingly witty, though I've long suspected she keeps most of her jokes to herself. Now, the fact that Morris harkens to one of these ladies, rather than the other, is part of the reason I wonder about the value of the Yellow Dog sensibility; certainly no one writing or talking about Democratic Party strategy in Texas shows any nostalgia for my grandmother's kind of partisanship. And maybe, by now, it is a relic: irrelevant to the political landscape of Texas (not to mention the nation); more endangered by the day (literally so; my grandmother turned 100 last year, and it may well be her passing that distresses me, not the loss of a Democratic golden age in Texas); and, in any case, not the unambiguously positive thing that I might like to think, or that I dare suggest we preserve or try to resurrect. As I was reminded recently, when I characterized Morris as a “Yellow Dog Democrat” and a friend retorted “By which you mean Republican, of course,” the term and the phenomenon are loaded. What do I achieve by attempting to describe it, much less by lamenting its loss?

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by Charlie Huenemann

At the beginning of book three of his Treatise on Human Nature, David Hume argues that justice is something we invent. In a word, justice is unnatural. It isn't something we just see in the world, since we only ever see what is, and nothing in what we see tells us how things ought to be. Neither does justice come from some inner, natural feeling, if by “natural” we mean the hard-wired, immediate pleasures and pains that we can't help but have. No; to have any sense of justice, we have to be taught to have it. We have to be trained by others to feel a particular kind of pleasure in seeing fair treatment being done. Our parents have to show us how to be fair, and encourage us in whatever ways they can to get us to want fairness, until it starts to seem natural to us.

Parents train their children in this way because, somewhere along the way, our ancestors figured out – probably the hard way – that respecting and honoring fairness eventually leads to the kind of life where we can live safely, raise families, and keep property. Justice works. And so these ancestors taught their children to be fair, and they taught their children, and so today do we. “In a little time, custom and habit operating on the tender minds of children, makes them sensible of the advantages, which they may reap from society, as well as fashions them by degrees for it, by rubbing off those rough corners and untoward affections, which prevent their coalition”. We become shaped by our early experiences to take some pleasure in a sense of justice – and a good thing, that.

Hume argues that this early and artificial shaping has to be in place well before promises can have any hold over us. Promises come about because, at some point, the affairs of daily life present us with circumstances where an exchange of this for that can't happen right away. “Your corn is ripe to-day; mine will be so to-morrow. 'Tis profitable for us both, that I shou'd labour with you to-day, and that you shou'd aid me tomorrow”. At this point, a promise would come in handy. So we invent special words and signs that constitute a promise. But there is no reality to this human invention, apart from all of us agreeing to treat it as a real thing, out of the interest in justice we have been shaped to have.

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Posterity:

………… all that
follows

every generation since Oldowan man chipped obsidian and flint
to make a stone ax to lay open the skull of an adversary
for food or turf, honing technique until

at this end
he’s chipped them
into ICBMs

the inner stuff of blind surge
the inclination of instinct
down a slippery slope

…………the popped buds
…………of hope

…………or

whatever’s survived
the gauntlet of a willful Demiurge
in which rank and ecstatic
blossoms collide

what morphs into the next thing
which unfolds from a chrysalis
and mounts the sky

a lime Luna moth the color of bliss
a bird that whistles, a bird that sings
desire that will not desist
the leading edge of everything

the fruit it brings

my daughters now in the outer world
pushing on, pioneers

………..a bird that whistles
……………a bird that suffers
…………………a bird that sings
.

by Jim Culleny
3/12/14

by Brooks Riley

We didn’t want a second cat. That said, we got a second cat, succumbing to the desperate pleas of a friend with two litters to give away. By the time we capitulated, she was the only kitten left.

If there were an antonym for ‘runt’, it would have applied to Sperl, as we finally named her (see T.S. Eliot’s ‘The Naming of Cats’). She was the biggest kitten of the two litters, a black-and-white, gangly thing with a strange face. Like a mother who loves one child more than another, I did my best to hide my antipathy. Our other cat, after initial outrage, lapsed into a state of chronic resentment behind a mask of indifference.

Sperl was huge, a gentle giant with muscles, not fat. Anthropomorphically speaking, she could have been a Valkyrie (with an operatic voice to match), or a female wrestler. When she was nearly grown, it dawned on me that she had become a great beauty. But something else made me sit up and take notice: It was that presence, so much greater than her body mass. I fell in love.

When she died eight years later (was it gigantism?), it was one of the saddest days of my life. She had brought us so much pleasure, and more: She had taught me a thing or two. In memory of Sperl I have written down the Sperl Commandments, as I learned them from her.

The Sperl Commandments

1. If they don’t like it, don’t do it.

There was almost nothing Sperl did that I didn’t like. She was a considerate cat, unlike others I’ve known. She never used her claws, even when she was kneading my stomach in a show of affection. She knew instinctively what I liked and what I didn’t. If I reprimanded her for something just once, she never did it again.

2. Don’t be forced to do something you don’t want.

Sperl didn’t like to be held. She might curl up on my lap, but if I picked her up, she would struggle to get down, using her muscles to get free, not her claws, not her teeth. Because I was so besotted, I sometimes picked her up anyway, just to hold that great bulk in my arms (I had yet to learn Commandment number 1). Over time, to please me, she would remain still in my arms a bit longer—one second, then four, in the end ten whole seconds–before she began to squirm.

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by Hari Balasubramanian

In my first piece for 3QD, I discussed some aspects of the science of queueing. In this essay, I'd like to ground that discussion in the context of delays that patients routinely experience in American hospitals. In 2010, there were around 130 million visits to the emergency departments (EDs) of hospitals around the country. Nearly 23% of these patients waited an hour or more to see a care provider [link]. Many urban hospitals and individual patients do much worse.

The documentary The Waiting Room foregrounds the human stories that underlie these statistical estimates, and lets patients, their families, nurses, doctors and social workers speak for themselves. The film is shot during a 24-hour period at the emergency department of a safety-net hospital: Highland Hospital in Oakland, California. 241 patients come to seek care during this one day. Most of the time the camera is in the waiting room, where patients reconcile themselves to a long wait; this applies even to a man with a gunshot wound, whose body is turning numb – hard to believe but true.

The problem faced by Highland Hospital is by no means unique. I've heard it many times from hospital administrators and clinicians. My own research on reducing delays in healthcare led me to work with a large hospital which sees nearly 300 patients daily — more than Highland — in its emergency department. I was quite familiar with what I saw in the documentary: the look and feel of the waiting area; the small rooms inside the main care section with beds and equipment, curtained off to provide patients and their families some privacy; the additional hallway beds with no privacy, but nevertheless necessary due to the sheer volume of patients in acute condition; the constant buzz of pagers, movement of personnel, calls for lab analyses and diagnostic scans; the flicker of computer screens with way too much information; the difficulties in deciding whether the patient should be admitted to an inpatient unit or discharged; and if discharged where the patient should go, for some psychiatric or substance abuse patients have no home to return to.

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