I Love to Count

I Love to Count

I Love to Count

At God-oh-no-clock in the morning, I woke for no reason.  I rolled over to go back to sleep, head still heavy, eyelids still drooping, but my heart was having none of it.

Flop.  Thump.  Run like a rabbit.

I knew this story.  This gripping feeling of dread in the middle of the chest, this disobedient heartbeat, was a common thread linking my clinic days together, binding my patients in commonality across ethnic boundaries, socioeconomic status, gender and age.

I also knew this story in men my age occasionally meant we had spontaneously developed a serious heart arrhythmia called atrial fibrillation.  The thought of being featured in a commercial for Eliquis did not appeal to me.  And of course, a little knowledge being a dangerous thing, this only added to the inability to ignore the avant garde jazz drummer in my ribcage, unable to decide between Dave Brubeck in 5 or a Balkan rhythm in 13.

It was time to follow my own advice, to do the thing I always told people to do in this situation.  The “poor man’s Holter monitor.”

I took my right wrist in my left hand and planted my left index and middle fingers squarely but gently over my radial artery, and I counted.

One heartbeat!  Two heartbeats!  Three heartbeats!  Four!  Four wonderful heartbeats!

No Brubeck, no Balkans.  Steady and boring as an analog clock ticking in an empty room.  The flopping and thumping stopped.  The Eliquis logo evaporated before my closed eyelids.  I fell back asleep.

Every night for the past 4 ½ weeks I’ve been counting.  Not heartbeats, but days.  The second night of Passover begins the counting of a period known as the Omer, named for the sheaf of barley brought to the Temple as a “wave-offering” on that day.  We count 49 days, seven weeks, until the next harvest, the festival of first fruits, which falls on the 50th day of Shavuot.

With the drift of time, and the historical upheavals that the Jews have endured, the Omer’s meaning has morphed from an agricultural one into a spiritual one.  It is the 49-rung spiritual ladder we climb from leaving slavery in the “narrow place,” Egypt, to the heights of Mount Sinai (ironically, according to midrash, the lowliest of the mountains, chosen for the purpose because of its humility) where we received the words of Torah.

Or, as my friend Rabbi Danny Schiff reminded us a few weeks ago, it is the rememberance of a plague which nearly wiped out civilization as we know it, or at least Jewish civilization.  The plague struck the students of Rabbi Akiva, the great sage who helped define the Judaism that we are discussing here, the post-Temple, post-agricultural Judaism that most of us recognize even though we may adhere to more Orthodox or more liberal forms of it.  At a time less than 60 years after the Romans destroyed the Temple, the survival of such a Judaism, of any Judaism, was by no means assured.  A plague ravaging the disciples who were being counted on to perpetuate that knowledge and those behaviors could spell the end.

As a result, our counting is one of the most spiritually confusing times of the year.  It is spring, midway between two of our greatest holidays and with the world in full rebirth and bloom.  We are anticipating the greatest gift of all, the gift of Torah.  We climb a mystical, spiritual ladder, one that the Chasidic tradition labels with the names of seven of the emanations of the divine, one for each week and then repeating these seven for each day within the week, giving each day a unique name like, “Strength that is in Lovingkindness.”  Yet at the same time, we are in mourning for those lost in the plague, and many Jews refrain from behaviors like cutting their hair, or going out to engage in entertainment.  We have been rehearsing for this year, it seems, for nearly two millennia.

And each evening, to keep ourselves on track, we recite an intention, a kavvanah (from the word for “direction” or “aim”), that says, “I am ready to fulfill the mitzvah of counting the Omer, as it is written in the Torah: u’s’fartem lachem – and you shall count for yourselves….”

The chanting of this kavvanah was what I heard as the Balkan Brubeck faded away.  U’s’fartem lachem.  Count for yourselves.  After all, wasn’t that what I was doing?  Counting for myself?

The counting has a power.  It allows us to take stock of time that has passed, to anticipate time that has yet to come.  To take a catastrophic event and put walls around it, drag it into perspective – or to appreciate the outsized significance of an event we have seemingly overlooked. 

When I count heartbeats, it allows me to take stock of what is really going on inside my chest, to uncouple the feeling from the phenomenon.  The dreadfully out-of-date novel The House of God popularized many rules that I would never follow, but one that retains its power is, “In a code (a cardiac arrest) the first pulse you take should be your own.”  We “take the pulse” of a situation.  When we count, we can control, at least a little bit.

Yet here too, the teachings are ambivalent.  The Torah tells of a huge census of all the tribes, giving exact numbers, yet another relevant parallel to this strange year we are living through.  Elsewhere in Jewish tradition, we are discouraged from counting heads of Jews at all, lest we discover that we are not “as numerous as the grains of sand on the seashore,” as God promised Abraham.  And what of the modern truth that when we count, the numbers mean nothing unless we agree on what exactly we are counting?  Numbers proliferate in the news, but many of them are just a primer in how not to understand statistics.

None of this matters to me in the middle of the night.  Nor does it matter to me just after dark each night, when I stand to recite, “From the day you bring the wave offering, seven complete weeks, until the day after the seventh week count fifty days.”  I, along with my palpitating patients, am counting to reassure myself I am OK, that I am still here.  Or they are counting to say, “I have had two migraines this week – that’s better than four last week, but maybe I can have a week with none.”  Or, “this piece of bread is my third serving of carbs for the day – I will stop now so my blood sugar doesn’t rise.”

Thirty-one!  Thirty-two!  Thirty-three! 

I am counting toward the end of a plague that I know will end, that with every passing day is one day longer, but also one day closer to being over.  Today, day 33, called Lag Ba’Omer after the letters lamed and gimel whose numerical values are thirty and three, was historically the day that the plague of Akiva stopped.  Will it be the day that our plague stops?  There is a debate as to whether “stop” means that it ended, or that it paused, only to resume again until Shavuot when it finally ended for good.  Some Jews pause their mourning rituals on Lag Ba’Omer only to resume them the next day, others finish and move on.  Will our “end” be the end, or just a pause? 

The chronically ill, and those that care for them, know this feeling.  We call it “remission.”  With every remission comes the sense that one shouldn’t celebrate too hard, rejoice too fully.  Remission could be the early recognition of “cure” – or it could just be a one-day reprieve before a return to illness.  A flare of the lupus.  A relapse of the addiction.  A new metastasis. 

Jewish social media the last few days is overflowing with comments about how Akiva’s plague is blamed on his students not respecting each other. If it stopped, was that because they learned their lesson? If it resumed, did they suddenly forget that lesson? It is a calculus that I don’t want to do, a different kind of counting – counting beans. If things go badly, do I blame you, who disagree with me, for being stupid? Disrespectful? Wearing your mask incorrectly?

It is one more attempt at control – but when we attempt to control each other, that tilts quickly toward the same kind of disrespect. There is only so much we can do about factors beyond our control to prevent relapses. U’sfartem lachem – count for yourselves. What can you do? What is your role?

I am counting toward Sinai.  I am counting because I know there is a high point coming.  Yes, I also know that Tisha B’Av, the lowest of the low points, will come exactly two months later.  Just as I know that one day, my heartbeat counting trick may not work, that the palpitations may be real.  But in the middle of this long night, counting reminds me of where I am, of what is coming next, of the approach of something worth keeping track of.  I am counting to regain a measure of control over a world that I know is fundamentally out of my control. 

Forty-eight!  Forty-nine!  Fifty!  Fifty wonderful days! AH-HA-HA – I love to count!

Dr. Jonathan Weinkle

Dr. Jonathan Weinkle is an experienced primary care physician seeking to fix our broken healthcare system by returning the focus to the relationship between human beings. His new book, Healing People, Not Patients, gathers together ancient wisdom, medical science, and the experiences of one doctor to draw a portrait of a partnership—a medical covenant—not just between doctor and patient, but also including receptionist, nurse, transporter, and radiology technician.

Healers Who Listen would love to listen to what you have to say, too.

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