Who You Callin’ Riffraff

Who You Callin’ Riffraff

The following post was originally a “d’var Torah” (the proper Hebrew term for a sermon) I delivered to my congregation on June 2, 2018.  I’ve added some examples, removed others, and taken out many of the specific citations.  If you’re interested in reading the original, email me at weinkle@healerswholisten.com and I’d be happy to send you a copy.

Only in Israel.  During the 1999 Israeli elections, actress and singer Tiki Dayan, known prior to that point for several Shakespearean roles and as the narrator in a Hebrew-language production of Joseph and the Amazing Technicolor Dreamcoat, took the stage at an artists’ conference where Labor candidate Ehud Barak was scheduled to speak.  In her speech, Dayan used an epithet straight from the Torah to describe the supporters of Barak’s opponent, the once-and-future Prime Minister Bibi Netanyahu, calling them “asafsuf min ha shuk.”

“Riffraff from the marketplace.”

If you are not a follower of Israeli politics, yet find yourself thinking, “I’ve heard this story before,” it may be because you remember a more recent comment by a US presidential candidate about her opponent’s supporters being a “basket of deplorables.”

You may also remember that in the aftermath of that comment, lawn signs sprouted in front of the homes of some of those supporters: “Adorable Deplorable.”  Little did they know, Bibi’s crowd had beaten them to the punch.  17 years earlier, bumper stickers all over Israel were proclaiming proudly, “Ani Ha Asafsuf!” – “I am the riffraff!”

So now we answer the question that I’m sure is on everyone’s mind: “What’s an asafsuf?”

Numbers, 11:4-5: “The riffraff (asafsuf) in their midst felt a gluttonous craving, and then the Israelites wept and said, ‘If only we had meat to eat!  We remember the fish that we used to eat free in Egypt, the cucumbers, the melons, the leeks, the onions, and the garlic.”

The commentators on this passage waste no time in identifying the “riffraff” as foreigners, a mixed multitude of other slaves and laborers who took advantage of the chaos during the Exodus from Egypt to come along for the ride, then started stirring up trouble in the desert when things weren’t going well.  One translation identifies them as being of other religions, perhaps outsiders who had married in.  One even compares them to the plague of wild beasts!

The asafsuf, in other words, were outsiders, people not like the Israelites leaving Egypt, and strongly implied to be bad news.  And boy, did those outsiders stir up trouble, with their gluttonous, insatiable craving, one that will never be satisfied no matter how much meat they get.  The whole section which follows, in which God tells Moshe he will give the people quail “until it comes out of their noses,” is blamed on this craving stirring up the Israelites to complain about wanting meat, fish, and so on.  When large numbers of people die due to a plague immediately after eating the quail, you can imagine the pitchforks and rope coming out to go after those lousy asafsuf.

Now we have some context for the political name-calling, whether Tiki Dayan or HRC.  “If it weren’t for all this riffraff living in our midst, the country would be happy.”  “None of our troubles would be this bad if it weren’t for those people.

Those people take the blame for a lot of stuff.  A friend who has been in a single-gender relationship for decades once told me of their struggles to adopt a child in the 1980s.  “The state of (fill in blank of neighboring state you love to hate) determined that we were not fit to be parents,” they said.

In many cases, the branding of others as “unfit parents” or as the cause of our troubles is a convenient device for shifting blame for those troubles away from ourselves, avoiding the recokningthat we ought to be doing.  Several years ago, a fascinating study came out showing that a large majority of physicians believed that pharmaceutical company inducements, like free lunches, trips, branded merch and so forth, influence prescribing habits.  But when those same physicians were asked if they had ever prescribed a medication due to pressure or inducement from a drug company, almost all answered, “No.”  Wasn’t me, it was those other corrupt doctors over there that did it.  If only we could just get those doctors out of the system….

Take an interaction I once had with a patient who was finding it difficult to find a prescriber who would continue to provide his prescription opioids.  “Those damn addicts make it so hard for the rest of us honest users,” he grumbled.  “And those cities who sued the drug companies – they’re the real problem!” he declared, stamping his foot.

Another time a woman who had been denied her initial application for Social Security Disability threw up her hands.  “What is it going to take for me to get approved, when all those people who have nothing wrong with them get approved on the first try?”

Still another time, I fumed at my desk as I read a consultant’s note who had changed all of the medications I had carefully chosen for the patient, even a couple not in her specialty.  “Those specialists do whatever they want, without ever calling me first!”  The phone, as it turns out, works in both directions.  Ask me if I had called her before the consultation happened…

Blaming those people is a cloak to hide our true intentions, diverting people’s attention to a “foreign enemy” while power struggles and intrigue take place close to home.  In the very next chapter of Numbers, Miriam and Aaron take Moses to task for marrying a foreign woman, when their real issue is that they want a share of Moshe’s leadership.

Had they forgotten that Tziporah’s father had been an invaluable resource to Moses and Israel in the desert?  Had they forgotten that one of the things Moses had done to earn God’s favor was, in fact, to show kindness to this foreign woman and her sisters?  Had they forgotten about not wronging the stranger?

To go back to my examples, how do we ignore that those doctors are our med school classmates?  How do we reconcile ourselves to those addicts being our friends and neighbors?  How do we forget how many times we were told there’s “nothing wrong with us” when we complain about those people being granted disability?  And how many times have those consultants or those ER docs made a diagnosis we could not, or saved the life of a person who would have died had they not seen the lethal danger we missed?

And sure enough, some of the commentary paints a different picture of the asafsuf: that they came up with the Israelites to dwell, not just as opportunistic hangers-on, and that the cattle and sheep that the Israelites brought out of Egypt actually belonged to the “riffraff.”  Many believed that they went up with the Israelites as converts, because they were sincerely amazed and moved by the drama unfolding before them and felt compelled to be a part of it.  Think of those people who are most under fire at the moment in America – immigrants.  The common complaint, dating back to the dawn of this country, is that those people are here to steal our jobs.  The real truth, which I learned as the husband and son-in-law of proud immigrants, is that these people whom I love are here because they are sincerely in awe of the American idea and dream the American dream. 

A few weeks ago, one of my longtime immigrant patients came in beaming.  She hadn’t looked so good in years.  I soon learned that she had passed her citizenship exam just a few days before, and it had been the proudest moment of her life.  After six long years, she could say she was an American.

Instead of blaming those people, who actually turn out to be people just like us, and sometimes really awesome people indeed, we need to be honest with ourselves about our own role in our misfortune instead of blaming others.  It is true that the asafsuf had an insatiable craving – but one commentator says that they nevertheless kept it to themselves until the insiders started to complain out loud and cry and only then did the two groups begin complaining, together, about the bland menu.

One line of thinking in Numbers Rabbah, the best known collection of allegorical readings of Numbers, says that the asafsuf is not some foreign element among the people, but actually their most revered leaders, the assembled or gathered ones (the root a-s-f, in asafsuf, means “assemble or gather”), who complaining bitterly to God and cause a fire to break out.  “Those people” are not responsible for our problems – we are, indeed our highest leadership are, and we need to do something about it before everything catches fire.

The opioid crisis didn’t start itself – we did, by writing prescriptions willy-nilly, by making pain the “fifth vital sign,” and by selling the myth that no one should have to have any pain.  We are the riffraff.

People don’t seek disability to freeload, or when they don’t have any real disease – they seek disability because we haven’t provided a good enough safety net for people who want to work but who get injured, are chronically ill, or have real disabilities that they’d like to work around.  We are the riffraff.

Pharma didn’t pour the Kool-Aid forcibly down our throats – we drank it willingly, either for petty personal gain or because we sincerely wanted to get our hands on the new, promising treatment for the people we cared about, and figured the fuzzy zebras or branded notepads were a small price to pay for being able to give free samples of a Rolls-Royce drug to patients on a city bus income.  We are the riffraff.

And in keeping with my last post, the ER and the consultants weren’t the only ones who skimped on communication.  We also failed to put our caring intentions into action and call ahead, have a real-time conversation, and proactively follow up to make sure patient, PCP and plastic surgeon were all on the same page.  We are the riffraff.

Now if you’ll excuse me, we riffraff have some work to do.

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.

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