A Brief but Rambling Note Regarding the Concept of Purity

I have spent my last two days at New York Presbyterian Cornell/Weil Medical Center, where names apparently grow longer and more numerous with time. This courtyard has a large sign saying Ronald O. Perelman Heart Institute, and is just outside the David H. Koch Wing. Even the small family waiting room outside the ICU has too long a name for me to remember.

On Tuesday, my mother underwent a (very successful) five-hour-long surgical procedure whose main purpose was to replace her mitral valve. The surgeon put in an organic valve (derived from bovine or porcine tissue) for the valve that was damaged by rheumatic fever over 70 years ago.

Jewish law is often about purity, as the lawmakers understood it. Today, I can no longer globally think of pigs as unclean animals if putting one of their body parts into my mother has the potential to extend her life by more than a decade. From one point of view, you might call ‘unclean’ the specific pathogens that cause disease, such as the bacterium that caused her to get scarlet fever, and subsequently, rheumatic fever all those years ago. Certainly it is good to wash our hands and follow sterile procedures in the hospital to prevent the spread of antibiotic-resistant pathogens. People who eat pork should cook it thoroughly to kill the trichinosis worms that once caused pork to be a risky food choice.

From a more distant view, all growing things have their evolutionary niches, and the concept of clean-ness or dirty-ness becomes a matter of perspective. Among the e coli are helpful gut bacteria and deadly germs. Most people think of molds as icky, but the first lifesaving antibiotics derived from molds. The prohibition against eating pig comes from a hazard that is no longer as relevant as it once was, and was based on mistaking the whole (pig) for the part (worm). Jewish law says you can never be too careful. If a part may be dangerous, ban the whole thing. Interestingly, from recent ideas about how exposure to dirt helps build children’s immune systems, it seems you can be too careful sometimes.

Intellectually, some people are better at analysis, separating or cutting things apart, and others are better at synthesis, seeing the connections or commonalities between things. An interesting distinction I mulled yesterday is between social competence and other kinds of competence. My mother’s surgeon is not a nice person or a good communicator. But he appears to have done an excellent job fixing her heart valve.

These are just some of the ways a mind turns while spending too much time in waiting rooms. It’s a curious thing, making distinctions between the clean and the unclean. And it can be perilous to take that distinction and extend it to other things. In the past, global thinking about physical and moral purity have contributed to misogyny and to homophobia. Similarly, when I walked in to the heart unit, I wanted to walk out again, because the name David H. Koch is icky, and that ickiness attaches to anything that comes into contact with it. But that would be superstitious, wouldn’t it?

A porcine mitral valve

A porcine mitral valve

3 thoughts on “A Brief but Rambling Note Regarding the Concept of Purity

  1. So insightful David, and a subject I’ve pondered. Would love to have a conversation with you on, especially, the various kinds of competence, and how they can conflict, as with your mother’s surgeon. And where exactly does “kindness ” fit?
    “Cleanliness ” is an entirely different matter, as it is a word with so many meanings in widely divergent categories: physical, spiritual, chemical, biological, moral, ethical, and etc. (Not to mention the “Oink Oink. “)
    Thank you once again.
    You are a treasure!
    M K


  2. David, so glad to hear that the surgery was successful. I wish your mom a very speedy recovery and many healthy years ahead. J


  3. Thanks for your “rambling” message, David. It reminds me of the many ways we have coping with the hospitalizations of loved ones. You have created in your blog an interesting mixture of feelings and thoughts. I’m pleased to be one of your loyal readers.

    Hope things continue to improve for your Mom. Take good care of yourself! H


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