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mardi 28 juin 2011


The Flight, an Air France Boeing 777 left Paris Airport at 12 midnight. After a good flight of 12 hours, we reached Singapour Airport. The only turbulence was over the Bay of Bengal.
I expected a gaggle of Chinese and giggle of asiatique children on board but this flight, like most Air France flights was full to a Tee, not a single seat was vacant in any of the various classes.. but you could count the chinese on the fingers of one hand. Almost every one was European and possibly French.
I was amazed how quiet and well behaved the entire crowd was, no hanging around the galleys drinking beer or chatting loudly disturbing passengers sleeping.
The Best thing about Singapore is its airport, I have to say. so clean and orderly. many flights in, from oceania to europe to asia at Terminal 1 and the arrival hall was crowded to the brim but within a few minutes I was facing a Malay face who stamped my passport within about 30 seconds. I must confess that I looked at the various lines and chose the line with the largest number of Europeans and the least number of Indians.
Free Wi Fi and quiet places to sit down, recheck in for my flight to KL. Another Malay girl at the Jetstar counter and within seconds I was headed for the Departure lounge.
I chose to stand in line behind a couple and quickly my turn came. Fortunately yet another Malay. I had noticed that at Changi airport there is a disproportionate number of Malays and Indians working rather than the majority Chinese.
As he stamped my passport, I said Teremah Kaseh and asked him: Do you know why Singapore government employs Malays at the Immigration, the first contact of many foreigners to the country.
He said, a slightly firm face, politely: No
I have been dying to tell the joke, my chinese friend in Singapore, told me:
It is because Malays are better looking and they give a better impression!

on to Malaysia, which feels like home these days, feel very comfortable...
and my best friend would be waiting at the KLIA..
the first act would be the symbolic Roti Canai.. you may wish to read my blog on Mindless Eating Explained by Raja Yoga.

I am looking forward to my week of Yoga and Life style instructions in the Classical Yoga and of course:
a visit to A Cut Above at Bangasr
Lunch with the Ambassador from Cuba who is going home soon for reassignment
meeting some old friends and making some new ones..
but the best of all rewards
to spend time with my best friend in Asia!


Last night while having dinner with my long time friend Dr Mark Walker and his wife Greta, we talked about collaborating on a venture which would provide quality comfort to patients who are suffering from various diseases, at the same time for us to continue enjoying our present vagabond lifestyle. Dr Walker is an experienced sailor and boat captain and we had spent a few trips together in the Bahamian waters when we were both postgraduate students at the University of Miami.
I was also thinking of my dear friend, MunChing, a certified Chartered Accountant (CPA) from KL in Malaysia who after 12 years at responsible positions in Price WaterHouse and four years in New York and another two years at the financial centre of Astro Multimedia in KL, had wanted to do what her heart had always wanted. To become a Yoga Teacher and thus be in a position to help people who are confused by the new life style presented to them, with increasing wealth , accessibility and international connections.
The common theme is that we all are dedicated professionals and serious about what we do but at the same time not caught up in the web of the social characterizations and with a genuine desire to help those who need help, or who cannot get the help they need in the conventional world of health, care and wellness.
Because of our very wide spectrum of education and cultural and experiential backgrounds, we have arrived at this juncture where the strategic focus of our effort, whether in KL or Miami, is to offer to those who desperately seek it, the distinct and focused Health Care, Advice and Lifestyle Coaching.
I have heard this before, it is better to be very good at a narrow field than be a Jack or Jackie of all trades and master of none. We jokingly refer to the legendary Dr Catz of Los Angeles who treated only one type of Thyroid disease, he was so good that he could diagnose the condition at a distance. He is a master at what he does and thousands of patients are grateful to him whereas many other Jack in the Box doctors had not paid much attention to the symptoms of the patients.
Our lives are such that we place an optimum price on the wellbeing of our lives rather than the income that is accrued which indirectly contributes to ill health. So our thoughts about Growth is not to grow in a linear fashion but Innovate in a linear fashion, so that we think in terms of what we can do for the person who is suffering, rather than what can be done for me. The shift from ME to THEM.
As all of us know, and as emphasized in the article in the Economist just this past week. Alternative Medicine or Complimentary Medicine work in reality, because of the time and concern shown by the alternative medicine practitioner, whether through crystals or alignment of chakras or Iridology. My current practice is about 80 per cent psychology or culture based Practice even though I am hired to do Endocrinology. But wellness does not recognize your degrees or your specialization but it does recognize your caring. Early in my career with the Indians, I did a short study of bringing about 10 older patients with Diabetes, Hypertension and High Cholesterol, once a week for a social session, where I was present. They sat around, talked and gossiped and ate and chatted some more and at no time was any of the diseases mentioned nor treatments stressed unless they had some urgent queries. Lo and Behold, at the end of the four weeks, their laboratory tests all showed improvement: The Hemoglobin A1C , BP readings, Cholesterol readings all had gotten better, and more than that they felt better as well.
This lack of understanding of emotional intelligence or an aversion to the social sciences among the doctors is one cause of their failure to gain better results . one in three patients with chronic conditions such as Diabetes or Hypertension or High Cholesterol will attain good results with whatever treatments are given to them, as observed by the fact that even in the war zone of Basra, they could achieve that, also in the inner cities of North America. To achieve better results, one has to look to other non pharmaceutical non clinical methods of treatments, which includes TIME spent with them and also adjustments in their way of thinking about their lives. Yoga is an excellent medium in which the cluttered mind can be cleared through the understanding of the philosophy of endurance and repetition.
Whether in KL with patients now seeking out our friend for Lifestyle coaching using Yoga or our philosophy which Mark, Greta and I share is about an Emotional Engagement with persons who come in contact with us. We impart to them, on that vessel of compassion and understanding, the knowledge we have about human body and mind and our knowledge about medications and nutrition.

I am glad to be part of the project in KL, I know that it is better for that to grow slowly, because if it grows rapidly neither the teacher nor the people who seek refuge there would be satisfied.
We are in a way social entrepreneurs, using the knowledge we have in science and social studies, to bring comfort and relieve the suffering of those who seek our advice.

dimanche 26 juin 2011


You can read this post in conjunction with the previous post: America by the numbers. You can substitute: Australia, UK, India... in every country, they predict that Diabetes would double in a few years time. and at the same time, they insist on intensive therapies for current patients and prevention therapies at all age levels.

Isn't there something wrong with this logic? Are we accepting defeat of our intensive treatment and prevention intentions, if we accept that Diabetes prevalence would double in a few years' time ?

New drugs are constantly being introduced and they all help a LITTLE BIT.. nothing dramatic.. whether the new generation of drugs or new class of drugs and a whole class is being withdrawn for side effects such as Heart Failure, Bladder Cancer. You get the feeling that everything is being done in a hurry without great thought going into it, so that teachers, professors and researchers (not all of them of course) can change their minds. I have seen prominent Endocrinologists and Diabetologists swearing by a specific drug and then changing their minds when its side effects are revealed. Don't be the first one in your region to use a newer drug, neither be the last one, said a professor of mine.

The fundamental problem is trying to tackle physiologically and pharmacologically diseases which are predominantly social in nature and manifest as cluster of abnormal laboratory values and symptoms (which do have deleterious effects). Always it was given that Blood Sugar be controlled and the world wide rates of control is only about 30 per cent ie seven out of ten people with type 2 Diabetes have uncontrolled blood sugar.
- Hide quoted text -

The newer medications bring down the A1C (laboratory measurement for control of blood sugar) by 0.7 to 0.3 ! which can be achieved by paying attention to Nutrition alone.

This week, some news which should receive greater attention among doctors and diabetes educators:

1. Intensive diabetes control does not provide any great protection to death from cardiac diseases. Since it is understood that cardiac diseases may begin even before diabetes is diagnosed, this makes you think pharmacological therapy is not what is needed, not by itself alone, by intense therapy of social nature is needed.

2. Newly diagnosed Diabetes was reversed by strict diet control, by decreasing the fat in the liver and decreasing insulin resistance.
Among the Native Indians of North America, with whom I work as a Consultant Endocrinologist, my personal experience has been:
the treatment of chronic diseases including Diabetes and Heart Diseases has to be based on a formula of society, social and family life with some help from the doctors and other providers(who would account for about a 1/4 of the help). This culturally oriented, respectful treatment of a disease in the context of suffering and oppression, has produced good results. The fact that Indian Health Service in the USA is not a fee for service system has also been helpful. Some of the best Diabetes care in America are to be found in the two non fee for service establishments: The Veteran's Administration Health Care System and the Indian Health Services. Here, a social illness is approached, not in a piecemeal fashion, but in much more holistic fashion.

May the rest of the Americans one day get such good total Care for Diabetes! !
After I had finished writing and put this blog up, further news came out at the ADA meeting which is being held in San Diego at this moment:

“The results of our research don’t suggest that standards of diabetes care for controlling blood sugar levels, high BP and cholesterol should be changed,” de Boer said in the release. “What the findings suggest is that these treatments alone are not doing an effective job of reducing diabetic kidney disease, and researchers need to find additional ways to do that.”
Diabetic kidney disease has become more prevalent in the US population over the past 2 decades and will likely contribute increasingly to health care costs and mortality,” Ian H. de Boer, MD, MS, and colleagues at the University of Washington, Seattle, wrote in the Journal of the American Medical Association.

if you are a patient with Diabetes, what would you think? Intensive therapy does not protect you from heart disease, medical therapy does not protect you against Kidney disease... wouldnt you look for something else?



79 million adult January 2011
57 million October 2010
25.6 million over the age of 20 have diabetes January 2011

68 million 2005-2008 (140/90)
48 million were receiving medications
31 million had adequate control (less than half)

71 million adults had high LDL
34 million were under treatment
23 million had it controlled

All indices were poor among
Poor patients
Those with no insurance
Mexican Americans
It is incredibly difficult to find research on hga1c at a national level. NHANES studies do have HgA1c as part of the studies, looking for comparisons of A1C brings only spurious results. In one study it was noted that 2/3 of the white people had A1C less than 7 % which I find it hard to believe.
Among the Indians, the A1C of less than 7 per cent can be achieved in around 28-32 % of the patients. It has remained constant despite increase in diabetes services to the patients. It has not changed much and it does not change much across the geographical areas.


CDC (Centre for Disease Control ) NOW BELIEVE THAT
45 % of adults had at least one of three diagnosed or undiagnosed chronic conditions—hypertension, hypercholesterolemia, or diabetes; one in eight adults (13%) had two of these conditions; and 3% of adults had all three chronic conditions. ( 2006)

We also know that only one out of 8 persons who has BP Diabetes Mellitus and Hypercholesterolemia is under control with treatment.

Perhaps most of the morbidity and mortality is in this group of people.

There are about 7 million people in USA, who has all three:
Uncontrolled BP (Blood Pressure)
Uncontrolled BS (Blood Sugar)
Uncontrolled LDL (bad) Cholesterol

Of the above, Hypercholesterolemia and High Blood sugar are Life Style Diseases, and to a good degree, Hypertension as well.

So the Doctor you go to see can tell you: Go and See a Dietitian, an Exercise Person, apart from visiting Laboratories for blood tests and Clinics to get various investigations done.

This reminds me of what a Meskwakia Indian told me: when you ask a white person in the country what is their heritage, they say: I am ¼ English, ¼ Irish, ¼ French and ¼ German. Four Quarters here do not make Whole but it amounts to Zero.

Lifestyle diseases need Lifestyle therapy and that is not accomplished by a little of dietary change, a little of exercise, a little of medication and a little of laboratory tests and 8 to 10 minutes spent with your Family Practitioner.

The Problem is identified, it is easy enough, now comes the hard part, what to do about it?
We are sick and tired of people telling us that we are sick and fat, tell us how to get rid of these? Asked a Lakota Indian Woman.

In other blogs I would be outlining various solutions based on the holistic approach to Health and the Person using American Indian and Yoga Philosophies.

mardi 21 juin 2011


I have worked with Native American Indians for awhile and have been educated in their ways of thinking and their philosophy of life. So when a graduate from the oldest organized yoga institution in the world, Yoga Institute (Santa Cruz, Bombay) came to KL to introduce us to Classical (Raja) Yoga Philosophy, I found the similarities exhilarating and most welcome.
The UNION of Mind,Body and Spirit is common in both philosophies. From the very beginning, I had wanted to bring the practice of Yoga and its philosophy to the American Indians. Since the philosophies are similar, one could build the practice on that common ground. Currently, American Indians suffer from “Lifestyle Diseases” or “the Diseases of the Civilization”, namely Diabetes, High Blood Pressure and High Blood Cholesterol.
I am sure that a Combined Philosophical treatment of these Lifestyle Diseases would eliminate all three of the diseases, since their origins are very similar. In the case of the American Indians, they face conflicts from the incongruity of their lives with the world in which they now have to live in; their way of thinking also is conflict with the way of thinking of the culture in which they have to survive.
Thus, I was very interested to explore further when a recent graduate of the Yoga Institute, Mun Ching, gave me a book, published by the Institute.
How to Reverse Heart Disease: The Yogic Way
Research, Facts and Programme.
It details their programme for patients who are already suffering from Heart Diseases, the most common of which is Ischaemic Heart Disease.
If their method of counseling and Yoga therapy can arrest the progression of this modern disease, how wonderful it would be if people could use it and prevent these lifestyle diseases from occurring in the first place.
The various approaches, it is not just Eat Well and Exercise mantra, is described in detail. I will describe the results of a scientific study done at the Institute and the results are as follows:
A control group of patients with documented ischaemic heart disease received the usual care from their cardiologists. No Yoga Therapy was given nor did they attend any of the courses at the Yoga Institute.
The Second group chosen to be given Yoga therapy and education at the Yoga Institute over the course of the same year was looked after by their cardiologists in addition to the Programme at the Yoga Institute. All medications judged necessary were prescribed by the Cardiologists with the exception of Statin group of drugs, which are powerful medications to lower Cholesterol.
The laboratory investigations included that which is normally included in the study of cardiology patients in a medically developed country (whether it is Australia, Malaysia or India). To satisfy the curiosity of those who require scientific proof, Myocardial Perfusion Scanning as well as Angiograms was done. (These would quantify the functions of the heart being studied)
Patients were on the average about 55 years old, as expected men predominating both groups.
(We all know about the Placebo effect and how it can be a considerable portion of the results when studying groups and comparing them. The very fact that a group is being studied, without actually being provided Yoga Therapy will result in some decrease in all the parameters being measured but what would be interesting would be the marked degree of decrease in patients being treated with Yoga Therapy).
These changes were observed at the end of the year of study.
Every one lost weight, and the common amount of weight lost was about 10 pounds.
There was a decrease in the Waist to Hip Ratio, considered a good indicator of Insulin Resistance.
There was a decrease in the number of Total Calories consumed with a decrease in total Fat consumed but an increase in the complex carbohydrates consumed.
The quality of that change is even more interesting. (Western trained nutritionists do not stress this aspect)
Almost complete disappearance of Processed foods from the diet.
Reduction of meat consumption to near zero, in a population that is already 50 per cent vegetarian. (Same advice was given to the control group as well, but their decrease was less dramatic).
Neither group was on Anti Cholesterol Medications. The study group dropped their total cholesterol by an impressive 62 points (from 247 to 185, the control group dropped their levels from 221 to 213). The “bad” cholesterol came down from 146 to a respectful 100, whereas there was very little change in the control group, 151 to 147.
Psychological measurements of Stress such as Overt and Covert Anxiety, Hostility, Time Urgency, showed that 6 out of 10 patients in the study group improved their scores.
Programme adherence was noted in the majority of cases studied. Those included in the study had some interest in Yoga therapy.
In 7 out of 10 patients there was improvement in their blood vessels to the heart as studied by coronary angiography. 3 out of 10 patients in the control group also had regression of their coronary artery disease. The main difference in the two groups was that there were twice as many deteriorations in the Control group compared to the Study group. Myocardial perfusion scans also showed an improvement in study group and more importantly showed that a great majority had not deteriorated any further.
So it is obvious that this Lifestyle change has had a significant benefit to patients already suffering from ischaemic heart disease. It is worth remembering that none of them needed any surgery or other dramatic interventions.
Impressive as the results are, and eager as I am to institute some of these into the Native American Indian patients, how to translate LIFESTYLE changes in the cultural context of the Indians.
As an example, I could think of the Traditional Tribe who shares their time between Texas and Mexico. They are a culturally intact tribe, with every member speaking the language of the tribe and many of the younger members are tri lingual: their own language, Spanish and English.
I can imagine borrowing a little bit from the Peer-to-Peer Programme of MoPoTsyo in Phnom Penh and integrating the philosophy of the Yoga Institute.
Problems to recognize:
The prevalence of Diabetes, Hypertension and High Cholesterol and Obesity has skyrocketed.
While they are in the USA, the food available to them, from Government and other sources is of inferior quality.
They cannot practice many of their usual leisure time activities, which they can practice in Mexico.
While they lived as Indians among Mexicans and now they continue to live as Indians among Americans, the stress levels (as understood by themselves) has increased.
Educate a few Agents of Change who are tribal members with or without health care experience, in a philosophically based wellness-oriented-care.
Include those, young and old, working within the structure of the tribe, who have some experience and knowledge in the field of taking care of illnesses and suffering. Incorporation of this knowledge into their daily and actual lifestyle, i.e. to understand their reality in the frame work of these diseases of civilization, can be achieved by a transfer of knowledge done with respect and caring, in the cultural context of the tribe. The great advantage of working with this tribe is that they still can maintain a traditional way of life in their village in Mexico. Traditional lifestyle includes leisure activities and culturally responsible communal activities such as building traditional homes, which would define their reality.
Let us wait for the next step in this dream of bringing an Eastern Philosophically based treatment and combining it with the ancient worldview of the Indians.

vendredi 17 juin 2011


The predominant discourse about Health in this world, in the developed and developing world is Western Medicine or called “Conventional Medicine”, the major aspect of which is Biomedicine or Biologically oriented medicine. In the early 16th century, at the beginning of the Renaissance, Siglo de la Luz, The Enlightenment, Descartes, French Philosopher and Mathematician, wanted to pry the control of the body away from the strict rules of the Church. Thus the Cartesian dichotomy was born, Doctors and Intellectuals in charge of the body and The Church in charge of the Soul.
This dichotomy has had deep influences in the practice of modern medicine, leading to a complete separation of Body and Mind. If you go to a Medical Practitioner, it is very rarely he/she would be interested in the socio/psychological/cultural aspects of you as a person, but would be deeply interested in the dysfunction in the structures of your body. Very seldom would they even admit to the influences of the mind on the body. This negation leads to a complete ignorance of such effects and leads to neglect and failures in the healing and curing portions of a Physician.
Along with migration of Non European people into Europe and other European culture dominant countries, the immigrants brought their forms of healing and curing systems as well.
The Immigration is such a recent phenomenon that its growth has startled every one. Just a few years ago, “Hispanics” accounted just 5 per cent of the US population and they are already in the majority in some states and are now second only to the White/Europeans and by 2035 is said be the dominant race in the USA. There are people who were born in Miami and had never heard a word of Spanish before 1962, now struggle to hear English in public places like Supermarkets or shops!
What is Conventional in one country and within one culture would be considered Alternative or Complimentary in other, depending upon the predominant culture. In China, herbal medicine is perfectly acceptable, is mainstream but is considered fringe in almost everywhere else in the world.
Ayurveda and Yoga are ancient  traditions of healing and prevention so they are also not Alternative in their Healing Capacities. Acupuncture is well established in China and in many other countries and it is considered Conventional Therapy within that cultural context.
Ancient forms of wisdom of healing exist among many indigenous groups of people scattered around the world. The best three examples would be the symbolic usage of nature and relationships to assist in the healing of illnesses by Medicine Men among the American Indians, Kalahari San and Australian Aboriginals. These three groups are considered the oldest of the continuously living cultures of this planet.
In my opinion, the Philosophy of Yoga and the Symbolism of American Indian Healing systems are more ideologies than techniques that dominate the conventional and alternative medicine landscape. (Yoga is a combination of ideology (based on Samkya philosophy and deep psychology) and tools/ techniques for better living)
First of all, the semantics. Alternative Medicine intends an option to the existing form of health care whereas Complimentary Medicine denotes a form of treatment that adds to the current conventional mode of treatment. In China, chemotherapy for Cancer may be considered Complimentary Medicine whereas in the Western World, they are considered evidence based and Conventional.
As Merleau-Ponty had suggested: Context is important. Senator Benjamin Franklin would evoke Sin for his Gout whereas nowadays we would evoke Fructose consumption for the same symptoms. So the changing grand metaphors of the society are also important.
I am trained as an Endocrinologist, one of the more thinking aspect of Conventional Medical Care where we are given problems to solve without much help from invasive techniques or investigations. So you can truly consider this an epitome of the Western Bio Medicine.
But my professional life has been spent with Indigenous peoples of this world and I have been exposed to a fair amount of Symbolic Healing and the philosophy behind it.
Being a frequent visitor to Cochin, in Kerala India, I have had various encounters with professionals in the field of Ayurveda and had more than my share of preventive therapy using Ayurveda.
Lately I have been introduced to the philosophy of Raja Yoga by my best friend in Asia, MunChing.
Thus you could detect these three major but divergent influences in Health Care and Disease Prevention in my notes.
Endocrinology is all about dysfunction or lack of balance of minute amounts of hormones that circulate in our bodies, some in pictogram amounts, that is ten to the power of minus 12 grams! Taking Thyroid disease as an example, until quite recently, the aetiology of hypo functioning of this gland was an internal one, mostly an autoimmune  defect. It was straight forward enough and taking a strict biomedical viewpoint was important and also produced excellent results. But as practicing physicians and suffering patients know, the lack of balance now has external chemical source, mainly the chemicals using in herbicides and pesticides. Ignorance or lack of regard for this one fact would lead to wrong diagnosis and unsuccessful treatment.
In my opinion, Endocrine Dysfunction has become the major metabolic abnormality of our times. 2/3 of Americans are obese or overweight, just to give you the scope of this problem.
There is a strong social element to these dysfunctions and health care providers continue to ignore it and thus driving the frustrated patients to loose faith and seek other forms of feeling better.
Two ideas I introduce here are
Before condemning en masse those in the thousands who practice and benefit from various forms of alternative forms of treatments, such as
Chakra alignment
Shamanic Treatment
Crystal Therapy
The list is a very long one,
We have to place the problem in context of
Ignorance of those in power to help
And loss of Faith in general in the society.

One idea that is helpful to distinguish between a valid health care modality and a way of the charlatans is to distinguish them:
Is this a technique?
Does this promise you the wonderful results you are seeking, if only you would buy this or pay into it?
Exercise Machines, Single Minerals, Nutritional Supplements all come under this. You can think of very many techniques which had been marketed ever since the entrepreneurial class invented Liver Tonic, snake Venom among other things
The number of Exercise machines languishing in the basements of homes in the developed nations is staggering.
When my sister in Miami was diagnosed with Cancer, a slew of emails arrived advising her to drink tea from the mountains of Jamaica, to eat Macrobiotic Diet and to make sure that she had all the elements of the periodic table in her blood! Of course she ignored all that and listened to her doctor who prescribed strong chemotherapy and at the end of the course of therapy, there was no physical or chemical evidence of cancer.
People who had gone on a specific diet or another, each year amount to millions. No single “Diet” can be considered successful in face of increasing Obesity!
I won’t confuse “diet” with neither “Nutrition” nor “exercise” with Diversion.
Health is not just an absence of Disease. It includes the well being of self, of those who you care and are around you. It also includes your situation at work, the country and the place where you live and most importantly the society you live in. Societies in Conflict, someone had remarked, show that conflict in the bodies of the individuals within that society. American Indians, Australian Aboriginals are the best examples of that dictum and you can find examples in your own countries among immigrants, marginalized people, excluded people, exiles.
It also includes knowing WHO you are and finding the balance in your life and have faith, but not necessarily religion, and be surrounded by love and affection of your friends and relatives. To the American Indians, Relationships, not just connected with blood, but shared earth, nature and universe are also part of their health. Mitakuye Oyasin (“We are all related’), they say this prayer often.
In a society where “WHAT you are”, is the measuring stick, many would  find themselves measuring using some other yardsticks other than their own. This is a sure way to find unhappiness and label you a Failure.
The rise of alternative forms of therapy has risen in parallel with the lack of trust patients and people have on those who are in charge of their health in their societies. Doctors and patients who think that they are independent of the powerful forces of the society, such as the Drug companies, are only deluding themselves.
Just in the past week alone, two medications used in diabetes have shown to be dangerous and a third one in higher dosages. There is a healthy skepticism of drug companies and their agents, the doctors, not all of them, by swathes of people in every society.
When you are unwell, you really want to trust someone or something, which would help you in an extraordinary fashion to regain your health. Descartes took the priest and the church out of the picture and a recent survey showed that up to 60 per cent of the Europeans have no faith in organized religion or its agents.
Politicians who were once held up in great esteem also have fallen down from their pedestals. Society that has become materialistic has no time to reflect what the philosophers and other thinkers in the society propound. Faster your life, slower your attention to philosophical matters.
Someone arriving with a miracle cure, mildly disguised as science, has an ocean of people to draw from.
In a couple of articles, published this month in the magazine, The Economist, they proposed that the success of many of the alternative forms of therapy, and not necessarily of their outcome, is related to the fact that these practitioners have a precious commodity in their hands! TIME!
The average medical consultation is around 8 minutes and during that time the easiest of the evidence is dealt with, that easy evidence is the results of the blood tests, not the narrative of the patient who has not been given the time, nor the concerns of the patients in the greater context than his body and society.
I knew the value of this precious gift, taught to me by the American Indians. The first year I began working with them as a Doctor, I was able to conduct two studies. The first one included a group of elderly members of the tribe who gathered every Monday morning; we shared jokes, family news and gossip and had a reasonably “healthy” snack. At the end of the fourth session, their Blood Pressure and Blood Sugars all had improved and even their total cholesterol had come down and A1C, which is a measure of Diabetes control, had improved. This without any medical intervention, except my presence at these meetings and I don't remember talking about any diseases at all.
Second study I did was to compare the outcome of Indian patients when they went to see an Indian Health Care Provider as against a White or Black Health care provider. Over and over again it could be seen that the Indian health care providers had the edge on better outcomes.
So there are intangible aspects to nursing someone back to their normal health and the Western Medicine does not have a monopoly on that. As less and less attention is paid to those intangibles, patients and others who suffer or wish to prevent future suffering would migrate to the care of people who offer them counseling, spend time with them, listen to them and accept the patients explanation while offering one of their own.
What most patients want when they are thinking of preventing future suffering by paying attention to the lack of balance in their life is kind, considerate respectful advice in the context of their professional life and social life in the respective countries in which they live in.
There are many ways to achieve this balance and the evidence based western medicine is only 25 per cent of the treatment of the chronic suffering of patients. Like life has to be balanced, one has to balance various forms of treatments as well, most of which do not include pharmaceutical therapies.
Will write more on achieving inner balance in another blog…

mercredi 15 juin 2011



I do not claim to know a lot of the philosophy behind Raja Yoga, except to say that I am a serious student of it, at this juncture in my life.
I have been associated with the North American Indians ever since I completed my postgraduate studies in Endocrinologist and currently serve as a Consultant Endocrinologist to some tribes.
I am sitting at the home of my sister. Lunch is being served.
Cesar Salad. I chose Asian Sesame Salad Dressing
Home made Hummus with Olive oil
Home made Mexican salsa
Pita Bread.
She had offered me several salad dressings. I rejected them one by one
NOT because of their caloric content
NOT because of the FAT content, but
BECAUSE some contained High Fructose Corn Syrup, and I wanted to try a new taste.
No one can say the above lunch was not nutritional, but that is not the only reason that I am eating it.
I like the taste.
I like the memory of its taste; a new taste or sensation is now becoming a memory.
Why do we eat MINDLESSLY?
What is MiNDLESS?
When the taste is no longer the reason for eating, but memory of a pleasant experience overrides TASTE or NECESSITY.
When you think about it, isn’t MEMORY more important in making that decision to eat what we eat?
Our minds keep on gathering from the time of birth and very soon the sensations become memories. You can see that with infants and children. Taste sensations for which they have memory, they eagerly gulp them down. A taste sensation for which they have no memory, they will reject it a few times and then, when that taste becomes a memory, they will begin to accept that taste.
So the mind retains SENSATONS, and then THOUGHTS and IDEAS, as we grow older and processes them into MEMORIES (IMPRESSIONS). Then the MEMORIES will short circuit the taste/sensation/thoughts/ideas and immediately create an action.
I am in Miami, there is no Roti Canai here to be had; there are hardly any Tamoul people here to warrant the food of Tamoul origin which is very popular in Malaysia.
When I think of Roti Canai, the sensation that comes up is a whole vision rather than a photo of Roti Canai.
Let me do it. I would think of Roti Canai and what does come to my mind?
The food court at KLIA (Kuala Lumpur International Airport) where very thin Tamoul girls make Roti Canai.
I had been there many times to search for Roti Canai in KL.
My best friend in KL makes sure that I eat Roti Canai at least once during my stay in KL, preferably at the Maulana Food Market presided over by a Moslem from Tanjore by the name of Soleiman.
It also brings up the taste of Teh Tahrek, the sweet India Tea, which is made bubbly by long pulling movements of the tea from two containers one in each hand.
So far, the taste of Roti Canai has not risen in my mind.
It is as if there is no intervention of the conscious mind, something automatic is taking place, because of the very many pleasant experiences now stored as memories that I associate with Roti Canai.
So much so, that when my best friend meets my flight arriving from Cochin or Paris or Miami (via a few stops), the first stop is always the food court at KLIA.
I used the same logic with my Indian patients when I saw them the next time.
If Pepperoni Pizza makes your Blood Pressure or Blood Sugar to go up (you can substitute Dunkin Donut, McDonald hamburgers or any international names Krispy Kreme or All you can Eat, Famous Dave’s)
Can you not try to suppress the memory of Pepperoni Pizza, concentrate on that memory and eradicate that memory?
Nutrition Facts
Serving Size 1 large slice (90.0 g)

Amount Per Serving 203 Calories of which 81 calories are from FAT (9 grams), mostly Saturated Fat which is not good for any one, a whopping 680 mg of Sodium, one quarter of your daily need, with 25 gram (100 calories) from Starch/Carb with negligible other ingredients or fiber.

How can I do that, doctor?
I imagined a cultural metaphor, which the Indian would understand easily.
I am Jewish and am prohibited form eating Bacon. However you extoll the virtues and taste of Bacon to me, you will not get me to eat Bacon, for more than health reasons. I have no memory of Bacon in my brain. I can easily create one, like you have created one for Pepperoni Pizza, but I don't wish to create that memory. In the same way, if I have to sacrifice some taste I have acquired, if you give me a good reason, I will suppress the memory quite easily, as my conscious mind is stronger than the automated action that makes me associate a vision about food rather than the taste or its caloric content or nutritional value.
In another blog, Lifestyle Changes for Diabetes,
I describe the determination I saw in a friend of mine, who has controlled his Blood Sugar to such excellent levels, Hemoglobin A1C is 5.9, by eradicating the memories of bad foods from his brain.
And then create memories for food that are beneficial for your Diabetes. And don’t make excuses like, oh. Just one time, just this one time and no more. Say NO MORE to memories of that taste if you wish to eradicate these memories. You can. Then food being presented would pose no dilemma to you, you don't have to decide to eat or not to eat, and automatically you would choose something else. It would be a joy for you to say NO.

It is time to go out for a nice cup of Cuban Coffee, made by a Cuban, very warm, strong, with steamed milk, Cortadito, like they serve in La Habana, while I can listen to the cadences of the Spanish speech of Havana or Cuba.
So you can see that the attachment to FOOD is much more than just Taste or Discretion.
Food served on the various flights during the month of May 2011

jeudi 9 juin 2011


Today my sister wanted me to go with her, to witness the end of the year ceremonies for her granddaughter who is graduating from Grade III.
As an Anthropologist, I am always ready to observe the rituals of the society I am visiting, this time around, a Private School run by an Evangelical Church. I was looking forward to observing the rituals of this group. Very well behaved, well groomed and orderly crowd.
Mostly white and most of them have Spanish surnames, but that is to be expected in Miami. I made a mental note that the first USA president with Spanish surname would be from this community, since they pay so much attention to learning and competitiveness.
That was not what I wanted to think about. I was thinking about symbolism.
American Indians with whom I am associated with, are masters of Symbolism as are many native communities.
“Give us the least of a hint, we can figure out the meaning.” say the elders.
The Little Girl was happy at the presence of her parents and was elated that others who are not related to her were also there.

This was what happened.
The ceremony droned on. Americans are very fond of giving honours and prizes to everyone, and it is important that the children be accorded the self-confidence. In France, the emphasis would have been on a feast with champagne but that is the cultural difference. Also, most people were eager to get home to watch an important basketball game.
The great grandmother of the little girl had passed away few weeks ago and a service was held in the Catholic Church for this religious lady who was adored by her family.
When we arrived, the auditorium was crisp and clean and everyone marched into the pews. We had taken a pew upstairs with a good view of the thirty of the children now graduating to the next year of their studies.
The younger sibling at the end of the celebration and award giving was wandering around downstairs with her good friend. She saw a piece of paper with a picture on it, she recognized the face on the photo, her grandmother who had passed away just a month ago. It was lying face up on a seat in the auditorium. She picked it up and excitedly ran up to her mother.
When I heard the story, I was so flabbergasted . I believe in the connections of the spirits, that go far beyond religion and rituals and as Indians say, in the symbolism of the spirits.
It was so symbolic when the celebrant who is only about 9 years old said: I had prayed to Grandma and wanted her to send me some sign.
I grasped this opportunity to talk to her and said: remember this is very important, what this means is that your grandma wanted to be here, beaming to watch you complete your third grade of education. Even though she is no longer with us physically, she is watching over you. Also this means that you would be blessed with good luck for a long time to come and you have to think of this as an answer to your prayers. “ If you pray with a strong heart,” I told her, “ your prayer will come true, as you have witnessed today.”
I requested to keep the paper which was given to me, for I know that this paper has power, which has granted the wish of a young girl, the power of a grandma who was a wonderful woman all her life and was loved by her family. What more of a blessing I can ask for when I was thinking of a reunion in London with another innocent pair or eyes in a few days time?
I had been reading and had the book with me at the auditorium about the Hebrew manuscripts from the second millennia of our history, which vaguely corresponds to the first millennia of Christianity.
I will quote from the book, on page 110
Mishnah had demanded: “whosoever makes his prayer a fixed task, his prayer is not a true supplication.” Other sources echo that call: “one’s prayer should be made new each day,” the Palestinian Talmud tells us, and “as new water flows from the well each hour, so Israel renews its song.” In many of the religious Jewish communities of the East, it was considered disgraceful to recite a prayer that was not one’s own.
I don't have to go far to find similarities. American Indians, by all reckonings the oldest continuously existing group of people do not follow any set scriptures. They begin all their activities with a prayer and the prayer is always fresh since it is from the mind and the heart of the person who is saying it.
And they advise you, when under the force of spirits be very careful what you pray for, because you will end up getting it. This is a warning that when you pray, one must not pray for trivial things. Not like the words form the beat songstress, Janis Joplin Oh God, Send me a Cadillac Car.
So this young innocent mind, which in all spiritual traditions are considered the most sanctified, whether it is Yoga or Indian or Jewish or Christian or Buddhist, said a prayer of her own making and it was answered. Please do not look for logic or scientific answers. This happened and we are blessed to be in the receiving end of this miracle.
I want to keep this paper, always to remind me of the face of a young child beholden to wonder of this world of spirits.
I am reminded of what Black Elk, a Lakota Medicine Man had said:
“ If there is a shadow of a doubt someplace, that will cause a weakness.”
In the spiritual world there is a spiritual law. The Law says: “ Like attracts like.” This means whatever mental picture we hold inside our minds, we will attract from the universe. To make this Law work, we must maintain a constant picture. If we picture or vision something, and along with this picture we have doubting thoughts, our vision will not happen and we will get EXACTLY what we picture or vision. The Law always works. A doubting vision will not materialize what we want. A vision without doubt will always happen. This is a spiritual Law (from the Wisdom of the Elders)
Tonight we saw the vision without doubt of a child, it did happen.

lundi 6 juin 2011



The popularity of Yoga has skyrocketed.
e practice of yoga has increased in many countries, such as the United States (US), the UK, and Japan. The popularity of yoga in US adults is evident by the estimated increase in participation from 3.7% in 1997, 5.1% in 2002, to 6.1% in 2007. While it is considered as part of a Complimentary Medicine, in western countries where the Conventional Medical practices takes the centre stage. Mind Body Therapy, which includes yoga, meditation and deep breathing exercises) has seen the highest increase in usage over these years. 35 million Americans use MBT on their own but the number of people with diseases who are using MBT under medical recommendation is growing steadily, 6.5 million. People who do MBT on their own are healthier and do it, in general for feeling good whereas the doctors refer the patients to do MBT, when the conventional pharmaceutical treatment turns out to be less than satisfactory. The conditions usually eliciting a medical referral for MBT were Chronic Lung Disease and Anxiety. The other common medical conditions such as Heart Disease, Diabetes, Hypertension or Cancer did not trigger a consultation or referral to the MBT.

Yoga has been found to be effective in reducing Anxiety, in various anxiety disorders. Another study had shown that a six session yoga programme reduced the anxiety of caregivers who were taking care of patients with Dementia. One week of Yoga prevented an increase in anxiety among flood survivors. A significant reduction in symptoms (anger, anxiety) was seen among patients with unipolar disorders who completed 20 sessions of Yoga. Moderately severe Schizophrenic patients benefited from a four month Yoga therapy and had greater benefits than just physical exercise alone. An eight week session of Yoga significantly reduced the Blood Pressure levels in a group of Hypertensive patients. More and more information and scientific proof is coming to hand about Yoga and its role in the treatment of Heart Disease, Diabetes, Musculoskeletal problems.

Many theories have been put forward and there is a common pathway of stress reduction. Here we are talking in strict conventional medical terms since Yoga is not a monolithic modality.

My own concept of Yoga is the Philosophy of Yoga, especially that of Raja Yoga, in which there is a cleansing of the mind, and a cognitive change, assisted by Asanas(postures) and Pranayama(deep breathing exercises). I firmly believe that Yoga is not just a form of exercise and the benefits seen are more than the benefits accrued from exercise alone.

I am an Endocrinologist (a doctor studying the effects of Hormones on the metabolism of the body and its dysfunctions) as well as a Social Anthropologist trying to understand the role of society in the sufferings of the body of the individual. As such I can see many of the modern day diseases such as Hypertension, Coronary Artery Disease, Diabetes with deep social origins and I am interested in their prevention among groups of people as well as individuals within that group.

Current medical wisdom dictate that many of our modern day illnesses are inflammatory diseases and that is why they use inflammatory markers to measure the extent and seriousness of certain diseases, A lot of this inflammation may be due to oxidative stress and there are ways to measure this. We know that many natural food items have the capacity to reduce this oxidative stress(such as Green Tea drunk copiously by the Japanese) and increase the oxidative stress( American fast food).

So I was greatly pleased to read this article published just yesterday, from researchers in Japan.

This is the first study to demonstrate that long-term yoga practitioners have a better mental state than healthy participants who do not engage in yoga. These findings suggest that ongoing yoga training reduces the level of mental disturbance, anxiety, anger, and fatigue not only over the short- or intermediate-term, but also over a long term. The two compared groups were both healthy so Yoga was not being practiced here or prescribed for alleviation of symptoms or suffering. A group practicing Yoga compared to a very similar group not practicing Yoga were compared and found that those practicing Yoga were emotionally healthier, another way of suggesting that they were healthier. To prove that some urinary metabolites were measured.

Oxidative DNA damage may be implicated in ageing, carcinogenesis and other degenerative diseases. Oxidative DNA damage can be assessed in humans in vivo from the urinary excretion of the DNA-repair product 8-hydroxydeoxyguanosine (8OHdG). As for urinary 8-OHdG, previous studies have shown that a depressive state affects female 8-OHdG levels. Others also reported that severely depressed individuals had increased serum levels of 8-OHdG in comparison to healthy individuals In the present study, the urinary 8-OHdG level in the long-term yoga group tended to be lower than that in the control group. It may be assumed that psychological stress was less among those practicing Yoga, thus persistent Yoga for a period of time is possibly plays a preventive role in keeping people healthy

I am thinking of many of the marginalized people in our world, in particular the Native American Indians. It would be nice to introduce Raja Yoga to them as well as other deserving but poor people around the world who seem to bear the burden of chronic diseases as well.(the patients who attend Mo Po Tsyo, coordinated by Maurits van Pelt comes to mind). People who are connected with powerful non human forces among them would be generally more keen to follow Yoga as they would understand the philosophy of Yoga. The Lakota indian word for healing, Wa pee ya has the same meaning as Yoga, Union, bringing together, for example. In the USA, in the study about utilization of Mind Body Medicine, it was seen that Native Indians had a higher usage of Mind Body Medicine than other minorities who inhabit USA.

samedi 4 juin 2011


Alain de Botton, the modern day philosopher who writes and talks about Happiness, Work, Love and Philosophy has something to say about what we call Success.
If you think, being successful or considered a failure are different notions in KL/Singapour compared to Paris or Miami, you would be off by a big margin. But what they have in common, is the idea of who is successful and what is considered successful, does follow a universal norm: the ideas with which individuals judge themselves success/failure are not their own.
Men and Women (boys and girls) are incredibly open to suggestions. As such, TV and advertising and media surround us and make us forget that you cannot be successful at everything and that your idea of success is maintained at the loss of (or failure in ) some other aspects of your life.
My dear doctor friend to the poor, Jim Kerr, once said: In our business, you can chase money or happiness, but never both.
So, the well known concepts of Balance among the American Indians and those of Raja Yoga, of the circle, which comprises of Work, Family, Social Responsibility and Spirituality. Raja Yoga advises people to devote one quarter of their time for Altruistic activities, which in the parlance of the American Indians, would mean our responsibility towards our fellow human beings.
This balanced life would give you less of a chance to omit or miss out on many wonderful things life has to offer, in which a “successful” person has become a “failure”: arts, literature, connections and relationshps, empathy, travel and voluntarism among others, the list can go on and on.
Perhaps that is why we never remember, nor does history, the rich people of the past centuries but certainly remember kind, gentle and helpful people of the past and still praise them.
The idea of what constitutes success is so judgmental in our societies that we are willing to forego many pleasures and satisfactions.
Ask yourself the question. If Money or making money is taken out of the equation for Success, on what other things or actions have you been “successful”? Would your many “friends” or relatives would be keeping you in adoration, if suddenly you become “unsuccessful” in their eyes.
A “successful” accountant who gave up a good salary to become a Yoga Teacher would be remembered a lot longer and far more fondly than another “success” who has an apartment along Park Avenue.
American Indians call the Spiritual Force in their lives, the Great Mystery, something that cannot be explained, that which will always remain non human, essential, transcendent and mysterious.
Many “successful” people of KL/Singapour or Paris/London/Miami have become so infatuated with themselves that they ignore the transcendent non human forces in our lives. The high rate of atheism (up to 60 per cent in some European countries and even more in that very unhappy country of the east, Japan). Is there a correlation between the onset of this concept of success, especially in the East and the proliferation of spas (expensive so that the successful people can pay for it) set in natural settings (always water, mountain, lush green nature in the background)? Are they looking for that non human element? Are they look for a quick fix for their lack of spirituality? A massage, an Ayurveda treatment, a work out with a new age Yogi?
These short escapes may be necessary escapes from their human dramas. My dearest friend who introduced me to Raja Yoga said: when the mind is not clear, you tend to dramatize your life. These created dramas are not the reality. Life is the reality.
Where is the compassion?
No self help manual will loudly proclaim: Success will bring you Happiness. Do not go to your school, college or university reunion, for it is the ideal set up for that social emotion: Envy, a by product of our concept of being “successful”. None of us are envious of Lee Kuan Yew, Mahathir Mohammed or the Queen, they are all weird and inhabit a strange space. No one says, the Queen is successful because she is richer than most people in KL or Singapour? Paris or Miami?
But you identify with those who went to school with you, and you as a “successful” person would succumb to that evil social character: Judgement.
Both the American Indians and the philosophy of Raja Yoga teache you: Do not judge another person. Walk in their moccasins, would say the Elders. Accept the other and try not to mold them to your thinking, would say the Yogis.
Having grown up in a snobbish society (Melbourne, amidst the children of Immigrant Jews from Europe), we regaled the fact that egalitarian society was a whitewash for the middle class to feel good about the new Australians, aboriginals and the Asian hordes.. I was taught that snobbery is natural and that it is not a peculiarly British custom, now we know it is universal, from dirt poor country such as Jamaica to upper echelons of Paris society (at least they take pride in it). Who is a snob? Let us ask Alain de Botton.
A snob is a person who latches on to a single aspect of the other person, eg: You are an accountant and then creates a whole universe of your life and judges whether to spend time with you or conclude you are a waste of their precious time.
Let me ask you. Do you consider yourself a “Success”
Name four books that you read this past year?
Do you know where the following places are and something about them? Suva Pemba Baracoa Quiberon Horn Island Hanga Roa Boca Grande

Can you tell me a little about Levinas? Derrida? deLeuze? Why did English language borrow from German rather than French? North Korean megalomania? Ugandan soldiers for Christ? The dying Yamana?

What do you know about our Beloved Pablo
Pablo Neruda (Parral 1904-Santiago de Chile 1973)
Always Already
Haunted by ghosts, Jacques Derrida’s writings confounded the march of time
A French Algerian Jew
You are a FAILURE always by someone else’s standards.
So be a success according to your own idea of what success is, not what someone thinks success is, what the media tells you success is. Focus on that, your own idea, you author them, tailor them to your ambitions in life. It is bad enough not getting what you want, it is much worse, at the end of the journey to feel that this is not what you wanted any way .. all along
Bail out, while there is still a journey ahead of you.
Octavio Paz had famously said: at our death beds, most people wish they had married someone else and had marched to the sound of their own drums, had they been given the right guidance early in their lives.
Don't let this happen to you!

A glass of Chardonnay
4 june 2011
Continental Airlines 737-500 Seat 2 F
Houston to Miami
Sister Jackie will pick me up at the airport (she did)

Dr Sudah Yehuda has been homeless since march 1993 but can lay claim to House of Glass in Kuala Lumpur, House of Innocent Affections in Paris, House of sisterly affections in Miami, House of sensuous affections in Havana and the House of Spirits among the UmonHon indians

vendredi 3 juin 2011


When you are Jewish, you can look at the world from the view point of the Other and feel left out or ostracized, depending upon the country and the century or marvel at the long continuous erudite history of the forefathers who were intellectuals' intellectuals and adventurous.
Avraham Ben Yiju left his native Tunisia and arrived in Mangalore in the Malabar Coast in 1428 and prospered for twenty years, and took his Nayar wife and two children to Aden and Israel (thus making them the first Malayalee Jews to be in Eretz Israel).. How did we know that?
Being a merchant, he was in constant contact (that era's FaceBook?) with his co religionists and colleagues in the business world. Their notes to each other and replies and requests were deposited in the Geniza of the Ben Ezra Synagogue at Fustat (where Maimonides once lived). An extremely erudite Romanian Rabbi Scholar by the name of Shechter (of the Solomon Shechter fame) brought the manuscripts to Cambridge University.
The story is well documented in Sacred Trash The Lost and Found World of the Cairo Geniza by Adina Hoffman and Peter Cole.
Reading the pages with such eagerness that the waiter at the Resto tonight was annoyed that I was paying no attention, so excited about this aspect of the dark ages of jewish history and also the attempts to distort the importance of the jewish sacred writing and discrediting them by trying to push them out of the general christian religious discourse... well written book and a must read for Jews and Gentiles to know this aspect of the jewish history..
No wonder, that great Indian writer Amitav Ghosh has written a good chapter in his book in an Antique Land about Abraham ben Yiju and his Indian agent, Bomma, a tulu speaking native of Mangalore..
It is amazing to me that Abraham Ben Yiju who was born in Tunisia had traveled through Fustat and then on to Aden and then to the malabar coast long before the Europeans had any idea of the place.. and Abraham Ben Yiju was one of the many jewish traders to have come and lived in that part of India for centuries...

Now all the Taylo-Schehter collection of Cairo Geniza manuscripts are available to be viewed on line
Open Access Cairo Genizah Manuscripts

The Friedberg Genizah Project (FGP)
...The Friedberg Genizah Project (FGP) was established to facilitate and rejuvenate Genizah research. It is achieving this goal by locating the Genizah manuscripts and then identifying, cataloging, transcribing, translating, rendering them into digital format (i.e., photographing) and publishing them online. FGP is operating in a joint venture with the Jewish Manuscript Preservation Society of Toronto, Canada.
The high-resolution digital images of the manuscripts (600 DPI, or dots per inch, the standard set by the Research Libraries International Organization) are, in a certain sense, "better" than the original manuscript because they can be visually enhanced by computer-generated viewing tools and can be accessed from any computer with internet access at the FGP's online research platform.

The huge academic interest generated by FGP is evidenced by the fact that the most prestigious university libraries in the world have signed copyright agreements with FGP, are participating in the project and are sharing their invaluable manuscript collections with the world...

...In May 2008, FGP released a fully-operational version of its online research platform, where it is now possible to view over 100,000 digitized images of Genizah manuscripts.

from the New York Times

The Secret Life of Cairo’s Jews
Published: May 27, 2011

About 120 years ago, a cache of manuscripts, mostly fragments, was discovered in the storeroom of an old Cairo synagogue. Its members had deposited them there over many centuries. This collection of documents managed to be both heterogeneous and comprehensive at the same time.
Enlarge This Image

The Lost and Found World of the Cairo Geniza
By Adina Hoffman and Peter Cole
Illustrated. 284 pp. Nextbook/Schocken. $26.95
Adina Hoffman is the author of “House of Windows: Portraits From a Jerusalem Neighborhood.” Peter Cole is a poet and translator. As they relate in their engaging book “Sacred Trash,” the materials in the storeroom included letters, wills, bills of lading, prayers, marriage contracts and writs of divorce, Bibles, money orders, court depositions, business inventories, leases, magic charms and receipts. One early examiner of the cache described the scene as a “battlefield of books.” The most recent deposits were made in the 19th century; there were fragments that dated back to the 10th century. Another early visitor described the scene thus: “For centuries, whitewash has tumbled” upon the documents “from the walls and ceiling; the sand of the desert has lodged in their folds and wrinkles; water from some unknown source has drenched them; they have squeezed and hurt each other.”