Holocaust film ‘Numbered’ reminds us how much people count

My favorite documentary from this summer’s Jerusalem Film Festival is a movie entitled Numbered. The film is a collage of narratives and photographs of Auschwitz survivors who were tattooed during their incarceration.

Viewers are challenged to see the Shoah through the lens of Uriel Sinai from vantage points that are novel and compelling; a survivor who defiantly adopts his number for all computer-based security codes, a “next generationer” who enters a tattoo parlor to perpetuate father’s number on her skin, entire families who decide to “move on,” and some who don’t.

I had the privilege of mentoring the film’s director, Dr. Dana Doron, while she was an inquisitive medical student rotating through our hospital’s department of oncology. Dana invited me to the premier at the festival where she told the crowd how the idea for this, her first film, evolved.

Several years earlier, as an intern, she had been paged to evaluate an 83-year-old woman in the emergency room. The stated complaint was chest pain but it didn’t take long for Dana, an astute clinician, to understand that this symptom was really not what brought this patient to the hospital. In truth, the patient was a frequent visitor to the ER where she sought people to hear her story. The woman was an Auschwitz survivor and had come because she was lonely and pined for an audience.

Quickly, Dana concluded that there must be others with a similar sense of isolation. As we are all too well aware, by tattooing numbers on forearms, the Nazi murder machines had attempted to dehumanize people in order to systematically and mechanically exterminate them in a guilt-free manner. Individuals defiled with numbers and devoid of names or personalities need not be related to as members of homo sapiens, the reasoning goes, and so could be guiltlessly discarded.

Dana therefore set out to identify other survivors; most of whom learned not only to live with the fact that they were indelibly branded like cattle but also found a way to be empowered by this form of physical and mental torture. The film is low key and low budget, but it works because the stories are jarring, and the photographs, arresting.

WHENEVER ATTEMPTS are made to portray the Shoah, hearts nervously palpate. Will the artist err in his or her characterization or, worse, trivialize the colossally evil event? Analogies to the Shoah face even greater trepidation. To understand the risks taken by those who dare to draw lessons from the Shoah, one need look no further than the criticism that Prime Minister Binyamin Netanyahu endured for having suggested parallels between the intentions of Iranian President Mahmoud Ahmadinejad and those of Adolf Hitler. Yet the Shoah must, in some manner, inform our behavior.

I do not make a formal comparison to the Shoah here since I acknowledge that there can be no parallel to, or overlap with, the barbaric ideology of the Nazis, but I confess that I walked out of the theater with new worries about the modern medical system. Our modern medical system has, of course, made great strides. One of the emblems of this progress is the “electronic medical record” or EMR. The intentions of the innovation are surely praiseworthy. The EMR was designed to make the physician more efficient and to serve the patient, but sometimes, we see opposite effects.

Recently, Abraham Verghese, Stanford University Professor of Medicine, published a cautionary article in the prestigious New England Journal of Medicine. He suggested that the availability of iPods, iPhones and iPads has made it easy to regard the human beings admitted to hospitals as “iPatients.” Verghese worries that physicians come to know the iPatient (especially the results of his blood tests and imaging studies) long before they know the real patient.

Ironically, the ease with which we can learn about patients on our touch screens makes us less inclined to touch the real patient. Why should we bother to perform the physical exam, young doctors conclude, when it seems so much more expeditious to derive patient data from the EMR?! By so doing, though, our patients have become digitized, and instead of representing an intricate tapestry of physical abnormalities and emotional conflicts, they have morphed into binary collections of data. In short, they are numbered.

On the surface, our use of technological innovations such as EMRs seems to represent progress. But, to some extent, we have all become losers in the process. Patients have lost the attention they crave. The relationship between doctor and patient has lost its intimacy. And physicians have lost the joy, intellectual stimulation and humility that would have emerged from a good bedside manner which has been miscarried by doctors who neither examine their patients nor speak to them eye-toeye.

What’s more, Verghese argues that poor bedside skill actually reduces physician efficiency, probably because the doctor departs the encounter with the patient feeling less confident in the working diagnosis and therefore tends to randomly order additional tests to compensate for the insecurity that arises.

JEWISH TRADITION places a taboo on using numbers to count people.

When a census was taken (Exodus, Chapter 30; Numbers, Chapters 1 and 26), the quantification was determined indirectly by using half-shekel coins as surrogates for people.

In the Book of Samuel, King David is punished for ordering an unauthorized census. And these days, when counting to see if a “minyan” is present, various 10-word scriptural phrases are used to infer whether a prayer-quorum has coalesced.

Alternatively, some jokingly point at the minyan participants and enunciate “not one, not two, not three…” as a way of pretending not to count.

The rationale for the prohibition against enumerating groups of Jews is often thought to be a mystical gesture to ward off some superstitious force that might construe our counting as a form of bragging and therefore retaliate by reducing our critical mass. But Rashi, the medieval French rabbi considered by most as father of all Torah commentators, suggests (Exodus, Chapter 30, Verse 12) that to count human beings would be tantamount to detracting from their dignity because no one can be encapsulated into a simple objective icon such as a number. A policy that forbids counting then reflects a worldview that emphasizes the need to relate to people as multidimensional human beings.

It may be impossible to exaggerate the value of seeking to understand the depth of another soul, especially if that soul is besieged by illness. We continually re-learn that life lesson.

The film by Dana and Uriel Sinai projects irony by documenting an emotional trajectory of human response to the infamous tattooing that arcs between shame and empowerment.

The very title of the film, Numbered, drips with double entendre.

The Nazis flagged people for counting purposes in the short-term, but in so doing hoped to eternally stigmatize the same men and women.

The Auschwitz survivors who testify in the film, by and large, would not accept such a reality but rather chose to affirm their unique personhood.

Have we the courage at this time to heal, to care, and to listen to people as unique human beings, each with their own story?

The writer, a doctor, is Professor and Chairman of the Institute of Radiotherapy at Tel Aviv Medical Center and Co- Founder of Life’s Door-Tishkofet. He was recently awarded the National Citation for Volunteerism by President Shimon Peres.