This is likely the basis for Wisse’s comparison.

What she is claiming here is that as liberal philosophies began to spread through Europe (French Revolution, North German Confederation, etc.), Jewish populations were in a position to drastically improve their standing in European society. As mentioned in previous annotations, some radicals saw Jewish emancipation as antithetical to German unity. On the surface, one could make a vague comparison to Occupy Wall Street’s claim that skyrocketing profits for the 1% are antithetical to civic and economic freedom of the 99%

However, Wisse fails to give any context to this “grievance and blame”. Instead, she seems to imply that outcries against U.S. inequality are akin to the Jewish conspiracy theories offered up by the likes of Marr (also: Russian folk hero Dostoevsky). This idea could not be further removed from reality.

Marr lived during a time of severe political tension, and saw a number of revolutions throughout Europe in his day. More specifically, he lived during a time in which many German radicals began to reject the notion of Jewish Emancipation.

While German discourse was consumed with theories of anarchism, democracy, and other liberal politics espousing equality for all, this was all mixed in with some serious patriotism, as well as hopes for a unified Germany. While many radical democrats fought for liberty for all Germans – including minorities – others noticed that many Jews refused to put Germany & the German people above all else. In 1843, the young Hegelian Bruno Bauer wrote:

The German Jews desire emancipation. What kind of emancipation do they desire? Civic, political emancipation.

Bruno Bauer replies to them: No one in Germany is politically emancipated. We ourselves are not free. How are we to free you? You Jews are egoists if you demand a special emancipation for yourselves as Jews. As Germans, you ought to work for the political emancipation of Germany, and as human beings, for the emancipation of mankind, and you should feel the particular kind of your oppression and your shame not as an exception to the rule, but on the contrary as a confirmation of the rule.
- On The Jewish Question

Though Marr was undoubtedly antisemitic, and even apologized during the latter part of his career for his irrational antisemitism, it’s important to grasp the historical context in order to see how this political antisemitism bears almost no resemblance to contemporary U.S. class conflict.

Why Dr. Wisse felt the need to drop this little tidbit in here is beyond me, but it raises a good point nonetheless: Antisemitism has existed within the mainstream thought of both the Right and the Left throughout the past two centuries, often at the same time.

Furthermore, it is always concentrated around times of social & political upheaval, which is probably why Orwell included it under the umbrella of “negative nationalism”. He offers a simple way of understanding the phenomenon:

By ‘nationalism’ I mean first of all the habit of assuming that human beings can be classified like insects and that whole blocks of millions or tens of millions of people can be confidently labelled ‘good’ or ‘bad’(1). But secondly […] I mean the habit of identifying oneself with a single nation or other unit […] and recognizing no other duty than that of advancing its interests […] A nationalist is one who thinks solely, or mainly, in terms of competitive prestige.

In their book Genetic Seeds of Warfare: Evolution, Nationalism, and Patriotism, Paul Shaw and Yuma Wong attempt to explain the purpose behind these generic nationalist movements:

[Nationalism] fosters pride, dignity and related sentiments among members of the in-group, thereby constituting a moral and philosophical basis on which to demand political sovereignty [from the out-group] (my emphasis).

If there is any similarity between antisemitism and U.S. class conflict, this is probably it. Namely, in times of political & economic turbulence, different social groups solidify themselves by finding a common enemy. However, unlike the Jewish conspiracy theories out there, there is plenty of data to substantiate claims of economic and political injustices carried out by the 1%.

There is nothing modern about antisemitism, or any prejudice, for that matter. Philo of Alexander wrote about hostility towards Jews, way back in the first century A.D.

Flaccus Avillius succeeded Sejanus in his hatred of and hostile designs against the Jewish nation.

However, what separates the study of antisemitism from other forms of ethnic prejudice is that many scholars cite multiple forms:

1. Religious – Based on the idea that the Jews were primarily responsible for the death of Jesus.
2. Economic – Probably came about due to the Jewish practice of usury when doing business with Gentiles (see Deut. 23:20 and Maimonides)
3. Social – This is the view that Jews can be characterized as antisocial, and thus, socially inferior. Probably goes back to the Hellenistic Era, during which Jews rejected Greek social customs.
4. Racist – As Jews began to assimilate more into different societies, and especially after Jewish Emancipation began, “new” reasons for hostility towards Jews had to be devised. This type of antisemitism coincides with the rise of scientific racism, before which time there was no real concept of “race”, Jewish or otherwise.
5. Ideological – AKA “political antisemitism”, this really began during Bolshevik revolution, as the Russian elite tried to portray revolutionaries as Jews looking to take over.
6. Cultural – This is sort of a catch-all type of antisemitism, with the idea being that Jews seek to supplant mainstream cultures with Jewish culture.

As you can see, these different forms of antisemitism are not really so different. They all fall under this sort of nationalistic philosophy described so well by George Orwell. Though, in the context of the historical periods in which these forms took shape, the distinctions can be insightful.

As defined in this report by the U.S. Bureau of Democracy, Human Rights, and Labor:

..anti-Semitism is considered to be hatred toward Jews-individually and as a group—that can be attributed to the Jewish religion and/or ethnicity.

Class conflict, as defined by Karl Marx, refers to the struggle between different social classes for control over the means of production. In other words, we are talking about the tension which exists between the competing interests of labor & capital (i.e. the poor & the wealthy).

Kristallnacht refers to the night in which German mobs descended upon Jewish communities in Germany and Austria, subjecting them to unconscionable terror, supposedly in response to the murder of a German diplomat, Herr vom Rath, by a young Jewish man, Herschel Feibel Grynszpan. It is sometimes referred to as the “Night of Broken Glass”.

In reference to Perkins' letter to the WSJ on January 24, 2014. Emphasis mine:

Regarding your editorial “Censors on Campus” (Jan. 18): Writing from the epicenter of progressive thought, San Francisco, I would call attention to the parallels of fascist Nazi Germany to its war on its “one percent,” namely its Jews, to the progressive war on the American one percent, namely the “rich.”

From the Occupy movement to the demonization of the rich embedded in virtually every word of our local newspaper, the San Francisco Chronicle, I perceive a rising tide of hatred of the successful one percent. There is outraged public reaction to the Google buses carrying technology workers from the city to the peninsula high-tech companies which employ them. We have outrage over the rising real-estate prices which these “techno geeks” can pay. We have, for example, libelous and cruel attacks in the Chronicle on our number-one celebrity, the author Danielle Steel, alleging that she is a “snob” despite the millions she has spent on our city’s homeless and mentally ill over the past decades.

This is a very dangerous drift in our American thinking. Kristallnacht was unthinkable in 1930; is its descendant “progressive” radicalism unthinkable now?

Yes, checklists..(buh-buhbuh-bummmm)

One would imagine that such a basic tool would reduce accidents/risks, and the research seems to support this assumption. In this case, we can expect that quality of care (i.e. less deaths from surgery) will increase while costs should remain pretty stable.

This is great news, no doubt, but how much of an increase in relative quality of care will we actually see? Consider the fact that in the U.S. roughly 51.4 million surgeries (data from 2010) are performed each year, resulting in roughly 100,000 deaths per year (data from 1999), of which, maybe 10-20% are easily preventable. Even if we see 50% reduction in preventable deaths, we are only talking about 5,000-10,000 lives being saved each year.

Again, that is great, and absolutely should be done. But compare this to the more than 2,468,435 deaths from CVD each year, most of which, if not all, are preventable. When you put it in perspective, having checklists will do diddly to improve the overall efficiency of the healthcare system.

Wait..what was the problem again? And how/why did it fail?

Gawande seems to be implying that the problem with the healthcare industry’s inefficiency is in the number of diagnostic procedures they carry out each year. He then seems to imply that, in hindsight, all those procedures weren’t really necessary. You know…despite the fact health is a dynamic process, always changing, and the trends of the past can hardly tell us what is necessary now, or will be in the future…whatever.

But then he switches the subject (next line) to deaths during surgery – a very real problem in the overall efficiency of healthcare, and one which has absolutely nothing to do with the # of CT scans given each year.

One reason cited for why the cost of diagnostic procedures like CT scans are so high, is the fact it costs so much to buy one.

For the top of the line scanner (64-slice), you’re looking at about $175,000-$275,000 + costs of maintenance. Assuming a 10%-of-baseline cost per year in maintenance ($17.5k-$27.5k…liberal estimate), your looking at no more than $491,000 over 8 years.

Yet, hospitals charge $4,000+ for each CT scan. This means that, with 52,000 people scanned, this hospital brought in atleast $208,000,000 just off scans alone. Hmm…

Should even more people be getting scanned? No, probably not (see next annotation), but there is absolutely no argument that fewer people should be scanned unless those scans had nothing to do with diagnosing a problem in the first place (which very well could be the case).