Tuesday, March 29, 2016

The Other 10%

Here's an interesting tidbit that relates to several topics discussed in this forum. A reader sent me a clipping from the Israeli Yated Ne'eman, which contains an account from the late Rav Shmuel Wosner ztz"l, author of Shevet HaLevi, of how Rav Isser Zalman Meltzer told him of the Chazon Ish's expertise in answering questions relating to medical matters of life and death (such as whether or not to proceed with an operation). Rav Meltzer said that "our teacher, the Chazon Ish, was correct 100% of the time." Amazing!

However, if one looks at the actual text of Rav Wosner's Shevet HaLevi, he says something significantly different:

שו"ת שבט הלוי חלק י סימן יג 

וזה לי קרוב לחמשים שנה שכבר הייתי פה רב בסביבה, והייתי מאד מקושר עם מרן החזון איש זי"ע, בקרתי אז את הגאון האמיתי בעל אבן האזל הגרא"ז מלצר זצלה"ה והוא ידע על הקשרים שלי עם החזון איש ומאחר ששמע ממני כמה דברים אמר לי בהתפעלות, וז"ל, החזון איש פוסק דיני נפשות ברגעים (אם כן לנתח או לא, וכיו"ב) והפלא אמר שיותר מתשעים אחוז זוכה לכיון האמת והצלחה, עכ"ל. 

What Rav Wosner actually attests is that Rav Meltzer said that the Chazon Ish was correct more than ninety percent of the time!

So how does 90% becomes 100%? Presumably, the doctrine of the effective (if not theoretical) infallibility of Daas Torah makes it difficult to say that the Chazon Ish was wrong even 10% of the time, especially if it led to people dying as a result.

Of course, a 90% success rate would still be impressive. However, seeing how 90% becomes 100%, one cannot help but wonder if even the figure of 90% has likewise been inflated along the way.

In any case, where did the Chazon Ish's medical knowledge come from? The standard view in the charedi world is that it came from supernatural sources/ his knowledge of Torah, as per the classical concept of Sod Hashem Liyreyav. (In my monograph on Sod Hashem Liyreyav, I demonstrate that the classical concept has been radically transformed.) But many years ago, I traveled to Bnei Brak to meet Rav Gedalyah Nadel ztz"l, one of the foremost talmidim of the Chazon Ish. I asked him about the Chazon Ish's medical knowledge, and he told me two things: First, that the Chazon Ish didn't actually know all that much, and second, that which he did know, came from the medical journals that he read.

It is reasonable to presume that one's views as to the source of the Chazon Ish's medical knowledge also have an effect on one's perceptions of his success rate. If his knowledge came from reading medical journals then it is acceptable for him to sometimes have been mistaken. But if it came from supernatural sources, then it should have been infallible.

I wonder if the Yated would print a correction?

52 comments:

  1. 90% becoming 100% Simple: batel b'rov!

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    Replies
    1. how does one know the decisions were "right" if one can not know the alternative results?
      KT
      Joel Rich

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    2. Rav Slifkin please add an upvote button!

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    3. Joel; your question answers itself (and R' Slifkin's question). With no test statistic and no control group it is impossible to give any credence to the 90% figure. The 100% figure, on the other hand, is easy to support. Surely the Chazon Ish wouldn't give bad advice (note, no Sod Hashem Liyreyav) needed.

      When you move from the empirical to the philosophical all becomes clear (provided you are willing to accept the logic).

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    4. Nah, it's like the old saying in medicine. The doctor never gives the wrong treatment but sometimes the patient has the wrong disease.

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    5. He used translate.ruachhakodesh.com

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  2. Don't hold your breath...

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  3. A little bit of knowledge is a (very)dangerous thing.

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  4. What does a 90% success rate mean in connection with advice on having an operation? Suppose the advice is have an operation and it actually was unnecessary, and the patient lived. How do you count this as a success because the patient lived or a failure since the operation was unnecessary. Or conversely suppose one has an annoying but not life threatening g condition and the advice is Don't have the operation and the patient lives and ceases complaining since he was advised by the Chaz on Ish not to have the operation. Is that part of the 90% success rate?

    ReplyDelete
    Replies
    1. Humpty Dumpty said "When I use a word, it means just what I choose it to mean- neither more nor less."
      When chareidim proclaim truth using what ever broken-logic artifice they can fabricate, they can sanitize it to mean whatever they want it to mean also.
      Its the same type of maical thinking that Alice was faced with in Wonderland.

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  5. I wonder if the Yated would print a correction?

    R. Slifkin, they didn't make a mistake. They just forgot to put in the error bars of +/- 10% ;).

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    Replies
    1. There's a chance he was 110% correct?!?

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    2. The Chazon Ish always gave 110%.

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  6. How can one gauge a success rate without follow up of each case?

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  7. 90% is not similar to 100% - there is no way to prove (or disprove) a 90% (or even 99%) claim based on anecdotal evidence (which is the only evidence there is) - if anyone claims that his relative died because of bad advice received, you can say that is one of the rare minority of cases when the Chazon Ish was mistaken (or not mistaken, but deliberately gave this advice for reasons we cannot understand).

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  8. What language were these medical journals (that the Cahzon Ish accodring R Gedalya) written in?

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  9. My late father's late cousin R' Dovid Landesman, was very interested in this "Chazon Ish knew everything about medicine just from learning Torah" belief. I seem to recall him claiming that there was evidence the Chazon Ish read widely in anatomy and medicine during his time in Vilna.

    I distinctly recall overhearing a conversation R' Dovid had with another of our cousins; a distinguished educator who came from a Mizrachi background, has continued extensive ties with the secular world, but is now very Charedi in his outlook. R' Dovid asked him how he thinks the Chazon Ish acquired his fabled medical knowledge, and whether he would accept that it came from simply reading it in the library. This cousin was very reluctant to entertain the idea, and said: "I don't know what the Chazon Ish did or didn't read in Vilna, but I do know what אסתכל באורייתא וברא עלמא is, and that's good enough for me".

    It is remarkable how things so esoteric and trivial as this become mandatory orthodox belief even among intelligent people in a Charedi environment.

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    Replies
    1. I am contemplating the measure of the arrogance required to make the statement "I do know what אסתכל באורייתא וברא עלמא is", but I fear it is beyond my simple human intelligence to encompass.

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    2. Only a complete AmHaAretz can refer to 'הסתכל באורייתא וברא עלמא' as a trivial matter.

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    3. The trivial matter is the belief that the Chazon Ish was perfect in his medical advice. Try to focus more when you read.

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  10. to be fair, listening to the CI could be labeled as always 100% correct no matter the result we perceive. perhaps this morphed into the ci was always correct which morphed into the result as we perceive it is always correct (or more cynically the reteller could have realized the first version is a tough sell sometimes to the involved individual)

    KT
    Joel Rich

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  11. I think you're over-interpreting the 100% thing. I think it is more likely attributable to exaggeration than a reasoned consequence of a philosophical position. The English version of the Yated (and other similar frum publications) is full of exaggeration, hyperbole, and purple prose.

    More interesting is the question of where the CI got his medical knowledge, and what it is acceptable to attribute it to in the Chareidi world.

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  12. I was learning a bit about kame`ahs with my chavrusah a short while ago, and I asked, how did they judge if any script was effective? He told me that it had to work three times, a chazzakah.

    I bet that the rabbanim use the same threshold, and nobody follows up. It's all anecdotal, like folk remedies. The ones who survive tell everybody why, the ones who don't, well, they don't say anything. And their heirs aren't in any mood to say much, either.

    Peretz Mann

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    Replies
    1. I think you got it all wrong. Kamehameha aren't considered effective based on Chazakah, but on reputation. ("effective" is a poor, modern translation of "Humechah")

      That's all - reputation. The halachic treatment results from the reputational attributes of the Kamehameha.

      Now, onto Rabbis. Rabbis don't give medical guidance in a professional capacity. Even the CI. Shame on you for your irresponsible remarks.

      Rabbis often help with decisions of gravity. That the CI and others had a remarkable intuition is what is admired by the population of good Jews who have a "more" proper Torah background than your ilk.

      Delete
  13. Who gets to decide what medical decisions are 'correct' or not? A peer review of Rabbis or Doctors?

    If the peer review is by Rabbis, then I'm sure he was correct 100% of the time. What Rabbi would have the chutzpah to contradict the Gadol?

    Suppose that the peer review was by doctors. Doesn't that beg the more fundamental question that everyone should be asking, which is "why the devil was a Rabbi offering medical advice?" Anyone who asked a medical question should have been referred to the appropriate medical professional, then been given a blessing and a solicitation for a donation to the yeshiva as a merit for a speedy and complete recovery.

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  14. "Suppose that the peer review was by doctors. Doesn't that beg the more fundamental question ..."

    Why does it "beg" a question? And, what is "more fundamental" about that question?

    If the peer doctors are real "scientists", they will report an honest review, no?

    Yitz, suppose, L"A, that someone close to you had a grave medical situation requiring a responsible decision. The Chazon Ish tells you, "don't operate". Does Yitz just say, "the hell with him! What does that Rabbi know about medicine!"...?

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    1. I would take into consideration that my loved one is emotionally distraught and that is why he or she was seeking unconventional advice from a well meaning, but highly irresponsible Rabbi.

      I would give my loved one a healthy does of emotional space and empathy, which would preclude using your straw man language. I would listen carefully to what they said and give him/her the chance to share the glory of sitting in the presence of the great Rabbi. Then I would ask him/her to tell me what she thinks and what he/she wants to do. Then, maybe, I would ask if he/she is interested in my opinion, which would be to take him/her to the doctor and do what the doctor says.

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    2. Yes that would be my response. No rabbis know anything about medicine so their opinions are just shy of worthless.

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    3. If the medical professionals are saying there's a 50/50 chance the operations works, and an equal chance of a cure without the operation, I would be inclined to listen to the Chazon Ish. If the medical professionals are saying it is imperative to operate, then yes, I would be saying "what does the Rabbi know about medicine", unless said Rabbi can give medical reasons for what he is saying.

      Note: I do not know of specific cases where the Chazon Ish went against express instructions from the Doctors in the way I just described, so don't take this as any attack on the Chazon Ish per se.

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    4. Yitz,

      I don't think my question to you was understood. Let me stuff a little more straw into my "straw man" story.

      There is a decision to be made. Possibly three or more alternatives are presented by the top-notch doctors that your (L"A) family is trusting.

      The CI is present with you, and hears everything that the doctors have to say. So, he knows everything that you know about the matter.

      He advises you to do X. (unsolicited, let's say, but while still being the actual Chazon Ish - not some wannabe)

      What is your reaction - in your heart? "Rabbi is invalid or at least not more likely to be right than, say, Natan Slifkin would be if he were also privileged to the same exact information that you and the Chazon Ish were in my story?

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    5. I would ask him if his advice was based on his understanding of medicine or data torah or something else.

      KT
      Joel Rich

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    6. The patient could be emotionally invested in following the Gadol's advice, and that emotional state could indeed be a very non-trivial factor.

      Other than that, no, I don't see why his advice should carry any credibility. Why would it?

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    7. > The Chazon Ish tells you, "don't operate". Does Yitz just say, "the hell with him! What does that Rabbi know about medicine!"...?

      Yes. I would be more respectful, but yes.

      If your drain backed up, would you go to a rav or a plumber?

      Delete
  15. In fairness, this may well mean that *after* he gave the advice, they then consulted a doctor, who agreed with him 90% of the time. So no one died. But that's still an impossible number.

    Ironically, a rationalist would point out that the only reason he would even get to 10% would be a result of reading the journals, not any other source, mystical or not.

    I imagine if anyone would deal with this question rationally it would be the Brown biography.

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  16. would any of you care to comment with your thoughts on the Baba Sali and that type who likely did not study secular books yet had many miracle stories reported about them some in the medical area....do you really believe it is all hogwash?

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    1. Would you care to comment with your thoughts on the many miracle stories reported about Jesus, Shabtai Zvi, and Nir Ben-Artzi... do you really believe it is all hogwash?

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    2. Not comparable. They probably read secular books and thus defiled themselves.

      Delete
  17. Perhaps we should distinguish between Litvish rabbanim who apparently offer advice based on intellect and chassidic rebbes and mekubalim who apparently offer advice based on spiritual factors.

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    1. The first are amateurs, the second are charlatans, and neither should be offering advice on things they are not qualified to comment on.

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  18. When the children of the "Divrei Chaim" (Reb Chaim Halberstam fron Tzans) were preparing a book with all the Rebbe's wonder works, the Gorlitzer Rov, one of Reb Chaim's less chassidishe children, threatened them: "If you publish such a book I'll write another one with all the 'Mofsim' which did NOT succeed". I guess this stopped their endeavor.

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    Replies
    1. Awesome. Great answer for the question: "File drawer effect" min hachassidus minayin?

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  19. did you publish something on chazal being mechayei meisim ?

    http://www.simpletoremember.com/media/a/torah-cause-and-reality/

    from 72 mins


    http://www.hebrewbooks.org/pdfpager.aspx?req=21194&pgnum=504

    http://dovbear.blogspot.co.uk/2010/08/follow-up-hazzon-ish-and-his-famous.html

    https://judaism.stackexchange.com/questions/2542/chazon-ish-neurosurgery-diagram

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  20. I'm not generally a defender of using Rabbinical leaders for matters outside their expertise, or a proponent of magical wishful thinking, but I think there is another way to look at the function of a Rabbi in assisting with medical decisions.
    Physicians often present patients with choices. We can do "X" which is invasive and has a 30% risk of death from side effect "Y" and a 50 percent chance of healing you. Or we can do "Z" which is less invasive and has a 10% risk of deadly side effects but only a 30% chance of healing you. (of course the typical case doesn't have such neat numbers).
    In that case, the decision is more a moral/philosophical one than a medical one. People can appropriately seek counsel from their trusted spiritual adviser to help them make decisions of this kind. The Rabbi isn't advising on medicine just as he wouldn't advise on how to fix a plumbing problem; he's providing moral and philosophical guidance with making a difficult choice.

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  21. In regards to the Chazon Ish's knowledge of medicine, one should read the story on page 35 of this journal, Nitzachon:

    https://8bb81c130fef73756601-e0592327e33502476a69db4f944e1067.ssl.cf1.rackcdn.com/Nitzachon%203-2%20[Final].pdf

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    Replies
    1. https://en.wikipedia.org/wiki/Ze%E2%80%99ev_Lev
      no mention of princeton and einstein

      Delete
  22. Nosson Slifkin:

    1) You claim the Charadim are biased on the fact that they extended the 90% comment to be 100%. You make a comment "one cannot help but wonder if even the figure of 90% has likewise been inflated along the way,"
    implying that the percentage should be lower. You are guilty of the same prejudice that you attribute to the Charadim. Just like they extended the 90% to be a 100%, you are suggesting the 90% should be less of a percentage, thereby showing your own bias.

    2) You claim "But if it came from supernatural sources, then it should have been infallible".
    There is a flaw in your thinking. You are implying if Chazon Ish had Divine Inspiration he should have been infallible in every statement and decision he ever made. If I am
    correct in 1% of the statements I make does not disqualify that that 1% did not come from Divine Inspiration just because I am incorrect 99% of the time. It still could be that 1% came from a supernatural source and there was no natural way of me being correct within that 1%.It could be those 90% statements came from a Divine Inspiration and the other 10% he was not zoche to have a Divine Inspiration at that moment in his life.

    Now you may argue being correct 90% of the time doesn't prove someone has Divine Inspiration. Agreed. One would need other evidence to prove he had Divine Inspiration.

    3) You quote your monograph on Sod Hashem Lireav. If I remember correctly you called it "An EXPANSION of a useful concept." It was not called a "Transformation" of a useful concept. Yet here you call it as being "Radically Transformed". Actually from your monograph you did not prove anything was radically transformed (I believe that was your Kezayit). Let me give you an obvious critique. EVERY CONCEPT IN SHAS HAS BEEN EXPANDED TO RISHONIM AND THEN ACHRONIM. For example if Shas uses a concept 5 times, you will find Rishonim extended it and discussed it 15-20 times. Then you will find the same concept being used amongst Achronim 60-75 times in various cases. Therefore your monograph can be renamed "From Shas through Rishonim to Achronim: An expansion of many useful concepts". Thereby you have proved nothing about Sod Hashem Lireav.

    4) You say after asking Rabbi Nadel
    " and he told me two things: First, that the Chazon Ish didn't actually know all that much, and second, that which he did know, came from the medical journals that he read."
    If the Chazon Ish "didn't actually know that much [in regards to medical knowledge] that strengthens the point his knowledge was from a Divine Inspiration! How could someone who doesn't know that much about a topic know more information and be more accurate than the top doctors in the field! Clearly there must have been a Divine Inspiration when it was needed.

    5) I am conducting a poll for the readers of this blog to be intellectually honest and who claim to have logical rational thinking. What makes more logical sense to you? If someone was correct 90% of the time on medical knowledge and knew more information then top doctors in the field by spending a minute amount of their time reading medical journals OR that even though they have spent a small fraction of their time reading medical journals the information they received within the medical field came from a Divine Inspiration? My logical mind concludes it must have come from Divine Inspiration, especially when he was known to be an individual who attained all the criteria to have received Divine Inspiration. What about you? Please vote here: Divine Inspiration or Medical Journals.

    ReplyDelete
  23. Nosson Slifkin:

    1) You claim the Charadim are biased on the fact that they extended the 90% comment to be 100%. You make a comment "one cannot help but wonder if even the figure of 90% has likewise been inflated along the way,"
    implying that the percentage should be lower. You are guilty of the same prejudice that you attribute to the Charadim. Just like they extended the 90% to be a 100%, you are suggesting the 90% should be less of a percentage, thereby showing your own bias.

    2) You claim "But if it came from supernatural sources, then it should have been infallible".
    There is a flaw in your thinking. You are implying if Chazon Ish had Divine Inspiration he should have been infallible in every statement and decision he ever made. If I am
    correct in 1% of the statements I make does not disqualify that that 1% did not come from Divine Inspiration just because I am incorrect 99% of the time. It still could be that 1% came from a supernatural source and there was no natural way of me being correct within that 1%.It could be those 90% statements came from a Divine Inspiration and the other 10% he was not zoche to have a Divine Inspiration at that moment in his life.

    Now you may argue being correct 90% of the time doesn't prove someone has Divine Inspiration. Agreed. One would need other evidence to prove he had Divine Inspiration.

    3) You quote your monograph on Sod Hashem Lireav. If I remember correctly you called it "An EXPANSION of a useful concept." It was not called a "Transformation" of a useful concept. Yet here you call it as being "Radically Transformed". Actually from your monograph you did not prove anything was radically transformed (I believe that was your Kezayit). Let me give you an obvious critique. EVERY CONCEPT IN SHAS HAS BEEN EXPANDED TO RISHONIM AND THEN ACHRONIM. For example if Shas uses a concept 5 times, you will find Rishonim extended it and discussed it 15-20 times. Then you will find the same concept being used amongst Achronim 60-75 times in various cases. Therefore your monograph can be renamed "From Shas through Rishonim to Achronim: An expansion of many useful concepts". Thereby you have proved nothing about Sod Hashem Lireav.

    4) You say after asking Rabbi Nadel
    " and he told me two things: First, that the Chazon Ish didn't actually know all that much, and second, that which he did know, came from the medical journals that he read."
    If the Chazon Ish "didn't actually know that much [in regards to medical knowledge] that strengthens the point his knowledge was from a Divine Inspiration! How could someone who doesn't know that much about a topic know more information and be more accurate than the top doctors in the field! Clearly there must have been a Divine Inspiration when it was needed.

    5) I am conducting a poll for the readers of this blog to be intellectually honest and who claim to have logical rational thinking. What makes more logical sense to you? If someone was correct 90% of the time on medical knowledge and knew more information then top doctors in the field by spending a minute amount of their time reading medical journals OR that even though they have spent a small fraction of their time reading medical journals the information they received within the medical field came from a Divine Inspiration? My logical mind concludes it must have come from Divine Inspiration, especially when he was known to be an individual who attained all the criteria to have received Divine Inspiration. What about you? Please vote here: Divine Inspiration or Medical Journals.

    ReplyDelete
    Replies
    1. 1) "You claim the Charadim are biased on the fact that they extended the 90% comment to be 100%". No, I claim that the author is intellectually dishonest, not biased.
      "You are guilty of the same prejudice that you attribute to the Charadim. Just like they extended the 90% to be a 100%, you are suggesting the 90% should be less of a percentage, thereby showing your own bias." No, I am saying that the same psychological mechanism which caused one person to go from 90% to 100% may well have caused another person to go from 50% to 90%.

      2) You are correct, Divine inspiration does not necessarily mean being right all the time, it only means being right at the time that Divine inspiration is being given.

      3) Your analogy is incorrect. With Sod Hashem, the fact that the Gemara uses it so rarely and hesitantly, and clearly on most occasions feels that it is entirely inapplicable, means that when modern figures apply it sweepingly, this is a qualitative rather than merely quantitative change.

      4) "How could someone who doesn't know that much about a topic know more information and be more accurate than the top doctors in the field!" That was Rav Nadel's point - that the Chazon Ish DID NOT know more information and be more accurate than the top doctors in the field.

      5) See the various comments above which explain why the "90%"claim is not very significant.

      Delete
  24. On page 13 it says according to Dr Tzvi Yehuda that the Chazon ish in Chutz le'aretz read in Yiddish many medical books and psychology books

    (I saw this linked in seforim blog)

    https://drive.google.com/file/d/1ONLg9uG3xAtR5yLWaw1h2z4oa4D9Guvk/view

    ReplyDelete

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