What exactly is the Middle East? "East" with respect to what?

I will try to answer the question in as non-confusing a manner as possible (but beware!). From the perspective of the "Old World," namely Europe before 15th-19th century colonization of the Americas (the "New World"), the "East" stretched roughly from Turkey to Japan. In the parlance of the 19th century, the "Near East" consisted of the Balkan States of southeastern Europe and the western part of the continent of Asia. The "Far East" referred to those countries bordering the Pacific Ocean and its associated seas, while the "Middle East" would have included such countries as Afghanistan and Pakistan.

Today, the term "Near East" is rare, though one occasionally finds it used synonymously with "Middle East." Rather, the term "Middle East" is the common designation for the predominantly Muslim nations of Southwest Asia, such as Saudi Arabia, Iraq, and Syria.

One also encounters the terms occidental and oriental. Occidental refers to the setting of the sun--which as we all know takes place every evening "in the west," while oriental refers to the rising of the sun, in the east. The Orient, then, consists of the lands and territories east of the "Old World," while the Occident, originally referring to the lands of western Europe, now includes the Americas as well. But never mind, the words "occident" and "occidental" have nearly fallen out of usage in the English language, though "orient" and "oriental" have persisted.

Of course, from the perspective of a Canadian or Mexican, Europe is actually "East," while the United States is "south" or "north," respectively. It's all a matter of perspective. (Now, has this shed any light on your question, or have I only heaped obscurity on obscurity?)

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