It’s the waning hours of Labor Day Weekend: Do you know where your children are? Well, in the great state of Alabama I can answer that fairly easily. Anywhere besides out of doors. We’ve been enduring god-awful temperatures in the high 90s with a level of humidity that’s driving the heat index to somewhere between 100 and 112- day in, day out for the last few weeks. I absolutely refuse to venture out of air-conditioned environments for more than five minutes.  I had vague plans of doing a bunch of things around the condo, but for the most part, even though my HVAC works perfectly well, the heat has kept me from wanting to much of anything.  Therefore, my Labor Day Weekend has been unencumbered by too much labor.

I did get a few minor things finished and caught up on everything that has an imminent due date so it wasn’t a complete vegetative state weekend.  I also managed to have a few decent meals out and spent time with friends, mainly watching old movies.  One of the nice things about having younger friends is the ability to acquaint them with cultural touchstones of earlier decades and being able to revisit them through eyes that have never seen them or read them or listened to them (depending on the medium involved).  Not having children or grandchildren, I have to do this outside of family circles and I often do it with younger gay men of my acquaintance – they have to learn gay culture 101 from somewhere and it might as well be me.

This weekend’s revisit was Baz Luhrman’s first film, Strictly Ballroom, which has always been one of my favorites since I first saw it on its initial release in the early 1990s.  Australian cinema was going through a bit of a renaissance at the time and one of the types of film that emerged were rather sweet souled dramadies with a bit of a loopy sensibility, a heightened reality and visual style, and a killer soundtrack.  Strictly Ballroom, made on a low budget based on an Australian stage play, set up Luhrman’s unique visual style which came to full fruition a decade or so later with Moulin Rouge!.  I’ve always thought of it as drag sensibility for straight people.  About 20 minutes into the movie, there’s a sequence when our hero and heroine ballroom dance together on a rooftop in front of a Coca-Cola sign while Cyndi Lauper’s Time After Time plays on the soundtrack.  It sounds odd but the actual combination of elements is magical in context and the first time I saw it, I knew this was a filmmaker to watch.  I haven’t always liked his work over the years, but even in his worst pieces, there are amazing visual and emotional moments.  It was lovely rediscovering the piece through someone who had no idea what it was about and I always find the ending with its message of family, connection, and joy emotionally cathartic.  It always makes me cry.

While it would be lovely to live in a society that’s a technicolor extravaganza with happy endings for all, we don’t.  We continue to have to contend with a society that seems to have gone off the rails at the very top.  A president who thinks he can run around renaming US states at his whim.  A Secretary of Defense who has pushed out most of the experienced senior leadership at the Pentagon, gleefully ignores facts that do not fit his worldview, and is busy wasting hundreds of billions in an unwinnable conflict with Iran.  A Secretary of the Interior busy facilitating the transfer of public lands into private hands.  A Secretary of Education busy trying to destroy educational opportunities to the underserved.  A Secretary of Health and Human Services destroying public health programs while advocating unproven therapies. An Attorney General gleefully trampling on the constitution.  Will things change in eight weeks or so at the midterms?  I’m not sure.  One thing I have learned about our current administration is that anything can happen (and usually does).

The next few weeks promise to remain relatively calm, whatever the weather and politics are up to.  I have short work weeks the next few weeks due to my jaunt to Seattle to check up on the family.  September has long been my favorite month there due to the magical golden light of the Indian Summer afternoons.  With my luck, it will rain the whole time I’m there.  I come back from that to a cameo role in a play (another judge) where I spend most of my time napping backstage. Then, a week or so later, my major fall trip to Eastern Europe.  Still trying to work out how to deal with the life changes of retirement.  I’ll probably try a few different patterns of living prior to finding what works best for me.  In the meantime, I’m still trying to organize myself and all my boxes of ephemera.  Someday I may be done.  And then what…

I’ve been watching the film clips of the flooding in Nepal with fascination. This son of an oceanographer has always had a healthy respect for the power of water. It can eat away cliffs, create deep canyons, carry boulders far from their origin. Our lives on this planet, nearly three quarters of which is covered in water, are continually shaped by where water is and isn’t. The geography that the movement of water has sculpted across land masses. The constant changes in weather patterns caused by the movement of water through the hydrologic cycle that produces storms and rain. Even our bodies remain those of water creatures with a heart pumping salt water through our vital organs and our kidneys regulating that balance of water and salt keeping our cells, the descendents of unicellular sea creatures, happy and productive.

What caused the disaster? Sudden glacial collapse down a steep mountainside which suddenly displaced millions of cubic feet of water out of glacial lake and into a nearby streambed. Gravity did the rest. At least some of the collapse was due to global warming and climate change and we’re likely to see more of these sorts of events in the future. Can it happen here? Of course it can and it has. Look up the Missoula Floods which shaped much of what is now Northern Idaho, Eastern Washington, and Central Oregon. We’ve even had manmade catastrophes such as The Johnstown Flood. The rather shoddy state of our infrastructure makes it only a matter of time before we have a dam failure somewhere helped along by either excess rainfall or seismic activity. I don’t know where the Amrican image as indelible as that of the Chinese/Nepal border crossing that was swiftly overcome by a deluge, scraping the area of everything down to bedrock is going to be. I just know that it’s out there somewhere awaiting us at some future date.

There are other less showy disasters of course. It’s been a while since I gave an update on covid but it has not and is not going away. Cases are on the rise throughout the US and, if it keeps to the pattern it’s shown the last few years, it will kill somewhere between 35,000 and 50,000 Americans over the winter cold and covid and flu season. It’s fallen out of the top ten causes of death but it’s still significant, running neck and neck with the flu. Covid causes about 1.5% of deaths and flu about 1.7%. Flu is deadlier as there are many more cases. Covid has a higher chance of killing you if you get it.

Keeping your vaccination status up to date remains the best protection short of isolation away from possible sources of infection. There is a new covid vaccine updated for the newer ciruclating strains such as XFG but you can’t get it yet. The FDA finally gave its approval for its use (long delayed for various political reasons) this past week and it will take a few more weeks for it to make its way through distribution channels to clinics and pharmacies. It should be easily available as of mid-September. Should you get one? If you have an immune problem, respiratory problems, or are getting older, it’s not a bad idea. I’m getting one because the data continue to show a consistent benefit in terms of preventing serious complications such as hospitalization and death and it significantly decreases the chance of long covid following an infection (and you can develop long covid after even mild disease). There are about 10 million cases of long covid in the US at the moment and their medical needs are one of the reasons why its so impossible to get a timely appointment with certain kinds of specialists these days. For those of you who remain dubious about the vaccine due to risks of side effects such as myocarditis, a recent meta-analysis in JAMA showed that cases of myocarditis were significantly higher in unvaccinated populations (due to the effects of the disease) than in vaccinated populations. I no longer argue with people about vaccines. I do my own research (which I’m pretty good at given thirteen years of higher education including medical school).

The news out of Washington DC this week is that the administration is busy uprooting the cherry trees on the Potomac in order to make room for a golf course that the president wishes to be built. Add that to the reflecting pool, the East Wing of the White House, the South Lawn, the Rose Garden, Lafayette Park, and the Kennedy Center in terms of mishandling of public property. I remain mystified at how the enablers, on both sides of the aisle – those with power to actually do something who either encourage bad behavior or wring their hands in public before abetting such behavior in private to keep their campaign dollars flowing are ultimately going to end up justifying their actions. There will be an accounting. I hope I am alive to see it.

I’ve been offered a role in a play that rehearses and performs late September/early October. I don’t know much about it yet but I think it’s a glorified cameo that will require little effort. It should keep me from becoming too bored before I head off on my next major travel trek in mid October. Still nothing penciled in after the first of the year other than opera chorus for Rigoletto in late April. Gonna get my Vendetta and Zitti Zittis ready. And if I’m going to talk about performing, I guess I have to mention Tim Curry who left us this past week at age 80. I’m of the Rocky Horror generation. The movie came out when I was in Middle School and became a midnight movie cultural phenomenon when I was in High School. I remember my first foray to it – It was after a Halloween party at Maren Beck‘s house and a bunch of us headed out to the Neptune Theatre and joined the line waiting to get in. I wasn’t sure what to expect but Tim Curry’s gleeful gender bending over the top performance made an enormous impression on my adolescent brain. I went back many more times during the next few years, even seeing a screening in NYC hosted by Sal Piro who started the phenomenon. I always had a fondness for Tim Curry in his later roles as he brought just an anarchic brio to everything he did from the butler in Clue to Pennywise to Long John Silver.

Monday marks the beginning of the six month count down until I retire from UAB Geriatrics Clinic. It’s becoming real. I’m not sure how to feel about that. I’ve been working in ambulatory clinics since 1984 and at UAB geriatrics since 1998. What a long strange trip it’s been

It’s 5:30 am, I cannot sleep and Dolly Parton is dead. There is no connection between these two things but it struck me as being a great opening sentence for whatever form today’s musing is going to take. Occasionally I plan these essays out, usually when I think it’s time to do a deep dive on a topic of interest but mainly it’s just brain vomit at some random hour of the day and I’m rather surprised that the end result is even readable half the time. I’ve been writing these entries (?) epistles (?) essays (?) in this form for something over eight years now. Only about a third of them made it into The Accidental Plague Diaries volumes. What should I do with the rest? Print them out and line the cats litter box I suspect. Better grab the ones which might be useful for ‘Boom’ before they’re too badly stained.

Dolly Parton was a first year Baby Boomer, born in 1946. She was not the one I expected to go this year. That honor would have gone to Liza Minelli who has been looking very frail at recent public appearances Other first year Baby Boomers (or very close) are Goldie Hawn, Bette Midler, Cher, Susan Sarandon, Sally Field, John Waters, Sylvester Stallone, Bill Clinton, George W. Bush, Donald Trump, and Steven Spielberg. They are all entering their uncertain 80s and we are going to hear of more and more icons of Western pop culture leaving us more and more rapidly in the coming years. It’s been a few year and there, but starting around 2030, when the lead edge of the Boom hits their mid-80s, it’s going to accelerate. Roughly 18% of the Boom (those born 1946-64 inclusive) has already died. Another 3 or 4% will die between now and 2030. Of the Boom population that will see that date on the right side of the sod, somewhere around 45% will die in the 2030s and another 45% in the 2040s. By 2050, only about 5% of the original Boom will be living and will range in age from 86 to 104 and will no longer be a major social force. (I expect I will go in that second cohort in the 2040s as that’s when I hit my uncertain 80s – going from 78-88 over that decade). Gen X will also be in their 70s and 80s and the Millennials will be of retirement age so Gen Z, Gen alpha and Gen beta will be in charge. Demography is destiny.

I’ve been peripheral to arts and entertainment circles on a national level for forty some years now and have heard a lot of scuttlebutt about celebrities over that time. The one person that I have never heard an unkind word or negative remark about in all of that time was Dolly Parton. She was not only incredibly talented, she was a smart business woman and a kind soul who believed in treating everyone with respect and leaving everything she touched better than when she found it. In a time when American Christianity seems to be drifting farther and farther away from the message of the gospels, she exemplified what the faith should and could be. I love my UU church and family but if someone out there starts a church of Dolly, I might be tempted. She was self deprectaing, the first to laugh at her image, never forgot her roots or her people, transformed the lives of the people of Appalachian Tennessee, gave generously, especially to children, and sustained a very happy marriage of nearly sixty years. I think the most fitting words for her epitaph are ‘Well Done’.

I never got to meet Dolly. I’ve never gotten to meet most people. I did perform with her once, in a fashion. A few years back, I played the Sterling Hayden role in the stage version of 9 to 5. The rental package includes video clips starring Dolly as narrator at the top and the end of the show. Our video clips were a bit tempermental and Dolly missed her cues on a couple of performances, something the live Dolly would never have stood for. It’s not the greatest of musicals, but it’s a lot of fun and that title song remains one for the ages. There is a social media movement afoot to have an unofficial holiday for her. If May the Fourth can be Star Wars Day, then September Twentyfifth needs to be Dolly Parton day (9/25). I am entirely in favor of this idea. Perhaps we all need to get out our rhinestones and tease our platinum blonde wigs to get ready for the occasion.

I was looking back over the political headlines of this past week and becoming somewhat nauseous. Hegseth’s purging of the Pentagon of talent in favor of ideology seems to have pretty much hamstrung our military. Trump is threatening to tear down The Kennedy Center if he can’t have his name on it. The Republicans continue to enforce policies that are destroying our immigration system, immigrant communities, and don’t seem to care who gets caught in the crossfire (remember that demographics is destiny thing? The die off of the Boom means that there will be more deaths than births in the US from 2030-2050 and, as everything in our society is set up around expansion, the only way to do that is going to be through continued immigration). There are lots of ominous signs that the Republicans will try to fix the midterm elections one way or another. The food safety system appears to be collapsing. And the president seems bound and determined to piss off all of our allies and trading partners.

I’m not sure I can take another two and a half years…

I had a cold this week, not an unsurprising sequel to a period of stress, so I’ve been a bit low energy and under the weather and haven’t felt like doing too much constructive. I have made my way through my usual weekly thickets of progress notes, the unravelling of thorny personal issues amongst patients and friends, and even got a couple of chores done around the house so I think things are going relatively well. I have a weekend with minimal obligation so I’m going to try and knock out another legal case and at least unearth the study out from under the top layer of detritus thats come to rest from the academic office having come home to roost. If that all happens, I’ll consider it a win.

I’m looking ahead at my calendar for 26-27. There’s not a whole lot on it yet other than fall travel dates and singing the Messiah in December. Other things will come, they usually do. I have received some notifications regarding auditions for upcoming projects that would fit in with other commitments so I may flex those muscles over the next few weeks. In the meantime, maybe a little bit of laziness is called for after a rather busy 25-26 season which included a couple of foreign trips, three plays, a musical, directing Shakespeare, two operas, several symphony concerts, and a serious illness requiring hospitalization and surgery. I am less than a year away from becoming officially geriatric myself. I’m still trying to figure out how that happened.

As things may be a bit slower than usual the next couple of months, I am trying to get things organized in my head (and on the laptop) regarding getting a complete draft of the new book, Boom, put together. (Perhaps I should retitle it Jug ‘O Boom’ as an homage to Dungeon Crawler Carl which has become my latest pop culture obsession – I’m nearly done with book three and will probably make my way through the whole series by the holidays. For those who haven’t heard of it, imagine The Hitchhiker’s Guide to the Galaxy crossed with a truly sadistic Dungeons & Dragons campaign). This is causing me to have to plow back through The Accidental Plague Diaries to lift the sections which discussed generational aging and impacts on society and institutions so I have somewhere to start on those pieces. In looking back at what I wrote not all that many years ago, I’m reminded what a wrenching time 2020-2022 was for society and for individuals, how much pain and trauma we endured. And now I’m looking at a society that seems to want to bury all of it in collective amnesia.

This does not strike me as being a healthy impulse (but an understandably human one). If there’s one lesson I have learned in life, it’s that trauma and pain and the negative aspects must be dealt with. If they are not, they will come out later in mutated forms and wreak additional havoc physically and psychologically and that’s not good for anyone. The administration, led by the Department of Health and Human Services is trying to extirpate the collective memories of that time. It’s doing nothing to honor those who sacrificed for others. Somewhere between 3500 and 4000 health care workers died in 2020 in the US from occupationally caught covid. No one seems to have kept count one the vaccines came out of what happened after. The structural changes in health care that have taken place following the pandemic is pushing all of my generation of clinical providers towards the exit. In another era, I might have worked another decade; not now.

For the last fifty years, the holes in the care system have been filled by immigration and the importation of workers willing to take lower level jobs or of high skilled workers to make up for what our system does not produce for various reasons. Haitian, Eritrean and Somali nurses aids, Filipino nurses, South Asian physicians have all become common and important pillars of the system. It’s all about to come crashing down. Let’s look at Florida which has some 800 skilled nursing facilities with about 90,000 residents. There are roughly 85,000 nurses aides/CNAs employed in these facilities. Of these, about 45,000 are immigrants. About 1/4 of these immigrants are Haitian. Nearly all of them lost their ability to work with the administration’s recent rescinding of Temporary Protected Status for Haitian immigrants. You can say, if you are of a certain political persuasion, Great! 12,000 new jobs for native borns. Immigrants fill these jobs for a reason. Native borns don’t want them. They are low paid, low status, back breaking labor. Anyone who has cared for an infant or toddler knows how stenuous it can be. Now imagine that toddler is two hundred pounds. Alabama is not as badly off as Florida looking forward for various demographic reasons but the long term care industry is not in good shape and, for the most part, I no longer make any recommendations regarding facilities as most have been bought up by corporate entities in post-pandemic consolidation and generally aren’t being run in the way that they were a decade ago.

The administration seems bound and determined to break pretty much every societal institution that has led to American power and prestige in the post World War II period. We can all speculate on the reasons. Putin trying to diminish the West due to unknowable holds over the president, the billionaire class as disciples of Curtis Yarvin, trying to prepare for a future technocracy in which they hold all reins of power, just the natural cycles of history which every eighty years or so turns over when the lviing memories of why instiutions and rules were created dies out so people think they no longer apply. The media is pretty much gone, bought up by those who wish to curry favor with Hegseth eviscerating Stars and Stripes editorial independence, which has existed since The Civil War, being only the most recent blip on the radar screen. The courts have been packed. SCOTUS could be won back with an expansion of one justice for each circuit (which should have been happening all along) but I’m not holding my breath. Everyday there’s a new horror story about the thugs of ICE ignoring law and human decency. Our new concentration camps remain full. (One thing I wonder, if ICE is reined back and immigrants are no longer in the cross hairs, who will the system decide is worthy of such treatment as those cells will be filled and the money will flow to the owners under federal contract for someone to be in residence and brutalized – I’d say the LGBTQ community is in line and I have no illusions that my social position or resources will protect me should the Christianists have their way).

The midterms, happening in about ten weeks, are promising for the Democrats, but I am, once again, under no illusions that the current administration will allow free and fair elections. I have no idea what executive orders, scare tactics, or chicanery is on the table. Unfortunately, our winner takes all system means that it doesn’t take a major shift in voting patterns to create a starkly different result. We would be better off with some sort of proportional representation to allow miniority voices and opinions to be heard but that would take a constitutional convention and that would open up a can of worms like we’ve never seen.

I think I better just stick with working through my ideas on the aging Baby Boom, an area in which I have some decades of expertise and an ability to envision some solutions and stay out of the other areas of politics and society. It gets too depressing. I think it’s a cocktail before and a cocktail with dinner evening.

I am constantly reminded that there is nothing like live theater. At last night’s performance of The Tempest, I watched an actress hurriedly exit the stage and heard retching sounds from the wings. She appears to have had an acute case of food poisoning and was on the mend by late last night. The show went on. Patti Steelman, stage manager extordinaire appeared a scene later book in hand to keep things together and the rest of the cast continued to give stellar performances. The friends with whom I went weren’t altogether sure that it was unplanned. Enough goofy things had happened that they thought this might just be one more. I’m very proud of the whole crew for rolling with it and not letting it phase them. Rebecca Luker used to tell a story of her time as Christine in Phantom of the Opera on Broadway of a performance where she was on stage near the end of the first act, watching her Raoul enter, race across the stage and vomit into a bucket in the wings before coming back on, taking up his part of the duet. And all the time all she could think was ‘We’re supposed to kiss’. You have two more chances to see The Tempest, hopefully without an illness interlude. Today at 2:30 and tomorrow at 2:30 at East Lake United Methodist Church.

Now that Summer Shakespeare is melting away into such stuff as dreams are made on, I am coming out of my narrow focus and back into paying attention to other areas of life. I can get back in the groove of putting away all of the boxes of ephemera that came out of my academic office, start deciding what needs to be rehomed, clean out my storage area of things I will never touch again etc. etc. It’s going to be a slow process but one box and bin at a time. There’s no deadline or timeline involved. That’s part of my problem. I can just close off the mess in the study and pretend it doesn’t really exist.

I have also got to get back to the new book which has been sadly neglected these last few months between foreign travel and theater commitments. The more I look at what is going on in society regarding aging, the more I think it is needed. The new National Geographic arrived in my mailbox yesterday. (It’s one of the few paper periodicals I still receive routinely – the others being Smithsonian and The New Yorker). The cover story is all about how the billionaire class is trying to end the aging process. If I were Michael Crichton, I’d be half way through a novel about what happens when they actually succeed at that and haven’t thought through whether they should just because they can. There are organisms out there that do not age and senesce the way we do but they are a minority (and few, if any are vertebrates). Aging is programmed into us. We are supposed to create a new generation, different from our own, and then get out of the way as they in turn create a new generation and so on and so on down the line. Without aging, We might still be jostling around with Caesar Augustus and Genghis Khan and Louis XIV.

The hoarding of resources by older generations preventing younger generations from flourishing is one of the underlying building blocks of the economic conditions that lead to revolution and destruction of political systems and empires. When enough parents cannot feed their children, the system collapses and we are rapidly beginning to approach that kind of tipping point thanks to the current administration’s bulldozing of safety nets in order to pay for tax breaks for wealthier Americans. The legislative class, which has more or less abandoned the job of producing legislation for the profit and protection of the American people for making sure that those who fund their war chests and campaigns get what they want seem to be caught up in full apres moi le deluge thinking. I don’t know what will happen with the midterms. If the elections are free and fair, it looks like the Democrats will flip the house and maybe the senate. But I’m not holding my breath that a Democratic majority is going to start actually producing legislation of significant benefit. They are just as beholden to money as the Republicans.

It seems fairly clear that Hegseth and Trump, with their ill advised war and clearance of decades of experience from the Pentagon in the name of ideology, have seriously damaged the US military. An enormous number of individuals with experience in logistics and supply have been relieved of duty as they aren’t MAGA warrior enough. Unfortunately, as Call of Duty has no quartermaster mode of gameplay, there is minimal understanding at the top that an army and a navy march and sail on their stomachs and without adequate and continuous supply lines, you’re screwed. I have enough connections into active duty to hear the real scoop and it isn’t pretty. When the Abraham Lincoln finally docks, thousands of misstreated sailors are going to start talking to their buddies and there will be wholesale deenlistments due to poor morale – not exactaly what is needed at the moment. Not to mention the billions of dollars in wasted munitions, now unavailable for defense and a hold up on new fleet as a president with no military experience demands a redesign on ships to align with his personal aesthetics.

The Department of Homeland Security has gotten smarter. After Minneapolis where their heavy handed and murderous tactics gathered nothing but bad press and the turning of the population against ICE, they have spread the wealth. They are now rounding up more immigrants than ever, many of them who have come here legally and obeyed every rule, to the tune of 50,000 a month. Got to keep those private detention centers full and the payments to GEO group flowing. Each story out of detention or in the community gets worse. Subhuman treatment. Lack of medical care. Inedible food. Physical tackling of American citizens on the street due to misidentification without so much as an apology. As a society, by not demanding that this end, we are all complicit and the true stories of what goes on behind those closed doors will eventually come out and we will all share in the guilt. Now ICE is getting some sort of fancy shock gloves. I’m just waiting for the tales of induced cardiac arrest on the street of people who were in the wrong place at the wrong time.

My fall is looking relatively quiescent. I have nothing performance on my calendar until the Messiah in December. That may change. It often does. If it doesn’t, more time to get caught up on the projects mentioned above. I do have three trips scheduled – Seattle in September (how Music Man), Eastern Europe in October, and Mexico in November. Travelogues forthcoming. In the meantime, off to my matinee.

Sometimes the gods of the theatre smile and make sure that everything turns out all right. Sometimes they don’t. Fortunately, The Tempest received the blessings of the former. Our first tech run on Monday was semi-disastrous. First dress on Tuesday was an improvement but still marred by some unfinished costumes and a couple of missing cast members. Final dress on Wednesday, was another leap forward with pretty much everything in place but with a few scenes still shaky due to folk being uncertain of line sequence (and I saw a few notecards out on stage…) Opening Thursday – every performance was in place. Any lines that were dropped were covered seamlessly and would only be noticed by a scholar following along with a transcript. The complex staging scenes were executed the way I envisioned. Audiences over the first three performances have thoroughly enjoyed by somewhat goofy Polynesian fantasy take on the material and have been very complimentary. A few whom I trust and who know Shakespeare well have said I have taken a play that is difficult to stage and sell to a modern audience and made it an enjoyable two and a half hours. Full of enough spectacle and color, even on our teeny tiny budget to keep people engaged even when they aren’t completely sure of the language. I take that as meaning I did my job. If you’re in the greater Birmingham area, you can catch tomorrow’s matinee or one of four performances next weekend.

A few people are talking about what should we do for Summer Shakespeare next year. I do not plan to direct. The production will coincide with my retirement so I have no idea what I’m going to be up to at that point. Possibly off on an around the world cruise. Or maybe locked in a cabin somewhere with a bottle of gin, some Judy Garland records, and a packet of razor blades. If I were to do another, I think I would like to do Twelfth Night but it’s time to let someone else take the reins. Actually, what I would really like to do is King Lear but we’re not ready for that one.

There were various issues getting through the last week. We had to cut the hazer after it set off the fire alarm in the middle of Act I during first tech. The tech crew will have to experiment with it some and with ventilation before we bring that out again. There was a case of Covid (it has not spread). Compared to last year when we were battling a light system that completely stopped working and a car accident that kept us from having any costumes for dress rehearsal, it was a piece of cake. I spent the whole week channeling Geoffrey Rush in Shakespeare in Love. Maybe I was on to something.

I’ve been living with The Tempest for about three months now and I’m still not completely sure what it’s about. Perhaps it’s why I love Shakespeare so much. Four hundred years later and we still haven’t completely penetrated all of his secrets and meanings. And has anyone understood the complexities, the joy, the terror, and the opacity of human life as well as he? I always do a bit of reflecting on how the play I am working on reflects current events and what society is up to today. Prospero is an autocrat. He deliberately and wilfully manipulates all of the other characters in the play for his own ends. His population is small but he places each of them in a place where they, in general get what they want.

My first thought was that Prospero is a Trump figure but then I realized something. Trump’s autocratic impulses are about one person and one person only. Prospero’s are not. At the end of the play, he has his rightful place as Duke of Milan but he has lost his powers, his daughter, and his servants so that they can fulfill their proper destinies. And he is OK with that and comes to terms with it in his famous epilogue. He is the anti-Trump. Using powerful means for selfless rather than selfish ends. It’s the underlying arc of the story of Jesus, Obi-Wan Kenobi, and Harry Potter vs Vodemort, a powerful Jungian myth which keeps cropping up in cultural tales as it’s what we know is necessary for the betterment of society as a whole.

I wrestled a whole lot with trying to figure out who are Ariel and the spirits and who is Caliban and Sycorax, his mother (a character frequently mentioned in the original but never seen) – I put her on stage as I had just the right actress at age 87 to provide a balance of old earth magic and age and wisdom against Prospero’s learning and empiricism. I wanted to leave the audience understanding that Prospero is not the sole center of power, but part of a larger cosmos which we may not yet fully understand. It also helps humanize Caliban. I must admit I was a bit goofy with the spirits giving them hakas and hulas and the all spirit kazoo band. It’s not the tack I would have taken if I had a larger budget but many of my ideas had to be constantly adjusted based on technical capabilities and what performers could handle. I’m a fairly fast and flexible thinker and my mantra of taking the simplest solution to problems as we put the production together ended up serving everything well.

I’m tired. Not only have I been Tempest tossed, I’ve also been helping a number of friends through life meltdowns and mental health crises. I think everything is calming down but I feel in need of a glass of wine, bad television and hiding away from the world for a few days. I can feel my brain getting older and more rigid and less able to absorb everything that is tossed at it these days. I’m just hoping it’s not the first fingers of my mother’s genetic dementia crawling along my cerebral cortex.

The tech period for The Tempest begins tomorrow. I’m trying something different this year. A dry tech without the cast to try and get all of the tech elements right so that we have a prayer of getting through everything at first tech on Monday night. IF I’ve done my job right over the last six weeks, things will go incredibly smoothly between now and Thursday. But then again, I thought I had done my job right last year and our tech period was one major disaster after another. The elements are ll there for an enjoyable show. We shall see if they gel. I have my Geoffrey Rush Shakespeare in Love hat on and am waddling around thinking ‘It will all be all right – it’s magic’. Given that it’s a play about magic. I’m hoping for some good karma. For those of you in the Birmingham area, head on out to East Lake Methodist next weekend or the one after; you can get tickets on line or at the door.

As I peruse the political news of the last week or so, Peter Allen’s song ‘Everything Old is New Again’ keeps running through my head as the administration keeps running out retreads of its greatest hits in some sort of vain attempt to distract the American public from the abject political and moral failures they’ve managed to achieve over the last year and a half. They seem bound and determined to somehow overturn an election that happened six years ago without any real evidence that’s been disputed and litigated multiple times through multiple courts. They seem bound and determined to bring back the McCarthy era smears of ‘communism’ that we moved past some seventy years ago. I suppse it makes a certain amount of sense when one considers that one of the chief mentors of the current president back in the day was Roy Cohn. For my younger readers, if you don’t know what that particularly odious figure was, google him and find out. Then there’s the spectacle of Jeanne Pirro and the DOJ trying to extricate itself from the laughable case of the Olympian and the reflecting pool. I hope bar associations are taking note and that plaintiff firms are starting to line up clients.

And, of course, the piece de resistance, was the attempt to crucify the 85 year old Anthony Fauci on live television through a perjury trap that he deftly avoided by remaining mum on all subjects behind the fifth amendment. For all the keyboard warriors out there claiming that taking the fifth is an admission of guilt, take a look at Trump’s depositions in 2022 regarding his business practices. The current regime has moved on from trying to rewrite the modern history of the insurrection into some sort of rowdy picnic into trying to completely rewrite the history of the pandemic. Now I know a thing or two about the history of the pandemic, having written roughly 900 pages about it as it was happening so I remember what actually happened pretty well. (If you need refereshing, The Accidental Plague Diaries Volumes 1-3 are still available).

Our current leading candidate for governor (presuming he isn’t 86d for not meeting the constitutional requirement for Alabama residency) was running around demanding Dr. Fauci be prosecuted for murder as vaccines killed nine million Americans. I did some quick searching regarding death certificates and found that during the pandemic period when vaccine was available (December 2020-December 2022) the total number of deaths in the US from all causes was only about seven million so every heart attack, every cancer, every car accident, every drowning, every suicide and every other death during that period must have been caused by vaccine, plus the other two million folks that never got a death certificate.

As a reminder, covid, during the pandemic, killed about 1.25 million Americans. That was roughly one in three hundred people. The total number of cases of possible vaccine injury death verified through authorities and not some story somebody heard from their neighbor’s chiropractor was, according to some sources 55. That’s out of some 650 plus million doses of vaccine administered in the pandemic. 0.33% chance of covid death vs 0.000000085% chance of vaccine injury death – you decide.

The blatant falsehoods and shear ignorance of normal practice of population protection in the face of pandemic infectious disease, protocols arrived at over centuries of human experience that have been burning up the back channels of social media this past week are disgusting and incredibly disrespectful to the families who lost loved ones, the healthcare workers who sacrificed their physical and mental health, and everyone that did their part out of a sense of shared community. Was Dr. Fauci perfect? Of course not, he’s human. Did he do a good job given the information he had and what the science told him? I believe so. But much of what he treid to do was sidelined and politicized until after the change in administration in January of 2021, nearly a year into the pandemic. While he was being ignored and vilified stateside, other countries did listen to him and his recommendations and took them seriously. Most of them had much lower casualty rates than we did. Credit where credit is due. The vaccine, which arrived in record time and helped break the back on transmission was produced under the first Trump administration.

For an in group to coalesce and feel good about themselves, they must have an out group on whom to project all of their anxieties and fears. And we have a lot of of those left collectively after the pandemic which I don’t think we’ve really properly dealt with as a society. So that fear becomes anger and cynical leaders turn it on convenient targets for deflection and other political purposes. And, in terms of public health, what has it gotten us? 20% of the employees of the Department of Health and Human Services have been fired. Measles, a disease that was considered eradicated, has come sweeping back with more cases so far in 2026 than from 2000-2025 combined. Foodborne illnesses are on the rise. Babies are bleeding to death as vaccine contrarianism has risen to such a point that parents are refusing to allow their newborns a routine Vitamin K shot to help their clotting factors work properly.

Those of us who work in clinical health care, caught between a corporate mentality that puts profit ahead of patients and a patient population that is increasingly rejecting medicine and science in favor of magical thinking beliefs and a complete misunderstanding of what medicine can and cannot do, are heading for the exits. As I look around, few of my generation are still working and those that are all have their exits mapped out (me included). I really have to get back to work on the new book that lays out some of the coming implosion in the system because as more and more crazy things become commonplace, I think it’s going to be a lot more spectacular than I was originally imagining. I’ve decided I don’t want to be at ground zero, but rather on the periphery sipping a cocktail.

I went to see Christopher Nolan’s new film version of The Odyssey last night. As it was shot on IMAX cameras for IMAX presentation, I decided that was the proper way to see it. Fortunately, the McWane Center, Birmingham’s children’s science museum, has a proper IMAX theater with the huge curved dome screen and it occasionally plays the summer blockbusters so I invited a friend to dinner and a movie. He had never been to the IMAX before. We’re suffering through the outer bands of tropical storm Bertha this weekend with fits of rain and occasional gusts of wind so a night in at the movies seemed just the ticket.

I was very impressed with the film and it takes its place, in my mind with some of the other classic Hollywood epics that are about a good deal more than they’re about such as David Lean’s Lawrence of Arabia and Peter Jackson’s The Lord of the Rings. I don’t think it should be taken as a straight forward adaptation of the Homeric epic that’s been around for three thousand years. When you do that you get caught up in the minutia as to whether this costume is historically accurate or whether that actor looks like what that historical figure might have actually looked like. It’s silly to do that. The collapse of the Bronze Age Mycenaean civilization (which is the background of The Iliad and The Odyssey) was true enough but the legendary stories of the men, women, and gods of that time have little to ground them in historical fact. I think it’s best to think of the film as an interpretation of a legend for a 21st century film audience and just accept it as what it is.

Nolan gives us a non-linear narrative telling of the story through various unreliable narrators making it impossible to know the objective truth. In the liminal spaces of the story, magic can exist and we can believe in the gods such as Zeus and Poseidon manifesting themselves through natural phenomena. The sea, in particular, varying from an inviting blue to a threatening gray, to a deady black is as much a character as any human. The only one of the gods who takes on human form is Athena, but as the film develops, it becomes clear, that she may simply be a personification of Odysseus’ guilt has he grapples with the heinous transgression against men and gods he created with the Trojan Horse.

Using a cast of fine actors, many of whom were at their idyllic cinematic peak some decades ago, we get worn lived in bodies, etched with time and grief and not the perfect physiques of sword and sandals epics of days past. Nolan splits the long running time of the film (which never drags and earns every minute) between Odysseus (Matt Damon) trying to return home and long delayed by Calypso (Charlize Theron) and events on his home isle of Ithaca where his Queen Penelope (Anne Hathaway) and son Telemachus (Tom Holland) try to keep order in his long absence while their home is continuously invaded by suitors for Penelope’s hand which would confer the Kingship.

The film’s script was written predominantly in 2024, prior to our most recent change in administration, with principal photography beginning in February of 2025, shortly after Trump took power. The theme that is introduced early in the film is that the most fundamental ethical and moral tenet of the society is Xenia, the law of Zeus. Welcome the stranger and treat them as you would wish to be treated. It’s sort of a Mycenaean variation of the Golden Rule which found it’s way into Christianity via Jewish scripture (composed at roughly the same time as Homer) and which also existed in other Mediterranean cultures and religions of the period. Hospitality was everything. In a world where journeys were terrifying and potentially deadly, depending on the kindness of strangers was everything. Odysseus’ trick with the horse shatters this precept and we are left by the end of the film to contemplate what will happen to a society which drifts so far from its ethical roots.

We have been doing the same thing in modern society. America was built and grew great on pluralism and assimilation and allowing anyone who wished to come and share in our society and values to come and prosper. We have spent four hundred years welcoming the stranger, not always perfectly, but with movement after movement towards a more perfect union. And now we are trying to tear it apart. The Trump administration is accelerating this but I have a feeling that even had the Democrats won the last election, we would still be seeing these deep seated trends. Rather than welcome the stranger, we are making them disappear from our streets through paramilitary personnel and fear. We are creating spaces not fit for livestock where they are confined and enriching people for doing so. The administration si trying to make the parts of history that tell stories of people unlike the mainstream disappear from museums and public record. In the name of anti-wokeness, the ability of hearing and learning from other perspectives is being curbed.

Somewhere in our military, there is a mind as brilliant as Odysseus’ who is busy creating a plan to end the current conflict in Iran. will the plan be a war crime? Will the blowback from it create confusion and moral uncertainty in our already weakened society? Will the leaders of our military, people who seem to think that injecting the troops with dangerous drugs in an attempt to make them more ‘masculine’ is a swell idea activate something from which we cannot turn back or recover? As I was watching the sack of Troy unfold on film, I coud not help but think about men hyped up on testosterone and amphetamines and the casual destruction of innocence that guarantees. They want to create a primal warrior. Are they ready for what happens when that primal brain is unleashed? It’s likely already happening behind the closed doors of ICE facilities. I have a feeling that when all of the truth comes out about ICE, Epstein, Iran, the current administration, all of it. That we will all need to atone.

It’s been a week full of life’s little mysteries. Like why are two of the bathmats from my master bath suddenly missing. And just whose unit above mine leaked water down the pipe alley flooding my utility closet and causing the parquet tiles in the hall to buckle and warp yet again. And why do the cats insist on peeing on any laundry accidentally left on the floor. And how can supposedly competent and educated adults employed by our federal goverment make such idiotic pronouncements on a daily basis.

We are now four weeks into The Tempest rehearsal and have three left to go. The show is staged and the scenes all have their arcs and necessary dramatic shape. Now comes the stitching of all of the pieces together. I have ten rehearsal hours to accomplish that task before we try running the whole thing and see what we’ve got. For the most part, the process has been relatively smooth. I wish people were further ahead on their lines than they are as it’s really hard to judge a performance when the actor’s face is buried in the book. I lost an actor this weekend to another commitment (the joys of community theater) but fortunately, I was expecting something like this to happen and had a secret plan B up my sleeve for dealing with it. All departments seem to have a grasp on what I’m hoping to achieve and seem to be moing towards the finish line with despatch. I’m sure I’ve forgotten some major detail but I’m pretty adept at creative problem solving on the fly. I’ve told the cast and staff that my mantra for the next two weeks is ‘simpler and cleaner’. Whatver the problem, we’re going to take the simplest and easiest path forward.

I was reading an article yesterday on the future of health care in the US and was struck by a statistic that I had not seen before. Somewhere between 10-12% of US physicians will leave the profession before the age of 50. In earlier generations, this was unheard of. Medicine, as much a calling like the priesthood as a profession, was something not to be entered into lightly as you would be spending your working life in a single track. Given that it takes anywhere from seven to twelve years after college to become proficient in a specialty, you aren’t ready to be turned lose until your thirties. Personally, it took me a total of 26 years of education from Kindergarten to completion of my geriatrics fellowship. After that kind of investment, you kind of want and need to stick around. I have. When I retire next year, it will be after 34 years of clinnical faculty positions.

This statistic does not bode well for our future. There is a significant shortage of physicians in this country, especially in primary care fields. (The educational system and the money is all tilted towards subspecialty care). We’ve been able to balance the numbers in recent decades by importing medical trainees and physicians from other countries and they have filled the gaps by taking jobs that US graduates have little interest in, especially in small town and rural America. The current administration, with its anti-immigrant stance, is trying to slam the door on this practice by rewriting the rules. The most recent one is to limit foreign students to four years to complete their course of study. Fine for a Bachelor’s degree or even an MD, but residency/fellowship training is ofen years longer than that

Covid did a number on the health care system. 20% of those working in clinical health positions in 2019 no longer do so. The older generation retired due to the stresses and strains of that period. Younger people reevaluated their lives. For the most part, the physicians soldiered on but now, five years later, things are beginning to fall apart. A profession that had minimal attrition is now due to lose 10% of the providers who should be in their most productive years.

Why are younger physicians leaving? It apparently boils down to four things which anyone who has been employed in health care over the last few decades could easily identify. The first is the hassle factor. Clinicians no longer run the healthcare system. Administrators do. There is a fundamental difference between the training and the thought process of the two. The shift to corporatization means that processes are put in place to benefit the C suite, not the boots on the ground. Healthcare now operates like any other big business, manufacturing patient encounters rather than widgets. Things like the electronic medical record, supposedly for patients and providers, is really designed for administrative tasks and is simply forced into a clinical role. My first job at age fifteen was as a data entry clerk. I have come full circle.

The second is the stress of the job. We spend our days with people on what is often the worst day of their life and we do that every work day, day in and day out. I’m lucky.. Some of my life experienes have given me a large pool of resilence and coping that most human beings don’t get. I have no idea where I would be if that were not true. The stress of the job places great strains on marriages and family relationships. And there is a culture in medicine that says you should be tough enough to take it and they should never see you sweat, much less cry. It’s no wonder the suicide rate in the profession is as high as it is.

The third is the unrealistic expectations of patients and their families. And let me tell you, honey chile we ain’t seen nothin’ yet as this is going to get exponentially worse as the Baby Boom enters its senior years en masse. It’s everything from the refusal of families to accept that their ninetysomething year old relatives will inevitably get sick and die to the people who want to spend hours discussing the research they did with Dr. Google on some spurious website to battles over the correct use of medication to the amount of anger displayed by people having to wait for service. I developed a technique for coping with most of this years ago. I tell patients that I am there to give them expert advice. They can take it or leave it. i don’t go home with them and I don’t run their lives. If they don’t take it or they do the opposite and end up making things worse, I don’t lecture or blame. I just keep moving forward with them. I’m their partner, not their nanny.

The last is a lack of satisfaction with the job. This probably flows from all of the above. Personally, I’m quite satisfied with the job. I enjoy what I do as it suits me so well. My favorite definition of geriatric medicine is ‘creative solutions to unsolveable problems’ and that’s my sweet spot as a person and personality type. If I just had to take care of my patients, I would probably stick around another decade, but the same things that are driving out the young uns are operating in my professional life as well and so I hang up my shingle next year and work on other things.

Yes, I’ve been following the national news. I give up when I read things like the administration wants to punish Canada as smoke from Canadian wildfires is crossing the border and leading to increased air pollution. Last I looked, weather patterns, airflow, and the physics of particulates was not under the control of any particular political apparatus. Where do they find these people who go on national media and make these hare brained statements. Unfortunately, the media, through tis corporate ownership which wants to play nicey-nice with power, finds itself in a position where it seems unable to call out idiocy as being idiocy. I don’t mind doing it for them.

It’s late. I’m going to bed.

I woke up this morning to the news that Senator Lindsey Graham of South Carolina had died suddenly last night. And to speculations of a nefarious assassination due to his recent trip to the Ukraine. Occam’s razor suggests to me that his death was natural causes brought on by an age over seventy, a long history of excess alcohol use (ask any bartender in Charleston), and the inner demons and self loathing that must have eaten away at his soul given his status as a closeted gay man actively working at all opportunities against gay rights and for his abandonment of everything he originally stood for in politics for short term political expediency and a place in the White House inner circle. I’m sure there are people out there who loved and cared about him but I imagine those are far outweighed by those who viewed him and his choices with loathing and opprobrium. You can’t please all of the people all of the time but pissing off the many to please the one for callous political considerations has never been a goal of mine.

This event, of course, changes political calculus going into the midterms, especially since Mitch McConnell seems to have joined the cat inside Schrodinger’s box. All evidence points to McConnell being either dead dead or brain dead but with vital signs making him technically alive. You would think a good investigative reporter could clear it up with a couple of phone calls but the administration and DOJ’s heavy hand on the first amendment in recent months seems to have cowed that branch of journalism into submission. When I was a resident, Racquel Welch checked into UC Davis Medical Center for a surgical procedure so as to be away from the prying eyes of LA. Everyone on staff knew she was there, what room she was in and why within twenty-four hours. And this was a time before cell phones and instant electronic communications. I can guarantee you that pretty much everyone on staff at whatever hospital McConnell is purported to be at knows something.

I haven’t a clue how the midterms will go. It will depend entirely on turnout. If the population gets off their butts and goes to the polls, the Republicans are likely to be routed in the house and just might lose the senate as well. But the Democrats, as an organized body, have a long history of snatching defeat from the jaws of victory through a combination of internecine strife, over reliance on purity tests, and the placing of party standing over electibility. Will the administration try to monkey with the election? They’re already trying and, if there are some more negative monkey wrenches thrown their way, they’re likely to double down. Everything from the SAVE act, which will disenfranchise millions to fix the statistically non-existent problem of undocumented people voting (even the Heritage foundation could only track down fewer than 100 cases by combing through every national election since the Reagan administration), to the vacationg of the Federal Election Commission (thank you SCOTUS for granting the presidency that power) so that there is no functional federal agency to make sure elections happen on the up and up, to the weaponizing of DOJ to go after local election officials.

The administration is also busy firing on the 1st amendment with DOJ issuing subpoenas to reporters who printed a relatively inoffensive story about Trump’s gold plated Qatari jet and how it did not have all the defensive capabilities of the older Air Force One planes. This dissing of his pet vehicle irked Trump so much that he’s determined to find out who gave the reporters that information and is using DOJ to try and get them to reveal their sources to a grand jury, completely against journalistic ethics and constitutional protections. But then again, the only amendment that appears to be sacrosanct to these guys is the second.

After destroying the East Wing and the South Lawn, the administration appears to have started on the North portico. No one really knows what’s going on underneath the tarp but I imagine the ionic columns will reappear as corinthian, likely with gilding as well. The conspiracy theorists have been running amok with stories about new fortifications so that the administration cannot be removed come January 20, 2029. I’m not inclined to believe these as of yet but, once again, I wonder at the lack of investigative journalists asking the workmen what they are doing from day to day. I’m sure they’ve all been forced to sign NDAs but a couple of drinks usually gets around those. The administration has also confused the National Guard with the Praetorian Guard and ordered them to remain on duty in DC through the date of the next inauguration.

So where are we all headed and why are we in a handbasket? I wish I knew. I’m just trying to keep my head down and make it through my projected retirement date at which time, if I so choose, I can isolate myself in my condo and ignore the outside world. Knowing me, that’s unlikely to happen. We have three basic paths to follow over the remainder of my lifespan. The first is the path of fire. The divides infecting politics and the economy spill out into the streets and eventually into military action leading to civil war. Our wealth inequality is greater than the conditions that brought about the French revolution and one could draw parallels to the conditions before the Russian Revolution as well. The second is the path of ice. The federal government ossifies and becomes more and more ineffective. We’re already seeing this in the legislative branch which has, for the most part, has ceased to function in terms of doing the will of the people. The end result of this becomes the Medieval papcy or the World War I era Austro-Hungarian empire. The last is the path of resetting the balance. We’ve done this before. We were in similar times from about 1885-1930 and the reforms of the Progressive era and later the New Deal moved power away from capital and back towards the people keeping either of the other futures from happening and creating postwar America which became the envy of the world. We’ve been busy dismantling that piece by piece for the last fifty years. Those who are proposing a restructuing in that way are being branded as communists (as if the people throwing that term around actually know what it means).

I’m all for capitalism (it’s treated me well) but I strongly believe that it has to be monitored and managed or else, as in Monopoly, one player ends up with all the money and everyone else ends up broke. And that’s no way to run a successful society. Put money back into the commons and get the profit motive out of the sectors of the economy in which it doesn’t belong – healthcare, education, corrections. And let younger generations have their place at the table and bring new ideas and new ways of doing things. The gerontocracy in DC is not healthy for either those participating or the country as a whole. Just because we can now live into our eighties does not mean that we have the bodies and brains of thirty and forty year olds at that age. Take it from the geriatrician