July 11, 2020

Line forming for Virus of the Caribbean

We’re up over 70,000 new diagnoses daily in this country, more than 130,000 are dead, hospitals in multiple states are running out of ICU beds, and Walt Disney World decides it’s a great time to reopen. Must be time for another entry in the Accidental Plague Diaries. I’m in a bit better mood than i was when I wrote my last missive. That was a low point. I’m not sure what refreshed my soul. Maybe my once a month trip to Target for supplies (100% masks on patrons and employees), maybe having appointments with a couple of my favorite patients over the last few days, maybe memories of Tommy and Steve. Today would have been mine and Tommy’s sixth legal anniversary. We didn’t use the date as we’d been together for nearly twelve years when we did get married. That was simply a formality for taxes and insurance.

Tommy and Andy go to criminal court

Prior to the Obergefell decision of 2015, marriage laws were something of a patchwork in this country but the Windsor decision of 2013 decreed that, at least for federal purposes, a legal marriage in any state would be recognized by the federal government. Tommy and I looked at our taxes and things and decided that marriage would be advantageous. We decided that we didn’t want a wedding. We were a decade or more too late for that and there was the issue of Alabama dragging its feet for state purposes so we decided, on our next trip to Seattle to visit the family, we would do the deed. I contacted my old friend Kanti Carolyn Ramamurti, an attorney in Seattle and she put us in touch with a judge who was willing to marry us so one July afternoon, we trekked down to the King County Criminal Court in Redmond along with my father, brother, and cousin Jenny for witnesses and said our ‘I dos’ in front of the power vested by the state of Washington right after she was done with the Grand Theft Auto case that dragged on a bit longer than anyone expected. That was followed by a dinner for family and friends in my sister’s back yard. Tommy felt that even that was too much hoopla but I expect he secretly enjoyed it. On the flight back to Alabama, our marriage dissolved and reformed several times depending on which state we were flying over and was not recognized when we returned home, but we were able to file a joint tax return that year and a year later, with Obergefell, remained married no matter what the flight path.

Our marriage was, of course, cut short by Tommy’s untimely death four years later but it was valid and made a huge difference in our lives in regards to dealing with various institutions. It allowed me to put him on my benefits without question, it helped at tax time, it announced to the world we weren’t giving up on each other (although everybody had already figured that one out), and it changed how we related to each other in some subtle but real ways. We both knew that leaving each other would now require a lot more than packing a suitcase and walking out the door and there was more strength to the bond when we had our fights (and believe me, we had some doozies). Most importantly, I think, was we understood that we were riding a wave of societal change forward. We had no idea where it was going to lead us, but we knew that there would be no turning back and that things would always be different.

I think one of the fundamental flaws of American culture, and I wonder if it’s descended from the Boomer ideal of how the media depiction of America prevalent in their childhood – the Leave it to Beaver and Sally, Dick and Jane world of perfection and safety – is some sort of quintessence that must be recaptured at all costs, is its rose colored nostalgia that causes people to look backwards rather than forwards. When applied to the current time of Covid-19, we all run around talking about things getting back to normal or things being all over. Honestly, we have no way of knowing if that is going to be possible and, even if the virus were to fall silent tomorrow, we wouldn’t be able to go back to where we were last fall. There’s been too much radical change to allow that. It’s the old You Can’t Go Home Again phenomenon.

I’m hoping that some of our brighter thinkers (and I do not count myself among that group) can start giving us ways to start thinking about moving forward to what can be rather than pining for what is no longer and can help us redirect our energies in that way. Our education system, for instance, was borrowed from Prussia in the mid 19th century and was designed to create an obeisant proletariat of workers and soldiers. Regimented, full of an unwritten curriculum of obedience to authority, subject to the tyranny of the clock (hungry? too bad – you can’t eat until the bell rings). We no longer live in that world. Perhaps this can be a time where we can take the underpinnings of the system and reinvent something for who we are in the 21st century, nearly 200 years later. We are the wealthiest society that the planet has ever produced and where does an enormous amount of our treasure go? Defense systems far above and beyond what are needed. Can some of that be redirected? Our health system is tied to employment due to mid 20th century historical accident. What are the possibilities there?

Follies girls and their ghosts – Original Broadway Cast

Living in the past with backwards thinking is toxic and corrosive and will set you up for failure. Being the show queen that I am, and having been primed with several viewings of Hamilton, I went to my CD collection and to the Sondheim rack where I tend to find a lot of life’s answers. I put on the Original Cast Album of Follies, a show that is about the dangers of living in the past, trying to stop time, and refusing to recognize that either you or the world has changed. That title is a double edged sword. It may be about the ghosts of the between the wars young adults and their mature 1970s selves but the same phenomenon is happening today, especially with the boom. How many Boomer icons in their 70s and 80s are trying to project the same image they have for the last fifty years? In my job, I see so many people in their 70s to whom I have to break it that their disease processes are chronic and not curable due to the ravages of time who simply refuse to accept it. Our two candidates for president are 74 and 77. Could this be the moment that we can move forward with a cultural reset and where younger artists with a new way of looking at the world get their chance to lead us in new directions?

I’m thinking that our sclerotic, if not downright fossilized social institutions are cracking under the strain of Covid and that may not necessarily be a bad thing, as long as the energy is channeled in positive directions. If it goes negative… well let’s just hope we avoid 1793 France or 1918 Russia.

Time to change the CD. Switching from Follies to Merrily We Roll Along, a caustic look at where the Boomers went wrong in middle age. Seems somewhat fitting, doesn’t it. I am allowed to criticize the Boomers, I am one, although at the very tail end of the generation.

In the meantime, wash your hands, wear your mask, and stay home when you can.

July 7, 2020

Thunderstorms over Birmingham

I came home from work this evening about 5:30, sat down on the couch, and found myself incapable of moving for about two hours. That’s become a fairly common pattern. About twice a week I get in from the day, feeling pretty normal, and then like someone stuck a pin into my balloon, I feel drained of all energy and can’t do much besides stare out the window (thunderstorms and rain today) and wait for my faculties to return. I assume it’s my personal physiologic reaction to the never ending Covid stress that we’re all living in. At least those of us who work in health care and are paying attention are living in. A significant portion of the population seems to be running around as if nothing has changed and that we aren’t living in a very different world than we were living in last year.

The local counts continue to rise. My hospital has over 90 inpatients with Covid (we were running 60-70 at the height of the early pandemic in March/April) and we’ve increased by over 50% in a week and a half. The numbers in surrounding Southern states are absolutely appalling with more than 10,000 cases a day becoming the norm in Florida and Texas with their large populations and relatively dense cities. The stories are spreading among medical professionals of overfull ICUs, patients being sent to other cities or even out of state for treatment, absolute exhaustion on the part of medical personnel, shortages of protective equipment and all the other logistical nightmares that have been reported in New York and elsewhere in the world. There hasn’t been much reportage on this – the powers that be (and the media that decides what we will hear and what we will not hear is very much part of that) has decided that a narrative of economic recovery is more important than one of personal safety. People have lost out to profits in our late stage capitalism enterprise.

There’s a lot of speculation as to why the death toll has not spiked in the same way as case numbers. Some may be due to changes in testing, some may be due to a shift in infections away from older populations who are taking greater precautions to younger populations who are not and that those younger populations are less likely to become seriously ill. (It is true that younger people in general, as they have healthier bodies with less chronic disease burden are less likely to be seriously affected but this malevolent disease that we do not yet fully understand makes a certain percentage of young and healthy people with no appreciable health problems deathly ill and appears to leave those that survive with chronic issues that may take months or years to resolve, if ever). But no matter what, every single infection is conceivably preventable with proper public health measures that we as a society are completely unwilling to take.

This spring’s lockdown was never about eradicating the virus and returning to normalcy. It was about buying time for the government and the public health system to put appropriate programs in place that would curb the spread over time so that we would eventually all be able to return to a semblance of normal. Most of the developed Asian countries and soon, the European Union, have done this and are heading back to normal economies and societal function. Our dysfunctional federal government has adopted a strategy of ‘live with it’ and pushed public health measures back to the states. The states, already cash strapped and unable to mount national responses are dealing in myriad different ways, most of which are unsuccessful and pushing down to the county and city level. The population, which needs strong leadership in an emergency and which will be able to pull together if clearly shown what the problem is and a road towards a solution, gets multiple conflicting messages and tunes out and goes to the mall with dinner at Applebees to follow. The end result in my life is a constant low level of exhaustion with no end in sight and no ability to take part in the activities I’ve always used to rejuvenate myself and I end up staring out the window for hours.

We’ve got some huge societal dilemmas coming up over the next year or so which are independent of current partisan politics or who occupies the White House. The first is the question of education. The vast majority of American families depend economically on two incomes which requires both parents to work. This means schools must be open and in loco parentis during usual business hours. Children gathered together in groups are highly unlikely to keep social distancing, proper hygiene or masks in place. The majority of veteran teachers are of an age to be in a higher risk group. If we send kids to school, how do we keep them safe? How do we keep teachers and staff safe? If Covid starts to spread in a school do we shut it down? What to do with everyone for quarantine periods? When veteran teachers decide to put their health ahead of their careers and take early retirement, how do we replace that lost experience? How do we deal with the extracurriculars which are sometimes the only things that will keep at risk kids in school? In higher education, where on line education is a little more feasible in certain subjects, what do you do with practicums like chemistry labs? What do we do about federal policies about students on visas not allowing them to remain in the country if their classes are on line? (A move that is going to decimate graduate and research programs nationwide – the US University system is one of the shining jewels in our culture and I can’t think of anything that could be done to destroy it more quickly than this particular piece of idiocy. Destroy the universities because of their perceived ‘liberalism’ and we will rapidly fall behind the rest of the world in science and innovation. It’s happened before. Look what happened to the research institutions of central Europe after the Nazis rose to power. They never fully recovered.)

I’ve certainly considered early retirement myself as it’s become clear that neither my state or federal government cares much about the safety of me and my colleagues or the stress that we’re being put through at the moment. If they did, they’d be paying more attention to the public health system (as underfunded as it is) and a little less attention to the chamber of commerce. If I were a few years older, I likely would, but in looking at all my options, I plan to keep soldiering on for a few years more. I’ll continue to hold up my little corner of the health care system and hope that things get better and maybe, just maybe the cavalry will eventually show up and give me and mine a little respite. I’m being a little unfair. Part of my job is with the Birmingham VA and they are bending over backwards to protect clinical staff as much as they can. I’m not high enough up the food chain to know what really happens in the C suite but they really are trying their best in a crazy and ever changing situation. Not every experienced health care provider is going to want to continue to work under these conditions. How do we replace them? We’ve been importing doctors to the US for years as US medical schools haven’t been able to produce enough to meet demand. If we become more cut off from the rest of the world and unfriendly to immigrants, where are we going to get people to replace them?

The right wing has been sending us down a path of isolationism for the last few years with their chants of build a wall etc. etc. The business community understands that, in this day of global economies and multinational corporations, that this has been relatively silly rhetoric that keeps the masses distracted while their pockets are picked. However, our complete failure to respond appropriately to the pandemic may lead the rest of the world to wall us off anyway, at least until we’re no longer seen as dangerous. Be careful for what you wish, for you may get it. I see advertisements for inexpensive international travel cropping up for late fall or winter and I can’t help but think that will never happen. We think it’s bad now. What happens when the usual flu season coincides with the pandemic with no adequate responses in place? I wouldn’t plan that trip to Paris quite yet.

Usually I’m relatively optimistic in these, my accidental plague diaries. I’m feeling pessimistic this evening. Maybe it was that two hours of staring out the window at the rain. Maybe it’s the life circumstance to have to go through this alone. Maybe the Smoothie King lunch I drank isn’t agreeing.

Wash your hands. Wear your mask. Use common sense.

July 4, 2020

High above the Rhine at the Neiderwald – Rudisheim and Bingen – one year ago

I dream a lot. Generally, they’re gone within an hour or so of getting up and getting on with the day unless I take a moment to jot them down. I’ve dream journaled off and on over the years, mainly off but I’m wondered if I should take it up again to try and make sense of all the insanity in the world today. If dreams are the ways our subconscious processes information, maybe it’s time to pay a bit more attention to them. I have a dream journal on my nightstand that Tommy gave me years ago. He inscribed it ‘Andy – For your dreams… Good or bad always remember you are in my heart. Take solace there! -Tommy’. Little things like that from the past are what allow me to keep going on the days when it all seems to be too much.

The dreams this last week have all been about travel. They’ve been somewhat variations on the actors nightmare or typical school dreams. One was about my trying to pack for an important trip and not being able to find the things I need which led to my being late to the airport, missing the flight etc. etc. One was about being in a foreign country where I did not speak the language and being lost in a crumbling palace of some sort. Then came the realization that I owned it and would never be able to afford the repairs. A third involved being trapped on a train with a lot of unpleasant people – sort of a Murder on the Orient Express without the murder.

I’m assuming I’m having travel dreams because I’m moving on. The immediate stresses of the move are over, I’m settling in and now I have to figure out who the new me is going forward. The new me was going to be defined by my two great interests outside of my professional career – music/theater and travel. Neither one of those things are currently possible and so there’s a huge void that has yet to be filled and I don’t know yet how to make those adjustments. I have projects to work on and the job gives me direction and purpose and uses up an enormous amount of energy given all the strains on health care that must be absorbed. I know it will all work itself out eventually and that patience and delayed gratification are called for (again). Still, I think I’m allowed to think back to last Fourth of July when I was floating down the Rhine and wondering when that such experiences will be possible again.

Social distancing – only for the little people

The local virus numbers are increasing as they are all across the South East. Alabama is adding a thousand new cases a day which is high for our state but only a tenth of what’s happening in Florida and Texas. I put that down to our lack of large cities. Birmingham is our largest but it’s quite small compared to the megalopolises of Atlanta or Houston or Jacksonville and, with smaller and less dense populations, we can keep numbers down, at least within our communities which will take things seriously. Alabama is not immune to the anti-mask idiocy that’s sweeping the land. It appears to be limited to communities of privilege who feel that they should be allowed to live their lives on their terms and that society is to cater to them rather than they are to cater to society. Communities of color and social outsider status who understand the importance of taking care of each other are much more likely to think of others as well as themselves. Americans seem to have forgotten that the unit of survival in human social evolution isn’t the individual or the family, it’s the tribe. We have effectively split ourselves into two tribes, eyeing each other with mutual suspicion and an unwillingness to reach out to help and that is leading to our country falling far behind the rest of the world when confronting a global threat. Those on the other side of the divide may get their dream of a wall, but it’s going to be built by the rest of the world to keep us in unless we start figuring out how to pull together, rather than apart.

Phillipa Soo in Hamilton

Like most of the rest of the theater world, I subscribed to Disney+ in order to watch the filmed version of the original production of Hamilton which is streaming for a brief time. I was fortunate enough to see the original production on Broadway (but with a different cast) a couple years ago (and those who want my reactions to that can scroll back to the fall of 2018 on the blog). Generally I don’t care for filmed versions of stage works as film and stage are such different mediums and what works for one is dull in the other. This version, as filmed by original director Thomas Kail, does as good a job as can be done to capture the energy, talent and sheer genius of the work. The addition of judicious close ups, heightening of the theatrical lighting, and the clarity of the sound allowing every word to be heard make this one a winner. Hamilton became a phenomenon in 2015-16, the end of the Obama era and now, only about five years later, watching it makes it so clear how much our civic life has changed over a very short time. I also picked up much more clearly on a couple of themes. First, while the show is called Hamilton and Alexander is the central character, the narrator, and our way into the show and our perspective comes entirely through Aaron Burr, the ultimate outsider among our critical founding fathers and the one whom we don’t remember on the coinage or the postage stamps. Second, the ultimate theme of the show, which became crystal clear in the filming, and in Phillipa Soo’s performance as Eliza Schuyler Hamilton, is that the most important thing in history is who gets to tell the story and control the narrative. For centuries, we have been taught a specific American narrative of progress and superiority and Hamilton gently reminds us that this isn’t necessarily the truth, the whole truth and nothing but the truth.

That has been my great revelation of the last few years. Telling the story is perhaps our most important function as humans. As I’ve realized this, it’s permeated all the various areas of my life. I succeed as a physician when I allow patients and families to tell their story. If I am patient and listen, there’s usually a nugget of information in their that will allow me to crack the case and figure out how I can actually help. I started writing these posts a few years ago when I came to the realization that I had a lot of stories to tell and, without Tommy, really no one to tell them to and I figured it was time to send them out into the world to see if they could touch anyone else. Its evolution into a plague diary was completely accidental and simply my attempt to trying to make sense of a crazy time in modern world history. Storytelling is, of course, essential to the whole nature of theater. I find I can do things in character that I could/would never do in my own persona.

Where do I go from here? No one knows the answer to that question. We think we do. We make our plans and then life interferes and off we go on a tangent. I’m sure something will make sense eventually and I’ll start down that road and then, as in the words of Robert Frost, way leads on to way and that has made all the difference. In the meantime, I’ll soldier on in the trenches of health care, keep up some writing, try to stay connected to the other parts of my life as best as I can, and the story goes on.

June 28, 2020

Plague in the classical world

As a student of history and prior pandemic illness, I am relatively optimistic that we will pull through this particular plague all right. We won’t be unscathed, but our understanding of infectious disease has come a long way from such ills as The Plague of Justinian, The Black Death, The Sweating Sickness, and even The Spanish Influenza (a misnomer if there ever was one as it had nothing to do with Spain, most likely originating in the farm country of the good old USA – Spain, as a neutral country in World War I was just more honest in its reportage than most everywhere else). Even though the long term prognosis for most of us as individuals is pretty good, I’m not so sure about what’s going to happen to various societal institutions.

I read the same news as everyone else (I avoid television news like the plague (so to speak) as there’s very little actual news coverage available and nothing nuanced or in depth). I try to seek out sourcing for some of the more outlandish claims and rumors and then try to digest it all and try to let my rational brain sift through it and not leap to the conclusions my intuitive brain wants me to take. Sometimes I get it right, sometimes I don’t. If any of you catch me posting something with a factual error, please point it out and I will immediately edit or take it down. I don’t get taken often, but I am human, and a rather tired one at that. Week after week grinding on through the stresses of a health care system in crisis, the move, a lack of rejuvenatory activities, and a somewhat dysthymic personality type will do that to you.

Breugel – The Triumph of Death

I’m feeling rather low at the moment as I am sure many of you are as well. Caseloads of Covid-19 are surging in my region of the country and the mostly conservative state governments seem either oblivious or hostile to the very basic public health measures that could curb this. People seem to have forgotten two basic facts. The first is that this virus takes time to fully manifest itself. The numbers we see now stem from what we were doing or not doing in May and it takes some weeks after the virus establishes itself in a population for enough people to get critically ill and the death toll follows some weeks after that. We won’t really know the mortality from the current surge until late July. Second, exponential numbers don’t work the way our linearly oriented brains think they do. Using the old example of powers of two and the metaphor of lily pads on the pond that double daily. If the pond is covered today, then yesterday the pond was only half covered, the day before only 1/4 covered and last week you would have barely noticed there were any lily pads at all. In the same way the virus is there, growing slowly, stealthily and then all of a sudden it’s everywhere.

I’m not sure if I should feel angry or sad over all the examples of American entitlement that have been running around these last few weeks. From the people delivering word salad against the use of masks at various council meetings to the people on social media complaining about poor restaurant and retail service to the pictures of people crowding into bars and onto beaches as if opening back up means that life has somehow returned to pre-Covid normalcy. The results of this willful ignorance to how infectious disease works has led to the USA, with five percent of the world’s population having twenty-five percent of the Covid cases. To the rest of the world contemplating banning travelers from the USA for the foreseeable future (which is a huge problem for my friends in the opera and theater world who depend on international gigs). To socially responsible merchants having to close their businesses to protect their staffs from inconsiderate and mindless customers. To my friends who work in the performing arts realizing that gigs won’t be back in the fall as they had hoped as society’s unwillingness to do something so simple as wear a mask is going to make it impossible to safely reopen indoor gathering spaces for some time yet. Of course all this strikes me exceedingly personally as the two things I have always done to renew my spirit are travel and theater, neither of which is possible so I really do want to reach through my computer screen sometimes and slap some folks silly for robbing me of my personal joys.

Where do we go from here? I wish I knew. There are a few scenarios that could happen. First, the virus continues to spread, we all get sick, most of us recover and we develop something akin to herd immunity. We seem to be choosing this option by default thanks to inaction on the part of our elected leaders. Of course, this option is likely to pull down the health care system as we know it and is going to lead to a lot of other collateral societal damage. And as all this is going on, the federal government is again trying to invalidate Obamacare. This, of course, will invalidate its ban on discrimination for pre-existing conditions which will, ironically enough, include Covid-19 so anyone who does get sick would essentially become uninsurable in a hypothetical future. We have no idea what the long term consequences for non-fatal cases might be and I can assure you, the health insurance industry has no interest in footing the bill for finding out. Second, the virus ravages for a while and then dies back into the background, similar to influenza and we all learn to live with it. This will likely cause some major changes in how society operates but what these will be is anybody’s guess. Third, we elect a new administration which takes its public health mission seriously and we put appropriate resources and measures in place. There will be reactionary complaints against this and it will continue to drive a wedge between red and blue America and won’t happen without additional civil unrest. Fourth, someone stumbles upon a vaccine or medical treatment which allows us to go back to usual patterns. We won’t go back to where we were in February, we’re too changed, but at least we can cling to some familiarities.

I was looking at the local statistics at Birmingham area neighborhoods. If you look at the rates of infection per population, the highest rates are not in poorer or in minority neighborhoods. The highest rates are in the moneyed white neighborhoods known collectively around here as Over the Mountain. I surmise this is due to higher collective rates of entitlement and feelings that rules and masks are for the little people. I had toyed with the idea of going someplace for the long weekend with fresh air and water, but I think I’ll be much safer in my central city neighborhood among medical types who understand how serious this all is. Might be a good weekend to get all the books on their proper shelves.

As always, wear your mask, stay home when you can, and wash your hands.

June 25, 2020

It’s deposition time…

I have spent the last three plus hours reading deposition transcripts and my mind is reeling and my eyes are a little blurry so it’s time to leave the medico-legal world behind and return to the accidental plague diaries. Someone posed the question today as to what I would entitle my memoir, should I ever write one and I’ve decided, given all the weird, wonderful and serendipitous things that have occurred in my life combined with my writing best in short essay form, rather than long form, it would have to be called ‘Accidental Notes’. And now all my musician friends are groaning in unison. I’m sorry, I do like a good pun.

The news on Covid-19 over the last few days is absolutely devastating. It’s skyrocketing across the sunbelt – in Arizona, Texas, Florida, South Carolina. Not quite as much here but we’re not far behind. It’s as if all the pain and misery we endured throughout the spring through isolation and quarantine and flattening the curve simply had no effect. That’s not true. It had the desired effect. The curve did flatten, the exponential rates of spread did come down. It was obvious that we couldn’t all remain behind closed doors forever and some of us (including yours truly), due to the nature of our jobs really couldn’t do it at all. I’ve done my best to be careful, being mindful of my activities, and given up a lot of the things I enjoy in life to help my patients, my colleagues, and my fellow citizens survive and I don’t regret that.

Flattening the curve was never about defeating or ending the virus. It was about buying time to allow the tried and true public health measures to swing into place which could eventually tamp the pandemic down. What are those measures? Public education on what measures are necessary and why, social distancing, quarantine of the ill until they become non-infectious, and contact tracing of those exposed to separate them from the uninfected until the disease spread can be curbed. What did the federal government do with the time our sacrifices bought them? I’ll let you answer that question as my answer would likely contain a few too many expletives and bring the Facebook police down on my head.

When the public reached their limit for total societal quarantine (around about Memorial Day) and various political forces decided to politicize public health measures for momentary gains, states began to take divergent courses. Well governed states, following sound scientific public health measures, have been slowly reopening based on scientific data and good epidemiology. Poorly governed states more or less threw wide the gates and encouraged everything to return to the way it had been. You can probably guess where the virus is spreading like wildfire. As I have said repeatedly, the virus doesn’t care about your politics, your vacation plans, your comfort or anything else. It has one purpose and one purpose only, propagation and it will seek any change in your behavior patterns that it can exploit.

Young folks avoiding masks in a pandemic

So, while the rest of the advanced world, by using everything learned about infectious disease epidemiology over the last two hundred years, brings their numbers down and the pandemic under control, the United States is merrily zooming the wrong way. I have a feeling the rest of the world is fairly close to placing a cordon sanitaire around the country to protect itself. For those unfamiliar with the concept, it’s a complete and total blockade around an infected locale. No one in or out. No foreign travel, no international business trips, trade severely hampered. Don’t think it can’t happen or that America, with its naive belief in American Exceptionalism is immune from the social forces of the rest of the world.

From what I can tell, there’s really only one way to bring the pandemic under control, and that’s for the American citizenry to change the government to one that will actually act on basic public health measures that protect its citizens. There’s a chance to do that in a few months. We’ll see if they are able. In the meantime, from what I can tell, older people will continue to protect themselves and younger people, believing themselves in no specific danger, will not. the problem is that a certain percentage of younger people are also falling deathly ill. It may be a smaller percentage than of older people, but it’s still significant. There’s also the issue of long term effects on those who don’t actually die. Some studies are suggesting that even young and healthy are having serious compromises of lung function which will likely play havoc on them as they age into middle and then older age.

With a failed societal response, we all have to do what little we can do. Wear our masks (it does help reduce transmission significantly when we all do that – and stop with the ridiculousness about HIPAA and the ADA and the nonsense about how you can’t breathe or you’re going to get carbon dioxide poisoning or any of the other pieces of garbage I’ve seen floating around), wash our hands, stay home when we can. It isn’t fun but they’re what will buy us the time to work on better societal solutions.

June 21, 2020

And over the last week, Alabama has 4,000 new Covid-19 cases, Jefferson County has 400 new Covid-19 cases and there have been sixty more deaths. This isn’t over by a long shot, even if the media and the zeitgeist have moved on to other things. There’s a couple of interesting trends that I’m following in terms of data. One, the divergence in case rates between areas with Republican/conservative governments versus those with Democratic/liberal governments. By most measures, the red areas are trending up in numbers and rates of infection while the blue areas are trending down. There’s a lot of interesting sociological possibilities behind this. The blue areas are more heavily urban and more crowded leading to easier transmission in the early days of the pandemic. Now the blue areas, having experienced what the virus can do, are much more cautious and vigilant in their public health orders leading to reductions in transitions. The red areas, being more concerned with the economic impacts of shut downs, have not implemented the tried and true ways of preventing disease spread so, as the virus has made its way to less densely populated parts of the country, it’s going to be more efficiently spread by people who have absorbed the political idea that the virus is a big nothing burger and that they should not be concerned about either themselves or their neighbors. If previous trends hold true, July is going to be a devastating month in red states as the death toll follows the increased infection rate and it will be very hard for the governments in those areas to walk back their laissez-faire attitudes.

The other interesting trend is the age of new cases. Data out of Florida is showing that the majority of new cases over the last few months is in younger adults with the median age falling into the thirties. Is this due to the substantial elder population of Florida taking precautions while the younger population, believing themselves immune, is not? Is the virus becoming more effective at being transmitted by certain social behaviors of young people? Is the virus, as it goes from host to host, starting to mutate somewhat leaving younger people, with less lifetime exposure to viral illness more susceptible? Fascinating questions that I, nor anyone else, don’t have the answers to at this time.

Epidemiologists and public health experts know what we have to do to get over the pandemic. The playbook hasn’t changed in decades. Social distancing/isolation, quarantine of positive cases, and contact tracing. It’s not that hard. It just takes political will and money. We’re definitely missing the former in today’s society. We’re not missing the latter, we just make some very odd decisions about where it goes. I’m not a trained epidemiologist but I’ve had my share of classes as part of my medical training and I’ve rooted about in the public health world for decades due to my work trying to identify and fix the disparities of health care that exist for the physically frail and cognitively impaired elder.

I remember my first epidemiology class quite well. It was in my first semester of medical school, towards the end of the term. On the first day of class, the professor, whose name I no longer remember, gave us an extra credit problem to work on. It was a breakdown of a society where a condition had struck a segment and we had to figure out what the disease was. We had breakdowns by gender, ethnicity, socio-economic status, marital status, age etc. We were given the information on Monday and told to give our answers on Friday in class. Friday came and I took my usual seat in the back corner, knowing that would make me one of the last called on to answer. I hadn’t a clue what it was. Some disease that hit men far more than women, the poor far more than the rich, single people more than married. People kept giving their answers and being told they were wrong. I was thinking Athlete’s foot and was going to go with that when something caught my eye. Only four females in the highest socioeconomic group had the condition. That rang a bell deep in the recesses of my brain. Something about only four women. Then I saw only one child in the highest socioeconomic group had it. I scanned all the numbers again and I knew what it was. I started squiggling in my seat waiting for the professor to get to me. When he did, I blurted out ‘I know it, I know it – it’s the Titanic and which passengers lived and which died. ‘ The professor’s jaw dropped. I was right, the first student who had solved that puzzle in the twenty years he had been teaching the course. And that’s a great example of how my mind works. It absorbs factoids like only four first class women died on the Titanic and then reorders them subconsciously so I all of a sudden just know an answer to a complex problem.

Worlds Largest Hubris Metaphor

I’ve finished one week in the new condo with pretty much everything being in place. I feel like it’s been the absolute right decision to move even if the process has been exhausting. I’m planning on just staying put with things where they are for a few more weeks, and then spend some time fine tuning. It has, of course, shown me its little quirks, the most interesting one being two of the drawers in the kitchen island refusing to stay closed. They were fine all through the move in process and the loading up; then, all of a sudden, last week, they started to open on their own. I’ve decided it’s maybe Tommy trying to communicate something to me about kitchen organization. Of course, this brings up unpleasant thoughts of the early scenes of Poltergeist. If the chairs start stacking themselves up, I may have to think twice about this place.

Four more work weeks, and then I get two weeks off – the first time off in nine months. I shall spend at least part of that in Seattle with the family. I haven’t decided on the rest. I may be here putting bookshelves in order although I would love a few days at the beach if I can figure out how to do that safely.

Stay well, stay safe, wash your hands.

June 16, 2020

I should have written a plague diary entry last night, but I was bone weary after a twelve hour work day. I don’t recall when I’ve had times where I’ve been as genuinely exhausted as I have from time to time over the last few months. I think it’s a perfectly normal phenomenon. Everything about life and all its certainties has been upended; little bits of stress seep into everything you do. Three months of unending stress, a lack of the usual activities that relieve stress, long work hours, and then a move added on top of all that when you can’t take any time off work is enough to flatten anyone I suppose.

A friend posed the question the other day asking if difficulties make you stronger. My answer to that is not really, I believe they make you more resilient and more able to roll with the punches that life is going to throw at you, but they don’t necessarily give you any additional strength. I’ve certainly had plenty of curve balls lobbed at me through life and I don’t think I’m any stronger than I was as a teen. I’m just a lot more prepared to bend and change and figure out what I need to absorb and what I can safely let go. I suppose it’s how I’ve made it this far. It’s the adaptable creature that survives, not the strong one under the theories of Darwinian evolution.

Speaking of moving, many of you have seen the video walkthrough I posted this weekend of the new condo. The remarks have been complimentary. Yes, I am my own decorator. I had some suggestions and help on the color scheme but the ultimate decisions were mine. I wonder how many picked up on my little joke with the colors. For those that didn’t, there’s one room for every color family of the rainbow. It is Pride month after all… I was able to pull it together so fast due to my wonderful crew of packing and moving elves headed by Holly McClendon. There’s still a lot to do in terms of getting books on the right shelves and media sorted and the closets are hiding a multitude of sins but it feels somewhat finished, and does what I want it to do – I want a space where people who enter can look around and get to know me in all my quirks and eccentricities.

So back to corona virus. The numbers of cases locally are accelerating like crazy. 5,000 new cases in Alabama and 400 in Jefferson county over the last week. UAB now has more inpatient Covid-19 sufferers than ever. And yet, the populace seems to have shrugged off the disease as yesterday’s news. Now that things have reopened somewhat, I see more and more people out and about without masks, hanging out in groups and in general living life as it used to be. They are mainly younger folk who aren’t hugely at risk for significant complications and I’m wondering if socially we are heading into a two tiered society of the young and healthy with minimal risk in one group living what we might consider a relatively normal life style and a more at risk group of older and chronically ill acting much more circumspectly. One wonders what a few years of that might do to politics and the economy. As someone whose age, profession, and general health status places him in the more at risk group, I can’t say I approve of what’s going on and worry that our already youth oriented culture may continue down that particular path in very unhealthy ways to the expense of empathy and wisdom.

When you look at the numbers nationally, especially when compared against other advanced societies, it becomes blatantly obvious that our government has completely abdicated its responsibility for keeping our population safe. The partisan politicization of science and expertise and the elevation of feeling and belief over fact and reason creates the perfect environment for a virus of this type to keep breeding and replicating and I don’t know that there’s a lot any of us can do as individuals about that. I keep my hands washed and sanitized and wear a mask in public and at work when with patients (which makes my job much harder – most older people rely at least partially on lip reading to hear properly) but there are times when I feel like I’m in a shrinking minority and I wonder just what motivates people? Are they thinking it’s over? (It’s not). Are they thinking they are not at risk? (They are). Are they thinking if no one else is, why should I? (My parents had a lot of pithy things to say about peer pressure when I was growing up).

Something that’s liable to happen is that those traveling on US passports will find themselves unwelcome to travel to other countries. The world will get a handle on the virus and travel will start up again, but will we be able to partake? If I were running the health ministry somewhere in Europe, I’d look at the US numbers and behavior and say no way Jose to those people coming here. That will come as a real shocker to most Americans of upper income who are used to coming and going across the world at will and put American business at a major disadvantage. You can only do so much over Zoom.

I have a new nest. I’m likely to spend a lot of hours in it as my plans for travel will be in abeyance and its unclear when the kinds of performance I participate in will be safe to resume. Time to put all that resilience to work. More writing? Something artistic? (I don’t generally do well with the visual art thing – most of my attempts look like they were done by someone with no arms or left foot). Perfecting my Xbox skills? Getting started on my retirement reading shelf? I imagine I’ll eventually figure it out. In the meantime, I’ll do what I can to safely make the world a better place and try not to be too much fo the crochety old man railing at the young folks to get off his lawn while doing it.

June 11, 2020

And just like that, the novel corona virus marches on, oblivious to whether we are bored with social distancing, distracted by other news stories, worried about the economic disruptions of pandemic disease. Viruses don’t care. They are implacable, unfeeling, designed with one purpose in mind – propagation at all costs. The reduction in case load achieved by aggressive measures in the spring has been reversed by an easing of those measures for socio-economic reasons. In Alabama, there were roughly 900 new diagnoses today, nearly twice as high as the daily rate at the peak of the original pandemic.

There will be those quick to blame the various demonstrations and rallies, a few of which made national news with the initial movement against long standing monuments to the Confederacy, aimed like a dagger at the heart of the African-American community. The numbers don’t bear that out. The rallies have been confined predominantly to Huntsville and Birmingham and those are not the areas in which cases are skyrocketing. It’s increasing quickly in more suburban and rural areas. I’m not surprised. We’re between two and three weeks out from the Memorial Day weekend (the demonstrations didn’t begin until a week later) and the spread is much more from a bored populace emerging from its cocoon, blinking at the fine weather, and taking off for the beach, the bar, and the backyard barbecue. This isn’t a second wave. It’s still the first wave of the virus, simply waiting until we let down our collective guard so it could continue on its relentless path.

There is a graphic running around (I posted it myself) breaking common social activities into nine levels of risk. It’s not necessarily the most scientifically accurate thing but it’s easy to understand and serves as a good reminder of what social distancing actually means. It’s not easy. Personally, I guess I live at level four. I can’t exactly avoid a doctor’s waiting room if I’m going to go to work. I’m still curtailing most of my activities. I’ve had to open up my life a little because of the process of moving but life is risk and it was one I needed to take. So far, so good. I guess I’ll know in about two weeks if I’ve been careful enough. I fully expect to contract Covid-19 at some point. I’m a physician and it’s my duty to be around the sick, no matter the personal cost. I’m not being stupid or taking unreasonable chances but I’ve tried to order my life just in case I become one of the deathly ill. Now that the moving is done, life will return to my usual workdays and weekends at home reading, taking long walks, and working on my Xbox skills (which don’t seem to be improving much).

The condo is pretty much together. Almost everything is stowed away in at least a temporary home. I’ll try to pretty it up enough so I can do a video walk through this weekend and share it with everyone as it may be a while before I can host a party. The old house is empty. The discards are being picked over by various folk and it gets its repair and facelift over the next two weeks and should be on the market by the end of the month. If anyone wants to live in the heart of Forest Park right on the triangle, drop me a message and I’ll get you in touch with my realtor. I’ll be glad when the last phase of this process is over. I’m looking forward to not having to move again for decades.

I tend to be an optimist when it comes to human behavior. I’ve worked in a caring profession that’s taken me inside so many homes of so many kinds of people for more than three decades and from that I’ve learned that no matter how people express it, they want pretty much the same things. A sense of safety, a few creature comforts, a better chance for their children, chances to feel fulfilled and do meaningful work within their professions and communities. It’s not that hard to understand that once you start seeing people as human beings. There have been two major social trends over the last century or so that have kept this from happening the way that it should. These have been deliberately implemented by the rentier class of property owners in order to protect assets at the expense of people. The first, and more familiar one, is the dividing of the working class on the basis of ethnicity. Of teaching both Black and White that the other is not to be trusted and making it difficult through a thousand little social rules for them to make common cause. The power structure has long known if they do get together and start pulling the same direction, they will be in trouble. Maybe Covid-19 striking at just this moment in time with the Millennials and Generation Z ascending to the majority becomes the inflection point that allows for this to radically change.

The second, more insidious one, is the co-opting of the professional and upper middle class by the power structure through economic means. As the old saying goes, if you were work for money, you’re not rich. When you’re rich, your money works for you. Most professionals have fairly high salaries but they’re still working for a living and their economic interests are firmly tied to the working class. However, when the power structure came up with the brilliant idea of replacing defined benefit pension systems with IRAs, 401Ks and 403Bs, they all of a sudden got the band of people who do a lot of the heavy societal lifting to start voting based on the casino of the sock market, not realizing that their paltry gains would never make up for what they were losing in both pension systems and the systematic privatization of the commons that’s been going on for the last half century.

Can we fix all of this mess? I do believe we can. No one ever said it would be easy and I think we have a lot more pain in terms of both Covid and the social unrest that it’s effects will engender to go before we get to the other side. Fasten your seat belts. It’s going to be a bumpy ride but we will make it if we decide we want to and we will reach out our hands to each other and not be afraid to take them.

Speaking of hands, you know what I’m going to say… Wash them well and often.

June 7, 2020

White Coats for Black Lives

My apologies that the accidental plague diaries have been missing in action over the last week. My mind has been elsewhere, what with moving and all of the multitude of tasks associated with that. The lions share of the work is done. I’m down to the last dozen boxes that need to be unpacked. It will be a while before everything is fully squared away but it’s more or less together and the space is starting to feel like mine. The next major task is readying the old house for sale. The last items should be out by mid week and then the crew can go in to do the minor repairs and spruce things up so it should be on the market before the 4th of July.

The number of Covid-19 cases continues to go up and up. We’re up to nearly 2 million cases nationally. 20,000 of those are in Alabama, 2,000 are in Jefferson County and the numbers have been rising relatively quickly over the last few weeks as the virus transmitted over Memorial Day weekend starts to make itself known. What we’re doing today is reflected in the numbers 10-20 days from now, one of the reasons it’s difficult for us as a society to understand the cause and effect of social behavior on our physical well being.

US Media, unable to keep more than one big story narrative going at once, has more or less decided to turn its attention from Covid-19 to the various rallies, marches, and occasional civil disturbances that have sprung up the last two weeks. I have two thoughts about this. First, corona viruses don’t care if they’re being reported on or not. They’re going to continue to do the one thing they’re designed to do – infect new individuals so that they can propagate themselves further. The number of cases in local hospitals is ticking upwards again and I am very afraid that a lack of emphasis on the need to continue masking and social distancing is going to lead to increased infection rates. Hopefully, we’ve had enough lead time to prepare but I can tell you from first hand experience that the health care system is strained and the practitioners are tired and there is no end in sight. Second, it doesn’t necessarily fit media narratives but the pandemic and the BLM protests are very much intertwined.

This country hasn’t seen this number of people out on the streets protesting against the powers that be for more than fifty years. The rallies I have been to have been orderly affairs, Black American and White America together saying that the systems that have divided us for so long and treated us so unequally have to stop. Locally, we’ve only had one serious disturbance, more than a week ago. The city’s response has been mainly subdued (some of the white flight suburbs appear to have over reacted) but it’s pretty obvious that the message has been received loud and clear. I’ve seen the photos from NYC, DC, Philly and elsewhere of enormous crowds, braving pandemic conditions to stand up for what is right and the ideals that this country was founded upon, ideals we often don’t live up to. i don’t think this would have been possible without the pandemic. BLM has been around for a few years and, of course, systemic racism has been around for four centuries, but it took the societal stress of a pandemic, a lock down, and economic uncertainty on a grand scale to get the majority of Americans to experience the stress and conditions that minority groups face on a daily basis. Worries about the rent, putting food on the table, indifference from the authorities to distress, seeing the oligarchy helping itself to the treasury, watching a militarized police traumatize peaceful protesters, understanding that a government that was unable to come up with the most basic needs of the health care system over months could conjure up what amounted to a military crackdown in days which has laid bare the myth that government was here to serve the citizenry. It’s become plainer and plainer that government currently exists to protect the property of the wealthy.

The younger generation isn’t especially at risk from Covid-19. Its education has been disrupted. Its been saddled with appalling levels of debt for that education as part of the monetization of society to benefit the wealthy. They don’t have a whole lot to lose at the moment and the pandemic has destroyed the social controls the elite has used to control them in recent decades such as student loans, entry into upper tier schools, and internships and other networking opportunities. There’s no reason for them not to continue being out on the streets continuing to work for systemic changes which will benefit us all. I can’t read tea leaves terribly well but I can say that we seem to be at an inflection point where the rules of the game have suddenly changed and the older generations haven’t quite figured that out yet and I think that’s going to be born out in the results of the next election cycle.

What’s next for Covid-19? It’s unclear. The amount of information available is reduced. Reportage on what’s happening elsewhere in the world is slim as the US focuses in on our internal struggles. I can’t always find trustworthy domestic numbers as various states present data in inconsistent ways for what seem to be political purposes. As a geriatrician, I am well aware that it continues its march through senior facilities. Some die, some don’t. It’s completely unclear what the difference between the two groups could be. There’s likely a genetic subset of us that is doomed to become incredibly ill if we get the disease but why that is and how to determine whom is at risk remains obscure at best.

In the meantime, now that I have my nest relatively feathered, I plan to stay in a lot, and watch the sunset from my terrace. In the meantime, everyone stay safe, stay well, and wash your hands.

June 1, 2020

A decade ago, I was fortunate enough to have been offered a slot in the Leadership Birmingham program (2011 – best class ever). It’s a program that takes local residents from all types of careers and walks of life who have proven themselves to be leadership types and gives them a crash course in how our metropolitan area actually works. With full days devoted to topics such as health issues, education, economic development, and cultural opportunities, it was a great chance to network, develop new friendships with people in other industries and job types that I might not otherwise meet, and a rare opportunity to peek behind the curtains into the realities of the power structures. My class included a federal judge, the school superintendent, a city council person, various business types, activists working on social justice issues for the African-American and Latino communities, and clergy. By the end of that year, we had bonded and discovered a lot of commonalities, despite our diverse backgrounds and we, like all of the other classes that have gone through the program over the decades, have used our experiences to help make our community a better place.

One lesson I took away from all of that was one that I don’t think was intended. I quickly recognized that when it came to local politics, the lower the level, the more intelligent and resourceful the individuals. Those working on projects on the neighborhood level tended to be bright, impassioned, committed individuals who cared deeply about their areas of town and who created great things on minimal resources. On the city of Birmingham level, the leaders were predominantly bright with hearts in the right place but were starting to be beholden to powers and economic interests that would at times lead to contrarian decision making in terms of politics and expediency. Those working at the county level had even more of this. It was only a few years since the Jefferson County sewer scandal (which we’re all still paying for – you’ll notice if you look at what’s happened to your sewer rates over the last decade) had roiled the county power structure top to bottom and most of those we met always struck me as having one eye over their shoulder looking for the feds. Those individuals we met working on the state level were to a person, far more invested in the game of politics than they were in the results or in the needs of the citizenry and a few of them struck me as just plain stupid. We didn’t meet much of anyone on the federal level for me to compare that but the stripping away of morals and IQ points as they ascended the ladder to Montgomery strikes me as being somewhat of an explanation for the two separate, but intertwined issues facing us at the moment. I can’t speak to the truth of this pattern in other states, not having been through leadership programs there but I have a sneaking suspicion the pattern isn’t unique to Alabama.

The first problem is that of Covid-19. The case loads locally continue to increase. It’s a little difficult for me to find out just how much as there’s not a lot of transparency in the numbers. Alabama, for instance, is one of the few states which is not reporting on what is happening in nursing homes. UAB, where I work, weathered the initial surge and is starting to return to more normal operations (and I had a fairly typical outpatient clinic day today) but everyone is on tenterhooks wondering if that other shoe is going to drop. As other stories start dominating the news cycle and as people, tired of social distancing, start crowding back into newly opened places of business, we could be well on our way to a fresh spike by the Fourth of July. Friends of mine are reporting the beaches are full, stores are filling up, and then, of course, there have been mass demonstrations. The state has pretty much abdicated its role in protecting the citizenry. I haven’t seen the governor or the legislature in evidence at all the last few weeks. Our mayor, a young and energetic African-American, has been one of the few local leaders who has had and kept media presence and given sound advice.

I’ve been watching as I’ve been out and about a bit more because this has been moving week. In the city, the majority are wearing masks (and we are under a mandatory city ordinance through June 12th). In the suburbs, not so much outside of health care facilities. It’s as if society has made a sudden decision that this is all over and on with it. The problem is that Corona Viruses don’t care if you’re bored. They don’t care about the economy. They don’t care about your politics. They have one mission and one mission only, to propagate and, until there is an effective treatment or vaccine, the only way to prevent that is distancing and masking in order to break transmission chains. We’ll know soon enough if we’re in trouble. In the meantime, I continue to stay home. I’ve been exposed to a few more people due to moving, but I’m keeping my hands clean and trying to keep a certain distance.

The second problem is the civil unrest currently gripping most urban areas. (I read somewhere that more than 140 cities have had demonstrations in the wake of the George Floyd killing this last week). While the murder by police of Mr. Floyd and it’s reigniting of the issues of the horrific injustices suffered by the African-American community for centuries is the proximate cause, I tend to think that widespread civil unrest was going to happen no matter what. An enormous portion of the populace is out of work, food prices are skyrocketing and it’s becoming more and more difficult for those at the bottom of the ladder to put food on the table. Many have been relegated to subsistence jobs for years, enough to survive but not enough to build wealth, get ahead or ensure that things are better for their children. Then add to that the lockdown and the cancelling of all those things that distract us or that make our lives a little more bearable. No sports, no cultural events, no concerts, no gatherings. When there is neither bread, nor circuses, the plebians become unhappy with their lot. The government had the chance to make grand gestures and side with the people but instead let big business run off with hundreds of billions of dollars from the treasury while telling ordinary folk to survive for months on $1200.

I don’t know where this is all going to take us but I remain relatively optimistic. All of the best scientific minds in the world are working together on methods of controlling Covid-19 and I imagine we will start to see some progress on prevention and treatment in the coming months. I went to the demonstration on Saturday at Kelly Ingram Park put together by local Black Lives Matter activists. (I stayed as far as I could from others and wore my mask. Most of the crowd was masked as well). I went because I thought it was absolutely imperative that white men of a certain age be represented as being in solidarity with the African-American community against injustice. I am but one small voice but every voice counts. Kelly Ingram, being the site of police dogs and fire hoses within living memory, is hallowed ground in Birmingham and the crowd was peaceful, well behaved and impassioned. That scene of all races together massed for a better world was my Birmingham and I was proud to be there. I was not at the Sunday demonstration where mob energy was misdirected leading to mayhem. To me, that was not my Birmingham and I was much more drawn to the news stories of this morning of hundreds of volunteers drawn to downtown to clean up and repair the damage. However, it is not my place to tell others how to feel, react, or protest. Suffice it to say that lives always matter more than property or money, even though capitalism pushes society to the opposite (as is very apparent with both of our intertwined crises where our leaders are much more concerned than money and property than with lives.) I write this now under curfew (which doesn’t bother me a bit) with Facebook Live video feeds showing that the city is indeed dismantling the Civil War memorial that was the flashpoint for yesterday’s problems.

The no longer extant Birmingham Civil War Monument – Birmingham never participated in the civil war. The city wasn’t founded until 1871.

A word about the memorial for those not of Birmingham. Alabama is governed under the fraudulently passed constitution of 1901 which was designed to ensure white supremacy and to concentrate political and economic power in a small group of white industrialists. It pretty much prevents home rule in the cities and has been amended roughly 700 times. (When South Africa was looking for models for their apartheid constitution, guess where one of the first places they looked was…) The Civil War memorial was erected a few years later, as were most such memorials around the south, by the White Citizens of cities as a reminder to African American Citizens as to whom held the power. It had been grumbled about for years but things came to a head with Trump’s election, the Charlottesville demonstration and resurgence of white supremacy ideology countering the Black Lives Matter movement. The city wanted to take the monument down out of respect to the African American community but, before they could do so, the state passed a law that effectively prevented such an action. The city countered by covering it up with plywood and there were various suits and countersuits and pretty soon, this fifty foot granite obelisk became a symbol for what was wrong with the system. (And much could have been prevented if the city was allowed to attend to its own affairs without state interference which continues to have racist undertones). Last night, following the demonstration, the crowd tried to pull it down as the Parisians once pulled down the Bastille but multi-ton granite and sandstone obelisk memorials don’t come down easily. If the monument had toppled, the crowd would likely have dispersed satisfied; as it did not, mayhem ensued. Tonight, the mayor, keeping his promise, is having a large crane do what human muscle could not. (Actually, human muscle could do it if properly leveraged. The anthropologist Sarah Parcak from UAB has a great Twitter thread on this based on her knowledge of Egyptology – look it up but don’t read the asinine comments).

I’m hoping in a few days we’ll all be calmer. Just don’t look for any help from a federal level where the executive branch seems bound and determined to make things worse with each passing day. In the meantime, to my African-American friends and colleagues, this White male authority figure remains your accomplice, not just your ally and feel free to turn to me if I can help in any way. All I ask is stay home when you can, wear your mask in public, and keep your hands washed.