October 22, 2020

The third and final presidential ‘debate’ is on this evening. I am not tuning in. There is nothing either candidate could say that will sway my mind in the top of the ticket contest. Besides which, I have already filled out and filed my ballot in early absentee voting. I’m a big believer in the old adage that democracy is not a spectator sport and that it is a civic duty to vote and that those who do not vote don’t get to complain about the state of the country. I’m very good about voting and have been for forty years now. I even turn up for some of the odd city elections and primary run-offs that have very low turn out. Generally, I get up a bit earlier on election day and vote on my way to work but this year, I decided to vote absentee given all of the uncertainties regarding Covid-19. The state of Alabama does not make voting absentee terribly easy but I qualify under the ‘works more than ten hours on election day’ so I sent in for it around Labor Day with the correct forms and copy of my state issued ID, filled it out a couple of weeks ago, got it witnessed by two independent adults and returned it via the post office. The ballot tracker told me yesterday that I had dotted my is and crossed my ts correctly and that my ballot was in the accepted pile awaiting counting week after next.

The news from the front lines in the Covid wars is not good, despite the optimistic drivel emanating from the White House. Locally, the numbers of patient’s hospitalized with the disease is slowly inching back up to the numbers we had in the late spring. Nationally, in a majority of states, the percentages of positive tests, which had been declining towards the 5% benchmark, are back up over 10%. (WHO suggests that there be a number of weeks of community testing prevalence of less than 5% before societies emerge from lockdown and the current 10% is a public health emergency). Deaths keep going up. Morbidity seems to be a bit on the decline and the reason for that is uncertain. Probably due to the fact that the majority of the spread these days is in populations with less susceptibility to severe complication, mainly young adults. It doesn’t stay amongst them, though. The majority of senior and chronically ill adults in this country are community dwelling in multi-generational households and even those in isolated senior communities rely on younger staff coming in and out. It’s where the whole herd immunity thing falls apart. It’s not possible to isolate those in danger from the rest of society while we let the virus spread.

The epidemiologists are starting to get a better hand on the big data. We’re at about 220,000 official deaths. The excess mortality for 2020 to date is about 285,000 deaths according to the actuaries and demographers. (285,000 more people have died in the US in 2020 then would have been predicted given the trends from 2019). Most of these are Covid. A few are probably from people who delayed health care due to fear early on in the pandemic. A bunch are probably Covid cases that were not diagnosed. As the disease rolls on it’s becoming clearer and clearer that it’s actually a disease of clotting and the circulatory system that shows up in the lungs rather than a respiratory disease so some of the deaths were probably coded as heart attack or stroke or from whatever long standing chronic illness the victim was suffering from that the altered physiology of the infection allowed to run rampant and tip a previously compensated person over the edge. Considering that we’re only about seven months into the pandemic, I expect these numbers to shoot up a lot higher before the end of the year.

Between an incompetent federal response and a third of the population believing that even the most basic of public health measures are some sort of cabalistic plot and that science should and must be ignored, I don’t forsee us having much success getting out of our current patterns this winter. I know we’re all bored with sitting alone in our rooms and want to get out and hear the music play but it’s just not a very good idea. Performing arts people are going to do what they do anyway and I am encouraged at the creativity that’s starting to pop up in the arts world. Rigoletto performed on a baseball diamond. La Boheme, stripped down to its essentials performed in a bay front stadium. Opera arias from the back of a flatbed in a parking lot. Any number of on line videos where people are stretching the capabilities of Zoom and other videoconferencing software to create new hybrid virtual forms of performance. Not to be left behind, I have turned my dining room into a temporary studio space where I have been filming my bits for Oscar Wilde, church choir, Politically Incorrect Cabaret and Arts in Medicine. I’ll post links as these various projects are completed and launched upon an unsuspecting world. I have a couple of unpublished plays I’ve written. Maybe I should recruit casts and get them out there.

I tend to keep my two careers of medicine and performance somewhat separate although they have been known to bleed into each other from time to time. Obviously, those in my theater life know I’m a doctor by day and those in my medical life occasionally turn up at something I’m performing in to see what I do in the evenings but, in general, they are separate arenas of existence. The overlap has been a bit more since the pandemic began. Generally, when I go to work and put on my white coat, I put on a persona that’s different from what I consider usual me. It’s a role. One I’ve been playing for thirty five or so years so I have it down pretty pat. The pandemic, however, has shaken up the system so much and created a major need to unleash my imagination to problem solve that my more usual self is popping up at work. I think it amuses the staff somewhat who are used to me being a little bit more buttoned down.

Story time…. About ten or twelve years ago, my dear friend Jan Hunter was in charge of something for one of the cultural groups that involved thirty days of random acts of art. She came to me and Ellise Mayor, my co-conspirator with Politically Incorrect Cabaret and asked us to participate so the two of us found ourselves one noon hour in our full cabaret get ups on the street in Five Points South doing our PIC schtick. My cabaret Ansager look has morphed a bit over the years but it usually involved white face makeup, lots of colorful eyeshadow, rouge, lipstick, and eyebrows that would make Eugene Levy proud. Tommy did my makeup in those days so he met me at my office with the kit, got me made up, blacked my hair (an affectation I’ve dropped from the character recently – I figure he’s gone grey with current politics) and I threw on my white tie and tails and met Ellise who, if memory serves me correctly, was in her Marlene Dietrich get up. After an hour of prancing around to the bemusement of passers by, we had done our part to make Birmingham a more artistic place. I decided that I should go down to my clinic before I took the make up off. My office staff weren’t very familiar with PIC and I thought it might amuse them.

At that time, the geriatrics clinic was in its own little building, the Spain-McDonald clinic so I let myself in the backdoor, snuck up on the office and launched into my best rendition of Wilkommen complete with my Ansager Mittel-European by way of Monty Python dialect. As I reached the big finish, the door of one of the patient rooms opened and out stepped the then president of the university (who was having her mother seen by one of my colleagues). I’m not sure who was the more unnerved – me having my ultimate boss run into me while I was capering around the office or her seeing the medical director of her mother’s health clinic looking like a refugee from one of the seedier parts of Weimar Germany. After a beat, we both laughed and had a nice conversation about the clinic and plans for geriatric medicine over the next few years. I did learn an important lesson… Always check the clinic schedule to see who’s coming in before performing impromptu musical numbers in the hall.

I had a mental health day today. I’m not sure that it worked. I’m still neurotic. But I do remember the litany:

Wash your hands

Wear your mask

Avoid crowds

It’s that easy.