March 11, 2022

Another work week has come to an end, just in time for the beautiful and balmy days we’ve been having to replaced by a storm, a sudden temperature drop and a threat of snow. I won’t believe that last one until I actually see it on the ground. I’m feeling a bit less pressured this weekend than I was last. Work stuff is more under control so I can turn some energy and attention to some other projects like Volume 2 of The Accidental Plague Diaries. A lot of the text is done but there’s still much to do in order to make it a worthy sequel. I don’t want it to be like the usual Hollywood part 2 where the plot’s the same, only there are twice as many explosions and it’s only half as good.

Ukraine continues to push Covid off the front pages. The big news on the pandemic front this week was a study in the journal Nature which used various scientific methodologies to try and gauge the real impact of Covid deaths. The authors estimates are that the mortality rate was roughly three times the official counts meaning we’re at about 18 million deaths world wide rather than the 6 million showing up on the various Covid counters. The vagaries of reporting, especially in non-Western industrialized societies, has kept the real scope of the disaster from being appreciated. 18 million, roughly the population of Guatemala or The Netherlands, is a huge number. It’s 34 years worth of minutes. It’s the number of people in the US of Asian and Pacific Island Ancestry. It’s about half the distance between the Earth and Mars in miles. When you divide it over the total human population of the earth, it comes out to about 0.25%. Seems small until you consider that the total world death rate in 2019 was about 0.75% for all cause mortality. In other words, Covid, in it’s two years of existence, has killed about 1/3 the number of people that die for any reason in any given year. We haven’t had something like that come along in a long time.

I’m going to accept the current lull in cases with good grace and enjoy the fact that some of the pressures are off the health system. UAB is down to about 25-30 inpatients rather than 200 or more allowing us all to heave a sigh of relief and regroup for whatever comes next. There will be more. Hopefully the awful reports coming out of Eastern Europe will start to convince some of the vaccine holdouts what a real fight for freedom looks like and their courageous stands against public health measures, in the true scale of human catastrophe, just make them look foolish. It’s actually been rather amusing watching a right wing noise machine, that’s been awash in Russian money of dubious provenance for some years, trying desperately to back pedal. Then there’s the internecine skirmishes breaking out between main stream right wing and far right wing. I guess they’re learning that simply being against things and trying to move the Overton window as far right as possible isn’t really a viable policy position for a complicated global economy and political system.

My mood’s better. I have made the decision to take some time off late spring and that has definitely helped. Now I just have to figure out how to shoehorn it in to the work calendar, the theater calendar, the opera calendar, the church calendar and all the other things that vary my days. The last two weeks of April are looking the most promising. I don’t know what I’ll do with it yet but if I can get it blocked off, I can figure that part out later. I think the stresses of earlier this week were due to good old fashioned burn out and with some renewal time to look forward to, it shouldn’t be as much of an issue going forward.

I can feel a subtle, but definite shift happening at work in terms of the needs and wants of patients. My new patients and families who are establishing these days have a different set of goals. The questions are much more about prevention of the problems of aging, how to adjust diet for optimum health, what sort of exercise is necessary to maintain vitality and physical function. What supplements and vitamins work best. I wish I had good answers for all of these questions but I don’t. Generations living into their 80s and 90s in good health is a new phenomenon that has only really come into being during the time I’ve been in medical practice. We’re learning a lot about things (and when I think back on some of the commonplace interventions we made back in the 80s, I shudder) but there’s so much that’s unknown. With that, here are Dr. Duxbury’s rules for healthy aging.

1. Choose your parents carefully

2. Don’t fall down

3. Recognize that medications (including over the counter) are really controlled doses of poison and treat them with proper respect

4. Eat a balanced diet but realize life is too short to not eat dessert

5. Don’t force yourself into someone else’s sleep patterns

6. Walk when you can and don’t be afraid to use a stick

7. Don’t fill your head full of problems you can’t solve

8. Create something new

9. Make time for sunshine, children, pets, music, and green growing things

10. Try to find something interesting about tomorrow to look forward to

I should probably add to this, wash your hands and wear your mask indoors in times of respiratory illness pandemic.

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