I was going to write a piece this afternoon after my audition for a reader’s theater piece (I got the role…) but when I came home, opened my laptop and started to gather my thoughts, I immediately fell asleep and woke up ten minutes before call time for this evening’s performance. Fortunately. I live less than five minutes from the theater and arrived with a few minutes to spare. Another solid performance (and I seem to be beating those paraphrases back into the ground) and I am home with a little energy and so I write when most people my age are settling in with their cocoa and something on the telly. I have, of course, completely forgotten what I was going to write about this afternoon so we’ll see where this goes.
News of the week: Edward, the ghost cat, has started to come out from under the office supplies on his own volition. I have actually seen him slinking around the condo one or twice and he seems to be spending most of his time under the library table in my office. He doesn’t immediately vanish when I enter the room and even deigned to go so far as to cautiously approach me and take a kitty treat from my hand. Baby steps. I think Binx has been communicating with him in Catese (Catanian? Catalan?) that this is a safe environment. They used to yowl at each other at odd hours of the night. Now they seem to just look at each other and move on about their business if they cross paths. I bought them a cat tree for Christmas. We’ll see if they can share it, or if they even attempt to use it.
I awoke this morning to news that one of RFK Jrs. attorney friends has filed suit to try and get the FDA to rescind approval of the polio vaccine. I’m not old enough to remember how frightened parents were of that disease when it ran rampant and what a miracle first the Salk and then the Sabin vaccines were considered when they became available in the 1950s but I am old enough to have heard the stories. My very first memory, from back when I was about 18 months old, was of the girl next door who was a few years older than I and who walked with metal braces on her legs due to her bout with polio some years earlier. It’s highly unlikely that this particular lawsuit is going to go anywhere or that the polio vaccine is going to go away in the near future but one really has to wonder what sort of twisted world view makes someone wish to see rows of children in iron lungs again. I can’t help but wonder what Mitch McConnell, architect of so much that is wrong with current politics and himself a victim of polio (and likely post-polio syndrome given what I can tell from video of his moving and walking) thinks of this particular fruit of the poisoned tree.
Checking in on pandemics and potential pandemics is always a good way to occupy my time so I looked up a few of the numbers. Covid numbers are down significantly from the spike this summer. Where we were up around 1200 deaths a week in the US back then, we’re down to between 300 and 400 deaths a week currently. Wastewater surveillance and other indicators are also low. We’ve usually had a winter spike in previous years so things may start to trend back up again in January, likely driven by holiday travel and gathering, but we’re not there yet. Keep those hands washed and, if you have respiratory symptoms, wearing a mask to protect others is never a bad idea. The flu season is continuing to rise somewhat. The big issue there remains H5N1 avian flu which has been spreading rapidly in both poultry and dairy herds the last few months. There have been only sporadic cases of human illness so far but we’re only a mutation or two away from it becoming human to human transmissible. And this could be a problem as it has about a 50% mortality rate in humans.
And then there’s the new kid on the block. An unknown virus that’s been spreading in the Democratic Republic of Congo, affecting mainly children and with a relatively high mortality rate. This seems like a bad case of deja vu five years later. An unknown virus in a remote location, far away from our personal concerns, tales of spread and lack of containment, and then… There hasn’t been any significant spread outside of the initial outbreak as of yet but in these days of rapid international travel, it only takes one infectious individual to seed a new population and, if it’s a newly mutated virus to which we have minimal immunity, we’re off to the races again. I’m not particularly worried about this virus becoming a new pandemic… yet. I am worried that we have so seriously damaged our public health responses administratively and politically (and that’s even before the new administration takes the reins) that we won’t be able to take proper action if and when a time comes where a decisive plan is what makes all the difference. I also worry that the usual strategy of ‘let’s fight it there so we don’t have to fight it here’ may fall victim to America First thinking and an unwillingness to grant foreign aid. Unfortunately, that sort of isolationist thinking no longer really works in an integrated global society as we have built since World War II.
I’m reserving judgment on what’s going to happen to public health and Medicare and medical schools and all of the other things that impact my professional life until after the new administration assumes power in a month or so. I think I know some of what’s coming but anyone who thinks they can completely predict this level of disruption in advance is lying to you. I’m planning on keeping on keeping on but there are a few things that will make me pack up my toys and go home. I will not take mandatory classes in MAGA ethics and philosophy. I will not violate the fundamental rule of medicine – primum non nocere. I will not assist federal bureaucrats in identifying patients for potentially nefarious purposes. I will not compromise my practice of medicine to ‘get along’ (and I know a whole lot about how to fight systems to better patient care – I’ve got nearly four decades of experience in that one).
I should have some announcements regarding writing projects soon. There’s a number of things that seem to be coming to fruition. Some of it depends on Armenian subcontractors and I don’t completely understand all the details yet but I’ll let people know when I have good solid information. Perhaps I’ll get a trip to Yerevan out of all of this. It wasn’t on the bucket list but I’ve never minded a more obscure destination.
Life, The Universe, and Everything 