Now is the winter of my discontent. I no sooner get over the various ailments of last week when wham bam alakazam some new horrible virus dropped me Wednesday evening and I’m just beginning to surface again. Last winter it was a whole string of respiratory illnesses for about ten weeks. This year it appears to be various GI tract bugs. I know this is all TMI but I’ve spent a lot of the last 48 hours or so barely able to move so it’s sort of uppermost in my mind at the moment. I’m hoping that this is the last of the onslaught. I really have no interest in feeling like this with some new variant week after week until April. I’ve got other things to do. At least it’s given me an excuse to neglect the various writing projects that lie listless and abandoned in files on my desktop.
I’m in the process of retrenching my life in preparation for retirement which ticks closer inexorably every day. There are days where I think I’m foolish for sticking to out at 65 – I’ve got a lot more to give. And there are days when I realize that I was built in a different time and era for a different purpose than that prized by the brave new healthcare world we’ve been busy putting together since the pandemic. I neither completely understand nor trust AI and it’s creeping into everything we do in medicine and it’s full of new tricks this old dog has no real interest in learning. Time to let the digital natives take over, work out the kinks and put the tools into proper alignment with the wielders. My plan continues to be to back out of clinical practice in early 2027 (lining up with UAB’s throwing out their current charting system and replacing it with a whole new system and I’ve been through too many of those sorts of transitions to go through yet another one but to continue as emeritus faculty as long as they want me around.
As part of this whole process, I had to dismantle my academic office after more than 27 years of occupancy this past weekend. Files that had not seen the light of day since the 1980s sometime were opened and most of the contents tossed immediately into the very large recycling bin that UAB generously provided for the purpose (I ended up filling it three times). Looking back over the whole arc of my career as I handled documents generated over the last four decades or so made me recognize just how much things have changed technologically, philosophically, and socially. There were papers typed on my trusty Smith-Corona. Dot matrix printed documents, some with the tractor feed edges still attached. Correspondance on various letterheads. And the amount of paper began to decrease rapidly after about 2000-05 when almost everything became digital. All of my Kodachrome slides from my lectures in basic geriatrics developed in the 90s when PowerPoint was in its infancy were still there. No longer. I packed up what I thought might be useful for personal archival reasons and have told the powers that be to do what they will with the rest. Colleagues can pilfer the remains or it can all go to the landfill. Ten thousand years from now, some future civilization will probably happen across a modern American landfill and start excavating and drawing some very strange conclusions about our society.
What with viral illness running rampant through my personal system, I was slowed down enough to take a look at the latest news in public health. From what I can tell, the inmates are continuing to run the asylum at DHS and CDC and our other previously great health institutions. Things are becoming so shaky in the vaccine world that the major manufacturers are discussing withdrwaing from the US market. In the past, access to vaccines was considered so vital that the manufacturers were legally protected from damage claims but the current regime is aiming to turn all of that on its head, mainly based on spurious evidence and conspiracy theory. The numbers of measles cases keep rising. I keep expecting a polio outbreak to follow. (It will be a few months – it’s generally a warm weather disease). Covid remains mercifully low and we seem to be tailing off a bit on this year’s nasty influenza outbreak. When vaccines no longer remain easily available in the US, I’ll be in a position to be able to arrange for boosters on a trip abroad but I am well aware that’s not usual.
I have a number of conservative friends. It’s fine with me. Your opinions are yours and my opinions are mine. What I do not tolerate is opinions created out of AI slop, internet memes, and made up garbage that have no basis in fact. Facts are facts. I can look at them and interpret them in one way and you may look at them and see something completely different. And you may be able to persuade me to your way of thinking assuming you use fact, logic, and cogent argument. But tossing all of the facts out the window and replacing them with non-fact is a non-starter.
There are reasons why I tend to see the world the way I do. Some of it is family roots. My mother, although born in the US, grew up in a culturally British family (her parents immigrated in the early 30s) and she brought much of that sensibility into the rearing of her children. My father escaped from a narrow close minded religious upbringing determined to have children open to inquiry and to be self reliant. All of us kids are very self-sufficient. I was the most academic minded of the bunch which took me to prep school (which was basically a liberal arts college education) and then to Stanford where I had a double science major and spent every night I could in a theater creating art. From my teens, I was determined to find balance in my world between the grind and creativity. The people I was around at Stanford were scions of some of the most powerful families on the planet and I saw how that world worked. I had no real interest in being part of it. ABout this time, I realized I was gay and being placed in an out group for the first time changed both my understanding and my attitude towards society. My medical education gave me a combination of ‘trust the science’ and ‘question the science’ and also taught me that science without human understanding isn’t worth all that much. My career, as it developed in geriatrics, primary and community based care, and especially house calls, has taken me into the private worlds of all social strata, from mansions passed down through generations to the small apartments of recently arrived refugee immigrants bewildered by a supermarket. All of this has given me a very developed sense of empathy, and understanding of human beings. Doctors aren’t all that different from priests. People confide their most intimate secrets and fears and it is your responsibility to guide them through some of the worst times of their lives.
All of this has made me hold liberal opinions on most social issues. I know the varied worlds of humanity and expression and we all pretty much want the same things; we just need different tools and opportunities to achieve them. The authoritarian/conservative idea that this is best achieved by making us, by force if necessary, into a homogenous population with a single set of beliefs is anathema to me because it is in our plurality and our differences, and even the little frictions between us that gove us art and beauty and culture. I learn new things every day from a new taste from a cuisine I was previously unfamiliar with to reading a book written by an author from a different culture to attending a film or play that explores a world beyond mine and I can’t imagine why people don’t want those sorts of experiences. I am not so liberal on financial issues. I have yet to see a problem solved simply by shoveling money at it. I have seen problems solved when science helps understand the true nature of a problem and root causes and then money is distributed to targeted solutions.
So this is why I oppose our current administration. At its head is a man who has been proven to be ethically and morally corrupt time and again for more than fifty years and who seems to feel that posting an insulting racist meme against Barack and Michelle Obama is an appropriate way to celebrate Black History Month or that using federal resources to try and relitigate an election five years past, where he lost more than sixty times in court, is a wise expenditure of the public trust. Pretty much every branch of the government, taking their lead from the executive, have ignored law and judicial decrees, trampled on the constitution (especially the Bill of Rights), and is using the power of the government to reward the faithful and punish those of other opinions. If after all we have seen over the last decade, you remain faithful to whatever vision this regime is selling this week (it seems to vary depending on the mood in the Oval Office), I have to wonder. I used to wonder about your education and your understanding of our world. Now I wonder about your moral compass.
Rant Over. Things do not appear to be improving in Minneapolis. And we may getting an ICE storm of our own locally. Sources tell me that ICE has rented out 200+ hotel rooms in the south suburbs. If they clearly identify themselves, use judicial warrants, and stop bullying people on the street just because they can, I might ignore their presence but their track record isn’t very good and I’ll be damned if I tet them terrorize my friends and neighbors for photo ops. I haven’t heard of any detention facilities being constructed locally but if I do, I’ll be out protesting that. Being in this country without proper documentation is not a crime. It is a civil offence. The place where people who have committed no crime are herded together in squalid conditions has a name. It’s called a concentration camp and I will not let one exist in my backyard unnoticed.
A few words about The Kennedy Center (I will not refer to it by its other name any more than the Gulf of Mexico is anything but that). I looked up its legal standing. It operates under a charter through the Smithsonian and is responsible to its Board of Trustees (replaced with lickspittles by the president). It can be shut down on presidential whim through the board. The idea that it needs a complete overhaul is nonsense. It underwent substantial renovations in 2019. There is one inconvenient fact that may delay much of anything happening. As the building is not on the mall, it is subject to the City of Washington DC in terms of construction and demolition permits and I have the feeling that the city bureacracy will be in no hurry to fast track any work there that has not been thoroughly vetted.
In the meantime, we’ll get Indy Cars on Pennsylvania Avenue and a cage match on the White House lawn. Although at the AEW match last night, the crowd kept erupting into chants of F**k Ice so even that demographic may not be as friendly to the administration as they think.
Get up, get dressed, go out, do good.
Life, The Universe, and Everything 