March 8, 2026

Life comes at you fast as Nationwide used to say on various late night TV spots and that has certainly been true this last week. I was feeling unwell last weekend with the relapsing fatigue and distress that had been ongoing for several months. I had put it down to some sort of viral syndrome I was unable to completely shake off, a nuisance to be endured. I went out to lunch last Sunday followed by a matinee of Yasmin Reza’s play ‘God of Carnage’ with its portrayal of how fast social niceties can break down under the stress of primitive emotions including a major sequence involving a bodily loss of control I would soon experience for myself. I went to bed early, not feeling the best but wasn’t sick enough on Monday morning to consider calling in. My work week is front loaded with Monday being my heaviest day. I went in, saw my patients, and then headed off for that evening’s rehearsal for the opera. Forty-five minutes in, I fell off my chair somewhere during the Cavalleria Rusticana drinking song in a vasovagal faint.

Going down in a room with thirty some other people always causes a bit of a kerfuffle. It’s not my first time at that particular rodeo. I have a genetic colitis (thanks dad) which has acted up from time to time over many decades and, when it does, it will often overstimulate my parasympathetic nervous system and drop my blood pressure. And then I have a tendency to low blood pressure to begin with. The stories of my public passing out over the years are somewhat legendary. The gold standard is the time in medical school when I went down in a room with forty medical students and eight attendings. That one caused much uproar and a free stretcher ride through the halls of University Hospital to the Emergency Room to recover. There have been others through the years, most recently about fifteen years ago when I had a colitis attack when out shopping. I went down while standing in line at the liquor store buying a bottle of Cointreau. I collected myself, paid for my purchase, headed across the parking lot and went down again. That’s when the clerk, assuming I was drunk off my butt, called the police. I got a free ride home in a squad car.

Back to the present… EMTs were called, I had no interest in being hauled off to the ER to check for a non-existent head injury. My vital signs and rhythm strip were stable, so I had a friend drive me home and another to come spend the night to keep an eye on things. Shortly after coming home, the start of about twelve hours of major vomiting, which came under control the next morning with an emergency prescription for Zofran. I slept most of the day and decided to give it one more night to see if I would turn the corner. When I still had no appetite, was getting dehydrated, and still feeling like crap the next morning, I knew it was time for the doctor. I called first thing in the morning and got an urgent appointment right after lunch. During that few hour interim, it became apparent that even though I really hadn’t had any of my usual colitis symptoms, I was developing a colonic abscess. I arrived at my primary care’s office, told them my suspicions, had them confirmed and was sent straight to the Emergency Room for poking, prodding, scanning, and additional evaluation, especially as it was pretty clear that I was beginning to go septic. I’m admitted that evening, scheduled for surgical abscess drainage around lunch the next day, monitored overnight and then sent on my merry way.

Two days of IV antibiotics and my physiology has more or less normalized, but I am learning firsthand the lesson I have gone over in theory with thousands of patients over the decades. When you get older, you do not bounce back with anything near the speed with which you think you should. After a couple days of rest at home, I definitely feel like I am over the acute illness and antibiotics through the end of the week should stamp out any last little beasties crawling through my circulatory system. But boy do I feel tired and have no real energy. I usually don’t have more than a day or so of lassitude following acute illness but I can tell this one is going to take a week or so to come under control. I’m smart enough to understand this so I’m taking this whole next week off from work and I am looking at my calendar and am going to strike some commitments and reduce my usual frenetic pace for a while.

There are reasons why we battle with ourselves as we age and do not understand why it takes longer to recover, which often leads us to pushing ourselves too far too fast and makes ourselves upset over our inability to do what our brains say we should with facility. The brain changes and matures very rapidly over our first quarter century. Five, ten, fifteen, and twenty year-olds are all very different from each other despite only being five years apart. At twenty-five or so, the brain finishes its maturation process and stabilizes. We remain that same healthy young adult as our interior self for the rest of our lives and our brain patterns and autopilots and macros are all set up for who we are at that time. We spend the rest of our lives looking in the mirror asking ourselves what happened. When we hit later years, and we have bodies with many more decades worth of where then our brains can understand, we continue to try and understand things through that young adult lens and if we just let our auto-processes run our bodies, we do it the way we did it then. And that doesn’t always work. We can engage our intellect and use them to override those pathways, but it requires discipline and vigilance.

So here I sit, binging prior seasons of Bridgerton before launching into season 4, trying to measure a certain level of activity with much needed rest. I made it to church this morning (I had the solo in the anthem and those who know me know I am not going to miss a scheduled performance of any stripe, come hell, high water, or a bout of sepsis) and I have a few other things over the next few days to keep me integrated with light without over taxing anything. I won’t hesitate to cancel at the last minute if I don’t think it’s a good idea and I know everyone will understand.

I’m also starting to catch up on the national news, most of which I have been ignoring for the last week while dealing with more personal matters. We seem to be something over a week into an undeclared war with Iran. This war seems to have been started on a whim and a gut feeling by the president that Iran was going to attack us (no evidence of this has yet been produced that I can see). The DOD (I’m not going to use Hegseth’s unilateral name change) seems to be playing catchup in regard to attack strategies and no one seems to have thought through any of what comes next. This was a huge problem with the Iraq war where no one in the halls of power appeared to have planned for how to handle the power vacuum and regional reactions and destabilization after the removal of the Baathist regime. There also appears to be no real attempt by the administration to communicate clearly about either gained advantage or culpabilities with the American public. I imagine I’ll have to spend some time with the BBC and Al Jazeera to understand what’s really happening.

It also seems to have exposed the mirage fantasy of the UAE and Dubai. Dubai, like Las Vegas, was built as a playground for the wealthy in an inhospitable desert just because it could be done and because it kept money rolling upwards in certain directions. I’ve never cared for Las Vegas either, but it at least has sex, gambling and alcohol which are not in such abundance in the Islamic world so I could never really see the point of visiting Dubai and never have (and it was never on the bucket list). The idea of it being a paradise free of the sectarian and regional conflicts that have plagued the Persian Gulf for millennia has been shattered, likely permanently, and I’m not sure what the sheikhs are going to do when the trust funders and nepo babies and influencers all find a new haven for their sybaritic lifestyles.

Kristi Noem has fallen at DHS and, with that, it’s becoming just how corrupt the institution has been from the top down under her leadership. The amount of money funneled by her paramour, Corey Lewandowski, in various shady dealings is rather breathtaking. And certainly far greater than any the Minnesota Somali community might have been obtaining fraudulently. If you want to make bank, perpetrate your schemes at the top, not the bottom. If you’re high enough up, when you conduct one of the largest frauds in Medicare history, they reward you with the governorship and then senate seat from Florida. Unfortunately, it’s unlikely to help those caught in the clutches of a rapacious and out of control immigration detention system through which much of the money is flowing. It’s going to take a change in congress to get that one under better control. I can’t help but wonder what Mr. Noem and Mrs. Lewandowski are making of all of this, other than calls to the best divorce attorneys they can find.

Now you’re caught up. With luck I can cease writing about my health for quite some time. I am getting up and getting dressed. Not going out so much but still endeavoring to do good from my land of counterpane and laptop.