It’s a Mrs. Malloy kind of weekend. What’s that you may ask? In Hello, Dolly!, towards the end of the first act, the widow Mrs. Malloy, having been liberated from a loveless engagement to Horace VanderGelder through the machinations of Dolly, is being escorted by Cornelius Hackl to view the 14th Street Parade. She runs into Dolly and, in her excitement about the possibilities of life, she blurts out ‘Isn’t the world full of wonderful things?’ Later on in the second act, Cornelius echoes these words in his monologue during It Only Takes a Moment where he uses the same words to describe Mrs. Malloy. Thornton Wilder came up with these genius seven words in his play The Matchmaker (they may have been in the earlier version, The Merchant of Yonkers as well but I don’t have that script in my library to check) and Michael Stewart was smart enough to keep them for the musical version. They are an exquisite reminder that the world is indeed a good place if we will just open our senses to it and live in it and experience it rather than always live in our heads. I am far too guilty of this latter far too often.

The quote popped into my head last night as I was joining my Unitarian Universalist crew for our annual appearance in the Birmingham Pride Parade. I was tired from a six hour tech rehearsal for Chitty and pulled rank and sat with the other revered elders on the float rather than walking the route which I would normally do. As we waited for the parade to start, I was mainly thinking about being hot and hungry and longing for a lie down and a good night’s sleep. But then the whistles blew, the parade units slowly trundled into formation, and off we went. As we turned the corner from 32nd street on to 7th avenue south, something magical happened. On a sultry Southern night under a crescent moon, waves of positive healing energy radiated from the crowds on the street (easily the largest turnout I’ve ever seen for Birmingham Pride by quite a large margin) and were reflected back by the marchers and a feeling of joy was infectious and my energy and sense of connection returned. The world was indeed full of wonderful things and possibilities and love.

Birmingham is not that big a city. The city itself isn’t even the biggest by population in Alabama anymore. Birmingham, Huntsville and Montgomery jockey back and forth for that title in the 200-250,000 population range. Birmingham, however, is by far the biggest metro area with about a million. We’re just balkanized in a couple of dozen independent civic divisions, (mainly created and maintained by systemic racism – but that’s another story) and it’s the economic powerhouse of the state. The structure of Alabama politics is such that power centers in a small group of landed aristocracy and is deliberately kept away from urban centers. Between this and the sociocultural hegemony of evangelical churches, it’s not an easy place to be of the LGBTQ persuasion as the recent battles over libraries stocking titles with positive messages to that community would attest. Nevertheless, there is a large and vibrant queer community – it just flies slightly under the radar.

When Steve and I moved here (with a good deal of trepidation in regards to our gay couple status), we moved into a neighborhood which we had heard had some gay folk living there. We shortly discovered that there were four other gay male and two lesbian couples on our block alone. Our zip code was one of the densest same sex household areas in the country but there weren’t a lot of visible signs. Despite moving twice, I continue to reside in the same general area and it remains heavily LGBTQ and the straight folk are nearly all allies. I have never worried about the people I have lived amongst for the last quarter century. And I think most of them were out cheering last night.

The parade had something like 160 units. Everything from reigning drag queens to tap dancers to bowlers to the dozen or so progressive churches in the area to veterinary practices to political and judicial candidates. Our parade tends to be more mainstream than the mega parades of New York or San Francisco. Fewer leather fetishes, go-go boys, and bare breasted lesbians. I’m not sure if that’s a sign of being more assimilated into the mainstream or our more conservative culture in general. My major feeling as we made our way through the crowds was what a positive message for the young people and how much easier a time they are likely to have, even in Alabama, than my generation who had to claw and fight for every little scrap of acceptance and representation.

I also was wondering about why the huge boost in attendance this year. I have a couple of thoughts. First is that 2024 has felt like the first true post pandemic year. People are not as afraid of crowds as they were a year or two ago. Covid is still out there and you can still very much catch it but case numbers remain down this summer and outdoor activity appears to be fairly safe in general. it’s well ventilated. Second is I think driven by politics. The stark contrast in vision for a future America being presented by the two major candidates running for president has got the bright blue dots in this ruby red state energized. Alabama’s electoral college votes are a given for the Republicans but the population of Birmingham is not going to gently bow down to a potential Christian Nationalist future. I think at times I need to prepare an exit strategy to leave the country should the worst of the worst come to past but then there’s a weekend like this and I think no – I am needed here as a role model for those generations coming up and to keep fighting the good fight – the one that says y’all means all.

Time to wrap this up. I’m due at the theater for 9 hours of tech today. Even though that’s a dreary and boring process for actors, we all like the end result and it true is a wonderful thing.

Whatever black humors that were coursing through my brain last week continue to dissipate and I’m feeling more like my usual self again. I’ve had mood swings of the negative variety for decades and am likely to have them until I’m carted off to Shady Pines. Why do they happen? The best I can come up with is that my usual sources of resilience and regeneration, usually deep wells due to the rather peculiar experiences I’ve had in life, just run dry and I’m just not in a good place until enough positive things line up to get things flowing again. It doesn’t have to be big or momentous things, but rather little ordinary everyday wins such as a kind word or an unexpected correspondence or a song on the radio that I haven’t heard in years which is connected with a happy memory of some sort. Ain’t nobody got time for dat wallowing in self pity for more than a couple of days anyways.

What’s going on? Slowly but surely I am chopping away at the ‘To Do’ list. Most of the work projects are on track for timely completion (other than reviewing the 8500 pages of hospital medical record I just got sent by an attorney’s office) and things theatrical are progressing in the way that they should. Chitty Chitty Bang Bang had its first full run yesterday and the performances are pretty much there. We have one more week to polish things up before we enter tech. And there’s a lot of tech in this show. Most of it doesn’t directly involve me other than one key moment. Anyone familiar with the film should remember the hair cutting scene. In this stage version, I’m the man who gets the disastrous haircut and I really have no idea how that’s supposed to happen on stage in full view of the audience night after night. I trust the tech team and I imagine I’ll be let in on the stage magic when the moment is right.

We had our first production meeting on my next project, The Merry Wives of Windsor, which I am directing for Bell Tower Players this summer. Apparently they liked what I did with A Midsummer Night’s Dream and so I’m back again. Birmingham thespians – This show has a cast of 18 (8 men, 9 women, 1 child) so if you’ve ever wanted to try your hand at the bard, now is your chance. (With an added bonus of performance in an air conditioned space unlike Shakespeare in the Park). Auditions will be Monday and Tuesday June 24th and 25th. Rehearsals begin July 1st. Performances are the weekends of August 15th and 22nd. I need all ages and types. BIPOC actors encouraged to audition. Ask around to other people who have been in shows I’ve directed. They’ll tell you that I’m pretty laid back and my two watchwords are collaborative and fun. Additional details as we get them worked out. The formal audition notice should be up in the usual places next week. It’s going to be cold reads from the script. No need to prepare anything.

The one piece of life that’s not moving forward is the writing. I churn out these essays (after doing it for more than six years, it’s become a habit and happens automatically). I still write my MNM columns. (Something over 600 over the last twenty years). I write what I need to for work. But as for the new book, nothing much has been forthcoming. I can feel it churning around in my brain and I’ve had a couple of conversations with my publisher about how to organize it so I’m hoping I’ll just get in the right frame of mind and it will start to appear. I haven’t figured out the right stylistic voice for it yet. It needs to be read and understood by the lay public so it can’t be full of academic gobbledygook and jargon but, at the same time, it’s a serious subject and can’t be all snark either.

I haven’t written much about politics recently. I used to get that out of my system with the scripts for Politically Incorrect Cabaret but that hasn’t come back from Covid and won’t until we can find a new generation interested in a combination of satire, classic European cabaret forms, street theater, and Brechtian alienation who can pick it up and run with it. If you’re a performing type in your 20s or 30s who wants to build on its 20 year legacy and move it into a new era, let me know. The editions we did in the age of Trump pretty much ignored the man because the minute you put him on stage, all of the oxygen was going to be sucked out of the room in the conflagration of divisive opinions that would be unleashed. And after nearly a decade of all Trump all the time news coverage, I have Trump fatigue. What happens next given the guilty verdicts in the NYC hush money case? I haven’t the vaguest. But whatever it is, both sides will bloviate egged on by a media environment desperate for clicks and engagements. The sentencing is scheduled for July 11th. That date would have been mine and Tommy’s ten year anniversary of our legal marriage. I wonder what Tommy would have made of all this? He tended to ignore politics as he felt that both sides were wrong so he would probably just roll his eyes at the latest screaming headline and return to the wig he was working on. Steve, on the other hand, would be following every detail, in high dudgeon, and probably organizing a march on the capital.

But enough about me. How are things in all of your lives? I spend way too much time scrolling social media feeds because I actually do care what’s going on with my myriad friends and acquaintances. I love the pictures, the celebrations, the vacations… all of it. This month is Pride month and seeing the Happy Pride stickers and rainbows popping up all over the place, especially when placed there by people I know are not of the LGBTQAI2+ persuasion, makes this old queen (who remembers the confused adolescent of his past all too well) feel that there is a seat at the table.

I owe an enormous debt of gratitude to all of the disparate people in my life who commented on my last long post or who otherwise reached out to make sure I am OK. Yes, I am OK. I’m an Eeyore by nature and always have been and, for that reason I get caught up in my own head and my own sense of melancholy from time to time. It doesn’t mean anything is seriously wrong and I’m certainly not suicidal or anything of that nature. It usually happens when lots of little things happen which causes my deep well of resilience to temporarily run dry. I can’t say I’m completely over it yet but I feel, with the three day weekend bringing me some rather significant down time for a couple of days, that the clouds are lifting a bit. I have no specific plans for Memorial Day. I’m on call for UAB for the long weekend which precludes my being able to leave the metro area as our beepers now work through our cell phones and there are a lot of dead spots out at the various lakes and things. (It seems a little wrong to wish folk ‘Happy Memorial Day’ but then ‘Solemn Memorial Day’ just doesn’t seem right either… what to do?)

Given my activities of the last few years, it might behoove me to spend Memorial Day thinking about the one and a quarter million Americans killed by the Covid pandemic. The numbers keep ticking up, fortunately fairly slowly at the moment, but no one should think that the disease is over and done. It’s still out there, quietly mutating in the way viruses do and we still don’t have a very good handle on the issues posed by Long Covid. My one major comment on that is that vaccines and boosters seem to do a very good job of preventing Long Covid and it is becoming more and more the purview of those in the antivax movement. Something about horse and water. I am keeping an eye on the movements of the h5n1 strain of bird flu which is creeping around the cattle herds of Texas as, with the right mutations, that could easily become our next pandemic. Fortunately, it appears to be quiescent currently. I really have no interest in writing The Accidental Plague Diaries Volume IV: h5n1.

My heightened melancholy having caused a great deal of introspection over the last week, I think I’ve figured out what’s going on in my little pea brain. I’m in a time of transition and those are the times in my life that I have had the most difficulty keeping myself on track. I do very well when life and life patterns are well defined. Job schedule is this, theater projects are that, life obligations are the other. But once every ten to fifteen years, there’s a pronounced shift that comes as I, like everyone before me who has gone through the life cycle to full maturity, have to say adieu to some old patterns and start adapting to new ones. We’re trained to do this. It’s part of the unwritten curriculum in the American school system. Once every three to five years, you shift schools and have to learn a whole new set of patterns. (I’ve been thinking a lot of school kids recently – my social media is filling up with graduation photos again. But I can’t help but think of a passel of kids from New Town Connecticut who should be graduating High School about now – and as a society we still refuse to do anything about that issue).

My current transition is a little odd. I’ve had two roughly five year periods in life where there has been one disaster after another. The first was from 1997-2002 and the second from 2018-2023. I’m just coming out of that second one and as I am trying to right the ship, here come all of the issues related to the transition from mature adulthood to older adulthood – the move from Ericksonian stage 7 to stage 8 if you buy into that sort of thinking. I have to figure out the practicalities of retirement, determine what my legacy of forty plus years in medicine is and how it can be maintained, completely redo my financial life, make the adjustments necessary to age alone without a by my side helpmeet – it’s a lot. Fortunately, it doesn’t have to be all neatly tidied away by the end of the weekend. I have several years to do that.

This is all complicated a bit by the fact that I seem to have developed two other careers. I think what’s going on in my head with the theater work is a realization that I will never again be able to keep up with the 20 somethings in the ensemble. This is the first big cast traditional musical that I’ve done working through the whole process since prior to the pandemic and I’ve aged a lot in the last four or five years. We all have. I’ll continue to do these kind of shows as long as they write the old guy character parts but I’m going to have to do some adjusting of my expectations regarding how I approach the material. And always be mindful that I am now two generations older than the ensemble and therefore just cannot relate to them in the way I once did. Because I started my performing career late, I was forging my bona fides in my early forties alongside a lot of twenty somethings. We were a generation apart but still close enough to relate to each other and many of those people remain among my closest friends. But as a sixty something, I’m just too far removed -I have no idea what they’re talking about half the time. I also worry about being viewed as a little skeevy if I hang around the young uns too much. I’ll probably transition away from big cast musicals unless there’s a part I’m really right for or it’s a property that means something to me personally. I’ve had a lot of success over the last five or six years in smaller cast comedies and dramas and that process is a good deal more equitable in terms of how the company is put together and relates to each other.

Then there’s the writing. I have not yet come up with the way to make the new book slide out of my brain and on to the page in any sort of order as of yet. I have found over the years that if I just continue to let it gestate, it will eventually mature and hatch of its own accord and then there’s no stopping it all coming down and through the fingers and onto the keyboard. This laptop, which I bought in the summer of 2018, is on its last legs and I think I’m going to treat myself to a late birthday present of a replacement. Maybe that will help stimulate things. The idea of turning The Accidental Plague Diaries into a Spalding Gray type monologue has resurfaced this past week. I have someone interested who would be the right collaborator to shape the material, a venue/company that would do a Birmingham production, and connections to do it a few other places regionally. I told my potential collaborator that if we do this and it works, I’ll pay to take it and us to the Edinburgh Fringe Festival.

I’ve been having waves of melancholy washing over me the last couple of days. I haven’t been able to trace the source. I think it’s just a little bit of this and a little bit of that. I’d feel better about it if I could say it’s this big and momentous thing in life but there’s nothing really that wrong. The biggest thing is probably a lack of a partner with whom I can just talk it out and who will make me some comfort food and tell me that everything is actually ok. I know it is but sometimes you need to hear that from an external source because the internal wells just run a little dry.

There’s nothing terribly wrong at work other than the having to bear up as the linchpin of outpatient clinical geriatrics. There have been a lot of new patients with serious psychosocial dysfunction recently – mainly stemming from families trying to nonchalantly pretend that nothing is changing as an elder is obviously succumbing to the ravages of cognitive decline and then the crisis happens and there’s an expectation that I will somehow be able to restore things to the way they used to be. I cannot do that. No one can. Life is change and aging accelerates that process and if you are unwilling to adapt your approach to life to those inexorable changes, there will be unpleasant consequences. The ones I am unravelling this week involve a serious traffic accident, misappropriation of funds, and adult children who are content to let clearly demented parents make very bad decisions for themselves and then trying to shove the consequences of those decisions off on the health system. It’s emotionally exhausting work and there’s so few of us involved now, just as the graying of the baby boom is starting to truly accelerate, that it’s very difficult to take a step back and recharge the batteries. I am trying to stick it out for another three years but I get tired just thinking about it.

There’s been disasters among my friend group as well. Two friends whom I have been assisting with health issues have died in the last few weeks and a couple more are going through major life crises such as sudden unemployment. Another one, whom I have endeavored to help stabilize through a period of serious mental illness, is on his way to state prison for acts committed while in uncontrolled manic episodes. The fixer/nurturer in me is beating myself up wondering what I could have done differently in all of these situations to ensure a different outcome. Probably nothing and my intellectual self knows that. My emotional self doesn’t always want to accept that answer.

Theater usually helps get me back to my happy place but the rehearsal process on Chitty Chitty Bang Bang is making me feel old. Maybe it’s all the teen early twenties ensemble leaping about the stage (a couple of whom I held as infants not all that long ago). Maybe it’s those bouncy catchy Sherman brothers songs that have a feeling of forced gaiety behind them. Maybe it’s the property itself – which I first saw in a movie theater back in 1968 – that is dredging up memories of my childhood and making me wonder what happened to that six year old kid and did he make the right choices and has the life he lived meant something over the last half century or so.

The movie version of Chitty Chitty Bang Bang was a bit of a milestone for me as a child. I remember it as being one of the first films I was aware of where I asked my parents to take me to see it (my father did the honors – he was my movie companion in my childhood – my mother was at home corralling two toddlers too young for movie theaters). I remember falling in love with the over the top Edwardian fashions, wanting to see Neuschwanstein for myself (It took me another sixteen years to make that happen), and being unconvinced by the cheap blue screen work. I was also more fascinated than scared by Robert Helpmann’s Child Catcher and was quite surprised when my mother knew all about his prior history as a principal danseur with British ballet and as a Shakespearean. (Look up his Oberon against Vivien Leigh’s Titania at the Old Vic in 1935).

I had been given the Ian Fleming Book for Christmas the year before the film came out and had read it. Anyone who has knows that the film deviates from the book in multiple ways and it was my introduction to the enormous changes that sometimes befall stories in their adaptation to the screen (Truly Scrumptious, Vulgaria and all sorts of other pieces of the film came from the fertile mind of Roald Dahl who wrote the screenplay). I also had a Chitty coloring book that was done from the original story boards and which had somewhat different plot points, the Corgi Chitty model car with wings that popped out when you pulled a lever and with the main characters all in their proper places. Jemima became lose after a few months, fell out and was never seen again. I also had, somewhere in there, a gerbil named Chitty who only had three legs. What happened to the fourth is something of a mystery.

It all feels like I’m spinning my wheels a bit and not moving forward. When I got into a rut following Tommy’s death, I was able to use writing and theater to propel myself forward. Then the pandemic and the books it produced kept up that momentum. Now I feel like it’s stopped. Yes, I’m working on another book but it’s not flowing and I don’t feel like I have the ability to get it out of my brain and onto paper. The career is entering its last phase. I don’t feel that I can physically continue to do the theater thing at the pace I have been doing it for a whole lot longer. I can’t make myself write as there’s no shut down pushing me that direction. I am reminded constantly that I’ve entered the decade when you have to start learning to say goodbye to your peer group as they begin to fall to perfectly normal life processes.

Time to find a really sappy movie and at least feel some ersatz emotion. Sometimes if I can find a chink in my armor and let some emotions out I feel better the next day. One can but hope.

Back in Birmingham. Back to the grind. Back at UAB. Back on VA house calls (today was spent in the wilds of the free state of Winston. If you haven’t heard of it, you can read the Wikipedia article). Back to church meetings. Back to reviewing legal cases. The one thing I haven’t gotten back to yet is rehearsal for Chitty Chitty Bang Bang as they’ve been working on the big dance numbers the last few days and I could break a hip if I were to try doing any of those moves. I return to my cozy little character track tomorrow evening. I just have to find some time tomorrow to look at lines and to keep working on dialect between now and then. I had this idea of trying to do a Yorkshire/Lancashire country accent for one of my characters but it isn’t coming out right, sounding more like a bewildered South African trying to read audio system instructions translated from Japanese when I listened to a self tape so I think that idea is going to go on the trash heap. I’m just not very good at mimicking accents. Just call me the anti-Meryl Streep.

The rest of the Seattle visit was uneventful. Got to spend time with my brother and my sister discussing the things that aging siblings do with each other. Had a delightful dinner with Teresa Mosteller and Paula Podemski, both friends of nearly four decades. I also made great progress with a couple of projects – one theatrical (making cuts to the script of The Merry Wives of Windsor which I am slated to direct later this summer – no one wants to sit through 2 3/4 hours of Shakespeare comedy where most of the jokes were out of date by 1630. I think I have it down to about 2:10 which is a much better running time) and one medical (revising educational modules for a national board review course in geriatric medicine). I’m beginning to feel like I just might be able to get through all of the things on the ‘to do’ list that have to be accomplished by the end of the month. I’m supposed to be on regular schedule from now until mid-September and that should also help.

Coming back into usual work life after a week off is helping me think that my decision to retire from active clinical work in three years is the correct one. Stepping outside of the system for a few days for a little clarity helps me see just how broken things are and they are far beyond my ability to fix – or even know where to begin. I have to stick with my usual philosophy of save the world entire one patient at a time because if I look up at all from the work and the patient in front of me, the problems seem insurmountable. In the two days I have been back at work, I have had to deal with a hospice company that is not even beginning to meet its obligations in regards to service (obviously cutting corners to maximize profits and minimize expenditures), four families who are blind to the fact that their nonagenarian loved ones are beginning to fail and who think that they can continue to exist independently and eternally in their usual lives despite the obvious evidence of an inability to put food on the table, rationally spend money, or safely operate a motor vehicle, a lack of neurology appointments for between six and eighteen months depending on the disease process, and a system unwilling to release the funds to hire me an assistant despite the fact that I have nearly double the number of patients I am supposed to be caring for under national guidelines. Or, as we say in the biz, an ordinary Thursday.

I’m still trying to wrap my head around the new book I’ve started. I’ve started referring to one of the central premises as ‘The Cher Effect’. What is that you may ask? It stems from the fact that Cher, who will celebrate her 78th birthday next week on Eliza Doolittle Day, has had an eternal and relatively unchanging appearance and place in pop culture for roughly sixty years. She is emblematic of the Baby Boom that continues to consider itself youthful even though they hit eighty in about 18 months. Cher (who comes by at least some of her appearance thanks to good genetics – google her mother Georgia Holt) is an outlier. The vast majority do not have her resources or thirty five off camera assistants to help us maintain that unchanging facade. But because we see this example, her peer group internalizes the outlier as the norm and expects to be able to pull off a similar feat. I get people in my office in their late 70s or 80s all the time who demand to know why their looks are changing or why they cannot do the things they could do at thirty or forty and the answer is often not that they are ill, but simply that they are aging. ‘But I heard about this ninety year old who can…’ they say. They don’t understand that the reason they heard about that ninety year old is because that person is also an outlier and not normal. This idea of time standing still has completely changed how our culture operates in recent years. In politics, it has led to a 78 year old and an 81 year old as the chief candidates for the presidency. It has kept many elders in the work force, often in top positions, unwilling to step aside for a younger generation and preventing evolution and change in institutions. It makes my life more difficult as it sends me people determined to somehow remove the normal trajectories of biology, physiology, and life as somehow being evil. And it creates the situations where, when time finally does catch up, a host of problems for families to solve that become crises because no one has been willing to confront the need for change with time until after the disasters start to pile up.

Dr. Duxbury’s advice for the week: It’s never good to make life altering decisions in emergency room waiting rooms at 3 am. Think through the scenarios and the life choices before you must so everyone in the family knows what steps to take if life throws a curve ball. A suggestion based on a campaign some group was running a decade or so ago- Talk Turkey at Thanksgiving. When the family gets together around the dinner table this fall, don’t shy away from the difficult subjects. Ask what people would want should they become terminally ill. What sort of living situation suits or doesn’t suit if they don’t have the cognitive abilities to live independently? How would you want to access the world if you were unsafe to drive independently. Does everyone have a will and a power of attorney for health care decisions? We may not like to think about things like decline and death but we all board the train, just at different stops.

I have no idea where I was going with any of this. Just a Thursday night brain dump. Now back to whatever is on Hulu.

Dateline – Seattle, Washington

So this is 62… Doesn’t feel a lot different from 61… or 58. It does feel significantly different than 44. The joints hurt more. I’m not as able to adjust positions rapidly and getting up and down from the floor is much more of an adventure than it was in the past. That’s what a generation’s worth of time will do to you. In another generation, should I survive that long, I will be experiencing my 80s and that seems like completely foreign territory and something about which I do not want to spend time contemplating at this phase of life. I may be here, I may not. If I remain on this side of the dirt, I hope my mental faculties remain relatively intact even if the joints have completely given way. I’ve been adjusting around those for quite some time now.

Seattle continues to roll out the red carpet in terms of terrific weather. High 70s/low 80s, sunny, no humidity to speak of. I’ll take it. So far I’ve had a lovely walk around Green Lake with Debbie Douglas and Thomas E. Davis, lunch on Lake Union with Lauren Marshall, a night at the opera (Barber of Seville) with Paula Podemski, brunch with my editor and publisher Steve Peha, and a birthday dinner en familie (most of whom are not on Facebook with the exception of my father Alyn C. Duxbury). It’s been a lovely time and I’ve been able to do some decompressing away from the every day pressures of UAB, Birmingham VA, and all of the other things that keep me on my toes in my usual day to day life.

I have had something over 500 birthday well wishes so far today. I read and respond to them all. I do this because every name as it scrolls by means something to me. Someone I shared a stage with either once or multiple times over decades. Someone I worked with and beat my head into the wall with the continuing unsolvable problems of geriatric medicine. Someone whom I shared educational experiences with from elementary school forward. Someone who helped me through the difficult times of widowerhood with the gift of presence either in person or on line. Someone whom I have never met but whom social media randomly threw together and who has become a touchstone of one sort another. Someone who is an international opera name. Someone who has no fame outside of their personal circle of acquaintance. Someone who once meant the world to me until our lives diverged. Someone who is a casual acquaintance at best. They all make up this crazy quilt tapestry of life and every year when the greetings pour in (made easy through the tools of social media) I reflect at least a bit on the fact that maybe my existence and my work has meant something on some small scale. Now if only a few more of you would buy one of the books. It would make my publisher happy.

Enough navel gazing on my part. It will all roll around again in May of 2025. Maybe not with a surprise phone call from my best friend from childhood Brock Hanson whom I had not spoken to in three or four decades but who called me out of the blue this morning with birthday greetings, but with something equally unexpected. I was talking this morning to my publisher about next steps with the writing career. How do I get the next book to flow in a brain dump so that it can be properly organized into something reasonable. Should I think about a warts and all memoir which includes all the things left out of The Accidental Plague Diaries (of which there are many). Should I move forward with turning APD into a theatrical monolog and test it out. No firm decisions were reached but there are things germinating and maybe something will start falling out onto paper. Watch this space.

Covid continues to evolve as all life does. The latest variants, which have been dubbed with the highly improbable name of Flirt (which I assume is an acronym for something but I’m too lazy to google and find out exactly what) are spreading as they are out competing the omicron JN.1 variants from this past winter. Wastewater studies show Flirt is spreading but how far and how fast is unclear as we’ve dismantled all of the rapid response systems that gave us epidemiologic data in real time. Hospitalizations and deaths do not appear to be going up at this time so we’re probably still in a reasonable holding pattern. It very much remains out there. I continue to advise vaccination as those with full vaccination status are 85% less likely to require hospitalization and are far less likely to develop long Covid. My niece missed my birthday dinner this evening as she currently has it. She’s fine but we decided it was best that she not be around my 91 year old father or my sister who, to our knowledge, has never been infected and would like to remain that way.

The rest of the news, on this joyous day, remains relatively depressing. The left wing continue to show that they have no idea how to differentiate a religion, a citizenship, or a political stance from each other suggesting a lack of critical thinking skills. The right wing were busy applauding a candidate who appears to have been endorsing cannibalism at his most recent rally which also suggests a lack of critical thinking skills. In all those years of writing Politically Incorrect Cabaret, I could never have made any of this up. Perhaps I should, like Miss Havisham, retreat into my abode with my memories and an avoidance of the modern world. I’ll just skip all the rotted food.

Tomorrow promises more merry sunshine and some time with my sister in her garden which should be soothing. Tra la!

Dateline – Seattle, Washington

It’s a gorgeous sunny day today in Seattle, so I am, of course, sitting inside and working my way through various projects. I should get out and enjoy the weather a bit so I’ll go for a walk later this afternoon. The biggest problem is no car and most of my favorite local walks are not convenient to public transportation. I suppose I can Uber if I’m feeling a real need.

I’m here for a few days to see the family. My nonagenarian father, the only one that’s come around so far, appears to be in reasonable shape. Geriatrician that I am, I worry about falls but assessing his mobility and gait last night and this morning, I’m not overly concerned. He’s doing well with a walking stick and a scooter for distance. The other family members will likely surface in the next day or so and we’re having a gathering on Saturday for my birthday which should bring everyone together for an evening.

I’m not sure what to make of turning 62. It’s not one of those nice round number milestones, but it does mean that I could apply for my social security should I so choose (not doing it for a few more years though…) It also means that this year marks my 40th year in medicine with all of the changes I’ve seen (most not necessarily for the better) and that I will have spent half of my life as medical school faculty (having received my initial appointment just after my 31st birthday). All that of course gets me contemplating what has all of this meant and how do I make sense of the last four decades. But then my brain hurts and I start thinking of other things.

I should be getting together with my editor/publisher this weekend to talk about the new book. I know what it needs to say and what the central themes and arguments are and pieces of it are arranging themselves within my brain. I just haven’t been motivated to do the brain dump to paper yet or something like that. I’ve written a few bits but nothing that could yet be shown to anyone. I figure I’ll hit the right moment and it will all fall out relatively rapidly. That seems to be the way I work. In the meantime, I have theater projects, a couple of legal cases, and an educational program that needs revising to keep me occupied.

Can’t say much about Seattle yet as I haven’t seen a lot of it other than Sea-Tac airport, the light rail and Aljoya Thornton Place. Seems to be about the same as it was when I was here in the fall. It’s been something over 35 years since I left and it’s not the city of my youth in any way, shape or form but, as I have no particular inclination to return (I could afford a semi-detached garge at current real estate prices) I’m not going to fuss too much. You can’t go home again. Neither you nor it have stayed the same.

I did something today that I very rarely do. I arranged my day so that I could get home mid afternoon with every intention of taking a nap. I very rarely do such things but I wasn’t feeling 100% today and it seemed like a good idea. I suppose, with my next birthday in just over a week marking the earliest that I can take my Social Security, I am simply entering the band of life that encompasses afternoon naps, lamenting for the way things used to be and yelling ‘get off my lawn’ at the neighbors’ children. I won’t be doing much of this latter as it is a condo building and the lawn is somewhat negligible. I’m also a generation younger than most of the residents so children are few and far between other than the occasional visiting grandchild or great grandchild.

Alas, when I returned home, my terrace was full of Hispanic construction workers doing various things that required banging, blowing, and occasional mariachi music from a portable radio. At long last additional progress is being made on the retiling project that started something over 18 months ago. My terrace, and one other in the other building, are continuations of the pool deck and, in doing the repair prep work, various previously unknown complications regarding building drainage were uncovered and the whole thing has been hurry up and wait for months and months. The big issue has to do with drainage and rain run off. Design flaws channel far too much water off the building and onto my terrace where it does not go down the inadequate drainage system, but rather seeps through the deck and down into the parking garage below. As none of the residents of Arlington Crest has any interest in living in Surfside II, repairs must be made. Even if it did cause me to miss my nap. I’m going to bed early to make up for it. I know, I know… First world problems…

I have put both UAB and the VA under notice that I plan to retire from clinical work in the late spring of 2027. We shall see if they use the next three years wisely to prepare for an outpatient clinical program that does not have me shouldering most of the burden and soldiering on day after week after month after year. These plans could change, but after all of the events of the last decade, especially the catastrophes of the last six years, I’m tired and feel that it’s time to be put out to pasture. I think I’ve earned it. I’ll stick around as emeritus faculty if they’ll let me but that will not include any regular scheduled patient care. That doesn’t mean people can’t call me up for the occasional sage advice.

Rehearsals have started for Chitty Chitty Bang Bang. I have the utility character track meaning five or six characters in one scene apiece – pretty much all vital to the plot and requiring a different look and sound. It’s going to be another one of those shows where I spend most of my time changing clothes. Fortunately, all of those years of Politically Incorrect Cabaret have made me king of the quick change. We’re just starting into staging so I don’t have a complete idea yet of what all I have to do. The ensemble is composed mainly of talented kids in their late teens and early 20s (musical theater BFA students from the local programs who are on summer hiatus). I trust the director is smart enough not to try and force me to keep up with them. They could be my grandchildren at this point. The audiences at Virginia Samford Theatre really don’t need to see me up there shaking my sixty something year old bon bons and trying to pretend that I haven’t become a Paw Paw.

I poked around the latest Covid news earlier this evening to see if there was any news worth passing on. There really isn’t. It’s still very much with us but numbers have continued to fall over the last month or so as the weather has warmed up. The death rate is about half what it was in January and February which is good news. If you call 500 people dying per week rather than 1,000 people dying per week good news. There don’t appear to be any new wide spread variants of concern and there seems to be some argument as to the formulation for this fall’s booster. Whatever they decide, I’m going to get it around Labor Day (presuming it’s available) so it’s in my system before I leave on my big trip for the year (South America – more details later).

The political news from all over is bad. It sort of makes me itch to do another edition of Politically Incorrect but I really feel that my generation is too old and needs to pass the torch down to the Millennials and Gen Z. Perhaps I can talk one of the ensemble kids that it would be a good idea to run with a Berlin style cabaret show with elements of street theater and agitprop. The local news is mainly about fighting back against the worst impulses of Alabama’s legislature and governor regarding book bans and downright cruelty to gender minorities. Apparently they haven’t figured out that those who would ban knowledge in any form are never on the right side of history. My take on it is that with Dobbs having overturned Roe vs Wade, the powers that be have needed to quickly find a new social crusade to keep the rank and file in line and gender minorities presented an easy pivot as they would have grave difficulties fighting back. I wonder sometimes if the Republican party has read any histories of the 1930s but then I realize of course they have. But they don’t read them as cautionary tales, they read them as instruction manuals.

Tonight’s an off night before the performances of ‘Opera Unveiled’ this weekend. In the opera world, because of the vocal demands on the soloists, there’s always a day off before a performance so Opera Birmingham usually has tech/dress Sunday to Wednesday, is off Thursday, and then performs Friday evening and Sunday matinee. The chorus doesn’t have a lot to do this concert (but it is nice to be back on stage singing with old friends again – the usual gang hasn’t been on stage together since Tosca in 2019 due to the Pandemic and the need to restrict the size of shows for health and budgetary reasons). Only one of our selections is difficult, the Anvil Chorus from Il Trovatore (it’s the big chorus the Marx Brothers destroy in A Night at the Opera if you want context). Verdi pitched the whole thing too high for the basses and there are some very weird counts on a couple of the entrances. There’s only twenty of us singing with the entire Alabama Symphony Orchestra so it also has to be a real sing out Louise moment. The other two numbers we are singing are the Habanera from Carmen (and barking out Prend garde a toi over and over isn’t especially taxing) and the Brindisi Libiamo from La Traviata which is an old chestnut and at least in a key that basses can sing relatively easily. If you’re not doing anything tomorrow evening or Sunday afternoon, come on over to DJD Theater at ASFA – tickets available at the door. The soloists are spectacular.

Rehearsals are beginning for my next theater project, Chitty Chitty Bang Bang, this weekend. I’ll have much more to say on that later as it starts to take shape. I saw the Broadway production back in the day. I don’t think the stage show is the greatest thing ever written, but it’s fun and has a stellar cast, some of whom I haven’t worked with in years and am looking forward to getting reacquainted with and some of whom I’ve been in shows with off and on for decades. Virginia Samford Theatre has upped its game this past season and I’m happy to be a small part of that.

I’ve been reading through various health news stories over the last few days and a couple of them have caught my eye. The first came out Monday when the Biden administration finalized new rules for nursing homes regarding minimum staffing. Skilled nursing facilities are supposed to offer 24/7 safety and monitoring for people unable to care for themselves due to various medical conditions and disabilities. Since the Reagan years, they’ve operated under a Reagan era nebulous rule that states that they need to have ‘sufficient staffing’ to offer care without really defining what that means. As of Monday, we now know that this is defined as a minimum of 3.48 hours of direct care per resident from nursing staff (lower than the 4.15 hours suggested by a Medicare report of a few years back).

The trouble is that more than 80% of the nursing homes in the country won’t be able to meet this metric and a lot are way behind it. (I think the average these days is something like 2.1-2.4 hours of direct care per resident). The rules are giving the industry years to catch up (and hire the hundred thousand or so new employees that would be needed to meet these numbers) but the industry lobbying groups are already on the warpath about unfunded mandates and are beginning the assault on congress and public opinion to get these changed.

The pandemic has changed everything about the long term industry. The workforce which provided a steady stream of employees was decimated by a combination of retirements, people moving up into better paying vacated positions, women leaving the workforce for family needs such as child and elder care, and some employees figured out new ways of economic existence that didn’t require back breaking work at just above minimum wage. With the collapse of the workforce, the owners of skilled nursing facilities have been forced to raise wages to attract and retain anyone and salaries are up about 30% since 2020. This is putting a dint in profits (the majority of homes being owned by for profit chains that are often under the control of hedge funds and the like) and requiring even more employees to provide minimal levels of care is going to greatly exacerbate the red ink on the quarterly balance sheets.

Where this is all going to end up, I do not know. But it’s happening at a time when the lead edge of the Baby Boom will hit the age of eighty in eighteen months or so. The chance of needing long term care starts to rise exponentially at that point in the life cycle and many Boomers, especially the women, have fairly weak social safety nets which would allow them to remain at home. The combination of widowhood and divorce means that about half of women over 75 live alone and they have far fewer children to take them in or support them than previous generations. And their children are far more likely to reside at a distance. It’s all headed for a perfect storm (which is one of the myriad reasons I plan on retiring in a couple years. It’s not going to be pretty).

The other story I’m following is that of the H5N1 avian flu. It’s not yet of significant concern but, if it were ever to leap into humans, it could cause major havoc as it has a very high mortality rate. There has only been one human case in Texas in the current outbreak which has spread from birds to dairy cattle in that state but in the 865 cases reported world wide over the last twenty years, the mortality rate was 53%. There doesn’t appear to be much danger of human to human transmission currently and bird to human or cow to human requires significant contact so unless you’re involved in commercial farming, I wouldn’t worry. But there’s always that slim chance. Like when a flu virus jumped into a pig farm in the midwest in March 1918, spreading to military barracks and promptly being shipped off to World War I causing what became known as the Spanish flu. (It was called the Spanish flu because Spain, not being involved in World War I, was reporting accurate casualty totals – most of the rest of the developed world was hiding the true caseloads for purposes of morale and war planning so it looked like Spain was an outlier and the source to the general populace when it had nothing to do with it).

What worries me is the politicization of public health and the gutting of statues by red states in the wake of the pandemic. Should it make the leap to human / human transmission in Texas, I don’t believe for a minute that a political system controlled by the likes of Greg Abbot and Ken Paxton will deal forthrightly with the problem and will almost certainly not allow public health officials to do what would need to be done to stop the spread. And a H5N1 pandemic could possibly bring down our civilization given that it’s about 1000x deadlier than the usual influenza A and B that circulate. But I’m not going to invite trouble. I’m going to think happy thoughts. Or at the very least find something mindless to watch on TV before bed.

It’s a negative energy weekend. It’s now 2:30 on Saturday afternoon and I still haven’t been able to make myself do the things I was going to make myself do this weekend. The must accomplish list is done including studying up on audition sides, a church stewardship committee meeting, and the inexorable tide of back progress notes. But the non-urgent pile of getting some work done on the new book, writing a movie review, and breaking the back on a new legal case remain relatively untouched while I lie here watching old episodes of Bones and staring out the window at the overcast. I’m not sure if the lack of energy is physiologic aging, psychologic coping or just plane laziness. Probably a combination of all three.

I have been in a bit of a melancholic state since returning from New York this past week. Every time I go up there, there’s this piece of me which wonders ‘what if’. I had a couple of opportunities in life to relocate to the tri-state area but I never took advantage of them for one reason or another and it’s too late now. I suppose with retirement I could find a tiny little studio pied a terre somewhere and come and go as I please but I know how I would want to live in that city and I doubt my retirement income would support that. Perhaps its best that it remains something I dunk myself in every year or two to refresh.

My upcoming audition is for ‘Sunday in the Park with George’. I don’t expect to get it. After some score study, it’s pretty clear from the tessitura that Steve did not have bass-baritones in mind when he set the keys. Still, it’s good practice to get out there and put myself up against the better people in town. Sometimes I get cast, sometimes I don’t. I’m competitive but when it comes to musicals, I remain on the B list. I just don’t have the training at a young age that so many others have had. My current voice teacher has done wonders and my technique and abilities are coming back post pandemic lay off but at nearly 62, I’m not going to be winning any vocal competitions. I’m relatively happy with my aging character man niche. I get lots of opportunities and usually have something lined up to work on. I counted it up. Since reinvigorating my theater career as a performer twenty years ago, the count is 11 plays, 29 musicals and operettas, 13 cabaret/revue shows, and 14 operas. I’ve lost track of the number of choral concerts.

I wonder sometimes how much longer I’ll be able to perform on stage. Memorizing lines is harder. My sight isn’t what it once was making wandering around backstage in the dark somewhat hazardous. I can’t move as quickly, get up and down from the floor like I once did, and my balance is leaving me. These are all normal aging things which tell me I’m unlikely to spend another twenty years on stage. I’ll have to retire, other than select projects, at some point. There’s still a lot of shows and roles on the bucket list and some of them may come my way, some won’t. Fortunately, the casting pool in Birmingham for my age and type is relatively small so I have a shot at a lot of things. I’m always up against the same guys. At least we’re all friends and I admire their abilities immensely so I never feel slighted when one of them gets the nod over me. The fact that I get the callback and get in the room to compete with them is enough.

I have to start working on a geriatrics educational program put out by a company that helps people pass board exams. I’ve worked on this before. It generally requires me to go over updated materials on various elder care topics and then video record lectures. The company likes me because I can do a forty five minute lecture in a single take, remain entertaining, digress on a few tangents which demonstrate the practicalities of the material under discussion but bring it back where it needs to be. Comes from many decades of public speaking. The public speaking and lectures on aging I did in my thirties were my training ground for performance. I figured out very early on that if you were going to be speaking about aging, dementia, death and dying, and other such uplifting topics, you’d lose the room in five minutes if you didn’t develop techniques for holding peoples’ attention including humor and a certain charismatic delivery. It was Tommy, after attending a couple of my speaking gigs in 2003, who told me I needed to get myself on stage. I owe that piece of my life. Which is the piece that has kept me sane through all of the disasters of the last decade, to him.

It’s the sixth anniversary of his death this next weekend. It doesn’t seem like it was that long ago, but I, like everyone else, has this distorted perception of linear time due to the effects of the pandemic. It was six years. I’ll be spending the day performing with his beloved Opera Birmingham in their gala concert ‘Opera Unveiled’ at the Day theater at ASFA. That seems somewhat appropriate. I spent a lot of time backstage at the Day with him as he did the wigs for Red Mountain’s summer shows including Les Miz, Mary Poppins (back again this summer), The Little Mermaid, Newsies, and so many others. I can’t walk into that space without seeing him in his blacks and his apron and his mouth full of wig pins getting everyone ready. He actually stage managed the very first performance in that theater when it opened. It was a concert by Angela Brown – ‘A Sistah’s Guide to the Opera’. A picture from a celebratory dinner after the dress is the cover photo on his Facebook page and there are the two of us, Angela, and others caught in a moment of happiness and triumph. I’ve never had the heart to take his Facebook page down. It’ll probably be there forever. And that’s OK with me.