It’s birthday week again. Both dead husbands had birthdays the second week of April – Tommy on the 10th and Steve on the 13th. Tommy would be having a milestone this year, turning 60. I’m not sure he would have liked that. Steve would be turning 77 and I know he would have insisted that the years stopped somewhere around fifty something. He would never have admitted to being more then ten years into Medicare territory. I’m missing them, but as so much of them remain a part of me in one way or another, the emotional state of crossing this particular week is becoming, as the years roll on, more and more a time of counting my blessings that they were part of my life. Steve gave me the ability to be my authentic self and to stick with my moral center, no matter what was happening in the world. Tommy gave me the ability to balance my right and left brain selves. I’m spending this weekend performing with Tommy’s beloved Alabama Symphony Chorus, the one he browbeat me into joining. We’re singing Bernstein’s Chichester Psalms and Missa Brevis. Both gorgeous pieces that bridge the sacred and the secular and I can almost hear Tommy’s tenor in my ear. The last time I sang Chichester Psalms he was still alive and in the chorus with me and I remember us sitting at the dining room table working on Hebrew pronunciation together one night.

I’m a bit preoccupied with moral thinking at the moment as our political moment gets uglier and uglier, moving steadfastly from the realms of farce and incredulity to those of true moral evil. I can think of no other way to describe the administration’s handling of the Kilmar Abrego Garcia case – transported to a gulag in El Salvador due to ‘administrative error’ and expressly against previous judicial orders and now the DOJ basically refusing to comply with repeated judge’s orders to repatriate him including a 9-0 decision from the Supreme Court. The executive’s refusal to follow the demands of the judicial and really no mechanism left by which that decision can be enforced shows how far we have sunk. Any one of us is ‘an administrative error’ away from a similar fate with no apparent recourse.

Another moral evil of the day is the Tump administration’s rescinding of federal moneys to repair the sewage situation in Lowndes county, one of the poorest places in Alabama (a poor state) and predominantly African American. Decades of state and societal neglect have led to a situation where the sewer lines from homes are basically emptying into yards. Federal money to put in proper sewer lines was yanked today under the excuse that providing it was due to DEI. Again, using a somewhat academic concept to effect bald faced discrimination obviously based in racial attitudes is, in my book, moral evil and inexcusable. Open sewers are a public health risk. As I have repeatedly said. Disease does not respect politics or socioeconomic status or privilege. Allowing disease to run rampant, which appears to be the new goal of the federal government, will hit us all. Tangentially, the CDC eliminated their arm which inspects cruise ships for health and infectious disease issues. This office was not paid for by the federal government but rather by the cruise industry itself by collected fees. So there’s no waste/fraud/abuse reasoning for this. I suspect strongly that a large corporate entity asked someone in the federal government to remove these fees and this is the result. Yet another example of our devolution back to a world where corporate profit trumps public health and safety. Given the rapidity in which norovirus and other goodies rocket through these enclosed systems, I’m not planning on joining 5000 of my closest friends in a floating tin can that hasn’t been inspected. You can make your own choices.

As I read through postings by well educated and liberal friends, I keep seeing vituperative anger at President Trump. It’s misdirected. He’s one person. Yes, he has tremendous power to set things in motion but he can’t be everywhere at once. And, given what I’ve seen of him over the years, he doesn’t have the ability or the attention to span to have come up with even a small percentage of the policies made in his name. Behind him are several hundred well educated, very wealthy, and intelligent individuals who are operating from a position of zealotry – some of it religious, some of it social, some of it political and behind them are tens of thousands of people who are actually moving destructive and detestable things forward. Some share in the ideology and feel like they are part of history. Some are doing it for a paycheck. Some are going along to get along. Some are scared that if they don’t do what they are asked that the negative powers of the current administration will be turned on them and theirs.

No matter what fuels them, or what angle they’re working – religious, social, or political – the current goal is an undoing of the last eighty years of social order defined by the liberal consensus that government should be there to protect the individual from the predations of capital and which has built a globalized economy and transnational political and social organizations. The operators of this system are the professional classes – those with advanced educations and the understanding of highly technical and sophisticated systems – of governance, science, economics and the like. They tend to have good incomes, live in desirable communities in coastal cities, and, in general, as the gatekeepers to societal riches, have had little understanding of the realities of those on lower rungs of the social ladder. I belong to this class and I suspect many of my readers do as well. They have been recast not as people to be emulated but as ‘the elites’ who must be pulled down in order for society to better serve those who have felt disenfranchised. In some ways we’re living in a rehash of the proletariat/bourgeoisie conflicts of the 1830s and 1840s that capped the industrial revolution.

There’s not going to be a wholesale decimation of professionals. We’d have a hard time keeping a hospital running without physicians or the power grid up without engineers but I think we’re going to see some targeted expunging to try and keep everyone else in line. Academics in social sciences like history and literature and political science, especially if they focus on ‘forbidden’ topics like gender and race are likely to be the first to suffer. There will also likely be a culling based on suspect class characteristics. Openly LGBTQIA, female, and ethnic minority individuals will be targets.

The administration is busy cancelling visas and deporting foreign students at US universities who have expressed opinions contrary to administration policy and goals. (This strikes me as being completely contrary to the first amendment but who am I?) The net result is going to be a major brain drain as foreign students go elsewhere for their advanced training. The money they bring to US schools will dry up. We won’t have the benefit of their talents. To use my own profession as an example. 25% of current US practicing US physicians were born and educated outside of the country. We already have a doctor shortage and we’ve been having to import for years to even begin to meet our needs. What happens when they don’t come? Lower the standards for admission to medical school to get more native born into training? And who is going to pay for the thirty or so more medical schools we would need to give capacity to have them trained?

I belong to two suspect classes. I’m openly gay and I have been openly critical of this administration’s policies for years in print (including in a couple of award winning books you might have read). I’m pretty sure I’m on someone’s list. Will I be watched? Will I be declared officially dead in the Social Security master file so that I cannot function in society? Will I be sent to a reeducation camp? I would rather not end my life in pain and misery in such a place but if that’s what it takes to show the world what moral evil is and to get people to do something about it, it’s a sacrifice I would be willing to make.

I do have a prediction regarding the LGBTQIA community. If the authoritarianism continues and there are no changes in the next few elections (I believe they will occur but that various things will prevent any change in regime), there will be a crackdown on gay men. It will likely take the form of protecting public health. There will be an outbreak of an STI in the gay community (similar to MPOX a few years ago) and that will be the excuse to try and break the power of the gay community and to make public declarations and display of male homosexuality illegal with drastic punishments for those who violate these proscriptions (in the name of protecting innocent children from diseased individuals). I hope I’m not right but it’s a very old and very effective playbook.

Alright, now I’m depressed and I’ve finished Season 3 of White Lotus so I’ll need to find something else to distract me from the moral evils of the world (not that there wasn’t plenty of moral evil happening at White Lotus Thailand…)

We’re having Alabama spring outside. The past few days were right out of July with temperatures in the 80s and then a major band of storms swept through last night, dumping gouts of rain and dropping the temperature significantly. One of the nice things about living in a concrete bunker of a condo building it that when storms do come through and rain is lashing against the windows in the wee hours, I just roll over and go back to sleep. I’m only going to get worried if I hear windows splintering and I’m only a few steps from the bathroom which is interior and right up against all of the reinforced pipe alleys running ten stories so I should be pretty safe. There are reports of spot flooding locally but that happens pretty much anytime we have a significant rainfall.

Yesterday, well before the storms blitzed through, there was a massive (at least for Birmingham) protest rally against the actions of the current administration. It was part of the national ‘Hands Off’ movement which scheduled rallies and marches in most American cities to give those who do not agree with current policies a chance to make their voices heard. There were 1200 scheduled nationwide taking various forms. A quick perusal of this morning’s newsfeed shows a couple of ugly confrontations from supporters of MAGA but no major violence so it will be difficult for the administration to claim lawlessness in the streets as a pretext for further ratcheting down or descent or the imposition of martial law.

I think yesterday was important. It reminded people that they are not alone in their feelings that current federal policy does not represent bedrock American values. When people see institution after institution capitulate to the whims of those in power, threatened with insolvency due to mob boss economic negotiating tactics, its sometimes hard to remember that there are plenty of people out there who share your worldview and seeing them gathered together can bring the endorphins up a bit. We are all in this together and the portion of the population which is in disagreement with current economic policies, DOGE’s erratic destruction of federal agencies, and the administration’s stance on civil liberties and personal rights, is too large to be made to disappear. It may not be able to get the press coverage it once would have as the leaders of corporate media are forced to pay lip service to the throne, but there are other ways of communicating and getting the word out which are not yet under government control.

However, I think there’s a few things that should be noted. First, there’s really no unifying message behind yesterday’s rallies. Everyone is bringing a different kind of ‘Hands Off’ to the table. The opposition needs to shape and focus the message. Is it hands off my rights? Hand off my money? Hands off shipping innocent people to foreign gulags? Hands off censoring and rewriting history and literature? They are all laudable but you can’t fight every battle at the same time. How is the energy unleashed by a day like yesterday going to be directed into effective action? If you let everyone take a reinvigorated commitment each in his or her own way, you’ll get nowhere. Personally, I feel we need to begin structuring movement progressivism to counterbalance movement conservatism which is currently ascendant. The conservatives played a long game of forty plus years with determined focus and are now reaping the fruits of those labors. Progressives need to take a page or two from that playbook and infiltrate the organized Democratic party, volunteer for the low level precinct work, select and run young candidates for obscure elected offices, bring Millennials and Gen Z into policy planning meetings as they will be the ones who will have to eventually craft the society we want. It’s going to take a long time but those are the rules of the game and how the system works.

Progressives also need to take the focus off people and personalities and put it squarely on policies. It’s easy to get mad at or make fun of Trump or Elon or MTG or any of the dozens of other visible high level individuals inhabiting MAGAland. But it doesn’t help anything. The work isn’t being done by those at the top, it’s being done by a small army of true believers who are focused on and carrying out policy directives. The messaging needs to be about what these policies actually do and mean to ordinary Americans and that information needs to be magnified in public discourse. When you’re the coach of a losing football team, you study the oppositions playbook and coaching methods. you don’t go out to the field on Friday night and tackle the opposing team’s mascot.

Back to work in the morning. I used to sort of enjoy that feeling, but not these days. Now it’s a feeling of walking in and knowing you’ll be blindsided by some new development rooted in the rapid federal policy changes that are rocking the world of medicine and science. I roll with the punches. I always have. Geriatrics is one of those fields that is first to suffer when the economic chips are down as it isn’t a high volume high revenue area. I’ve learned a lot about advocacy inside systems and simple survival tools over a forty year career.

I do have one bright spot. I’m getting a tax refund this year so I’ve decided to treat myself to a late spring/early summer break. I have no idea what I’m doing yet but I did schedule the time off. In the meantime, I have a Alabama Symphony Orchestra to perform in next weekend, a play in mid May and a play reading in late May so my dance card is filling up again after the winter of the never ending bronchitis. Must learn lines.

Happy liberation day or economic independence day or whatever piece of focus group tested rhetoric the Trump administration is currently attaching to its announcement of economic policies likely to implode the economy. I am not an economist. I didn’t even take economics in college as I had no interest in being a business major but even I know that a tariff is and who pays them and how and why. I also did take American history and did not sleep through the lecture on the Smoot-Hawley tariffs and what they did to the economy during the great depression. (Anyone? Anyone? Bueller? Bueller?) I thoroughly expect all of our retirement savings, bound up as they are these days in the world of IRAs, 401Ks, and 403Bs, to tank this week. It should line up just about right with the Social Security program missing its first payments in 90 years due to deliberate destruction of its data systems. Be prepared for a world where many cannot pay their basic bills and store shelves are empty. Be prepared to band together and figure out more cooperative ways of living. I found today’s tariff list interesting for two reasons. First, the placement of tariff’s on uninhabited territories like the Heard and McDonald Islands (showing that those in charge really don’t know what they’re doing – either that or the penguins are cryptocurrency geniuses). Second, there are two countries with no tariffs placed – Russia and North Korea. I find that particular tidbit fascinating.

Also in the news this week, RFK Jr. and his reformers at Health and Human Services have pretty much completely gutted the CDC and the FDA and defunded the vast majority of public health programs.. They may try to reform them elsewhere in HHS but with whom and what expertise? Given the fascination with pseudoscience over actual science among those riding roughshod in that department, whatever emerges is not likely to keep us safe from unscrupulous manufacturers and I expect cases of food borne illness to skyrocket and the chance of a zoonotic virus developing and then leaping to human populations has just gone up about a gazillion times.

I have a feeling we’re about to enter a new golden age of patent medicine where pretty much anything will be allowed to be sold under the guise of ‘wellness’ or ‘natural’ or ‘organic’ or any of the other buzzwords that make people think that it’s got to be healthier for you than chemicals from a lab. Nutriceuticals have been relatively unregulated for decades and allowed to exist as long as they don’t claim to treat or cure any specific disease process (that would then make them a pharmaceutical and subject to intense FDA regulation – whoops I forgot we just more or less got rid of the FDA). As they are mildly regulated at best, they are very much caveat emptor and there’s been little oversight to make sure what’s in the bottle matches what’s on the label. Expect government to actively encourage these products over traditional pharmaceuticals. I’m still going to trust in amlodipine to lower my blood pressure over some mix of ground up roots that may or may not be what it purports to be. I can pick you an all natural salad from a local meadow that will ensure you die in agony within a week. Antibiotics are manufactured in labs.

There have been a few bright spots. The results of the special elections in Florida and the judicial election in Wisconsin which all swung about 20 points away from previous Republican totals suggesting that the current administration has lost the middle that they need to retain a majority. If that same swing were to happen at the 2026 midterms, we’d end up with a House that’s about 320 Democrats to 115 Republicans. Then there was Cory Booker’s record breaking filibuster. It struck me as being a bit performance art but a lot of things were said that needed to be said and it does show that Democratic leadership is not completely asleep at the wheel.

I cannot help but wonder what the end game is here. The most obvious one is an autocratic takeover in such a way that democracy is formally ended through one mechanism or another. Careful planning has gone into this. (It’s not Trump – he’s not bright enough). There have been lightening fast move against the societal institutions most adept at curtailing such a power grab exploiting their greatest vulnerabilities. Judiciary – banking on the slow speed of the judicial process, purposely ignoring court rulings they don’t agree with, and using the bully pulpit to discredit the judiciary as an enemy of progress and the people. Universities – slashing their funding and then targeting additional penalties against elite institutions to make sure their voices and faculties remain on the sidelines. Legal entities such as law firms and legal aid societies – using DOJ and lawfare to threaten them with financial annihilation unless they withdraw from the field. Media – now that media are pretty much consolidated in six major corporate entities, threats to their access to information or to their ability to use public utilities and resources that they need to operate. There are no white knights coming to the rescue. The only thing that can and will change the way this country goes is participatory democracy, assuming we will be allowed to participate going forward.

There seem to be three major forces acting behind the scenes, all of which need an authoritarian outcome to advance their goals, but which strike me as being incompatible with each other in the long run. If authoritarianism continues, there is going to be quite the power struggle to determine which of these competing worldviews comes out on top and it’s going to be ugly. The first is what I call Fortress America. It’s those who want to withdraw the US from the globalized society and economy we’ve been building for the last eighty years. The US is large, rich, and has a powerful military so it has a prayer of succeeding as a lone wolf separated from the rest of the world politically, economically and militarily. To do this. we have to get rid of immigration, the melting pot, and decades of societal progress which have allowed us to have a non-homogenous society where in turn, women, minorities, and other nonconforming groups have been allowed to grow into flourishing cultures of other. The idea is the conformity of the 1950s but not as it really was, rather as it was portrayed in the media. The second is the New Apostolic Reformation and Dominionism. This is the evangelical Christian ideal of a biblical based society where everything is ordered on some sort of biblical model. Just whose model is not explained. There are vast differences between the various conservative Christian sects and there’s no war like a religious war. (The religious wars in Europe were fresh in the minds of the founding fathers when they decreed the separation of church and state – they knew). This is the America of The Handmaid’s Tale. The third is the rise of the technocrats who view a nation state as some sort of corporation where only the CEO class using business decisions should have any sort of societal weight. It’s epitomized by Elon and the Muskrats and what’s happening with Doge. It has some twisted eugenics mixed in. Which is why Elon keeps have IVF sons with different women and felt so betrayed when one of his sons turned out to be trans. I have no idea which of these general philosophies would prevail. I just know I have no real interest in living under any of them.

What comes next? I imagine the country club Republicans will check their portfolios tomorrow and start screaming at congress to do something before things get worse. The problem is Musk and Thiel and their ilk can outspend them ten to one so they may not find their voices as loud as they once were. We’ll see an acceleration of deportations and eventually some American born citizens who happen to be the wrong color will end up in a gulag in El Salvador or elsewhere. I’m expecting some prominent critical voices to be silenced or disappeared. All of Heather Cox Richardson‘s posts to Facebook since March 25th have mysteriously disappeared. Get on her Substack list. I won’t be surprised if some of my writings start vanishing, but I’m small potatoes. If they need to deflect and distract there will be some new nonsense they can feed the news cycle – something to provoke maximum outrage which makes minimal difference in life. Trump to paint White House gold or the like.

I can’t do anything about any of this. You can’t do anything about any of this. Well, that’s not strictly true. You can get out and volunteer for civic organizations which are having their funds cut, start doing the boring precinct work for the opposing party, register to run for office yourself. I’m getting too old for most of this but there’s a huge generation of younger people who will have to live in this world for some decades. Don’t like it? Change it.

And the bronchitis wanes just in time to be replaced by seasonal allergies. It’s pollen time and I have the pale green coating on my car to prove it. Perhaps I’ll take it in for a wash and detailing this weekend. It’s overdue. Hope is now 7 years old, has 75,000 miles on her and I was kind of thinking about replacing her this year but with tariffs about to crash through the automobile market, I think that may have to wait until some sanity returns to the economy. Given the rate we’re going, that may not happen until sometime around January 2029.

So what’s happened this week? The most senior members of the cabinet were caught texting each other on an unsecured app about battle plans that should have, by definition, been classified data. There are protocols for handling this sort of thing, put in place to prevent leaks, foreign peeking and interference, and appropriate adult decision making over things that have life and death consequences. Texting them back and forth with emojis like a bunch of middle school girls trying to plan a group outing to the mall doesn’t strike me as being particularly wise. But then wisdom does not appear to be a strong suit in federal circles at the moment. A quick reading of project 2025 shows that the idea for using Signal as a means of communication comes right out of their playbook. It bypasses data and communication retention laws on the federal government and prevents those pesky FOIA requests so beloved of journalists. Of course when you mistakenly (or was it a mistake – could it have been a set up?) add a journalist to the group chat…

Today’s announcement is that FEMA is being wound down and, after October 1st will no longer be available for long term rebuilding following national disasters. My guess is the play here is that special exemptions will be passed in the future to assist red states after the usual vagaries of wind, water and weather but that no such exemptions will be issued to blue states. The politicization of the federal government continues with an authoritarian executive rewarding friends an punishing enemies. It’s also very apparent in DOJ which seems to be focusing it’s resources on going after law firms that dare to represent clients suing the government for various illegal acts and violations of civil liberties, preventing potential plaintiffs from retaining competent counsel as the big firms circle their wagons to protect their interests.

Meanwhile, out on the streets, people are being snatched up and disappeared into various ICE hellholes without charge or warrant for having opinions critical of official administration policy. Those who suffered rendition to El Salvador on minimal evidence have been erased from ICE databases. They no longer exist. I have also heard from a number of sources of cases of native born US citizens having been stopped for driving while brown and a demand for proof of citizenship. We’ve never had to carry our papers or passports in the past but that may be changing.

Now that the war on the trans community is pretty much won, the MAGA machine is turning its sights on the LG and B. The drumbeat is on to overturn Obergefell, prohibit and nullify adoptions, and repeal the laws that on local and state level protect us from discrimination (there is no federal law and there won’t be under this administration). It is, of course, all being done ‘in the name of the children’ which resurrects the old canard that gay people should be equated with pedophiles. I read the news. I have yet to see a drag queen arrested for child abuse. I’ve seen plenty of preachers, teachers, and scoutmasters. Most pedophiles are heterosexual and gravitate to where children can be found, which is not the local gay bar. One trend I have noticed over the last month is corporate America pulling back en masse from sponsoring Pride festivals or other LGBTQIA events. We’ll survive without their money. But it’s emblematic of a sea change in the culture which is going to leave the community very exposed over the next few years. If you’re not LGBTQIA yourself, are you truly an ally? What will you do when bit by bit there is a crackdown on what gay people can do with their lives? Will they be banned from certain professions? Will they be forbidden from joining the military? Will their ability to travel be restricted? Will landlords be given incentives to turn them out of their homes? Will their safe social spaces be raided and closed? Don’t think it can’t or won’t happen.

RFK Jr. is planning on firing 10,000 people from Health and Human Services and taking the FDA, CDC and NIH and rolling them all up into a new agency AHA (America Healthy Again). My major objection to this is that the very defined missions of the older agencies will be left to wither and die while we chase after some sort of impossible nirvana made up of untested supplements, nutritional recommendations that cannot be afforded by a significant part of the population, and deliberate discrediting of various areas of proven science for political reasons. Big food and big agra and big pharm will be salivating as they’ll be able to figure out cheaper (and potentially far more dangerous) ways of getting their products to the public and there won’t be the watchdog eyes to stop them. I never dreamed we’d be in danger of going back to the days of Upton Sinclair’s The Jungle but it’s a very real possibility. Buy your stock in Lydia Pinkham’s Tonic and Carter’s Little Liver Pills now.

After writing all of that out, I’m feeling a bit overwhelmed. Time to get out my optimistic nihilism glasses. (I had my annual eye appointment last week – my eyes haven’t changed in nearly twenty years and the freckle on my retina remains exactly the same). I have two performance things to work on the next few weeks. I’m doing a supporting part in the play Second Samuel for Bell Tower Players which goes up Mother’s Day Weekend and I have a symphony concert in two weeks singing Bernstein’s Missa Brevis and Chichester Psalms. My inability to sing due to bronchitis from hell seems to have been a blessing in disguise with my singing voice. Now that it’s back, I’ve made some huge strides in my voice lessons. I’m also still plowing through Covid writings. What they will end up as I’m still not sure. More news on that later.

I need a prolonged break from work. I’m going to take some time off in late May and or early June. I don’t know yet what I’m going to do with it. I’m planning my big trip for the year for September/October. Don’t have specific plans yet for that one either. A lot will depend on how the taxes fall out and I should know that in the next two weeks.

It is March the 22nd. We are past the equinox and spring has sprung. In Birmingham, we’re having a sunny, but cool day, the flowering trees and shrubs are starting to show out, and the birds outside of my condo seem to be particularly happy about something. As it is also Sondheim’s birthday (his 95th and the 4th since his apotheosis at Thanksgiving 2021) which is one of my personal holidays. I suppose I could spend my retirement years pushing for Sondheim awareness and devising the just so ways of celebrating Sondheim-mas every 22nd of March – a national toast of vodka stingers at noon, a celebratory recitation of The Story of Lucy and Jessie before the evening meal, ‘Don’t Touch the Coat’ sales at Macy’s. But I think there are, perhaps more important calls on my time and energy.

I continue to be as befuddled as the next American of reasonable education and moderate intellect at the explosion of relative insanity emanating from Washington DC over the last week. I am not the person to collect and analyze all of the actions and repercussions of the administration’s actions and Trump’s endless stream of executive orders. I’ll leave that to the trained political scientists and historians who are sifting through the wreckage and trying to make sense of it all. One of the first things I do in the morning, after Wordle, is to read Heather Cox Richardson’s piece from the previous evening summarizing the political events of the day and contextualizing them within the arc of American history, pulling out parallels from the last three hundred years. If you haven’t discovered her yet, look her up.

I have noticed a number of themes and variations that are making themselves known. First, while it all seems like chaos, this has all been carefully planned and orchestrated by the Trump team and the work likely took several years. There are too many results too quickly. If it were happening in an off the cuff manner on whims, there would just be a big muddle and not much forward momentum. Second, the administration is determined to shred the idea of three coequal branches of government (and if there is a first among equals in the constitution, it’s the legislative as that is the branch that represents the people) in favor of an authoritarian unitary executive. The fact that the legislative seems to be rolling over and playing dead with a few notable exceptions like Bernie and AOC makes little sense to me. Does the administration have kompromat on them all? Are they that scared of the MAGA true believers harming them personally if they foil any of dear leaders plans? Is there money changing hands in ways we are not privy to? Well, that last one is always true no matter where you go in politics. Third, the political party that made an art form out of judge shopping and using the federal judiciary to create injunctions based in politics rather than in legal theory (see the career of Judge Matthew J. Kacsmaryk of Amarillo Texas) has now decided that a judge should not be able to stop any action of the executive, no matter how illegal it may be. The lawyers issuing forth from DOJ are going before the bench with arguments and preparedness that would have gotten them laughed out of first year law school and the judiciary is starting to clap back. It also shows just what kind of ‘only the best people’ are left at DOJ. On a tangential note, I have heard that the Kennedy Center is canceling a planned production of the musical ‘Legally Blonde’. I wonder what the objectionable material is – the gay character or the portrayal of competent legal counsel.

The most dangerous things happening are those happening on the immigration front, whether it is high profile deportations of physicians and scientists or the keeping of ordinary European tourists with visa paperwork problems in chains for weeks. Each one of these cases is being used to test the boundaries of what the administration can get away with. While the victims of these actions are probably random, my guess is that the types of cases are not and they are all being used to build, bit by bit, an infernal machine dealing in human misery. The rendition flights of the Venezuelans to El Salvador are particularly troubling as there seems to have only been the most slapdash vetting of the cases and those unfortunates have been marched into a gulag from which it may be very difficult for them to win release. I was taught in elementary school civics that the American justice system was built on the idea of innocent until proven guilty in a court of law and that it was better that ten guilty people should go free rather than one innocent one be convicted. We seem to have thrown that whole basic ideal of American jurisprudence out the window.

I am very worried that when the deportations do not go quickly enough to satisfy the Stephen Millers of the world (I don’t think that Trump himself much cares – he just thinks of it as a winning strategy to keep MAGA behind him), we’re going to see more and more extrajudicial actions and likely extrajudicial violence as well. I don’t think it would take a lot for Fox News to foment a pogrom against immigrant communities or for that good old American pastime, the lynching, to make a comeback. I hope I’m wrong but I’m feeling it in the air. The other community in extreme danger is the transexual community, a tiny and harmless minority. There are various legislative movements afoot which will eradicate their existence as human beings in the eyes of the law – very similar to Germany’s first moves against the Jews in the mid 1930s. And I don’t believe for one minute that the unleashed forces of MAGA and Dominionism will stop with the T in the LGBTQIA+ – they’re just the low hanging fruit as they have few defenders outside of the queer community. I’m starting to feel the target settling on my back as a gay man – but I lived through the last decades of the 20th century in that condition and I know how to handle it. The young uns with only 21st century experience are about to get an unpleasant education. If I have one piece of advice for young queer adults it’s to make some friends in older generations – you’re going to need them when things get worse.

Here’s to multiple targets: Gay man, openly critical of the administration in print, non-Christian, strong ethical and moral code. At least I’ll enjoy the other passengers in the boxcar.

Day 35 – down to just an intermittent asthmatic cough from time to time. I’ll take it. I actually felt relatively normal this past week and stamina for work and other activities and managed to make it through all of my usuals without too much trouble. I actually thought I sounded rather good in my voice lesson this past Wednesday. It made a nice change from croaking. Wednesday also brought a rather unexpected piece of news regarding the performance career and a rather high profile gig for next season. I have to vaguebook about this one as I have not yet signed the contract. I’ll spill the tea once that happens. I’ve been walking around all week thinking that this proves I have moved from the Birmingham performers C list to the B list. I just don’t think I’m versatile enough for the A list. Maybe I should learn to unicycle while playing the mandolin – but then again, I’d rather not fracture a hip.

The week has been uneventful, consisting mainly of work duties and board meetings. I really need to stop saying yes to serving on non-profit boards until after I retire and have the time to devote proper time and attention to civic life. At the moment, I’m on the board and executive committee of Opera Birmingham, the board of The Virginia Samford Theatre, the board of Central Alabama Theatre, the board of Alabama Equality, the executive committee of Bell Tower Players, the advisory council of Birmingham Music Club, and the Alabama Symphony Orchestra Volunteer Council. That doesn’t include the other things that are health related and are rolled up under my day job. I get it from my parents. My parents were that couple in the neighborhood who stepped in and ran every organization and ran it well – PTA presidents, Boy Scout and Girl Scout leaders, Soccer coach and ref, community club etc. etc. I was raised to be civic minded and to want to give of my gifts to improve things that are available to much wider circles than just me and mine. Pity our politicians have abandoned this.

The weather is warming. This has produced a nasty storm front which is even now barreling into the greater Birmingham area. The weather reports have been full of hyperbole as to how bad it could be and the high likelihood of tornadoes. My condo building is a cast concrete bunker. I think I’m safe. I’ll just move into the master bath if the windows start blowing out. The last really bad tornado day was in April 2011 when a chain of tornadoes, began outside of Tuscaloosa, ravaging the center of town and then moving northwest as far as the Birmingham suburbs while other storms touched down outside of Gadsden and in various rural areas. 338 people died across five states, more than 200 of them in Alabama. The Tuscaloosa tornado was a late afternoon storm. I had finished work a bit early and gotten home. Tommy and I had heard the weather report so we made an early dinner, and went down the many flights of stairs to the basement to watch a movie while we ate. While we were there, both of our phones started to ring like crazy. Various friends from out of state who had put on their five o’clock news and wanted to make sure we were OK. We were fine. We didn’t even know how serious things were until we got those calls. That’s when we switched over from whatever we were watching to the news. I found a piece of someone’s roof on our top deck the next morning and a couple of pieces of paper floated down from the sky into the yard but none of them was of particular interest.

The cold and flu season from hell appears to be retreating, another effect of warming weather. Along with allergic rhinitis. I’m going to blame the Bradford Pears as it’s fashionable to blame them for any number of horticultural ills these days. How bad flu season was is difficult to discern. The current administration’s knee capping of NIH, CDC and withdrawal from WHO has made it difficult to find accurate numbers regarding cases, morbidity and mortality from the usual respiratory viruses. From what I have been able to discern, Influenza A and B are both in retreat. RSV is hanging out at a low level and Covid continues to be an ever present issue with about 10% of the population infected over the winter. The continued rising and falling of Covid makes me worried about how the prevalence of long Covid or other sequelae is changing in the general population. It’s pretty much impossible to know currently due to politics.

The FDA cancelled the usual meetings regarding the formulation of next year’s flu vaccine and debate over what strains should be covered and what likely patterns will be. They gather data worldwide through WHO and use Southern Hemisphere mid year data (their winter) to make best guesses. If additional work on the 2025 flu vaccine is canceled due to politics, we will miss the deadlines necessary for the manufacturers to gear up production in mid to late summer so that it is ready for distribution by early September. My reading of the tea leaves is that the US will not have a flu vaccine in 2025 (and likely not in 2026, 2027, or 2028 either). If obtaining one is important, start planning that weekend jaunt to Montreal now. Assuming we haven’t invaded.

We are also likely to lose our access to covid vaccines for political reasons. The scuttlebutt is that the Department of Health and Human Services will pressure the FDA to revoke the approvals for any mRNA based vaccine (the Moderna and Pfizer Covid vaccines). It will be couched in quasi scientific terms but will basically be the codifying of a lot of junk science, false information, and political imbroglio that erupted once the vaccine became widespread in the spring of 2021. The most recent update of the covid booster was last September. If you haven’t had a booster since before that date, it might not hurt to get one as it’s entirely possible we won’t have them any more in a few more months. The current recommendation for boosters is annual (like flu) but every six months for those who are frail or who have significant immune or pulmonary problems. After my month with phlegm fountains throughout my respiratory tract, I’m thinking about taking that six monther this spring.

There’s been the usual firehose of political bad news. They’re invoking the Alien Enemies act which makes it easy for the federal government to move against non-citizens. It doesn’t apply to US citizens but once the hysteria gets going, you get Japanese American internment camps. The markets continue to tumble, whipsawed by nonsensical tariffs, an economic concept that no one in the Republican party seems to understand. Elon and the Muskrats continue to knock out the foundations of the government by infiltrating data systems. And, the government is not shutting down today as a continuing resolution was passed regarding spending meaning we’ll go through this all again in September. I’m just not sure what game the Democratic leadership is playing. They seem to be stuck using Clintonian tactics for a massive emergency thirty years later. They give the impression of having shown up for a street brawl with a nerf gun, a couple of badminton rackets, and a pointed stick someone broke from a tree. Perhaps it’s time to clean house and send all those over 70 or so home and let Gen X and the Millennials take over. They at least seem to understand what the issues are.

The rains are here and it’s time for dinner. Must lay down pen (actually laptop keyboard).

Now officially celebrating 31 days, one full month of bronchial inflammation! Everything has cleared up other than the occasional coughing fit which produces reactive airway wheeze and a feeling of impending status asthmaticus which resolves itself in a minute or two. I figure I have about a week to ten days to go until that finally subsides but as long as everything else is holding together, I’ll put up with it. I am most happy about the return of my singing voice which suddenly came back on Sunday evening after having been missing in action for over four weeks. I hadn’t realized how much I had missed it until some bass sonority started rolling out of me when I sang along to the radio. I don’t know just what nasty little virus this was, but I hope my immune system does its job going forward and keeps it from ever returning. It was heinous.

I took this past weekend off from usual pursuits. Instead, Patti Steelman and I road tripped it over to Atlanta on Friday afternoon for an overnight at the W hotel. After checking in and a visit to a not very good vegan restaurant at Ponce City Market (atmosphere 7, food 4) we headed off to the Cobb Energy Center to see Verdi’s Macbetto at the opera. (I’m going to cling to theatrical supersition here and not use the English version of the Scottish Play’s name). Patti is now a regular theater buddy but I doubt I shall ever get her to really appreciate opera. But she does tolerate it. And I gave her some homework so she had some background on Verdi and his approach to the material before we went. I had listened to this one before but had never seen a production so it was nice to tick it off of my life list.. Michael Mayes, Baritone played the title role. Many long years ago he sang the role of Valentin in a production of Faust for which I was in the chorus. He was handsome, supremely talented, affable, and an all around good ol’ boy – which befits someone who hails from Cut n Shoot Texas. Now he sings dramatic heavy roles in all of the great opera houses of the world (De Rocher in Dead Man Walking, Sweeney in Sweeney Todd, Alberich in The RIng Cycle etc.) I made journeys to Atlanta opera to see him in the first two roles. Haven’t had the courage to take on the full Ring Cycle yet. He and Tommy, in particular really got on well. They were both scions of the rural working class and saw the world in the same way. The opera was quite good. Atlanta has come way up in the world over the last few decades and is now a top ten company like Houston, Seattle, San Francisco, and Santa Fe.

On Saturday, Patti and I headed back to I-20 and continued east another three hours or so to Columbia, South Carolina where we met up with one of my favorite partners in crime, Frank Thompson. Patti and Frank had gotten to know each other on social media but had yet to meet in real life so we had a very pleasant long late lunch/early dinner, before we had cocktails (none for Frank before a show – there’s a very long story there involving a performance of Cabaret some years ago) and headed out to the small suburb of Chapin to see Chapin Theater Company’s production of Chicago, in which Frank was continuing his journey through all of the roles originated by Jerry Orbach by essaying Billy Flynn. It was done in a small black box space, making it all very in your face which served the material well and I ended up enjoying it immensely. Or was that the cocktails? More cocktails post show and then to bed to enjoy the time change before getting up for the long drive back.

I pretty much divorced myself from news and politics during my weekend away, but, when returned, I found that 1) measles continues to spread with the government drop shipping budesonide and vitamin A into the affected area rather than vaccinations. 2) tuberculosis is starting to surge in Africa with the collapse of surveillance and treatment programs that were run by USAID. 3) right wing thinkers are pushing the narrative that it is our manifest destiny to invade and occupy Canada. 4) the stock market is in free fall 5) the president is selling cars on the south lawn 6) that the rhetoric is being put in place to dismantle Social Security, Medicare, and Medicaid using a makers and takers dynamic in which only those who are productive and make society go truly deserve government benefits. The takers who depend on government largesse to survive are simply second class citizens whose needs and wants need not be considered. Honestly, I am seeing American society as an oversize Jenga game. The current administration keeps knocking blocks out and eventually the whole thing is going to collapse on all of our heads.

Anyone who can do simple math (and I don’t think this includes most politicians of either party) can understand that the government has been in deficit spending for decades. We can have long arguments about what this actually means but those who try to reduce it to some sort of upscaled kitchen table family budget are way oversimplifying things. If we wish to reduce the deficit spending, there are two choices: increase revenue or reduce expenditures. Increasing revenue (taxes) has been anathema to Republicans since Reagan and they remain slavishly devoted to the idea of supply side economics despite nearly fifty years of failing to do what they constantly promise. The administration is desperate to extend the tax cuts it passed for the wealthy in 2017 during Trump’s previous term. This will skyrocket deficit spending. The only way to offset this is to cut trillions from federal spending.

If you look at federal spending, there are only three areas in which trillions of dollars in savings can be achieved. The Department of Defense, Medicare/Medicaid, and Social Security. Elon and the Muskrats can take a wrecking ball to the entire federal bureaucracy, fire everyone and close every program and office and it will only reduce federal expenditures by about 4%. Everything that’s going on right now is pretty much waste fraud and abuse theater and has nothing to do with any sort of logical plan to save money. Cutting where the real money is is fraught with political difficulty. Elon’s public statements show that he is ready to ride in and pull down the temple but those who actually have to face voters for reelection don’t seem to be quite so sure.

Let’s look at the law of unintended consequences as applied to Medicaid, the most vulnerable of these buckets of money as it is for ‘the poors’ and therefore must be going to the undeserving poor and meet the rather malleable definition of waste fraud and abuse that’s currently being bandied about. As I mentioned in a previous essay, Medicaid is the public funding mechanism by which we provide custodial care (nursing home placement) to those who have become unable to care for themselves due to age, infirmity, or bad luck. Somewhere around half the dollars in the long term care industry originate in the program and it is one of the most expensive line items in the general funds of many states. Why? More older people who are living longer. And for the most part, the Baby Boom hasn’t yet aged into their custodial care years so these expenditures are going to increase mightily over the next couple of decades, and then come back down as the Boom enters its die off in the later 2030s and 2040s.

Let us say we take an axe to Medicaid and that pot of money with which we have been paying to maintain this population shrinks while the population itself is increasing. A number of nursing homes, most of which are corporate owned under venture capital firms, will simply close as unprofitable, causing huge strains on the ones that remain. If the federal government is not providing dollars anymore, what is the state to do? I suppose it can abandon frail elderly people on railroad sidings and downtown parks but that doesn’t look good on the nightly news. It will look for alternate revenue sources. Thirty of the fifty states (Alabama is not one of them) have what are called filial duty laws. These are laws that state that if a parent is aged or infirm, it is the legal obligation of the children to provide for their parents needs and that the state can use the legal system to enforce this duty. This means that the state can seize assets, garnish wages, sell off property of the children to meet the nursing home bills of the parents which are no longer being covered by federal Medicaid dollars. The public hasn’t figured this one out yet but when the state takes your kid’s college fund to pay for your mother’s dementia care, you might have certain visceral reactions to that.

I have no idea how this is all going to work out. There are now calls from both sides of the aisle to leave Medicaid, Medicare and Social Security sacrosanct. Fine. But if they do, those extended tax cuts for the wealthy are going to skyrocket the debt making all of the chaos that’s currently being sown moot. I’m not a politician. I’m not an economist. I’m just a professor of geriatric medicine pointing out that when you make changes in complex systems, there are ripple effects and the more complex the system, the more titanic those effects may end up being.

Here endeth the rant. Gotta write some patient progress notes.

Day twenty-six. Down to just an occasional coughing fit reminiscent of a bronchial orangutan. With luck I’ll be through it all by the end of the weekend and can start afresh this next week. In the meantime, I’m still trying to get plenty of sleep and not over extend myself. I’m not doing a lot outside of work other than writing – on those evenings when I don’t feel too draggy. Writing these missives, movie reviews, work progress notes, and stuff my publisher wants keeps my brain active but at times I can only do so much before I stare blankly at the screen without anything more to say. I look at the prodigious and well reasoned output of someone like Heather Cox Richardson and I wonder how she can possibly do it. Maybe if I was a trained historian with an encyclopedic knowledge of US history – which I am not.

In terms of the areas in which I do have training and expertise, not much has changed this week. Measles continues to spread. Covid and flu numbers remain high (but down from what they were earlier this winter). The bird flu continues to lay waste to factory farming – don’t expect the price of eggs to come down in the near future. It’s difficult to tell what’s happening on the international front given the severing of ties between the US and WHO and the muzzling of CDC but there are rumors of a new respiratory virus in China and a filovirus in Africa. Who knows if either of these will get out and start wreaking havoc.

In politics, POTUS used his bully pulpit to hurl personal invective, insults, and both misinformation and disinformation to a joint session of congress. But that’s neither new or surprising. The Secretary of the VA announced that he will cut the VA’s workforce by 83,000 jobs (about 20% of the total). What that will mean for services or for what I do within the VA who knows? I assume they’ll simply remove the house call program wholesale nationally as being inefficient. It’s been a dream of the right wing to privatize VA services and monetize them for corporate profit for decades so that’s likely the short term set of moves. Veterans around here tend to skew pro-Republican and may be a bit surprised to find their benefits curtailed as time goes on.

I hear about various other things in my readings and internet wanderings but I can’t always tell what is true and what is hyperbolic rumor. Both left and right are so busy lobbing verbal grenades and propagandistic memes at each other that it isn’t always possible to decipher what is actually going on and I try my best to stay relatively objective when it comes to politics and to comment on policy and not on personality. While I’m on the blue team, I don’t think that means all red team ideas are automatically wrong or backwards and that all blue team ideas are delivered from the gods on stone tablets. It’s much more nuanced than that. I’m a firm believer in shades of gray.

Much of the current dysfunction can be traced back thirty or forty years to the ascendancy of the Baby Boom (then known as the Yuppies) who gravitated to centers of power in coastal cities and began to discount anyone who did not do the same or share their values – flyover country. As the center of the country, both geographically and economically, hollowed out through policies aimed to bolster the more monied classes, those left behind, became more and more desperate for a voice. The modern Republican party, especially Trump, gave them that but has done so mainly by funneling impulses into destruction and hardening of partisan lines, rather than in compromise, dialogue and cooperation, traits necessary for functional society.

The left also refuses to unify, generally splintering itself over purity tests of one kind or another which diminishes their power or ability to accomplish things on a national scale. The ostracism of Al Franken over a poor taste joke was a huge strategic blunder. The inability to understand the history of the Palestinian conflict. I read a news article about the cancellation of a student production of Stephen Sondheim’s Assassins at Northwestern last week. I assumed it was due to right wing complaints of the glorification of presidential assassins and the message this could send about the current administration. No, it was due to left wing complaints about the use of the N word in a song lyric, placed their deliberately due to historical conflict and to make the audience feel uncomfortable. If we on the left cannot accept the more uncomfortable parts of our past, how can we accept those on the right to honor such ideals?

What’s someone of the center left to do? I work to educate younger LGBTQ people about the realities of the experiences of my generation so that they don’t have to go through the same things. I try to stay informed, while using my brains to try and stay out of the weeds of propaganda. I use my talents to create things that can help people see problems – in healthcare, in society, in aging – in new ways. I don’t have the answers to most of what’s facing us but somebody out there does. Maybe I can be a spark to help light a fire.

At last, after three weeks of hell, I have turned the corner and am on the mend. I still have the occasional chest death rattle and cough like a kudu with pertussis but it’s only about once every ninety minutes or so and I didn’t wake up once last night. I’m still feeling a bit tired and under the weather but I’m hoping it all clears up over the weekend and I can meet next week with full gusto. Fortunately, next week is a light one as both of my full VA days are devoted to classes that I don’t really need, especially the one about defending myself against attackers armed with fresh fruit, or is it pointed sticks?

The world continues to go to hell in the proverbial handbasket, at least here in the USA. I could not bring myself to watch the attempted mob shakedown of Zelenskyy in the oval office, reading about it was bad enough. The right wing was busy chortling about Trump’s masterful diplomatic skills. My take was a couple of thugs who had a petulant temper tantrum when they didn’t get what they wanted. But it might all have been Trump’s understanding of the presidency as some sort of reality TV show where he performs for the cameras and I’m sure he felt it all made for exciting television. Governance brought to you by Real Housewives…

So now that the executive branch is all in for Russia (with the Republicans in congress acting as a cheerleading squad from the sidelines – just don’t let Mitch or Lindsay form the top of the pyramid), I’ll have to assume that our traditional alliances are pretty much on life support. If I were the EU I would not only offer immediate admission to the Ukraine, but I’d throw in Canada and Mexico as well, walling us off in a major time out until our toddler tantrums are done. I am putting off making my major travel plans for the year as I can see the diplomatic wars escalating over the next few months and a US passport may not be as welcome as it was a few months ago. If nothing else, I expect I’ll be socked with some very expensive visas going forward.

It is definitely time to revive Politically Incorrect Cabaret. I’ve got a venue that’s willing to host it going forward and I am in possession of the company’s few assets. I just feel that I’m the wrong age. My generation is on their way out. Dealing with this political moment and the aftermath is going to be a task for the millennials and gen z. So come on, one of you theater kids out there in the greater Birmingham area has to have an interest in Weimar Berlin style cabaret forms, street theater, political satire, and holding that mirror up to society. People assume that PIC is/was an anti-Republican thing. It’s not. It’s a way of using theater to expose the problems in the power structure, no matter which party may be in charge. (Heck, we did a whole show lampooning the Democrats a few years ago). And we never did a number or a sketch about Trump. If you think you and your friends are the right people to pick up the torch, let me know. And now a chorus of Do You Hear the People Sing?

For the first time ever, a state has eliminated previously granted civil rights. The legislature of the state of Iowa passed a law to remove gender identity from the list of innate human characteristics that is protected by anti-discrimination law. So if you live in Dubuque, you are now free to refuse to hire, provide services to, or rent to Caitlin Jenner. The vitriol and cruelty being unleashed against transgender Americans by current political forces reminds me a good deal of the sort of behaviors that led to public lynchings and I won’t be surprised if they start to occur. They’re a tiny minority with zip political power and we’re starting to see denial of state documents such as passports due to ‘incorrect’ gender markers, organized campaigns against their participation in public life and there are moves afoot to force medical detransitioning which would be exceptionally cruel. This was, of course, all begun ‘because of the children’ but the proscriptions are rapidly moving out of pediatric medical treatment to all medical treatment of gender dysphoria. And so many of the proposed laws are so vague and broad that all sorts of things will be caught up in them. No stage depictions of a character in gender inappropriate clothing would get rid of most of the Shakespeare comedies and even Charley’s Aunt, delighting audiences since 1892. (When you’re looking at banning things the Victorian’s didn’t have a problem with, maybe you’re the problem…) Heck, even Les Miserables would be out as Eponine dresses as a boy in order to cross the barricade.

Then there’s the medical front. The Texas measles outbreak continues to mushroom. At least one ill person, of course, got on an airplane so there should be additional pockets of infecton popping up shortly. There has not been one word out of the usually loquacious governor and attorney general of Texas regarding this particular issue. Word has come down from on high that staff at the CDC are prohibited from collaborating, coauthoring papers or doing any other professional work with anyone at WHO. Preventing the sharing of scientific knowledge has never been a winning strategy for any society ever so I’m not sure what the powers that be think they’re going to gain from this decision. And, the destruction of USAID has taken out the TB control programs which prevent its spread. The program not only protected the US, it was also the backbone of the global harm reduction program. We can hope the EU will step into the gap but there’s no guarantees. I wonder what global corporation is investing in new TB sanitariums?

There are other disasters in the offing. We’re two weeks from defaulting on the national debt with a congress that’s completely out of control and which has abdicated a number of its constitutionally mandated duties. Elon and the muskrats took a chainsaw to NOAA and the National Weather Service. Sure, there are private weather forecasting services, but where do you think they get the data that goes into their models. Be prepared for far less accurate warnings of tornadoes, hurricanes, tsunamis and the like. Twenty-six months to go until I can hide under a rock, if I can make it that long. In the meantime, I have to get back to my other writing projects now that I have a bit more stamina.

I am now on day eighteen of the cold virus from hell. While the snot factory has reduced production somewhat over the last few days, it hasn’t quite gotten to the point of going out of business sale and I am still blowing my nose and hawking up pieces of lung far more frequently than is comfortable. I don’t feel that bad. Just a bit tired. I’m just really really over feeling under the weather. It will be three weeks on Sunday and that’s about two weeks too long. I keep hoping each morning when I open my eyes that I’ll check out my body and I’ll feel that finally this is the day that I’ve turned the corner. No such luck so far. Hope springs eternal.

Not much happened on the rest of my brief visit to Seattle. I spent most of my time visiting with family, writing, and watching bad TV. Not much of import happened other than my sister producing a very good family dinner of linguini with clams at her house on Sunday night. Would have been better with a good glass of wine but I’m avoiding alcohol at the moment other than the medicinal amounts in NyQuil so as not to exacerbate anything. Monday was devoted to the return trip and, for the first time in five years, Sea-Tac airport was not a complete zoo when I stepped off the light rail to check in for my flight back to the southland. Bag drop and security lines were both properly staffed and functioned as designed. I was gobsmacked.

Fortunately both this week and next week are relatively light weeks at work so I should get in enough rest time outside of work to shake this puppy for once and for all. And once I do, I plan on nailing this particular virus in a lead coffin and tossing it overboard several miles offshore in the Gulf of (insert your preferred geographical term here) as I never want to see it again. It should also give me the time to tackle the next major domestic chore – the taxes. And I’m still trying to catch up on the writing assignments due to my publisher. I have clawed my way forward on some, but I’m still a few weeks behind on the schedule as it exists in my head.

So what’s going on in the world? The House of Representatives passed a resolution to allow a ‘Big Beautiful Budget Bill’ which will be stuffed with tax cuts for those with more money than they can possibly spend and draconian cuts to those with the least. I wrote a bit about what the proposed Medicaid cuts will do if made law last time I wrote one of these essays. None of that is off the table as only one Republican, Thomas Massie, found the spine to stand up and say that this sort of gutting of services is wrong and not who we are. It’s not law yet. It will have to pass the house still as a budget, requiring the Republican party to go on record as specifically voting to take a meat cleaver to Medicaid (and a lot of their constituents are going to be shocked when they find out that’s what pays for their kids and mom in the nursing home and very little of it is going to fictitious Cadillac driving welfare queens in some far off big city). One can hope that the Senate will hold the line some but I’m not sure about anything these days when it comes to members off congress which makes me wonder what hold to the powers that be have on them (and what sort of data have Elon and the muskrats been vacuuming out of various archives that they don’t wish to have publicized).

I’ve always loved Charles Dickens’ A Christmas Carol and find Ebenezer Scrooge a fascinating character. When we first meet him, he’s a miser, a misanthrope and a thoroughly odious human being whom we later learn through the visits of the ghosts was not always that way, but was self created due to fear, generational trauma, and bad choices. At the end, he is the same person, only returned to who and what he should have been had he made different choices earlier in life and if he had not been as badly scarred as he was by others. I got to play him once in a production that used most of the original Dickensian language. It was interesting figuring out all of those psychological underpinnings. The story is a cultural touchstone as we identify with the redemptive arc. If Scrooge remained the man we first meet, no one would have read the piece after about 1845,

The current Republican party is perfectly embodying Scrooge in his counting house on Christmas Eve. It’s mistreating the workers of the nation, begrudging them every little pleasure, feeling that they are not worth the pittance they are being paid. It has no interest in supporting a more charitable view of the world when it comes calling looking for a donation. In it’s withholding of social services and health care, it is fulfilling Scrooge’s axiom ‘If they would rather die, they had better do it and decrease the surplus population’. Unfortunately, I don’t see the ghosts of Teddy Roosevelt, FDR, and Lyndon Johnson visiting the leadership in the depths of the night to give them moral clarity. It’s going to take things causing pain to the professional and upper classes before there’s likely to be much shift. Or a complete blowout in the 2026 midterms.

On the public health front, there are a few things of note. The measles outbreak in West Texas continues to grow with the first child now dead. (The first measles death in the US in ten years). More are likely to die. A number of people have asked if they should get a MMR booster. If you have had the disease or the two shot MMR booster, you carry life long immunity and you should not need to do anything. There is one caveat: if your two MMR shots were between 1957 and 1968 (when they reformulated the vaccine), there is a chance that your immunity may be low and a booster might be advisable. (I had a booster in the 1990s when I was in an area of an outbreak so I know I’m OK). A number of people are asking me if they should bring their vaccinations up to date given the new administration. I have no idea what will happen to vaccine availability going forward so it’s not a bad idea. Ask your doctor. I’m caught up with everything other than RSV so I’ll go get that sometime after I stop coughing up my bronchial tree.

The H5N1 bird flu continues to be of concern. It continues to spread through poultry flocks and dairy herds (don’t expect the price of eggs to come down in the near future). There are some strains in Wyoming that are showing mutations that will make it easier to spread in humans increasing the likelihood of pandemic spread at some point. We’re not there yet and there’s no reason to panic. There’s just two things to keep in mind. First, H5N1 has a mortality rate in humans of up to 50%. (Coin flip whether you live or die if you get it). If that sort of mortality were to happen in healthy working populations, we could no longer function as a society. Second, the current administration is busy destroying all of the tools we would need in order to identify and contain a rapidly spreading virus before it becomes pandemic. In a lot of ways, we’re in a worse position now than we were five years ago when Covid began to spread.

As I start to read some of the reasoning behind MAHA (Make America Healthy Again), it reads very similar to the social hygiene/eugenics movements of the last century, the attempt to prevent lesser humans (however you want to define that) from reproducing and taking from societal resources. The belief is that those resources should be reserved solely for the industrious and the deserving. I can see a wish for a doomsday pandemic to sweep through and clear out ‘the dead wood’ so that the healthy trees can flourish in the aftermath. It’s a dangerous philosophy with so many slippery slopes that I really don’t feel like going into it at the moment. All I can do is implore those of you with differing political opinions to please think carefully about what you are supporting and where it leads. There are many, many exemplars through history and not one of them ends well.

In the meantime, I filed my five bullet points, haven’t received a termination notice, and I’m going to continue to provide the best care I can to a population that’s frail and vulnerable and just as deserving of the fruits of society as any other.