June 28, 2020

Plague in the classical world

As a student of history and prior pandemic illness, I am relatively optimistic that we will pull through this particular plague all right. We won’t be unscathed, but our understanding of infectious disease has come a long way from such ills as The Plague of Justinian, The Black Death, The Sweating Sickness, and even The Spanish Influenza (a misnomer if there ever was one as it had nothing to do with Spain, most likely originating in the farm country of the good old USA – Spain, as a neutral country in World War I was just more honest in its reportage than most everywhere else). Even though the long term prognosis for most of us as individuals is pretty good, I’m not so sure about what’s going to happen to various societal institutions.

I read the same news as everyone else (I avoid television news like the plague (so to speak) as there’s very little actual news coverage available and nothing nuanced or in depth). I try to seek out sourcing for some of the more outlandish claims and rumors and then try to digest it all and try to let my rational brain sift through it and not leap to the conclusions my intuitive brain wants me to take. Sometimes I get it right, sometimes I don’t. If any of you catch me posting something with a factual error, please point it out and I will immediately edit or take it down. I don’t get taken often, but I am human, and a rather tired one at that. Week after week grinding on through the stresses of a health care system in crisis, the move, a lack of rejuvenatory activities, and a somewhat dysthymic personality type will do that to you.

Breugel – The Triumph of Death

I’m feeling rather low at the moment as I am sure many of you are as well. Caseloads of Covid-19 are surging in my region of the country and the mostly conservative state governments seem either oblivious or hostile to the very basic public health measures that could curb this. People seem to have forgotten two basic facts. The first is that this virus takes time to fully manifest itself. The numbers we see now stem from what we were doing or not doing in May and it takes some weeks after the virus establishes itself in a population for enough people to get critically ill and the death toll follows some weeks after that. We won’t really know the mortality from the current surge until late July. Second, exponential numbers don’t work the way our linearly oriented brains think they do. Using the old example of powers of two and the metaphor of lily pads on the pond that double daily. If the pond is covered today, then yesterday the pond was only half covered, the day before only 1/4 covered and last week you would have barely noticed there were any lily pads at all. In the same way the virus is there, growing slowly, stealthily and then all of a sudden it’s everywhere.

I’m not sure if I should feel angry or sad over all the examples of American entitlement that have been running around these last few weeks. From the people delivering word salad against the use of masks at various council meetings to the people on social media complaining about poor restaurant and retail service to the pictures of people crowding into bars and onto beaches as if opening back up means that life has somehow returned to pre-Covid normalcy. The results of this willful ignorance to how infectious disease works has led to the USA, with five percent of the world’s population having twenty-five percent of the Covid cases. To the rest of the world contemplating banning travelers from the USA for the foreseeable future (which is a huge problem for my friends in the opera and theater world who depend on international gigs). To socially responsible merchants having to close their businesses to protect their staffs from inconsiderate and mindless customers. To my friends who work in the performing arts realizing that gigs won’t be back in the fall as they had hoped as society’s unwillingness to do something so simple as wear a mask is going to make it impossible to safely reopen indoor gathering spaces for some time yet. Of course all this strikes me exceedingly personally as the two things I have always done to renew my spirit are travel and theater, neither of which is possible so I really do want to reach through my computer screen sometimes and slap some folks silly for robbing me of my personal joys.

Where do we go from here? I wish I knew. There are a few scenarios that could happen. First, the virus continues to spread, we all get sick, most of us recover and we develop something akin to herd immunity. We seem to be choosing this option by default thanks to inaction on the part of our elected leaders. Of course, this option is likely to pull down the health care system as we know it and is going to lead to a lot of other collateral societal damage. And as all this is going on, the federal government is again trying to invalidate Obamacare. This, of course, will invalidate its ban on discrimination for pre-existing conditions which will, ironically enough, include Covid-19 so anyone who does get sick would essentially become uninsurable in a hypothetical future. We have no idea what the long term consequences for non-fatal cases might be and I can assure you, the health insurance industry has no interest in footing the bill for finding out. Second, the virus ravages for a while and then dies back into the background, similar to influenza and we all learn to live with it. This will likely cause some major changes in how society operates but what these will be is anybody’s guess. Third, we elect a new administration which takes its public health mission seriously and we put appropriate resources and measures in place. There will be reactionary complaints against this and it will continue to drive a wedge between red and blue America and won’t happen without additional civil unrest. Fourth, someone stumbles upon a vaccine or medical treatment which allows us to go back to usual patterns. We won’t go back to where we were in February, we’re too changed, but at least we can cling to some familiarities.

I was looking at the local statistics at Birmingham area neighborhoods. If you look at the rates of infection per population, the highest rates are not in poorer or in minority neighborhoods. The highest rates are in the moneyed white neighborhoods known collectively around here as Over the Mountain. I surmise this is due to higher collective rates of entitlement and feelings that rules and masks are for the little people. I had toyed with the idea of going someplace for the long weekend with fresh air and water, but I think I’ll be much safer in my central city neighborhood among medical types who understand how serious this all is. Might be a good weekend to get all the books on their proper shelves.

As always, wear your mask, stay home when you can, and wash your hands.

June 25, 2020

It’s deposition time…

I have spent the last three plus hours reading deposition transcripts and my mind is reeling and my eyes are a little blurry so it’s time to leave the medico-legal world behind and return to the accidental plague diaries. Someone posed the question today as to what I would entitle my memoir, should I ever write one and I’ve decided, given all the weird, wonderful and serendipitous things that have occurred in my life combined with my writing best in short essay form, rather than long form, it would have to be called ‘Accidental Notes’. And now all my musician friends are groaning in unison. I’m sorry, I do like a good pun.

The news on Covid-19 over the last few days is absolutely devastating. It’s skyrocketing across the sunbelt – in Arizona, Texas, Florida, South Carolina. Not quite as much here but we’re not far behind. It’s as if all the pain and misery we endured throughout the spring through isolation and quarantine and flattening the curve simply had no effect. That’s not true. It had the desired effect. The curve did flatten, the exponential rates of spread did come down. It was obvious that we couldn’t all remain behind closed doors forever and some of us (including yours truly), due to the nature of our jobs really couldn’t do it at all. I’ve done my best to be careful, being mindful of my activities, and given up a lot of the things I enjoy in life to help my patients, my colleagues, and my fellow citizens survive and I don’t regret that.

Flattening the curve was never about defeating or ending the virus. It was about buying time to allow the tried and true public health measures to swing into place which could eventually tamp the pandemic down. What are those measures? Public education on what measures are necessary and why, social distancing, quarantine of the ill until they become non-infectious, and contact tracing of those exposed to separate them from the uninfected until the disease spread can be curbed. What did the federal government do with the time our sacrifices bought them? I’ll let you answer that question as my answer would likely contain a few too many expletives and bring the Facebook police down on my head.

When the public reached their limit for total societal quarantine (around about Memorial Day) and various political forces decided to politicize public health measures for momentary gains, states began to take divergent courses. Well governed states, following sound scientific public health measures, have been slowly reopening based on scientific data and good epidemiology. Poorly governed states more or less threw wide the gates and encouraged everything to return to the way it had been. You can probably guess where the virus is spreading like wildfire. As I have said repeatedly, the virus doesn’t care about your politics, your vacation plans, your comfort or anything else. It has one purpose and one purpose only, propagation and it will seek any change in your behavior patterns that it can exploit.

Young folks avoiding masks in a pandemic

So, while the rest of the advanced world, by using everything learned about infectious disease epidemiology over the last two hundred years, brings their numbers down and the pandemic under control, the United States is merrily zooming the wrong way. I have a feeling the rest of the world is fairly close to placing a cordon sanitaire around the country to protect itself. For those unfamiliar with the concept, it’s a complete and total blockade around an infected locale. No one in or out. No foreign travel, no international business trips, trade severely hampered. Don’t think it can’t happen or that America, with its naive belief in American Exceptionalism is immune from the social forces of the rest of the world.

From what I can tell, there’s really only one way to bring the pandemic under control, and that’s for the American citizenry to change the government to one that will actually act on basic public health measures that protect its citizens. There’s a chance to do that in a few months. We’ll see if they are able. In the meantime, from what I can tell, older people will continue to protect themselves and younger people, believing themselves in no specific danger, will not. the problem is that a certain percentage of younger people are also falling deathly ill. It may be a smaller percentage than of older people, but it’s still significant. There’s also the issue of long term effects on those who don’t actually die. Some studies are suggesting that even young and healthy are having serious compromises of lung function which will likely play havoc on them as they age into middle and then older age.

With a failed societal response, we all have to do what little we can do. Wear our masks (it does help reduce transmission significantly when we all do that – and stop with the ridiculousness about HIPAA and the ADA and the nonsense about how you can’t breathe or you’re going to get carbon dioxide poisoning or any of the other pieces of garbage I’ve seen floating around), wash our hands, stay home when we can. It isn’t fun but they’re what will buy us the time to work on better societal solutions.

June 21, 2020

And over the last week, Alabama has 4,000 new Covid-19 cases, Jefferson County has 400 new Covid-19 cases and there have been sixty more deaths. This isn’t over by a long shot, even if the media and the zeitgeist have moved on to other things. There’s a couple of interesting trends that I’m following in terms of data. One, the divergence in case rates between areas with Republican/conservative governments versus those with Democratic/liberal governments. By most measures, the red areas are trending up in numbers and rates of infection while the blue areas are trending down. There’s a lot of interesting sociological possibilities behind this. The blue areas are more heavily urban and more crowded leading to easier transmission in the early days of the pandemic. Now the blue areas, having experienced what the virus can do, are much more cautious and vigilant in their public health orders leading to reductions in transitions. The red areas, being more concerned with the economic impacts of shut downs, have not implemented the tried and true ways of preventing disease spread so, as the virus has made its way to less densely populated parts of the country, it’s going to be more efficiently spread by people who have absorbed the political idea that the virus is a big nothing burger and that they should not be concerned about either themselves or their neighbors. If previous trends hold true, July is going to be a devastating month in red states as the death toll follows the increased infection rate and it will be very hard for the governments in those areas to walk back their laissez-faire attitudes.

The other interesting trend is the age of new cases. Data out of Florida is showing that the majority of new cases over the last few months is in younger adults with the median age falling into the thirties. Is this due to the substantial elder population of Florida taking precautions while the younger population, believing themselves immune, is not? Is the virus becoming more effective at being transmitted by certain social behaviors of young people? Is the virus, as it goes from host to host, starting to mutate somewhat leaving younger people, with less lifetime exposure to viral illness more susceptible? Fascinating questions that I, nor anyone else, don’t have the answers to at this time.

Epidemiologists and public health experts know what we have to do to get over the pandemic. The playbook hasn’t changed in decades. Social distancing/isolation, quarantine of positive cases, and contact tracing. It’s not that hard. It just takes political will and money. We’re definitely missing the former in today’s society. We’re not missing the latter, we just make some very odd decisions about where it goes. I’m not a trained epidemiologist but I’ve had my share of classes as part of my medical training and I’ve rooted about in the public health world for decades due to my work trying to identify and fix the disparities of health care that exist for the physically frail and cognitively impaired elder.

I remember my first epidemiology class quite well. It was in my first semester of medical school, towards the end of the term. On the first day of class, the professor, whose name I no longer remember, gave us an extra credit problem to work on. It was a breakdown of a society where a condition had struck a segment and we had to figure out what the disease was. We had breakdowns by gender, ethnicity, socio-economic status, marital status, age etc. We were given the information on Monday and told to give our answers on Friday in class. Friday came and I took my usual seat in the back corner, knowing that would make me one of the last called on to answer. I hadn’t a clue what it was. Some disease that hit men far more than women, the poor far more than the rich, single people more than married. People kept giving their answers and being told they were wrong. I was thinking Athlete’s foot and was going to go with that when something caught my eye. Only four females in the highest socioeconomic group had the condition. That rang a bell deep in the recesses of my brain. Something about only four women. Then I saw only one child in the highest socioeconomic group had it. I scanned all the numbers again and I knew what it was. I started squiggling in my seat waiting for the professor to get to me. When he did, I blurted out ‘I know it, I know it – it’s the Titanic and which passengers lived and which died. ‘ The professor’s jaw dropped. I was right, the first student who had solved that puzzle in the twenty years he had been teaching the course. And that’s a great example of how my mind works. It absorbs factoids like only four first class women died on the Titanic and then reorders them subconsciously so I all of a sudden just know an answer to a complex problem.

Worlds Largest Hubris Metaphor

I’ve finished one week in the new condo with pretty much everything being in place. I feel like it’s been the absolute right decision to move even if the process has been exhausting. I’m planning on just staying put with things where they are for a few more weeks, and then spend some time fine tuning. It has, of course, shown me its little quirks, the most interesting one being two of the drawers in the kitchen island refusing to stay closed. They were fine all through the move in process and the loading up; then, all of a sudden, last week, they started to open on their own. I’ve decided it’s maybe Tommy trying to communicate something to me about kitchen organization. Of course, this brings up unpleasant thoughts of the early scenes of Poltergeist. If the chairs start stacking themselves up, I may have to think twice about this place.

Four more work weeks, and then I get two weeks off – the first time off in nine months. I shall spend at least part of that in Seattle with the family. I haven’t decided on the rest. I may be here putting bookshelves in order although I would love a few days at the beach if I can figure out how to do that safely.

Stay well, stay safe, wash your hands.

June 16, 2020

I should have written a plague diary entry last night, but I was bone weary after a twelve hour work day. I don’t recall when I’ve had times where I’ve been as genuinely exhausted as I have from time to time over the last few months. I think it’s a perfectly normal phenomenon. Everything about life and all its certainties has been upended; little bits of stress seep into everything you do. Three months of unending stress, a lack of the usual activities that relieve stress, long work hours, and then a move added on top of all that when you can’t take any time off work is enough to flatten anyone I suppose.

A friend posed the question the other day asking if difficulties make you stronger. My answer to that is not really, I believe they make you more resilient and more able to roll with the punches that life is going to throw at you, but they don’t necessarily give you any additional strength. I’ve certainly had plenty of curve balls lobbed at me through life and I don’t think I’m any stronger than I was as a teen. I’m just a lot more prepared to bend and change and figure out what I need to absorb and what I can safely let go. I suppose it’s how I’ve made it this far. It’s the adaptable creature that survives, not the strong one under the theories of Darwinian evolution.

Speaking of moving, many of you have seen the video walkthrough I posted this weekend of the new condo. The remarks have been complimentary. Yes, I am my own decorator. I had some suggestions and help on the color scheme but the ultimate decisions were mine. I wonder how many picked up on my little joke with the colors. For those that didn’t, there’s one room for every color family of the rainbow. It is Pride month after all… I was able to pull it together so fast due to my wonderful crew of packing and moving elves headed by Holly McClendon. There’s still a lot to do in terms of getting books on the right shelves and media sorted and the closets are hiding a multitude of sins but it feels somewhat finished, and does what I want it to do – I want a space where people who enter can look around and get to know me in all my quirks and eccentricities.

So back to corona virus. The numbers of cases locally are accelerating like crazy. 5,000 new cases in Alabama and 400 in Jefferson county over the last week. UAB now has more inpatient Covid-19 sufferers than ever. And yet, the populace seems to have shrugged off the disease as yesterday’s news. Now that things have reopened somewhat, I see more and more people out and about without masks, hanging out in groups and in general living life as it used to be. They are mainly younger folk who aren’t hugely at risk for significant complications and I’m wondering if socially we are heading into a two tiered society of the young and healthy with minimal risk in one group living what we might consider a relatively normal life style and a more at risk group of older and chronically ill acting much more circumspectly. One wonders what a few years of that might do to politics and the economy. As someone whose age, profession, and general health status places him in the more at risk group, I can’t say I approve of what’s going on and worry that our already youth oriented culture may continue down that particular path in very unhealthy ways to the expense of empathy and wisdom.

When you look at the numbers nationally, especially when compared against other advanced societies, it becomes blatantly obvious that our government has completely abdicated its responsibility for keeping our population safe. The partisan politicization of science and expertise and the elevation of feeling and belief over fact and reason creates the perfect environment for a virus of this type to keep breeding and replicating and I don’t know that there’s a lot any of us can do as individuals about that. I keep my hands washed and sanitized and wear a mask in public and at work when with patients (which makes my job much harder – most older people rely at least partially on lip reading to hear properly) but there are times when I feel like I’m in a shrinking minority and I wonder just what motivates people? Are they thinking it’s over? (It’s not). Are they thinking they are not at risk? (They are). Are they thinking if no one else is, why should I? (My parents had a lot of pithy things to say about peer pressure when I was growing up).

Something that’s liable to happen is that those traveling on US passports will find themselves unwelcome to travel to other countries. The world will get a handle on the virus and travel will start up again, but will we be able to partake? If I were running the health ministry somewhere in Europe, I’d look at the US numbers and behavior and say no way Jose to those people coming here. That will come as a real shocker to most Americans of upper income who are used to coming and going across the world at will and put American business at a major disadvantage. You can only do so much over Zoom.

I have a new nest. I’m likely to spend a lot of hours in it as my plans for travel will be in abeyance and its unclear when the kinds of performance I participate in will be safe to resume. Time to put all that resilience to work. More writing? Something artistic? (I don’t generally do well with the visual art thing – most of my attempts look like they were done by someone with no arms or left foot). Perfecting my Xbox skills? Getting started on my retirement reading shelf? I imagine I’ll eventually figure it out. In the meantime, I’ll do what I can to safely make the world a better place and try not to be too much fo the crochety old man railing at the young folks to get off his lawn while doing it.

June 11, 2020

And just like that, the novel corona virus marches on, oblivious to whether we are bored with social distancing, distracted by other news stories, worried about the economic disruptions of pandemic disease. Viruses don’t care. They are implacable, unfeeling, designed with one purpose in mind – propagation at all costs. The reduction in case load achieved by aggressive measures in the spring has been reversed by an easing of those measures for socio-economic reasons. In Alabama, there were roughly 900 new diagnoses today, nearly twice as high as the daily rate at the peak of the original pandemic.

There will be those quick to blame the various demonstrations and rallies, a few of which made national news with the initial movement against long standing monuments to the Confederacy, aimed like a dagger at the heart of the African-American community. The numbers don’t bear that out. The rallies have been confined predominantly to Huntsville and Birmingham and those are not the areas in which cases are skyrocketing. It’s increasing quickly in more suburban and rural areas. I’m not surprised. We’re between two and three weeks out from the Memorial Day weekend (the demonstrations didn’t begin until a week later) and the spread is much more from a bored populace emerging from its cocoon, blinking at the fine weather, and taking off for the beach, the bar, and the backyard barbecue. This isn’t a second wave. It’s still the first wave of the virus, simply waiting until we let down our collective guard so it could continue on its relentless path.

There is a graphic running around (I posted it myself) breaking common social activities into nine levels of risk. It’s not necessarily the most scientifically accurate thing but it’s easy to understand and serves as a good reminder of what social distancing actually means. It’s not easy. Personally, I guess I live at level four. I can’t exactly avoid a doctor’s waiting room if I’m going to go to work. I’m still curtailing most of my activities. I’ve had to open up my life a little because of the process of moving but life is risk and it was one I needed to take. So far, so good. I guess I’ll know in about two weeks if I’ve been careful enough. I fully expect to contract Covid-19 at some point. I’m a physician and it’s my duty to be around the sick, no matter the personal cost. I’m not being stupid or taking unreasonable chances but I’ve tried to order my life just in case I become one of the deathly ill. Now that the moving is done, life will return to my usual workdays and weekends at home reading, taking long walks, and working on my Xbox skills (which don’t seem to be improving much).

The condo is pretty much together. Almost everything is stowed away in at least a temporary home. I’ll try to pretty it up enough so I can do a video walk through this weekend and share it with everyone as it may be a while before I can host a party. The old house is empty. The discards are being picked over by various folk and it gets its repair and facelift over the next two weeks and should be on the market by the end of the month. If anyone wants to live in the heart of Forest Park right on the triangle, drop me a message and I’ll get you in touch with my realtor. I’ll be glad when the last phase of this process is over. I’m looking forward to not having to move again for decades.

I tend to be an optimist when it comes to human behavior. I’ve worked in a caring profession that’s taken me inside so many homes of so many kinds of people for more than three decades and from that I’ve learned that no matter how people express it, they want pretty much the same things. A sense of safety, a few creature comforts, a better chance for their children, chances to feel fulfilled and do meaningful work within their professions and communities. It’s not that hard to understand that once you start seeing people as human beings. There have been two major social trends over the last century or so that have kept this from happening the way that it should. These have been deliberately implemented by the rentier class of property owners in order to protect assets at the expense of people. The first, and more familiar one, is the dividing of the working class on the basis of ethnicity. Of teaching both Black and White that the other is not to be trusted and making it difficult through a thousand little social rules for them to make common cause. The power structure has long known if they do get together and start pulling the same direction, they will be in trouble. Maybe Covid-19 striking at just this moment in time with the Millennials and Generation Z ascending to the majority becomes the inflection point that allows for this to radically change.

The second, more insidious one, is the co-opting of the professional and upper middle class by the power structure through economic means. As the old saying goes, if you were work for money, you’re not rich. When you’re rich, your money works for you. Most professionals have fairly high salaries but they’re still working for a living and their economic interests are firmly tied to the working class. However, when the power structure came up with the brilliant idea of replacing defined benefit pension systems with IRAs, 401Ks and 403Bs, they all of a sudden got the band of people who do a lot of the heavy societal lifting to start voting based on the casino of the sock market, not realizing that their paltry gains would never make up for what they were losing in both pension systems and the systematic privatization of the commons that’s been going on for the last half century.

Can we fix all of this mess? I do believe we can. No one ever said it would be easy and I think we have a lot more pain in terms of both Covid and the social unrest that it’s effects will engender to go before we get to the other side. Fasten your seat belts. It’s going to be a bumpy ride but we will make it if we decide we want to and we will reach out our hands to each other and not be afraid to take them.

Speaking of hands, you know what I’m going to say… Wash them well and often.

June 7, 2020

White Coats for Black Lives

My apologies that the accidental plague diaries have been missing in action over the last week. My mind has been elsewhere, what with moving and all of the multitude of tasks associated with that. The lions share of the work is done. I’m down to the last dozen boxes that need to be unpacked. It will be a while before everything is fully squared away but it’s more or less together and the space is starting to feel like mine. The next major task is readying the old house for sale. The last items should be out by mid week and then the crew can go in to do the minor repairs and spruce things up so it should be on the market before the 4th of July.

The number of Covid-19 cases continues to go up and up. We’re up to nearly 2 million cases nationally. 20,000 of those are in Alabama, 2,000 are in Jefferson County and the numbers have been rising relatively quickly over the last few weeks as the virus transmitted over Memorial Day weekend starts to make itself known. What we’re doing today is reflected in the numbers 10-20 days from now, one of the reasons it’s difficult for us as a society to understand the cause and effect of social behavior on our physical well being.

US Media, unable to keep more than one big story narrative going at once, has more or less decided to turn its attention from Covid-19 to the various rallies, marches, and occasional civil disturbances that have sprung up the last two weeks. I have two thoughts about this. First, corona viruses don’t care if they’re being reported on or not. They’re going to continue to do the one thing they’re designed to do – infect new individuals so that they can propagate themselves further. The number of cases in local hospitals is ticking upwards again and I am very afraid that a lack of emphasis on the need to continue masking and social distancing is going to lead to increased infection rates. Hopefully, we’ve had enough lead time to prepare but I can tell you from first hand experience that the health care system is strained and the practitioners are tired and there is no end in sight. Second, it doesn’t necessarily fit media narratives but the pandemic and the BLM protests are very much intertwined.

This country hasn’t seen this number of people out on the streets protesting against the powers that be for more than fifty years. The rallies I have been to have been orderly affairs, Black American and White America together saying that the systems that have divided us for so long and treated us so unequally have to stop. Locally, we’ve only had one serious disturbance, more than a week ago. The city’s response has been mainly subdued (some of the white flight suburbs appear to have over reacted) but it’s pretty obvious that the message has been received loud and clear. I’ve seen the photos from NYC, DC, Philly and elsewhere of enormous crowds, braving pandemic conditions to stand up for what is right and the ideals that this country was founded upon, ideals we often don’t live up to. i don’t think this would have been possible without the pandemic. BLM has been around for a few years and, of course, systemic racism has been around for four centuries, but it took the societal stress of a pandemic, a lock down, and economic uncertainty on a grand scale to get the majority of Americans to experience the stress and conditions that minority groups face on a daily basis. Worries about the rent, putting food on the table, indifference from the authorities to distress, seeing the oligarchy helping itself to the treasury, watching a militarized police traumatize peaceful protesters, understanding that a government that was unable to come up with the most basic needs of the health care system over months could conjure up what amounted to a military crackdown in days which has laid bare the myth that government was here to serve the citizenry. It’s become plainer and plainer that government currently exists to protect the property of the wealthy.

The younger generation isn’t especially at risk from Covid-19. Its education has been disrupted. Its been saddled with appalling levels of debt for that education as part of the monetization of society to benefit the wealthy. They don’t have a whole lot to lose at the moment and the pandemic has destroyed the social controls the elite has used to control them in recent decades such as student loans, entry into upper tier schools, and internships and other networking opportunities. There’s no reason for them not to continue being out on the streets continuing to work for systemic changes which will benefit us all. I can’t read tea leaves terribly well but I can say that we seem to be at an inflection point where the rules of the game have suddenly changed and the older generations haven’t quite figured that out yet and I think that’s going to be born out in the results of the next election cycle.

What’s next for Covid-19? It’s unclear. The amount of information available is reduced. Reportage on what’s happening elsewhere in the world is slim as the US focuses in on our internal struggles. I can’t always find trustworthy domestic numbers as various states present data in inconsistent ways for what seem to be political purposes. As a geriatrician, I am well aware that it continues its march through senior facilities. Some die, some don’t. It’s completely unclear what the difference between the two groups could be. There’s likely a genetic subset of us that is doomed to become incredibly ill if we get the disease but why that is and how to determine whom is at risk remains obscure at best.

In the meantime, now that I have my nest relatively feathered, I plan to stay in a lot, and watch the sunset from my terrace. In the meantime, everyone stay safe, stay well, and wash your hands.

June 1, 2020

A decade ago, I was fortunate enough to have been offered a slot in the Leadership Birmingham program (2011 – best class ever). It’s a program that takes local residents from all types of careers and walks of life who have proven themselves to be leadership types and gives them a crash course in how our metropolitan area actually works. With full days devoted to topics such as health issues, education, economic development, and cultural opportunities, it was a great chance to network, develop new friendships with people in other industries and job types that I might not otherwise meet, and a rare opportunity to peek behind the curtains into the realities of the power structures. My class included a federal judge, the school superintendent, a city council person, various business types, activists working on social justice issues for the African-American and Latino communities, and clergy. By the end of that year, we had bonded and discovered a lot of commonalities, despite our diverse backgrounds and we, like all of the other classes that have gone through the program over the decades, have used our experiences to help make our community a better place.

One lesson I took away from all of that was one that I don’t think was intended. I quickly recognized that when it came to local politics, the lower the level, the more intelligent and resourceful the individuals. Those working on projects on the neighborhood level tended to be bright, impassioned, committed individuals who cared deeply about their areas of town and who created great things on minimal resources. On the city of Birmingham level, the leaders were predominantly bright with hearts in the right place but were starting to be beholden to powers and economic interests that would at times lead to contrarian decision making in terms of politics and expediency. Those working at the county level had even more of this. It was only a few years since the Jefferson County sewer scandal (which we’re all still paying for – you’ll notice if you look at what’s happened to your sewer rates over the last decade) had roiled the county power structure top to bottom and most of those we met always struck me as having one eye over their shoulder looking for the feds. Those individuals we met working on the state level were to a person, far more invested in the game of politics than they were in the results or in the needs of the citizenry and a few of them struck me as just plain stupid. We didn’t meet much of anyone on the federal level for me to compare that but the stripping away of morals and IQ points as they ascended the ladder to Montgomery strikes me as being somewhat of an explanation for the two separate, but intertwined issues facing us at the moment. I can’t speak to the truth of this pattern in other states, not having been through leadership programs there but I have a sneaking suspicion the pattern isn’t unique to Alabama.

The first problem is that of Covid-19. The case loads locally continue to increase. It’s a little difficult for me to find out just how much as there’s not a lot of transparency in the numbers. Alabama, for instance, is one of the few states which is not reporting on what is happening in nursing homes. UAB, where I work, weathered the initial surge and is starting to return to more normal operations (and I had a fairly typical outpatient clinic day today) but everyone is on tenterhooks wondering if that other shoe is going to drop. As other stories start dominating the news cycle and as people, tired of social distancing, start crowding back into newly opened places of business, we could be well on our way to a fresh spike by the Fourth of July. Friends of mine are reporting the beaches are full, stores are filling up, and then, of course, there have been mass demonstrations. The state has pretty much abdicated its role in protecting the citizenry. I haven’t seen the governor or the legislature in evidence at all the last few weeks. Our mayor, a young and energetic African-American, has been one of the few local leaders who has had and kept media presence and given sound advice.

I’ve been watching as I’ve been out and about a bit more because this has been moving week. In the city, the majority are wearing masks (and we are under a mandatory city ordinance through June 12th). In the suburbs, not so much outside of health care facilities. It’s as if society has made a sudden decision that this is all over and on with it. The problem is that Corona Viruses don’t care if you’re bored. They don’t care about the economy. They don’t care about your politics. They have one mission and one mission only, to propagate and, until there is an effective treatment or vaccine, the only way to prevent that is distancing and masking in order to break transmission chains. We’ll know soon enough if we’re in trouble. In the meantime, I continue to stay home. I’ve been exposed to a few more people due to moving, but I’m keeping my hands clean and trying to keep a certain distance.

The second problem is the civil unrest currently gripping most urban areas. (I read somewhere that more than 140 cities have had demonstrations in the wake of the George Floyd killing this last week). While the murder by police of Mr. Floyd and it’s reigniting of the issues of the horrific injustices suffered by the African-American community for centuries is the proximate cause, I tend to think that widespread civil unrest was going to happen no matter what. An enormous portion of the populace is out of work, food prices are skyrocketing and it’s becoming more and more difficult for those at the bottom of the ladder to put food on the table. Many have been relegated to subsistence jobs for years, enough to survive but not enough to build wealth, get ahead or ensure that things are better for their children. Then add to that the lockdown and the cancelling of all those things that distract us or that make our lives a little more bearable. No sports, no cultural events, no concerts, no gatherings. When there is neither bread, nor circuses, the plebians become unhappy with their lot. The government had the chance to make grand gestures and side with the people but instead let big business run off with hundreds of billions of dollars from the treasury while telling ordinary folk to survive for months on $1200.

I don’t know where this is all going to take us but I remain relatively optimistic. All of the best scientific minds in the world are working together on methods of controlling Covid-19 and I imagine we will start to see some progress on prevention and treatment in the coming months. I went to the demonstration on Saturday at Kelly Ingram Park put together by local Black Lives Matter activists. (I stayed as far as I could from others and wore my mask. Most of the crowd was masked as well). I went because I thought it was absolutely imperative that white men of a certain age be represented as being in solidarity with the African-American community against injustice. I am but one small voice but every voice counts. Kelly Ingram, being the site of police dogs and fire hoses within living memory, is hallowed ground in Birmingham and the crowd was peaceful, well behaved and impassioned. That scene of all races together massed for a better world was my Birmingham and I was proud to be there. I was not at the Sunday demonstration where mob energy was misdirected leading to mayhem. To me, that was not my Birmingham and I was much more drawn to the news stories of this morning of hundreds of volunteers drawn to downtown to clean up and repair the damage. However, it is not my place to tell others how to feel, react, or protest. Suffice it to say that lives always matter more than property or money, even though capitalism pushes society to the opposite (as is very apparent with both of our intertwined crises where our leaders are much more concerned than money and property than with lives.) I write this now under curfew (which doesn’t bother me a bit) with Facebook Live video feeds showing that the city is indeed dismantling the Civil War memorial that was the flashpoint for yesterday’s problems.

The no longer extant Birmingham Civil War Monument – Birmingham never participated in the civil war. The city wasn’t founded until 1871.

A word about the memorial for those not of Birmingham. Alabama is governed under the fraudulently passed constitution of 1901 which was designed to ensure white supremacy and to concentrate political and economic power in a small group of white industrialists. It pretty much prevents home rule in the cities and has been amended roughly 700 times. (When South Africa was looking for models for their apartheid constitution, guess where one of the first places they looked was…) The Civil War memorial was erected a few years later, as were most such memorials around the south, by the White Citizens of cities as a reminder to African American Citizens as to whom held the power. It had been grumbled about for years but things came to a head with Trump’s election, the Charlottesville demonstration and resurgence of white supremacy ideology countering the Black Lives Matter movement. The city wanted to take the monument down out of respect to the African American community but, before they could do so, the state passed a law that effectively prevented such an action. The city countered by covering it up with plywood and there were various suits and countersuits and pretty soon, this fifty foot granite obelisk became a symbol for what was wrong with the system. (And much could have been prevented if the city was allowed to attend to its own affairs without state interference which continues to have racist undertones). Last night, following the demonstration, the crowd tried to pull it down as the Parisians once pulled down the Bastille but multi-ton granite and sandstone obelisk memorials don’t come down easily. If the monument had toppled, the crowd would likely have dispersed satisfied; as it did not, mayhem ensued. Tonight, the mayor, keeping his promise, is having a large crane do what human muscle could not. (Actually, human muscle could do it if properly leveraged. The anthropologist Sarah Parcak from UAB has a great Twitter thread on this based on her knowledge of Egyptology – look it up but don’t read the asinine comments).

I’m hoping in a few days we’ll all be calmer. Just don’t look for any help from a federal level where the executive branch seems bound and determined to make things worse with each passing day. In the meantime, to my African-American friends and colleagues, this White male authority figure remains your accomplice, not just your ally and feel free to turn to me if I can help in any way. All I ask is stay home when you can, wear your mask in public, and keep your hands washed.

May 29, 2020

I’m going to take a break from the accidental plague diaries this evening to tackle a different subject, one that’s certainly very much on the minds of those that live in the South, the question of the underlying issues of race and class that always simmer but that are currently exploding in Minneapolis. I posted a short message earlier today about not being able to truly understand the African-American experience, as I am obviously not a member of that group, but at the same time needing and wanting to listen rather than to speak. I did that because I am tired of reading inanities from white people about ‘how they don’t see color’ or how ‘they understand the feelings but they don’t understand the actions’ and I didn’t want to write about such a charged subject without some input from my friends of color with lived experience.

The message that I received was one of ‘please – speak’ that I, as a white male of a certain age and privilege associated with my educational background and title, and with a bit of a following for my writings needs to be the sort of person that identifies and calls out injustice for what it is. So this essay is my feeble attempt to speak up for fellow humans pushed past what humans should endure by systems that were created and continue to by silently enforced by powers out of their control. What is happening in Minneapolis is a perfectly understandable reaction to the continued abuse of black and brown male bodies by a system that considers them suspect at best and disposable at worst. This is then combined with a gaslighting by the media practicing ‘bothsidesism’ which tells the population that they aren’t really seeing what they’re actually seeing and with a disastrous and rapidly decaying economic system due to the pandemic which is hitting working class people of color harder than most other populations. I’ve studied enough history to know that revolutions are born when enough parents cannot feed their children and that the class that’s hoarded the wealth at that juncture usually ends up with their heads on pikes.

I’ve heard a lot of ‘tut tut’ about the riots and about how can they destroy their own community. Again, knowing a bit about history, I would suspect that the majority of businesses catering to that community are not owned locally and are not putting money and resources back into that community but rather are profiting individuals who wouldn’t be caught dead actually living in that neighborhood. Decades of redlining, bank restrictions, interstates plowing through African-American neighborhoods and bypassing White neighborhoods, and wholesale destruction of African-American economic success (Tulsa anyone?) have created pent up communities with pent up rage. And when African-Americans have the wherewithal to move on up they are often forced to endure the hundreds of slights, large and small that face them when they are seen in traditionally white social spaces. The birder in Central Park is only the latest story. Working some in the classical music world, I have heard so many tales of African-American musicians dissed in the audience for a symphony or opera as some privileged white person assumes they cannot understand or appreciate the art form.

About twenty years ago, I had spent the night in downtown Indianapolis. I left the hotel about 9 the next morning and was attempting to find the entrance to the interstate. I didn’t know the city. Half of downtown seemed to be a construction zone making things even more confusing and, on my way to the on ramp, I missed a stop sign and rolled through it while searching for my next turn. That’s when I was stopped by the police car that was tailing me and whom I had not noticed due to my intense search for something that would tell me I was going the right way. The cop came up to the window and demanded to know if I was drunk; I said no, just a lost tourist. Let me give you my license and registration and reached for the glove compartment. He immediately went into react mode (I guess he thought I might have a gun in there) but eventually he realized I really was just lost, he gave me directions, told me to be careful and waved me on. It occurred to me later, that if my skin color were anything other than white, he could quite likely have shot me but it didn’t cross my mind at the time that was a possibility. That was my white privilege – something that my friends of color just wouldn’t have in a similar situation.

Over the last forty years, I have learned a lot about white privilege and how real it is. The above is just one small example. As a white male with a professional degree, I receive a lot of deference socially that I don’r really think I deserve and which I try not to use or rely on too much. I’ve always tried to live in racially mixed neighborhoods and I’ve always tried to have a wide variety of friends with a vast array of life experiences from whom to learn. When Steve and I moved to Birmingham all those years ago, we refused to live over the mountain or in suburbia – we wanted a real urban neighborhood. I’ve seen a lot of my peers start out life this way but, as they marry and have children, they have closed themselves off to these experiences in the name of protecting or providing better opportunities for their kids. This keeps their social capital within a segmented community of people like themselves, rather than flowing out among other communities. Perhaps I’ve been able to keep my eyes and ears more open as I am childless.

I have my own minority status. I’m an openly gay man in an openly homophobic society. When I moved to Birmingham, I learned some things very quickly. Don’t walk to close to your partner. Don’t hold his hand. Don’t put anything identifiable like a rainbow sticker on the car. Don’t wear certain clothes other than in safe spaces. I wasn’t prepared for some of the nastier things that happened early on like the HVAC tech, who when he figured out he was on a call to a gay household, deliberately plugged the drain line in the condensation pan in the attic so that Niagara falls poured through the dining room ceiling a few weeks later, but I learned how to navigate and earn a modicum of respect from both UAB and Birmingham at large. I can hide my minority status if I need to and pass to the casual observer as something that I am not, another privilege. It’s funny, I’m now old enough that if I’m more flamboyant in public, it’s no longer seen as a threat but more as a harmless eccentricity of the rapidly aging. Probably the same social thing that gives elderly character actors like Ian Mackellan a pass in Hollywood but that prevents leading man types from coming out.

I’ve been doing house calls for thirty some years now. I started doing them in the early 90s when they were almost unheard of as it became clear to me early on in my career that there were certain geriatric patients where it made a lot more sense for the doctor to go to them than for them to come to the doctor. It didn’t take too many years of home care in California for me to spend a lot of time in homes of all ethnicities and classes of people. I’ve taken care of people in tar paper shacks without running water and in elegant family mansions that were built by great great gandparents more than a century ago. Spending a lot of time in other peoples homes teaches you a lot about respect for other people, their circumstances, how they rise to their challenges, and how they view the world. One thing I have learned is that White America can learn a lot from Black American about the meaning of family and kinship and care. The amount of love and pride in accomplishment present in Black homes and the care that is shown to their less able members is incredibly gratifying. Most White Americans don’t know this because they generally don’t enter Black personal spaces. It’s always interesting to take a med student or resident who is a Birmingham native, usually white from an upper class suburb, around on house calls. They have no idea what neighborhoods other than their own are like or how they operate or even that cultures other than their own exist.

So, in the words of my cousin Sojie, I am declaring that I am not an ally in the fight against institutional racism. I am an accomplice. I will call out racism where I see it. I will do my best to treat all of my patients equally no matter what race or class they may come from and how they may view the world. I will support arts that speak to communities of color. (I was given an amazing opportunity by Birmingham Black Repertory Theater this year to be part of their inaugural production of Choir Boy and am proud to support Encore Theater and Gallery). I will listen to my friends, neighbors and colleagues in the African American Community and try to help them get their messages through to people in power where and when I can (and they shouldn’t feel afraid to call on me if they think my voice will help). It’s the least I can do in these troubling times and even though our elected leaders cannot find it within themselves to see the problems, I don’t wish to be part of those problems, despite accidents of birth and genetics.

May 25, 2020

It’s Memorial Day. The day we are supposed to reflect on those who have given their lives for our country over the generations. In reality, however, it’s the long weekend that kicks off the summer season of lightened schedules, better weather, family outdoor activities, pool parties, outdoor concerts, and all the other things that we associate with a more languorous time of year. But not this year. We’re all engaged in another sort of fight, one that doesn’t fall into the traditional conventions of armies clashing. The enemy is unseen, of completely unified purpose, and is part of the usual design of nature with no ability of understanding the rhythms and rituals of the human race.

I, like everyone else, saw the pictures and video of the enormous pool party somewhere at Lake of the Ozarks full of squealing and slightly inebriated twenty somethings doing their best to violate every rule of social distancing. I saw the vituperative comments from their elders bouncing around social media. It didn’t make me angry, it made me profoundly sad. They are young people doing what young people are supposed to do, acting goofy in a large group full of energy and hormones. I did it in my day. I’m sure my parents and my grandparents had their variations (although my grandparents probably involved a great deal more layers of clothing). I completely understand their wish to gather and let off steam after this horrible spring and I completely understand the revulsion that their engaging in what would be otherwise completely normal and unremarkable behavior engenders as well. The public health failures that have allowed Covid-19 to become entrenched and endemic in the community are putting us all in an impossible situation. The few weapons we have that we can bring to bear as a society – social distancing, masks in public – are completely contrary to every social impulse present in those under the age of thirty or so. And it’s a population who isn’t neurologically able to make the connection between actions and consequences. Those frontal lobes don’t finish developing until after the age of 25 which is why frat boys think it’s a great idea to light fire to the couch and throw it off the roof of the house. How do we balance the needs of the mature for safety with the needs of the young for socialization? I really don’t know unless we all decide to become Shakers or some such.

I can confine myself to work and home because, at the age of 58, I’ve had my youth and know it’s another generations turn. I will admit that I spent all of my 20s on the educational treadmill so I was never able to get too wild and crazy and I more or less got married to Steve about half way through them which also slowed me down some. I still had my share of group road trips, late night parties, slightly excessive alcohol intake, heart to hearts in corner booths of all night diners, solo travel to distant parts with groups of young people from all over the world bonding in hostels or sleeping on the floor of the train station. and it breaks my heart that we’re stuck in a world at the moment where the young will have a difficult time going through these rites of passage, if they’re even possible at all for a few years. Because of my theater work, I’m around a lot of young people in their twenties and have enjoyed settling into the wise/wicked uncle role with them. Telling the stories of what the world was like back before computers ruled our every move, of how things were the same and how they have radically changed. That’s what our job is, we of the grandparent generation (I’ve finally woken up to the fact that even though I never had children, i”m definitely paw-paw) to tell the stories and provide the cultural continuity. Those friendships have kept me young and without those people around, whom I mainly see at rehearsal or theater related activities, I feel like I’m aging at an accelerated rate.

These are my friends… See how they glisten…

Speaking of theater, some of the Birmingham musical theater performers got together to do one of those virtual musical theater numbers which is now complete and posted to YouTube and linked above. I think it’s worth three and a half minutes of your time. I have fond memories of moments on stage, backstage or just shooting the breeze with pretty much everyone in it so give them some love. I don’t know when we’ll all be able to be together again in person, but when we are it will be a marvelous moment. All of my upcoming theater gigs are either cancelled or postponed along with everyone elses and I have barely sung in three months. I need to find someone who will do some virtual voice lessons/coaching or I’ll barely be able to croak out a tune at the end of the summer.

What are we to do as a society? The death toll will break 100,000 in the US in the next day or two. It shows no signs of slowing down. Locally, we’re spiking again in the rural areas as Alabama’s underfunded health care system starts to buckle. The news on Friday was that rural cases were flooding into Montgomery which was essentially out of ICU beds. I’m assuming they’ll be heading up I-65 this week putting more strains on UAB. We’re in a damned if we do, damned if we don’t situation. We can continue opening up some and contribute to the spike or we can stay the course causing additional social damage. I don’t have the answers other than continuing to do my part to keep the infection rate down – stay home as much as I can, wear a mask in public, keep my hands clean, avoid enclosed spaces with lots of other people as much as possible. It’s what I have to do to fulfill my pledge to my patients. I’m not ready to write off the elderly or the chronically ill en masse unlike certain other societal forces. All of us are having to look within and ask ourselves very tough questions. I think I know my answers but it’s testing my fortitude to keep moving forward.

May 21, 2020

I should have written an accidental plague diary entry last night but it was another one of those nights when I got home from work and felt completely drained of all energy and limp as a dishrag so not much constructive was done. I know it’s just my body and brain reacting to being steeped in the toxic miasma of stress hormones we’re all having to contend with. I’m pretty sure the current era is busy taking time off of our collective life spans due to excess catecholamines bathing our systems but there’s not a whole lot I can do about that. Cat videos on the internet only go so far to rejuvenate the soul.

I am happy to report some good news on the move front. Most of the house is packed and ready to go. Progress is also being made on the painting of the new condo (and what I’ve seen of my color selections on the walls so far makes me think I’ve gotten those pretty right.). On the bad news front, the HVAC at the condo is busy giving up the ghost and my usual service guy has suggested just tossing it off the roof in favor of a new unit. There’s probably HOA rules against doing that. I’ll have to check. I may be able to temporize for a couple of years with a more inexpensive repair and there is a home purchase warranty included with the whole deal which may cover most of it so that’s a good thing. Something else to deal with. Part of the reason for moving was to get out of having to deal with such things. Ah well…

The local numbers for Corona Virus are not looking good. We’re still doing well here in Birmingham with its heavily medical population but it is, as I had feared, beginning to explode in the more rural areas as the state continues to open up rapidly (and likely ill advisedly). A number of the rural hospitals in the central state are overloaded, Montgomery is nearly out of room and the cases keep coming in and will soon be diverted here. As painful as social distancing and isolation may be for all of us, we really do need to stay the course for the foreseeable future. I don’t think anyone will be very happy if the health care system, already strained, starts to collapse around us. I figure I’m spending the summer putting my home and life back together in the new space and perfecting my Xbox skills. There isn’t likely to be a lot of theater for a while. At least I went out on top. There is a lovely virtual musical number featuring a lot of the Birmingham musical theater performers (including yours truly) in the final phases of editing. I’ll post it when it’s done. Hopefully sometime this weekend.

The big argument in the hinterlands continues to be over the use of masks. Masks are not about protecting you from catching the virus unless you’re wearing a properly fitted N-95 medical mask (and unless you’re working around ill people in a hospital setting, I would wonder why you were doing so if I saw you in one due to the shortage of such supplies). Masks are about preventing you from spreading the virus to others as a possible asymptomatic carrier. They don’t do a lot of good unless they’re worn relatively universally at the moment which is why all the ordinances and requests for their use in public. For general socially distanced interactions, the cloth ones folk have been running up on their sewing machines the last few months are fine. I have a number. i keep one in the car, one in my pocket, one on my face if I need to be indoors around others. Today’s features classic Mickey Mouse. As I move around my area of Birmingham, adherence to masks (required by local ordinance) is pretty good. I hear it’s not so good in the suburbs but I haven’t been venturing out there to check.

Bliss Hall – The Lakeside School

I’ve been trying to think of a good story to tell. Part of the bone weariness is a certain mind stasis that prevents me from thinking rapidly and in an entertaining way over my misspent younger years. Besides which, I’ve already written up most of my best stories for this blog over the last couple of years. This last week marked the 40th anniversary of the eruption of Mount St Helens in Washington, an event forever entwined with my memories of high school graduation. As most of you know, I grew up in Seattle and I went to the local college prep school, The Lakeside School – a sort of transplant from New England complete with brick, white paint, colonial architecture, and maple trees that looked like it could have been helicoptered in from Andover in the early 20th century. I was the academic of the family and Lakeside was a good match for my needs. I started to realize just how good my education was when I arrived at Stanford and was handed the same Western Civ textbook I had used in 9th grade and a reading list for that course and Freshman English full of titles I had already dissected. Needless to say, i didn’t have a lot of difficulties adjusting to even an elite university. I was class of 1980. This makes me technically a baby boomer but my peer cohort has very little in common with those ten or fifteen years older than us. We came of age in the disco years of the late 70s, not the cataclysmic upheavals of the mid to late 60s.

Mount St. Helens in Washington spews smoke, soot and ash into the sky in April, 1980. The eruption is the first for the volcano since 1857. (AP Photo/Jack Smith)

I had my 18th birthday on May 11th of 1980, which was Mothers Day Sunday that year. I can’t remember if we did anything terribly special as a family although I do remember quite well what my present was from my parents – a suitcase. They were ready for the fledgling to leave the nest. (We all grew up knowing that once we graduated high school, we would be welcome back home as long as we continued our educations but, if we decided we were done with that phase of our lives, we had to figure it out for ourselves.). I had a mild case of senioritis that year and I wasn’t spending a lot of time paying attention to classes. AP exams were over, the diploma was in the bag and it was just a countdown to summer and then on to new adventures in September. The following Sunday, the 18th, the family had a duty call to pay on my paternal grandmother who lived in a retirement apartment outside of Olympia in a large senior life care community called Panorama City. My grandparents were among the first residents there and had bought in on life care contracts so they received whatever services they needed to support them until their deaths at no additional expense. You can’t find those deals anymore, they’re not actuarially sound but the modern senior care industry was in its infancy at the time they moved in in the late 60s.

We were up fairly early for a Sunday and all loaded into the car and heading south on I-5 when my father turned on the car radio and we got the news that St. Helens had blown the top 1500 feet or so off the mountain. it wasn’t a huge surprise as the volcano had been showing more and more signs of life over the previous year but we were a bit apprehensive as we were traveling down the highway towards an active eruption. Fortunately for us, the ash cloud was headed south and east rather than north and west where we were. We kept looking to see it, but it wasn’t visible from our vantage point. We spent a few hours with my grandmother, who was in a serenely foggy state at that time of her life, and then raced back to Seattle to indulge in the TV news with helicopter shots of roiling ash, flattened forests, and mud rivers carrying off stray automobiles.

Back at school the next day and comparing notes, we all found out something interesting. Whether you heard the explosion or not depended on your proximity to water. Those on the lake or on Puget Sound (even some off on a beach hike on the Pacific Coast) head an enormous explosion and raced out to see what had happened. Those more than a couple hundred yards from the water hear nothing. I’m assuming there was something about the physics of the sound waves echoing off flat surfaces involved. The mountain had several minor eruptions throughout that summer and I was lucky enough to be able to see the steam and ash clouds from those from Seattle. For one of them, I was on a boat on Lake Union (I cannot remember why – I think it had something to do with my job that summer working in the water chemistry lab for Seattle METRO – the sewer agency) and had a gorgeous view of this billowing white column towering over the city in the distance on a pristine blue sky day. For the children of the Pacific Northwest, May 18th 1980 will always be one of those ‘where were you days’. And I remember it far more vividly than my high school graduation ceremony which was a couple of weeks later where I marched into the gym between Jackie Durbin and Joanne Dwyer. I still have a bottle of ash collected from the roadside a couple of weeks later when I was down near Portland. My packers found it this week and were somewhat afraid it was somebody’s cremains. They have been reassured. Cremains at my house ride around in car trunks or live in an old shoe box.

Stay safe. Stay well. Wash your hands.