Masks

Masks are the talk of the town lately, are they not? To wear them or not to wear them. Cotton or synthetic. Single layer or multilayer. Inserts or not. Mainstream or rebellious. Republican or Democrat. Individualistic or conformist. Surgical or fashionable. How did a little piece of fabric with ear loops rise to the level of cultural totem for the various groups that see it as medical savior or condemn it as heresy in 2020?

According to Wikipedia, a mask is an object normally worn on the face that may be used for protection, disguise, performance or entertainment. Masks have been used for various purposes since antiquity. The word “mask” appeared in English in the 1530s, from the middle French masque “covering to hide or guard the face”. How have masks been used throughout history? Well, there are funeral masks, life masks, death masks, ceremonial masks, performance masks, ritual masks, religious masks, healing masks, and political masks. Masks may be used in festivals, carnivals, burials, plays, and stories.

Now, all of these are similar, but they differ a bit from the functional masks that have as their purpose the protection of the wearer. We are a bit more familiar with these in the year 2020. There are oxygen masks, surgical masks (including the N95 that has been in the news off and on since March of this year), face shields, and even pocket masks that can be used by a good Samaritan who happens upon someone who needs CPR. Protective masks filter the outside air in some fashion to make it safe for the breather. Other functional masks might include the kind worn by robbers and thieves to keep their identity safe from their victims or security cameras that might capture them as they go about their dastardly deeds. Plague doctors in Europe wore beaked masks that contained herbs in the beak to attempt to ward off the Black Death.

Do you get the point here? Masks have been around for literally thousands of years and have served every purpose from identifying the wearer to hiding his identity to celebrating his life to commemorating his death to punishing him to keeping him healthy. According to Stephen E. Nash writing in Sapiens Anthropology Magazine, the earliest well documented masks came from the arid Judean Desert in the Middle East about 9000 years ago. They may not have been the earliest ones, but they were certainly among the earliest preserved ones. Masks have been important cultural phenomena for thousands of years.

How about the medical aspect of mask wearing, which confronts us now in 2020? A bit of history is informative here as well. A July 27, 2020 piece in The Conversation said that during the 1918 flu pandemic, cities around the world passed mandatory masking orders. In the United States, the American public at that time embraced mask wearing as “an emblem of public spiritedness and discipline”. Mask wearing was widely unpopular in Canada during that time, but was embraced by the public in Japan. To the Japanese, mask wearing symbolized “modernity”. The Japanese continued to wear masks to protect themselves from the flu, and later against SARS and avian influenza. In a country that takes etiquette very seriously, wearing masks has become a form of politeness. Controversies over mask wearing continue in the United States and other countries as well as the coronavirus pandemic rages on. To some, masks represent control, are uncomfortable, unnecessary, and possibly even harmful to their own health. To others, seeing people wearing masks is a tangible reminder that the pandemic is real, and is frightening to them. Some have an “optimism bias” and believe that the coronavirus will not affect them.

The latest advice from the CDC and other groups maintains that the Three W’s (watch your distance, wash your hands and wear a mask when not able to social distance) are still the best way that individuals can protect themselves and others from infection with coronavirus.  Masks have been around for millennia, and they still appear to be one of the easiest and best ways to protect ourselves as we navigate this pandemic. Educate yourself, practice good social hygiene and stay safe out there.

Fake It Until You Make It

I have been talking with friends, family members, and patients over the last several months about our lives in 2020. We continue to try to describe what it feels like for each of us to live in the middle of the biggest pandemic in the last hundred years. We talk about the things that we have all been feeling: the sense of loss, grief over the changes in our normal lives, the lack of social interactions with others, the inability to participate in things that used to give us joy, and the lack of certainty that pervades every aspect of our lives. We talk about how these stressors have changed the way we work, play and interact with others. We talk of the longing for things to get back to the normal, the predictable, and the reassuring. Almost everyone I know feels less confident, less powerful and less able to influence his environment since the start of this pandemic. We have been shrinking into ourselves, staying at home more and shunning the very social interactions that make us fully human.

There is a phrase that I am sure you’ve heard before. Fake it until you make it. This idea probably goes back to at least Alfred Adler in the 1920s. According to Wikipedia, Adler developed a therapeutic technique that he called “acting as if”, which allowed his clients to practice alternative behaviors that would help them to change dysfunctional patterns. You may know this technique by its more modern name still used today, “role play”.  Fake it until you make it leads us to imitate confidence, competence and a positive optimistic mindset until we can actually achieve these things in our real lives.

Wikipedia offers another way to look at this, attributed to William James:

“Action seems to follow feeling, but really action and feeling go together; and by regulating the action, which is under the more direct control of the will, we can indirectly regulate the feeling, which is not.

Thus the sovereign voluntary path to cheerfulness, if our spontaneous cheerfulness be lost, is to sit up cheerfully, to look round cheerfully, and to act and speak as if cheerfulness were already there. If such conduct does not make you soon feel cheerful, nothing else on that occasion can. So to feel brave, act as if we were brave, use all our will to that end, and a courage-fit will very likely replace the fit of fear.”

— William James, “The Gospel of Relaxation”, On Vital Reserves (1922)

Another place that I have recently found reference to this ability to fake it until we make it is in the 2016 TED talk given by Amy Cuddy. In it, she describes how body language visually telegraphs our mood and state of confidence, and how our nonvisuals impact not only those around us, but ourselves as well.

One of her main points in her talk is that we can fake it until we become it, until we can tell ourselves, “I’m really doing this!” Tiny tweaks in our behaviors can lead to big changes in our lives.

We are living in very stressful times. We are dealing on a daily basis with social upheaval, political unrest and the possibility that we might contract a deadly illness. Even without being told, we have felt ourselves shrink from daily encounters with others, decrease our normal social interactions, and forfeit many activities that give us joy. We may not feel overtly afraid, depressed and defeated, but our body language and our actions may telegraph otherwise, both to others and to ourselves.

Can we fake it until we all make it? Yes, I believe we can. Listen to and act on the recommendations by the CDC. Wash your hands. Wear a mask when you leave your home. Observe social distancing recommendations. Be smart about how and when you interact with others both indoors and out. This pandemic is fueled by the spread of a tiny virus that will stop spreading when it is deprived of new hosts. Our behaviors, coupled with the eventual development of viable, effective, safe and reliable vaccines that we all choose to receive, will stop it in its tracks, and this medical nightmare will finally be history. Until then, even if you feel deprived, depressed and distanced from the people and things that make life worth living, fake it until you make it.

Fatigue

Words are interesting, aren’t they? I love to use words to convey meaning, to educate, to enlighten and to try to persuade. We all use words that we are familiar with, that we understand and that are part of our normal vernacular. We get used to these words as ways to express a familiar thought or idea that we hold dear or that comforts us. The interesting thing about the English language is that many of our words have nuanced definitions and can be used to express many similar or related meanings.
Fatigue is one of the words that comes to mind for me lately. When we look to the Merriam Webster Collegiate Dictionary definition of fatigue, we find several aspects of this word that pertain to our current situation as we struggle with pandemic life.
First, a definition that was certainly not top of mind for me. “Manual or menial work, such as the cleaning up of a camp area, performed by military personnel.” There is also a corollary definition that goes with this, being “the uniform or work clothing worn on fatigue and in the field”. Think about many households now as young families struggle with educating their children at home, cooking and eating many more meals at home than usual, and having one or more adults working from home at the same time. This scenario has created home landscapes akin to domestic camp areas, staging areas for vocational, culinary and educational missions that were often outsourced and performed far away from the home just a few months ago. We are constantly “cleaning up the camp area” while wearing the new uniform of 2020, shorts, tees, sweats, and Allbirds, trying our best to be efficient and productive while staying as comfortable and low key as possible. For the most part, I think we are succeeding admirably in spite of all the odds against us.
The second definition is more the traditional one that we think of when we think of fatigue. “Weariness of exhaustion from labor, exertion, or stress.” We have all felt this in one way or another over the last seven months. We are working hard, sometimes in vastly different ways or in different places than we are used to. We are caring for families, our coworkers, and others at the expense of caring for ourselves. Some of us have fallen ill with COVID-19 and that has given an entirely new meaning to fatigue for us. Physical weariness that precludes meaningful activity and productivity wears on one’s body, mind and soul. Even if you want to get up and actively engage the world, sometimes a physical illness like COVID-19 stops you in your tracks and says, “not today”. This fatigue, unlike the camp that can be tidied and cleaned, must be managed until it has passed. It is insidious, long lasting and debilitating.
The third definition that caught my eye was the one describing “a state or attitude of indifference or apathy brought on by overexposure (as to a repeated series of similar events or appeals)”. Now, this definition encompasses several different aspects of our current lives in the time of COVID-19. Not only are we feeling extremely overwhelmed by the pandemic and how it has disrupted our daily lives for months now, but we have been dealing with racial tensions, economic stresses and political dissent and strife as we approach one of the most contentious presidential elections our country has held in our lifetimes. When there were fifteen cases of COVID-19, the threat felt small. When there were one thousand deaths, we felt that this was something terrible. Fifty thousand deaths were almost unfathomable. One hundred thousand deaths were unbelievable. Now, we have had eight million cases of COVID-19 in our country and well over two hundred thousand deaths. We have been seeing and hearing these numbers for so long now, and in such quantities, that we are numb to them. We are fatigued. It is harder and harder to muster compassion, much less hope that things will eventually get better. On top of the ongoing pandemic and its stresses, add the civil unrest, the political intrigues and countless ads on television and in the news, and we are simply bombarded with negativity that further numbs and chastens us.
What to do?
See things as they are. We have already found that one cannot wish away a viral pandemic. It will run its course, relentlessly, until we either achieve immunity overall or we have a workable vaccine. We cannot make the government attend to our financial needs. We have had to be creative to find work and put food on the table. We cannot fix racial unrest and social inequalities overnight. These changes can come, but it will take much time and much work by all.
Limit negative exposure. Keep up with the news, but only in prescribed amounts and at certain times. Constant exposure to negativity and stress will only increase social, emotional and physical fatigue.
Act. Plan. Work. Vote. Talk. Collaborate.

One final definition of fatigue that Webster’s offers us? “The tendency of a material to break under repeated stress.” We do not want to let ourselves get to that point, do we?

Random Covidisms: 63

  1. Yesterday was one of those days that gave me, as my three daughters would say, all the feels.

I had my sixty-third birthday, a day I had been anticipating with a sense of profound wonder, dread, longing, excitement and fear. As many of you know, I had already lived one day longer than my father back a few months ago, so that sigh of relief could be expelled slowly and softly and with gratitude. However, I had still not vaulted over the next hurdle, the official one, the birthday that would make me officially older than my father had ever been. He never celebrated his sixty third birthday. Yesterday, I did.

What did this mean to me and those who care about me? It meant that I am now older than the man who with my mother had a thought about me that lead to my being born and having time on this planet. I am sorry that he died young, but I am glad that he got to live at all. That is the reason I am here now. Unapologetically cosmic thoughts, I know, but you just can’t help having those thoughts about your place in the universe and what it all means at these monumental times. You just can’t. So, I am having them. I am sitting with them. I am thinking the thoughts and feeling the feels. I am sorry that my father never got to celebrate sixty-three. I am grateful and happy that I have been allowed to. In a sweet card that my mother sent me yesterday, she said ” I’m glad you reached 63 and can now look forward to growing older with Trina and enjoying many years of joy and happiness.” I think my astute mother summed it up for me while giving me permission as only mothers can. You made it. Now, move on and live your life. Don’t fear. Live. Thanks, Mom. You’re the best, and I love you.

2. COVID-19 is still rampant in our country, and the numbers are awful, but there are people out living their lives and being careful as they do. I drove to my office in Barnwell County in South Carolina on Thursday for the first time since March. It was very odd. The route I took was the same, but the landmarks were different. Timber had been harvested along one highway, leaving a broad vacant expanse that made me feel quite disoriented for a few seconds as I drove through it without my usual landmarks. Another stretch of trees and houses looked devastated, as if a bomb had gone off over them. I later found out that a tornado had touched down there, destroying most everything in its path since the last time I drove past that area. There were people in cars driving to their destination, stopping at stores, all along the route, and it all felt so normal, but not, sort of like being in a Stephen King novel. I just knew that the rabid dog or the possessed car or the Man in Black were going to come out of no where and undo my world.

When I got to the clinic I donned my mask, went inside, said hello to the few people who were physically working at that site, went to my office and closed the door. I came out only a very few times before leaving at five PM to return home. Meetings were on Microsoft Teams. Appointments were on Doxy.me or Doximity on my computer or my iPhone. Things at the office, my first time physically working there in seven months, were decidedly not normal. We are going through the motions, but the motions seem too scripted, too acted, too fake.

3. We voted yesterday, a very good way to start my birthday. The whole process took ninety minutes, was very smooth, professionally facilitated, and seamless. The wait in line in the already hot sun at 9:30 AM was something I have never had to do to vote before, much less voting this early. It was worth it. The sense of active participation in our government is palpable as you stand there with several hundred of your neighbors, all waiting to take part in this grand experiment that we call democracy. This is not a political blog, so I won’t go there, but let me just say this. We need to get back to decency. We need to get back to caring for one another the way we care for ourselves. (we talked about this is church this morning-see below). We need to get back to compromise. We need to get back to working for the things that benefit the majority of us, that lift and elevate all of us, not just the privileged few. If you have not voted, do so. It’s important. Exercise your privilege. Vote.

4. We watched a wonderful documentary last evening after an even more wonderful grilled filet mignon birthday dinner. The piece, Bruce Springsteen’s Letter to You, was an uplifting look at life, relationships, growing older and contributing to the world using your talents and your need to communicate with others. If you like rock and roll, you will love this up close look at how Springsteen and the E Street Band make their fabulous music together. Even if rock is not your cup of tea, watch this for its take on life and love, grief and loss, paying tribute to those who have gone before and carrying on traditions that are timeless. It will be well worth your time, then listening to the album itself will just mean that much more to you.

5. We went back to the Church of the Good Shepherd for in person worship for the first time since March this morning. Just like my drive to Barnwell this week, this trip to the sanctuary we love to worship with others was anticipated with joy. The services are limited to only forty eight parishioners (the sanctuary holds many times that in normal times), everyone is socially distanced (we sat in a pew by ourselves, at least six feet away from all others) and all are wearing masks. We were able to wave to friends at a distance and even spoke to a couple but it was nothing like normal times of meeting and greeting. Although there was wonderful organ music by Jim Nord, the congregation is not allowed to sing at all. Communion consists of going up one by one to the priest, receiving the bread and then exiting the sanctuary. No common cup is allowed. The service is short and sweet. Once again the pandemic has altered our day to day lives to the point that we are going through the motions and grateful for it, but we are certainly not getting the richness of experience that we got before COVID-19.

So, my friends, I have now lived sixty-three years on this planet and my mother has given me permission to move on and live many more happy ones! I intend to do just that, starting today. May our post-COVID-19 pandemic life continue to be filled with celebrations, music, worship, friendships, creativity, love and connections that enrich us, nurture us and give us myriad reasons to live life to the fullest. Happy Sunday!

Gimme Shelter

Gimme Shelter

Ooh, a storm is threatening
My very life today
If I don’t get some shelter
Ooh yeah, I’m gonna fade away

The Rolling Stones

Shelter. It’s a safe sounding word, a comforting word, a good ending to the story word. We have all needed shelter at one time or another in life, if just to lay our head on a pillow for the night and sleep to be able to face another day. What is shelter, exactly? Well, Merriam-Webster tells us that a shelter is something that covers or affords protection, or an establishment providing food and shelter. There are shelters like lean-tos in the open forest, homeless shelters in inner city neighborhoods and animal shelters that care for strays until they might be adopted. Remember Maslow’s Hierarchy of Needs? Shelter fits right into those bottom two sections of the pyramid that talk about basic needs like food, water, rest, security and safety. If you do not have these basic needs, safe shelter being one of them, then it is very difficult to focus on the more complex, higher needs like relationships and self-actualization. 

I have worked in and around shelters run by the Red Cross and other organizations in times of need, and maybe you have too. The traditional shelter layout that most of us envision is a very large, somewhat open space like a church parish hall or a gym, with room for the cots and belongings of hundreds of people who for some reason need to be there. These people are very close to each other, sleeping just a few feet apart. There is usually some kind of communal eating, with shared tables full of foodstuffs and community coffee pots. There are often common bathrooms, albeit cleaned and monitored to the extent possible. Helpers and volunteers often work in very close proximity to those in need. There were some days during my deployment for Hurricane Katrina in Mississippi and Louisiana that I would talk to literally hundreds of people a day, some for one minute, some for fifteen or thirty, depending on need. We worked, ate, comforted and rested in very close quarters. There has been the need for this type of sheltering and aid during Hurricane Laura and now during the catastrophic wildfires in California, some of the worst ever. 

Shelter has recently become a concept and an operationalized idea that is fraught with challenges. The age of the COVID-19 pandemic has turned on its head the idea of getting many dozens or even hundreds of people in the same large room, living and eating and breathing in the same vicinity, for days if not weeks at a time. This is virtually impossible. Or is that the key word? Virtual?

We have all been asked to shelter in place for varying lengths of time since the start of this pandemic. We have found ourselves staying in our homes for days, weeks, or even months at a time, with little contact with the outside world or even with others in our own extended families. We have made makeshift home offices, set up school environments for our children, ordered our groceries and meals from companies who will deliver to our door, and driven by for curbside pickup of everything from internet purchases to communion. We have found that parking by school busses that are reconfigured to be WiFi hotspots might be the most reasonable way to stay connected while still sheltering in place, that place being the family vehicle. Our concepts of normal work, education, and providing for our families have been significantly challenged, altered and modified, some perhaps for the foreseeable future. 

What is the new meaning of seeking or providing or benefitting from shelter? There are several aspects to this new pandemic-inspired concept. 

First, there will always be the physical component. The facts as we know them now mandate that we continue to exercise caution in the form of physical distancing at least six feet from others any time we are outside our safe zones, which for most of us is our own home. This physical distancing, combined with wearing face coverings, gives us the ability to essentially “shelter in place” no matter where we are, so that we can roam a little more freely to get groceries, fill up the car with gas, or make short trips as needed. 

Emotional support is going to be an ongoing need. This is hard. No question. I talk to people every day who are tired of being cooped up, tired of not seeing their loved one and friends and tired of basically being on house arrest. We are human animals, and we crave social and emotional togetherness, closeness and community. That is never going away, but it must be tempered until this pandemic goes away for good. Connectivity that leads to communication is key. As discussed before by many others, use FaceTime, Skype, messaging apps, email, phone calls and even good old fashion letter writing to keep in touch with those you care about. The need for connection does not go away just because physical distancing is necessary. 

School has been a huge issue for many families over these last many weeks. How do we go back to school? When do we go back? For how many days each week? Virtual versus hybrid versus online versus paper versus-you get the idea. Kids must be sheltered and protected even as they learn. This may be in the classroom with plexiglass and masks, or it may be at home with Chromebooks and headphones, or a combination of both. Education is paramount, but safety is on the hearts and minds of everyone who has ever taken on the wellbeing of a child as a primary responsibility. 

Daycare and the ability of parents to work is another major component of this new sheltering in place idea. Are parents able to supervise kids while still doing their own jobs at home? Must in home childcare and supervision be obtained in order for parents to go back to the office? Are kids sent back to school rooms that have been modified based on current knowledge in the hope that teachers and kids will all remain healthy? 

Almost by definition over the last six months or more, we have been physically and socially distanced, but we are still very much emotionally connected. That connection and common purpose are the only way that we will survive the stresses of the pandemic, social upheaval, climate change, and an economic downturn that has impacted so many in our country. Educate yourself. Challenge suppositions that seem spurious or nonsensical to you. Protect yourself and your family in the ways that you feel are scientifically based, logically thought out and that are in the best interest of all. 

COVIDISMS: There’s Got to Be a Morning After

Well, it’s been six months since this hell began for most of us. Life changed about mid-March. The pressures of pandemic life and racial unrest and climate change and monster storms and COVID-19 and political upheaval and all the rest of the plagues that currently beset us are almost too much to bear. Almost. But bear them we do, baring our souls when we need to, our teeth when we must and our hearts, always. As Master Yoda wisely taught us, in times like these, “No! Try not. DO or DO NOT. There is no try.”

Yesterday was the nineteenth anniversary of the brutal terrorist attacks on our country on September 11, 2001. Like many of you, I can remember the exact spot I was sitting in, the exact thing I was doing, the exact sameness of that morning, until someone told us to step into the next room. A group of caregivers, patients, doctors, counselors and family members were glued to the small television on top of the rolling cart, watching in disbelief as a plane hit the World Trade Center. A tragedy. A fluke. An accident. Until it wasn’t. Until another plane took that elegant, sweeping, graceful arc of death into the second tower in a ball of fire and melted glass and metal and a second plane full of people lost their lives in an instant. I listened to some of the phone calls from the planes and the towers last night, against my better judgment, and was absolutely devastated by the sadness, the finality and loss of it all. Lives and families shattered, a city reeling, responders who had been trained to handle anything that could ever happen, except this one thing. No one had ever used planeloads of people as weapons of war. I know that it is not good for me to watch and listen to histories of tragedies such as 9-11 after long weeks of work and stress, especially when I am home alone, but how can I not? How can we not hearken back to that time, that era, that innocence lost for us and for our children? NEVER FORGET.

Today is September 12th, and the thirty sixth birthday of a woman who I admire greatly. (Happy birthday, Greer. I love you!) My oldest daughter, who bears the Scotch feminine form of my first name as her own, has become a force to be reckoned with. (From Houseofnames.com: The old Scottish-Dalriadan name Greer is derived from the given name Gregor. The personal name Gregor, which is the Scottish form of Gregory, is derived from the Latin name “Gregorius” and from the Late Greek name “Gregorios,” which mean alert, watchful, or vigilant.) She is a daughter, a wife, a mother, a friend, a political activist, a party planner extraordinaire, a home schooler, a sister, and aunt and so many other things large and small. As I have written about before, she was performing in a production of Oklahoma! in Augusta, Georgia when 9-11 happened, and was about to celebrate her birthday with friends and family that year. I am quite sure that she has vivid memories of that year as we all do. There was a morning after for Greer, a birthday morning after, and there have been September 12ths every day since that fateful attack. Birthdays must be celebrated, even as losses must be mourned.

My wife has worked for Delta Airlines for forty years. She is very good at her job. She is a people person, remembers details that are lost on most mortals, and can anticipate things that others need before they know they need them. I know, because she does this for me at home all the time. Every time that I see she has left the coffee pot ready to brew the morning coffee for me the day after she leaves for a flight, or manages to fit one more container of that German shower gel I like into her bag on the way home from Frankfurt or fills up the fridge with just the soft drink that I have been craving this week or any number of things, I feel the love that she shows through her actions every day. She has gone back to flying after a voluntary two month furlough. Delta’s business plummeted ninety percent when this pandemic started, and some of her flights have less then three dozen people on them even now. The airline industry will survive, Delta will go on serving the transportation needs of many, but it’s going to be slow going. Some estimates say that the industry as a whole will not be anywhere near back to prepandemic levels of business for four to five years. In this time of COVID-19, political unrest, and commemorations of 9-11, do I worry about her as she flies from Atlanta to Amsterdam to Frankfurt to London to Dublin to Seoul and back again. I would obviously be a liar if I said I didn’t. We don’t dwell on it. It’s her job, it’s been her job for forty years, and she’ll keep doing it for another half dozen or so years and then retire. That is the plan. I believe in the plan. We simply cannot live our lives in fear of terrorists, viruses and world political unrest. We cannot, and we will not.

One cannot be a writer of any kind without reading.

(“Can I be blunt on this subject? If you don’t have time to read, you don’t have the time (or the tools) to write. Simple as that.”
― Stephen King, On Writing: A Memoir of the Craft)

To write, you must get out in the world and experience things that compel you to write and you must read. A lot. Widely. As I age, I find that for some reason my mind takes in the written word better in an audio format than it does by holding physical books or magazines or papers in my hands. Now, I still have stacks of books and reports and papers in every single physical space that I occupy in this life, from the living room to the bedroom to my home office upstairs to my office at the clinic. I pare these down excruciatingly slowly most of the time, and I severely chastise myself regularly for not being more diligent in doing so. Be that as it may, I have loved audiobooks since a physician colleague of mine turned me on to those long cardboard boxes of cassettes that got shipped to me regularly and that I would play in the car on my daily commutes starting back in the eighties. Now, of course, having passed through the cassette and CD phases, the industry is almost purely digital and portable and held conveniently in your phone, computer or tablet. I love this, in that I always have a book or essay or article at hand and there is little excuse for lack of time to read. What do I read? I love political books lately, given our collective angst in that sphere, as well as biographies, novels, and histories. Some of the titles I have enjoyed this year include Me, by Elton John; Leonardo da Vinci, by Walter Isaacson; A Very Stable Genius, by Philip Rucker and Carol Leonnig; You Never Forget Your First: A Biography of George Washington, by Alexis Coe; The Hardest Job in the World, by John Dickerson; Blindness, by Jose Saramago; and Front Row at the Trump Show, by Jonathan Karl. I am currently listening to The Second Mountain, by David Brooks. I also listen to podcasts, mostly on politics, but sometimes on other topics, on a daily basis. The pandemic has caused me to really sit down and evaluate how I use my time, every day, and the results have been eye opening. We waste a lot of time on things that, to use a football metaphor since it is finally fall, do not move the ball down the field. I am trying to rectify that in my own life.

It is Saturday morning as I write this, and football is starting back. I love football, but somehow this year I’m just not feeling it the same way, you know? Life is moving on, and time with it, and traditions and markers too, but things are different. Time will tell if we get back to normal, pre-pandemic normal, ever. One thing I am sure of is that life will go on. We will continue to live and love and work in some fashion, there will be babies born and some of us will die. As my wife and I have been learning by listening to The Great Influenza, by John M. Barry, things are bad now, but they could be orders of magnitude worse. All pandemics end, and the world will continue to turn.

A last thought. There were some good things about the seventies. This song was one of them that pertains to us now, more than ever.

Enjoy your weekend, and thanks as always for reading my Musings.

D Day + 1+ 51

My father died on D Day +1 + 51 years.

It was only fifty three days until he would have celebrated his sixty third birthday.

As many of you know, I have been thinking and writing about his death on and off for years, here and elsewhere. The thought that I might one day outlive my father has never been far from the front of my mind.

Well, tomorrow is the day. Today, September 2nd, is fifty three days from my sixty third birthday.

If I wake up tomorrow, as I certainly plan to do, I will have seen one more sunrise in my life than my father. I will have one more day to live, to love, to work, to play and to think about what is and what might have been, than he had.

What if today had been the last day of my life? I worked at home today seeing patients, as I have been doing for the last half year. I chatted with people by cell phone and on video calls, listening to them and trying to be helpful in the midst of the worst public heath crisis in a hundred years. I electronically prescribed medications that I sincerely hope will help alleviate suffering. I asked after one of my new employees to see how she was doing. At lunchtime I listened to a book about politics, as one does during a presidential election year. After work I took an intense forty five minute bike ride in my neighborhood and along the river with the heat index 106 degrees. I was hot, winded, and soaked at the end of it. It felt good. I felt alive. I missed my wife today, as I always do when she is away on work flights. She sent me a beautiful picture of Germany today, where the temperature and the pandemic are cooler than here in the US. I took delivery of a wonderful set of pastels that she wanted to order for her birthday, which is this Friday. (No, it is not a surprise. One of the pleasures of getting older and having most everything you need is that you can special order your gifts with no shame at all!) I smiled when I saw the box, anticipating the pure joy that these little sticks of color will give her when she holds them in her hand and applies the pigment to the special papers she will use in her art room upstairs.

Did I do enough today? Did I care enough today? Did I get outside my own head, lay aside my own anxieties and worries and needs enough to give of myself to others in a way that would have made my father proud today? Did I learn something new? Did I grow emotionally, spiritually? Did I question my own motives today, vowing to have purer ones if I am given one more tomorrow? Did I care for my physical health? Did I take care of myself in the same way that I am always asking my patients to take care of themselves?  Did I have a good day today, a day that could have been, that could be,  my last?

My wife is convinced and has ordained that I will live until I am  ninety six years old. The odds, not to mention my family genetics, do not support that wish I’m afraid, but I do love to hear her say it. I would love to live ten, twenty, even thirty more years if God grants me that special privilege. There is a lot I want to do. There is a lot I want to experience. There is a lot I want to learn.

Tomorrow, I will have lived one day longer than my father. An accomplishment? No, not at all. A gift. A true gift. A pleasure. A reminder that we are not promised one more day, but that we are allowed over and over again to take possession of that most precious of commodities and choose to use it in any way we wish. We are given the gift of time.

I will wake up tomorrow morning and rejoice in every small muscle twinge, every sleepy yawn, every hunger pang, every emotional surge, every cognitive challenge and every warm sunbeam that graces my aging face. I will rejoice in another day and the simple fact that it has been gifted to me.

Besides, what is my other option? If I die tonight and make it to heaven by morning, I would be greeted by my father, a man who preceded me in death by decades but who would be exactly my age. Somehow, I don’t think even God would find that amusing.

 

Death is nothing at all,
I have only slipped into the next room
I am I and you are you
Whatever we were to each other, that we are still.
Call me by my old familiar name,
Speak to me in the easy way which you always used
Put no difference in your tone,
Wear no forced air of solemnity or sorrow
Laugh as we always laughed at the little jokes we enjoyed together.
Play, smile, think of me, pray for me.
Let my name be ever the household world that it always was,
Let it be spoken without effect, without the trace of shadow on it.
Life means all that it ever meant.
It it the same as it ever was, there is unbroken continuity.
Why should I be out of mind because I am out of sight?
I am waiting for you, for an interval, somewhere very near,
Just around the corner.
All is well. ”

Henry Scott Holland

Things Unseen

You might have heard the stories about how and where Steve Jobs got his design sense and his obsessive attention to detail. Steve’s father Paul Jobs was a good  mechanic with (from his son’s perspective) a decent sense of design. He worked with cars, metal and wood and could build most anything his family needed. Jobs said that his father cared about how things looked, but he cared even more about how the things that were hidden from plain sight looked also. He would never put a flimsy section of plywood on the back of a fine piece of furniture. He would build the back of a fence with the same care that went into the front of that same fence. He cared about the things that were unseen.

Jobs carried that aesthetic into his own work at Apple. He would have rough seams on plastic computer cases sanded and polished. He rejected components that were not precisely made. He wanted employees to sign the inside of some of the computers they made, even though the buyers of those machines would never see the signatures. This was to get them to own and be proud of the quality of the work they were doing.

Today, many of us are working from home. We have set up office space with desks, computers, lights, printers and screens by which we can interview, assess, meet with and deliver services to our patients, customers and coworkers. We spend many hours in front of a glowing screen that is anywhere from five inches to three feet or more across. We are highly visible to the people we work for and with, except for one small detail: the part of us that is unseen.

We are working from the waist, or the mid-chest, up.

I have had several people, when finding out that I do telemedicine from home or office for ninety five per cent of my work nowadays say things like, “Cool! You can go to work in shorts or pajama bottoms or sweatpants! You don’t even have to wear shoes. You can work barefoot!” Yes, that would technically be an option I suppose. Like a television anchorman, you would know what kind of shirt I am partial to (cotton Oxford button down), what kind of ties I wear on the job (NONE!), and possibly a little bit about my taste in jewelry and watches (currently wedding band, Medical College of Georgia senior ring class of 1983, and Apple Watch Series 5 WiFi and cellular capable).

Like Steve Jobs, I believe that the things that are unseen are just as important as those that are. The rest of my working clothes get me into the right frame and state of mind to listen carefully, think clearly and act decisively. You may not see them, but I know I am wearing them everyday, and that makes me feel prepared and ready for whatever the day brings. A nice pair of year round wool slacks, a Hugo Boss or Hanks leather belt, a Bellroy wallet, nice socks from Vermont or (if I’m feeling a little more dressy some mornings) a little mill on the banks of a river in England, and one of my several pairs of Samuel Hubbard shoes. (I am often up and down and on my feet for up to eighteen hours in a day, and I have very unforgiving feet).

So, could I trudge upstairs with a nice fresh Oxford shirt over a pair of khaki shorts and flip flops? Yep, I most certainly could, and no one would ever be the wiser.

Except I don’t. I’m channeling my inner Steve Jobs.

And now, you know.

 

Rhythms

My mother buried her husband this past week, the second man she had to say a tearful goodbye to after her had endured a protracted illness. The first was my father, who passed away suddenly, almost violently, from a brain hemorrhage twenty five years ago. It got me thinking about a lot of things, as these events and times do. I began to think about them in the context of the rhythms that they settle into.

We are born into this world, we hope, the objects of joyful celebration, welcomed to the world with open arms and warm fuzzy blankets and the kootchie-cooing of adoring parents and grandparents. If we are lucky, we are loved. Undeservedly, unequivocally, unabashedly, unconditionally loved. We are cared for and nurtured. We grow and learn and succeed. One day, we head out into the world, adults who know nothing ready to control everything, only to finally realize that our true education has just begun. If we are smart and savvy, we learn even more about how things work, how to live and love in a harsh world that owes us nothing, nothing at all. We create, we procreate, we work, we amass, we collect, we build, we inhabit, we settle in for that delicious part of life which is the “we made it” part. We expect that “we made it” leads to “we earned it” leads to “we deserve it” which gradually morphs into “it will always be this way” and “no one can ever take this away from us”.  The train is heading down the track at a dizzying speed, wheels singing on rails and billows of black smoke trailing behind to darken the other fellow’s sunny skies, not ours. Not ours.

Then, a once in a century, a once in a lifetime event happens for the second, third and fourth time. The hurricane leaves nothing but concrete slab and green slime-infested pool at the edge of a sunny shore that once heard the laughter of children and now hears the wails of retirees who find that their physical address, what is left of it,  has moved over three streets. The lingering siren that warned of the monster heralds a dawn in which the rubble is piled three stories high, the muddied teddy bear and the family album strewn across a neighborhood that no longer has landmarks of any kind after the wrath of the mighty winds visited. A casket is lowered into the ground, a tiny one, and is covered with earth, covering hopes and dreams and sleepovers and play dates and senior proms and trophies that will never be displayed, all because of a stray bullet that was stopped by the innocence of a child.

We are born. We grow. We dream. We work. We love. We die.

The virus creeps in on Sandburg’s little cat feet. Yes, I can’t get that descriptor out of my mind in the past few months because it seems like everything that hits us, hurts us, kills us comes in that way nowadays, gliding on silver airplane wings to knock down buildings, hissed in a a quiet string of expletives designed to hold us down, or breathed quietly towards us, inhaled death. Quiet. Stealthy. Deadly. The rhythm of death.

I’m home. I work every day. I talk to everyone and yet touch no one, shake no hands, pat no one on the back, proffer no gifts except my words. The rhythms of this daily pandemic grind are cold and mocking. Upstairs to work. Listen to music that used to soothe but now just bores. Hear the rumble of the construction workers’ trucks and trailers heading into the area to work. FedEx truck by for the first of one, two or three routes that day, always before ten. UPS truck (What can Brown do for you?) close on his heels before noon. Construction guys to lunch, sans trailers. USPS truck chugging out and back, albeit later than usual these days. Rhythms. The daily grind of good coffee and hard work and tedium and our inexplicable complacency with mediocrity of leadership and one thousand deaths per day.

And yet, we do it.

And we do it again.

And we do it again,

until,

one day,

we understand

why.

The masks come off,

and we smile.