I don’t usually ‘get’ poetry, but sometimes poetry – somehow – gets me. SINGULARITY(after Stephen Hawking) Do you sometimes want to wake up to the singularity we once were? so compact nobody needed a bed, or food or money — nobody hiding in the school bathroom or home alone pulling open the drawer where the pills are kept. For every atom belonging to me as good Belongs to you. Remember? There was no Nature. No them. No tests to determine if the elephant grieves her calf or if the coral reef feels pain. Trashed oceans don’t speak English or Farsi or French; would that we could wake up to what we were — when we were ocean and before that to when sky was earth, and animal was energy, and rock was liquid and stars were space and space was not at all — nothing before we came to believe […]
There she is. Have I told you? I met her on my only blind date. I saw her and walked over right away, introduced myself, and asked her if I could visit her again that night. When she said that I could, I drove back to town and got all the money I had to buy her an engagement ring. We’ve been married for 67 years. She is the most beautiful woman I’ve ever met. I’m the luckiest man alive. He is almost 90 years old. He can’t get out of a chair by himself. He can’t walk without hunching forward over a walker with severe pain in his legs and hands. He has trouble feeding himself. There she is. Have I told you? I met her on my only blind date. I saw her and walked over right away, introduced myself, and asked her if I could visit her […]
I recently listened to a podcast on happiness on The Knowledge Project that featured best selling author Neil Pasricha, who – it turns out – is a pretty successful guy. Apparently, he makes a living out of telling people how he became happy (despite the unhappiness that must accompany a degree from Harvard and a successful career) and helping them learn how to be happy too. I am skeptical when someone tells you how to achieve something that each person struggles to define. For instance, love is something that we feel, but something that is hard to pin-down. Even so, there are variations of love. I love my wife differently than I do my kids, than I do my parents, than I do my brother. How I experience love is likely different than how it is experienced by others. My love for Christine probably varies significantly from how Christine loves […]
I know that I am depressed. And no, I’m not being mellow-dramatic … I just am. I have little motivation to do anything. I sleep like shit. I have a hard time mustering the energy to do things that I usually enjoy. I drink a little too much; I eat way too much. I can’t convince myself to walk or hike, much less exercise. I’m lonely. My PHQ-9 score is 15, which according to one website means: “moderately severe depression; patients typically should have immediate initiation of pharmacotherapy and/or psychotherapy.” Been there. Done that. I’m not worried. I’ll get better. It seems that I always do. Besides, I’ve been much, much worse. This too shall pass. . . . . I laid on the air mattress this morning for 2 hours before Christine’s alarm sounded; it was finally an acceptable time for me to rise, put my air-bed against the […]
2 days ago, we were walking Adeline throughout the neighborhood; I told her that this was as good as its gonna get: The daily positive cases from community spread are between 10-20 in Onondaga County, with it’s population of 450,000 people. The hospitalizations have leveled off – 50-60 people are in the hospital at any given time for COVID-related care. 25-33% of hospitalized patients are typically in critical care. This has been the case for the last 3 weeks. There is a little variance here and there, but this is what we can now expect pre-re-opening. She asked me what I thought about it all. I told her that if we didn’t stop distancing in the home now, I don’t see a circumstance when we would. I’m going to continue to see patients. The community numbers will worsen with the phased re-opening of the local economy (to what extent, we […]
The data is starting to come in and CNY is faring pretty well. Coupled with decreased population density, social distancing has been successful. The local hospitals haven’t seen the numbers of patients that were projected by epidemiological models, nor have the seen figures near what I had even calculated. We never had exponential growth. Our 3 major hospitals combined have only rarely had more than 60 COVID-positive patients at any given time. New antibody testing (now up to 15,000 tested statewide) reveals that far less than 3% of the CNY population has had COVID-19. Figures downstate are near 20%. The fatality rate is not going to be as high as was initially feared, although the numbers will be difficult to ascertain with any certainty. There are certainly people who have expired early on who won’t be captured in the data. Then again, this thing is also far more contagious than […]
Epidemiology is the study of the distribution and determinants of health-related states or events (including disease), and the application of this study to the control of diseases and other health problems. World Health Organization They should know better. Since the early part of the week, my answer has been the same: “They are far smarter than me. I don’t understand how they’ve come to get their curve to look like that, but it doesn’t make sense to me. I’ll try to figure it out later.” Later is today and today I’m pissed. I would expect better from a high school senior. Seriously. It is that bad. It draws ridiculously unreasonable conclusions that are implausible and defy direct observation. It is meaningless drivel. This isn’t even science; it is bullshit. If this is what passes for epidemiology – and I know better than to think that it does – then we’re […]
When I am reviewing patient cases with my staff, I ask them, “Where are we going with this?” By now, they know that I am asking them when they plan to discharge the patient from home care services. Home care services are necessarily finite. Criteria for coverage includes both necessity and a reasonable expectation that the intervention is going to have a significant impact on the patient’s abilities. Sometimes the patient achieves their goals, warranting discharge. Sometimes the patient plateaus, and the intervention is discontinued without an expectation of continued benefit. Similar considerations need to be made as I frequently re-evaluate the strategies deployed in the home to prevent spread of COVID. The kids and Christine are COVID-free. Considering their enhanced hygiene habits in/out of the home 2 weeks prior to school closures and their vigorous social distancing since, I would be shocked if they were to have any antigens […]
We made a calculated decision. On the evening of March 14, we allowed Austin to go to a friend’s house for a birthday party with 4 other classmates. We knew this was going to be the last time that he would see them face-to-face for a long while. We justified this decision by acknowledging that this same close knit group of 5 kids had already been with each other all week; one extra day probably wasn’t going to make a difference. By that time, either they had COVID or they didn’t. When I picked up Austin, the father approached me and grabbed my hand when I walked in (a hand that I had purposefully left at my side) and put his arm around me and placed it on the opposite shoulder, not hesitating to share with me his disappointment that local school administrators had elected to close the schools. As […]