The Woods

 There are good things about the lake and bad things about the lake. Good things: it’s water. Sunsets are pretty. Herons. Good breezes.  Bad things: it’s “The Lake.”  This stringy, hillbilly shellac prevalent down there. Real estate agent couture. It’s mine, by right and birth, but I don’t quite get it. 

Played a gig last night—sat in with a group from LA. The guitarist was my age, and trying to hide it (isn’t this the case with all these terrific guitarists in these B bands from out of town?) intelligent, despairing, slightly crazed, that coke-y energy you start channeling when your joy dries up. But some real kindness and some honest frustration.  We didn’t have a rehearsal prior to the gig. I’m not a professional.  I’m a nice person with a good ear, good vibrato, a rotten bow arm, and unusual ideas about what the fiddle should do. I’m not a virtuoso by any means, but I don’t play like anyone else, but it speaks to some. I’m in a band, a wonderful, crazed, soulful, hard-living group and we have become mysteriously good. We are actually going to be opening for Wynonna Judd.

Back to last night. The guitarist’s name was Lucian. He sat down with me right before we went on:

“Ok—on this one—the timing of the chorus is a little odd—what you have to remember is—it’s just a 5 turnaround.”

“Oh, Ok. “ I said nodding. “5 turnaround.  Got it. “ 

He moved on, but my conscience kicked in.

“Lucian, I’m really sorry, but what is a ‘5 turnaround’?”

To his credit he tried to cover it. But, I am a clinician. I work 5 inches away from surgeons over a spinal cord, so nuance is everything.

He explained it to me. Then he paused.  “I know I seem like an asshole,” he said. “But I’m really not.”Which of course gave away how he really felt.

The gig commenced. We were opening for someone famous—young, hot, country star. Pretty girls around the green room. “Who are you? Are you with….?”

Incessant coaching from Lucian through the show.  Finally, on the last two numbers, I though, “Fuck it. This band isn’t going to ever have me play for them again, and I’m going to play the fuck the way I play. My friend Ben Bushman, another crazed fiddler, calls it ‘being in the woods.” So off I went. I have a lot of hair, which keeps me from having to make eye-contact with people.

When I met Ben Bushman, the fiddler I admire most, it was at a house concert.  I knew he would play after us, and the fiddler that comes next is ALWAYS better than I am.  After we played, he came up to me and stared at me. We looked into each other’s eyes for a very long time.  He shook his head.  “I always thought you were just some nice lady,” he said, “But you’re in the woods.  You’re deep in the dark woods, just like me.”

That’s my half-hour.   But I’m actually going to learn what a ‘5 turnaround’ is after this.

Nick’s Birthday

 Lilly’s visiting. She’s just like she always is. I haven’t seen her in a year.  We’ve been separated by the pandemic. She’s long and lean and lovely and therapy-ed. Her face has changed a little.  Something in the relationship of the cheekbone to the corner of her mouth. A little thinner or harder. She has endless energy for pondering, chatting, musing, listening. The first week, she sort of collapsed and reverted to her 11 year-old self, but now she’s more adult.  Taking the dogs on walks, working from the upstairs bedroom, zooming with her sweetheart.  For my part, her presence is a deep and lovely comfort, and I feel a little thrum of happiness which seems to be a baseline, background comforting hum, like a purr.

Already I regret her absence. I regret not looking at her deeply enough, not inhaling her, spending more time with her.  

I’m trying to keep my weight under control. I’ve signed up for an online program called NOOM on the advice of my acupuncturist. I lost 20 pounds doing keto for a year, but then, at my last check-up, my liver was funny, so I’m backing away.  I feel guilty doing this, given Lilly’s problems with anorexia in the past and I know how she views this sort of thing. So I feel funny over this separating force. I need to mention that I am eating Cheez-Its as I am writing this and it’s 838 am on a Sunday morning.  That’s like waking up and putting gin on your grape nuts, as far as I’m concerned. One of the things Lilly does is have snacks all over the house, so she can just munch on things mindlessly, which keeps her weight normal.  Who on earth gets to do that?

Jay likes Lilly, too, but the walls are thin in this house and you can hear what goes on in the other rooms.  So sex has been rare.  He got so frustrated he rented a room in the Hampton Inn across from the hospital last Thursday. It worked out. We made love, sat in the whirlpool tub in the room, felt sneaky and guilty.  It was lovely. We were home by 8.

She’s writing. Comedy bits, since the stand-up has come to a (rim shot) stand still. She’s also done some videos. Her stuff is hilarious. Zany, pee-in-your pants stuff. She was reading one of her bits to me in McDonald’s (Lilly goes to McDonald’s) and I laughed so hard my stomach hurt. It’s about a guy who uses his pandemic time to go into the woods and write a rock opera, and he comes up with a character named O’Reilly and, when he performs it for the first time, he realizes that he’s actually re-written the Macarena and the O’Reilly auto parts commercial. 

This place can really knit you back together. Potato, the very present Australian Shepherd, Latke, his scrappy lab-esque girlfriend—the three cats, the hill that rolls away from the house and pond. The fields greening up around us. Peepers at night, birds in the morning, owls at twilight. Tulips on the table.  

New York assumed this terrifying chaotic impenetrability in my mind this year.  I couldn’t get Lilly to leave. It was the city of death. How I longed to have her here, safe.  So one month of quiet for Lilly, home to heal.  Nick’s 30th birthday was on Friday. Jay was on a shoot, so it was just the three of us. I got out the old dragon table cloth, the one we use for every celebration, that I made for Nick’s third birthday out of an old sheet, when we didn’t have any money, and he requested a birthday with “dragons and trains.”  I spread the project out on the courtyard of our apartment in Little Havana, and at one point, 2 year old Lilly ran across it, dipping her tap shoe (and Lilly’s tap shoes are a story in and of themselves) in the paint. The print’s still there.  I made a strawberry buttermilk cake, and picked up Popeye’s. And it was just us three again, with the early spring night outside, frog song rising, and our voices wishing, hoping joy.

For a Friend--A beginning

 This year my resolution is to take three steps towards every single hare-brained idea that occurs to me.  So here they are so far:

1. Start a Podcast focusing only on women with blue hair, with each episode telling the story of someone who's chosen  to dye their hair blue.

2. Curate a art show featuring only artists who have day jobs as healthcare providers.

3. Start a Super Pac dedicated to promoting candidates who are pro-consensus.

4. Free Pedro Pablo Kuczynski.  A good friend of mine is a relative.  In a rare, personal facebook post, she noted, that if every person she knew, and his extensive contacts here in the states, had pressured the United States to intervene on his behalf, he might be free. So, why is he not free?

Here is his story.  He became President of Peru in 2016.  He's currently under house arrest.  The conditions are reportedly very poor and he has health issues.  He is 83.  A year older than my mother.

He's been a player at the very highest levels of the world economy, and you know, that always seems opaque and slippery to me, and beyond my understanding. But I remember him coming up to see my friend a few times during college.  He always went on long runs, no matter what was going on or the weather. He went in the evening, and if we were all going out to dinner, and ready to get in the cars and go, well, that was just too bad.  It was such a contrast to my father, who never exercised at all. I remember my father discussing with my mother, his voice horrified, that he'd read an article saying running sapped one's libido.  "Mark," my mother said, "then you mustn't do it."

When he became president of Peru, he undertook some laudable efforts at social reform.  He sought to be inclusive of indigenous people, promoted abortion rights, women's rights, and the rights of the LBTG community as well.  He apposed Maduro, Venezuela's leader.

I really don't know where to begin with this.  I spoke to one of the surgeons I work with, catching him as he was going out the door, carrying a bunch of empty boxes.  His name is Dr. Ter-Petrosyan. He's a good man.  His family emigrated from Armenia to South America.  I thought to Peru.  He's a big man, almost 7 feet tall, with a funny square head and square glasses, which accentuate his boxy, kind face.  I thought I'd start with him, since he's the only Peruvian I know, outside of Paddington Bear, who is an imaginary character.

"You're from Peru, right?" I asked him.  He looked a little exasperated, but in a nice way.  I felt bad.  The surgeons work so hard, I feel bad asking for any extra minute of their time.

"No, Nicaragua, actually."

"Oh, God." I said.  "I'm sorry."  I felt really stupid.  It was such a stupid, white person thing to do. A real "Karen" move. Mix up Latin American countries. As if they're all the same. "Didn't you give a big talk about medicine in Peru?"

"Yes.  But I'm not actually from there. So, that is why you thought that. Well, what do you want with Peru, Miss Haley?"  He put the boxes down and gave me his full attention.

I told him.  He nodded.

"Here is the thing," he said, after I had finished, in his formal way. "I have a great deal of respect for you, Miss Haley, and I think this is something we could perhaps move in some way positively towards, and I know a lot of doctors in Peru. It is not right, is it? It is unjust."  He nodded. "I will work with you to fix it."  He nodded definitively, picked up his boxes and walked out the door.

Well.  There you have it.  We'll see what happens.  If you, dear reader, have any suggestions about next steps, please leave them in the comments.

Traveling

 We’re traveling today. Despite the CDC recommendations.  Despite my own trepidations. Logic, epidemiology classes, evidence based practice.  We’re getting on a plane and flying down to Florida, where we will rent a kayak and hie out to the 10,000 islands.  Except for the airport/plane, I think this is a pretty risk free thing to do. The islands are lonely and pristine.

I haven’t packed, of course. I can’t seem to rule my days the way I used to. I just can’t seem to get all that excited about them.  The things that used to really worry me hardly make a dent. Is my surgeon irritated? Is my husband disgruntled? Am I getting fat? A B? Could be!

Maybe the equanimity we associate with Zen masters is just that they’ve reached the point where they “can’t even.”

Mainly we’re going because I think my husband is at risk psychologically.  I don’t think he’s going to kill himself or anything, but he’s pretty despondent. His father is being put on hospice.  He’s 96. Flew B29’s in World War II.  Came home and made a fortune in television advertising.  Managed to piss off the Pulitzers. Watches Fox News. Adores Trump. His kidneys are failing. Well...he’s had a glass of vodka over ice every morning at 11 am for most of his adult life, so no surprise there.  He calls it his “special water.” Even at the assisted living center where he resides he continued the tradition.  Going to brunch with him, our achingly young trans waiter would bring him a glass of ice without even being asked...it was clear they shared an understanding...and he would take out a flask out of his pocket and fill the water glass up.  Now they’re talking dialysis, and the high - end facility doesn’t want him going back and forth.  So he’s on hospice.  Have I told you about the family I married into? They’re shiny, rich and fun, but they don’t much like inconvenience.  To me, it doesn’t seem like dialysis a couple times a week would be that different from the life he’s already living.  I mean...hook him up...turn on Fox News.  Voila.  And I’ve tried to explain that the wackiness they’re seeing is partly a result of his failing kidneys.  They all have degrees in marketing and communication.  I also, to Jay, explained how difficult and painful a death from kidney failure is.  He gets it. The rest...unmoved. His older brother is the executor. And I get that he was chosen because of his success in the business world.  He’s a big power broker in the communications industry. But this dismissal of biology....well.  I guess they’ve all decided 96 years is enough.

I think of my little old lady patients (I have a handful) who take the frickin bus to dialysis. Who find meaning and joy, and persist, despite their swollen legs and aching backs. Who sit and knit for grandchildren while the machine runs.

So I’m taking my husband down to the sea, and we’re going to do what he does best...get into a situation where he has to make something out of nothing.  Camp on the beaches, fend for ourselves. I understand why he was so drawn to the wilderness, now, growing up in that environment. 

Well, that’s my half hour. I guess I’m ignoring biology, too.

Some Guidance

 Well. Wow. The world. Need I say more. I’m not going to hold-forth on the zeitgeist. There are a lot of other good writers doing that.  I’m going to draw from my own limited experience and cautiously offer some insights and share my own guidelines, in the hopes that you might find a thruline, something to tether you to the mast in this storm.

1. Keep charity with others.  This is the small, humble bond with each other we all share, a tacit nod to the other’s dignity and humanity. It’s not a grand thing really, and social media can provide you an easy laser knife to sever it. Be careful. Don’t give in to the informer culture. Stay away from the stranger’s eye and protect your friends as well.

2. Write a letter to yourself to remind yourself of what you value and what you generally need to do to keep sane. Because sometimes it all feels like dross, and you can’t trust your feelings right now. Put it somewhere you can access it easily.

3. Take a shower every day (or a bath). Moisturize with something a little more than you can technically afford. Wear deodorant, if that’s your thing. Those who wear makeup—take it off at night, ok? You’ll feel better about yourself. Don’t fall asleep in your bra.

4. Download the Good Housekeeping daily, weekly, monthly, yearly maintenance lists and try to follow them.  You won’t complete everything, but it will be better than nothing, and you will feel guilty about the things you don’t do, so you’ll eventually do them, even if not on schedule.  That way the rats won’t eat you and your house won’t be condemned by the city.  Unless they’re doing something sneaky like trying to declare underprivileged areas as “blighted”, totally screwing minority property owners.  But I digress.

5. Lay out your clothes and iron them for the week ahead.  It’s sock weather! Get those together. Nothing makes one feel more hopeless than being sockless. Stretch, one of my homeless friends (now gone) told me this, and actually gave me a pair of new socks, because he noticed I frequently was without them.

6. 12 minutes at least of Zen a day. You can’tfind it? 5? Every other day? Not a Buddhist? Just make sure you are silent and still for a few minutes each day.  Then fill the rest up with whatever you want.

7. Eat vegetables.  Blecch. But yes, you must. Water, too. 8 oz every 2 hours. Ok?

8. Checklists. I exist on checklists. Because with the schedule I work, my brain is too fried to distinguish my right from my left.  I have a checklist for what I need to go to work (badge, pager, glasses, hair tie, mask), what needs to go into the gym bag (deodorant, tennis shoes, earbuds—if I ever go back to the gym again once this cursed plague has recedes). Give your brain a rest.

9. Pay attention to the people you love. Listen to them. Look at them. Take their calls.

10. Objectively, even though you may not be “feeling” it, you know what you love, right? We are only made up of a sequence of minutes. Grains of sand in one pile or the other. Put your minute/grains in the love piles. Love what you love.

11. Figure out your sanity essentials and try to get them in.  ZEWMS are mine—Zen, Exercise, Writing, Music, Study. Don’t get all hinky about them and feel guilty if you can’t get them done daily. Roll on, my friend.

That’s my half hour.

Green World

There was frost on the grass this morning.  I hope the lilacs made it.  Lilacs are my favorite flowers, but I don't have any. Actually, I now have one bush of white lilacs, planted by the utility company as recompense after they destroyed my back yard.  They have a legal easement to clear the area under the lines, but they went crazy.  I actually cried.  They cut down a 100-year old magnolia and a third of the peach trees.  They met with Jay the day before and asked him what to do, and then they did the exact opposite.  "You made my wife cry." Jay told them.

So now we have some scraggly azaleas and a little white lilac bush, doing its damnedest.
A long desultory week at work.  Even though I don't have very many patients, I find myself utterly exhausted.  Partly, it's anger.  I have a friend who works at the VA.  The precautions they're taking are so much more sensible--and it's not like they're hiding them.  They're available to the public.  262 pages of really gripping stuff...

The Magical University of Paloma Hospital.  Where viruses have to abide by OUR rules. Take that, you disobedient thing! Science, schmience.

I had a bit of a snit over the fact the screeners aren't wearing PPE.  You can't have too much of a snit.  Too much gets you noticed.  I just quietly requested the screener put on a mask and gloves before touching me.  She's one of our lovely front desk women.  "I'm a cess-pit" I laughed.  I printed off the latest from the NEJM, on the possibility of airborne transmission (not peer reviewed by any means--but worthy of a nod, I think), left it laying around.  One of our administrators is in the hospital on a vent, but they're saying it's not COVID 19. Nice woman. Single parent. Religious.  Black. Has an autistic kid who shines with care and love. Has a boyfriend who is a professional bass player.  Last Monday she was walking through the halls, nodding and smiling.  Now she's reportedly on dialysis and can't breathe.  She has a rare gift with difficult patients, a saint's touch.  She could find the human thread in an impossible knot of a problem (not that I get into too many of those--but although I mean well, I am privileged, white and stodgy, so I occasionally bang my shins on this, God help me).

Well, that's my half-hour.  Be well.

Plague Dog Dreams

Thinking of the scene in Wolf Hall when Cromwell sees his wife sitting on the stairs in the morning before she leaves, returns home in the afternoon to find her dead.  Gleaming wooden coffins on the television, containing Italian doctors. Confounded in my mind with the Svengoolie Dracula movie last night, the open window of stained glass, letting in unfiltered light. Beautiful vampires, decaying before our eyes, once the stake is hammered in.

Spent yesterday mostly alone. Jay was out on a shoot. Zazen, yoga, 2 hours on the concerto I'm working on (Wienawski, Concerto No.2 in D minor, if you're interested).  Long walk with the dog on these deserted country roads. A mountain lion (yes, you heard me) on the far edge of the pond--that's why I took the dog on my walk! Then some studying.

The clinics remain open, incredibly. There is "screening" at the door, by people who are not health professionals. No PPE employed by staff. Jay is angry. Thinks we're chasing money. Wants me to call in. Quit. But people break bones and herniate disks even during a pandemic.  As usual, it's neither entirely one thing or the other.  This will pass, and we can't shut down, but I also think we could be safer and smarter. The school of medicine published one of the most heartless, callous documents at the outset of this I've ever seen.  Not surprised.  This was followed after several days by communication from the dean in a much different tone.  Must have had some feedback. :-)   But that was the first reaction.  Wiz always said, "When people reveal themselves...believe them." 

 It's interesting to see who people really are, isn't it? Or would be if my life and health and the health of my family didn't depend on their choices...

Interestingly, Fran, my direct report, who has a reputation as being very calculating and heartless, is one of the most humane voices out there. Making sure everyone is in on the plan. Emails at 10pm. Checking in personally. I always suspected she was a human being.  She was one of the few in the building who reached out to me when my father was dying. 

Oh, wow.  People.

Are we doing the best we can? Are we going to be able to look in the mirror after all of this is done?  If we make it?

80% have mild symptoms.  I have to assume, however, given the lax screening measures, that I might have it and not know. There's this little game we're playing, however, with the symptomatology. So people aren't being tested.  "Oh, it's not exactly this...so no test for you!" So our numbers officially stay low, and we stay open.  But the reality is that we are now basically travelling vectors of disease, spreading it to the community, as if the rules of social distancing and infection control just don't apply to us.

Chances are, I will make it out of this. I am relatively young and healthy and the odds are on my side.  Knock wood.  But aren't I at risk of infecting my patients?  What about the people still coming to work?  People I know have comorbidities.  What about the people who simply don't need to be here? 

And here again...financial exigencies. I'm the only stable income in the ENTIRE family.  Easy for Jay to tell me to quit and get angry at me for going into work.  Eighteen thousand dollars to Jay in the last year to cover basic expenses. 12,000 to my son. Plus healthcare.  Not feasible. God protect us all.