portrait

Sol Duc loves the neighbor’s back steps. I have permission to walk her in their yard. Walking cats is quite different from walking a dog. It’s more following the cat around. Elwha is quite scared of being outside in the day, partly because we live on a busy street and there are all those NOISES. Sol Duc is braver, but tends to stay away from the roads in the daytime. Cats like edges and shadow, except when sunning.

When I walk them in the early dark, they are both much braver. Sol Duc has gone around the whole block. She is annoyed when I won’t let her go under a house or way into a yard where I do not have permission. And she has seen birds and deer and another cat and dogs and other humans! Whew!

soft foot and arms too

Tenderfoot reminds me of my sister and our family’s summer visits to Lake Matinenda. We lived in tents. My grandparents and aunts and uncles and cousins were all in cabins.

We were always the last to head home. We usually mislaid our flipflops, towels, t-shirts and flashlights, so we head down the path in the dark. When I was little I have cuts every summer in the arch of my foot. I learn to walk in the dark on the path with the foot curled and lightly, so that if there is something sharp I can change weight to the other foot. If there are two sharps in a row, usually rocks, I get cut anyhow, but less often. I still love to take my shoes off on the paths there.

I would go this summer except for the oxygen. We did not bring in electricity. I do not quite feel up to acquiring a solar panel/battery combination that is adequate this year. It’s also the heavy lifting. We drink the lake water and bring it up in buckets. We do filter it, but carrying the buckets. It just does not seem like a brilliant idea alone with my lungs still challenged.

Anyhow, here is another soft footed and soft armed creature. This is taken at the Baltimore Aquarium a few years ago.

For the Ragtag Daily Prompt: tenderfoot.

Juneteenth and Father’s Day

Juneteenth and Father’s Day, I am celebrating and thinking of both, and missing my father and my grandfathers. Yesterday was a delayed memorial for my ex mother-in-law. I loved her and we stayed in touch and I continued to visit her and also loved her second husband. He was another grandfather to my children. We had six grandparents, with my ex’s parents divorcing a year after he and I married. Now we have one living. My paternal aunts and uncle have stepped in as the parents and grandparents that are missing for me and my children.

The pressman is my paternal grandfather Kenyon Charles Ottaway. Or Charles Kenyon? Now I need to ask my Aunts. I do not know what year that was taken. He was head pressman in Knoxville Tennessee in the early 1960s. He went by Ken. My Aunt Pat adds that he was nicknamed “Inky” and that the above photograph was taken in Bridgeport, CT. On the back it says ’45, so our guess is 1945.

My father, me, and my sister Chris.

The second photograph is my father, Malcolm Kenyon Ottaway, and me and my sister. My father went by Mac.

Jubilee for freedom and for both father’s day and Juneteenth. I miss my parents and my grandparents, love to all of them. Hooray for Sweet Honey in the Rock, too.

Sending love and peace.

For the Ragtag Daily Prompt: jubilee.

wild game

My maternal family played a wild game every summer when I was growing up. Wild in that we were in cabins, on a lake, no electricity, no television, living in tents and cabins. My grandparents had two cabins, my Uncles each had one and we were in tents. I loved our tents, though. I still have the tent that my sister and I used. It is over 50 years old now and doesn’t leak. We had very strict rules about tent care. And canoe care. And we could use all the tools but had to PUT THEM BACK. We had aladdin lamps and candles and drank the lake water. We filter it now, and the cabins are still there.

For the Ragtag Daily Prompt: game.

website ethics and mine

Two days ago I wrote to the owner of the website that “separated” me for “not explicitly breaking the rules”.

I have not gotten an answer.

Doesn’t matter, you say. I disagree. I think our ethics matters and it matters on line. Isn’t that part of what we are fighting about?

Let’s drill down. The editors stated on this obscure not to be named site that they were tightening rules and removing write-ups that should be logs or are just not high enough quality, and letting the writers repost them as logs. So far they have removed over 250 of my writeups. Ironically, I was one of the two most prolific writers in the last year. Let’s kill the golden goose because she’s annoying, won’t we? The other writer has not been “separated”.

I note that they have removed my write up called “birth of ——–“. Now, this interests me. This was a well received write up, had up votes, and was the start of a category. The category was people explaining how they chose their on line name.

So: the editors are liars and abusing their power. They have removed a well received and well liked write up because they have personal animosity towards me. I have protested the removal of 250+ writeups and asked that they be reposted as logs. No answer.

The other writeups in the how I chose my name category are still there. So this is PERSONAL and the editors of the site are unethical.

Therefore, I hope the site dies. Or gets rid of those editors. I think I want it to die, even though it has writing by my sister. This does matter. As a species, we will either learn to be fair and human on line as well as off line, or we will end in conflagration. The site will certainly not be there if we start lobbing nuclear bombs at each other. The owner works for the US government. Why is he/she not paying attention to this obscure website that he/she owns?

Whether or not the world burns this month, if the editors are manifestly unfair on the site, the site will die and deserves to die. I wish that I could have my sister’s drafts before it shuts down.

I ended my email that is not answered with this: Good luck. I hope that ethics matters to both of us.

Thank you.

on line site name

_______________________

I will not name the site here or anywhere again, until and unless those editors are shut down and the site becomes ethical.

We are fighting this fight as a species, as humanity. We have to learn to be as ethical on line as we are in person. Well, you say, some people AREN’T ethical. Yes, that is true. As a rural physician, my goal is to take care of ANYONE WHO COMES IN. The emergency room physician cares for the family of four hit by the drunk and the drunk too, even if there is a dead child in the family of four. We set our judgement aside and do the best for each and every patient, regardless of the story. At least, that is the goal. It is the highest goal I know of.

Blessings and be your ethical self on line. As my children said to me when I threw their father out of the house once, “We don’t care what he does. We want you to be polite to dad no matter what.” And they were RIGHT! We answer to ourselves and to the Beloved and to our children.

Blessings.

The photo is me and my sister, dancing before my wedding in 1989. She died of cancer in 2012.

April A to Z reflection

April was a very interesting month! I went to Europe for the first time since 1988 and got covid, so had to stay an extra 8 days. The version I got was a mild cold and my lungs did not get worse. Traveling on oxygen is really challenging. I was anxious to get home because my son and daughter-in-law got married after postponing in 2020 and 2021, so they married on April 30th! It was a wonderful wedding!

So, I had to do some planning for the A to Z, writing about women artists, mostly Helen Burling Ottaway, my mother. I took a number of my mother’s etchings to give to friends in Europe and used those because they were what I had. In typing up her resume, I learned more about her! She was a prolific artist and I want to get more of her art out there. I had originally planned to set up an on line shop of her work, but the Europe trip, covid and the wedding derailed that idea! I still want to do that, but I am a bit slow about it. I need to catalog and photograph her work, after I recover from the wedding extravaganza.

When I got home from my trip on April 12, I started doing two posts a day. I did the present letter and then worked from the end of the alphabet, setting up Z for Zarathustra to go live on April 30th. By the last week of April, I had it all set to go live day by day. This is good, because there was no way I would have posted from the last Wednesday on!

I did not get to surf other writers blogs as much as I had planned. Too busy in Europe and too busy with wedding. This week I mostly want to do not very much. I am sorting wedding photographs, the ones I took, and sending them to the new bride and groom.

The picture is of my two aunts at the music rehearsal. I was cantor and led the two hymns. Both of my father’s sisters are church organists. They played four hands for the processional and the recessional and were wonderful! With both my parents gone I was very very grateful to have them present.

what would YOU choose?

Here is a story of a choice about an abortion, a theraputic abortion, where a mother has to make a difficult choice. I have seen Family Medicine patients since 1991, so this will not identify a particular person. No HIPAA problem.

I see a new patient in clinic, a woman, who already has children. She has back pain. All is routine until she says, “Sometimes my leg goes numb from the knee down.” I stop. This is NOT normal. “Completely numb?” I say. “Not patchy?” “Yes.” “How often?” I ask. She shrugs. “Not very.” “If it happens again, call me and I want to see you right away.”

Why? This is unusual because most numbness follows dermatomes if it is from back pain. The dermatomes on the skin wrap from the back down the leg all the way to the toes. When someone describes numbness or the pain of shingles in that distribution, we know which nerve is affected. Numbness from the knee down can come from diabetes and other causes, but it is not on one side and it doesn’t come and go. So the unusual stands out for me.

“Anything else weird?”

“I had vision problems in my last pregnancy. They sent me to specialists, even a neuro opthamologist. He couldn’t find anything.”

“Ok.” I shrug. We move on.

She calls two days later. “Both legs are numb from the knee down.”

“Come in today,” I say.

Both legs ARE numb from the knee down. She also can’t lift her feet. The muscles from the knees down are weak. I get neurology on the phone. “MRI her from the top of her head to the base of her spine.” I call the hospital and set it up. That day.

She has seven brain lesions suspicious for multiple sclerosis. She did have an MRI in the previous pregnancy, which was negative. I do not remember how old the child was, 2-4 years or more when I saw mother.

I call her back in for results, we talk about specialists, and I call a neurologist in the nearest big city, three hours by car from where she lives. We start medications and my patient is scheduled.

She has multiple sclerosis. The flare improves. The visual symptoms were MS in the previous pregnancy, but it was not yet visible on brain MRI.

Then she gets pregnant again. Her symptoms immediately flare. She comes to me and I call the neurologist.

The symptoms are not a little worse. Much worse. “I suggest she terminate the pregnancy.”

My patient is horrified. Until the neurologist’s next words. “She needs to terminate if she wants to be able to walk for the children she has.”

My patient chooses an abortion, to terminate the pregnancy. Because she has a bad version of MS*, she remembers the symptoms in the last pregnancy, she is young, she is clearly progressing and she wants to take care of the children she already has.

What would YOU choose? For yourself, for your sister, for your wife. If you are male, do you have any right to make that choice? Now picture yourself pregnant with that choice. And thank you for reading this.

*Addendum: present evidence says that multiple sclerosis does NOT worsen with pregnancy. However, another illness, NMO (neuromyelitis optica) instead tends to become more active in pregnancy. It previously was lumped in with MS until the antibodies (anti-NMO) were identified and it was realized it’s a different subtype of demyelination disease, with its own treatment options. Medicine changes over time and the woman, the neurologist and I were working with the information available at that time.

Covert covid conundrum

I had covid recently AND I have been very lucky with it.

WHAT?

Ok, so when the war started I had been talking to a friend in Europe about visiting. He said nice seasons were May and September, but he and his wife have a kitchen make over planned for September.

“My son is getting married at the end of April, after two year long postponements, and so May doesn’t seem feasible. Maybe next May.”

Then the war starts. And it is affecting gasoline and causing inflation. I call my friend. “Can I come in two weeks?” March to early April.

“Yes. We have other guests a week after that.”

“Ok.” I try to get a British Airways ticket to stop in London to see an old friend from high school. British Airways has a computer attack and three days go by. To heck with it. I buy a ticket to Paris and on to my friend’s country.

I spend an hour on the phone trying to change to a layover in Paris for three days. I manage that. I fly to Paris and then take the train to London. Three wonderful days with my friend in London. I mask on planes, metros and trains. I double mask on the airplane, with my oxygen, and use a ceramic straw to drink liquids.

After three days I take the train back to Paris, the local train to the airport, and fly to my old friend’s. I arrive at midnight and we take the metro.

We do lots of sightseeing and take a memory trip to his parents’ graves and the town we lived in when I was 17 and he was 18.5. I was an exchange student. The language comes back. I can read but listening is more difficult. My brain won’t process it fast enough.

Four days before I am due to fly back, I get an email from AirFrance. I need a negative PCR covid test within 24 hours of flying to return to the US.

Well. I have a mild headache and muscle aches. Probably not covid, BUT. I go online, register in the country for a test and go to the testing site. Positive. I read about covid. The muscle aches of this strain usually happen at day 4-5. I did notice that going from London to Paris to my destination four days earlier, I feel a little off balance. Not bad, not spinning, just slightly weird. So my guess is that I am at day 4 or 5 of covid.

My hosts have both had covid within the last month, so I am not confined to my room. I read the rules for being allowed on the airplane once you HAVE covid. I have to wait 11 days, have a certificate of the test and then the eleven day certificate saying cleared. I isolate for 5 days, spend about 8 hours rescheduling the flight with Air France and Delta, and contact my doctor. My doc wants me to take medicine, but the local medical people where I am say I am not sick enough. I agree with the local people. The headache is gone the next day, I have mild sniffles, and my lungs are fine. Well, at least, they are no worse.

When I am out of isolation, I take a train to another town masked and stay at a hotel for four days. In that country, 80% of the people are vaccinated and 80% have had covid. They are no longer masking, except a few. I am feeling good. I mask when I am around other people and in all public spaces in the hotel.

The trip home is rather more exciting than I would like. At the airport I am informed that I need a doctor clearance ALSO. They say retest. I say “I AM a doctor.” and pull out a copy of my license. I brought it just in case the war spread and I needed to help out. They let me on the plane. In Paris I nearly miss my connection, but am one of the last 8 people on the plane. I am very relieved once we take off.

The silver lining is that at my son’s wedding I am now very unlikely to get covid or give anyone covid and mine was very mild. The Omicron BA2.12.1 that is circulating in Europe is milder than the previous strains AND ten times more contagious or more. So the covid is morphing towards a cold, which is what coronaviruses used to do to us. There are some strains that I read about that are going in a more virulent direction, so I would prefer to have the mild one and be protected from the nasty ones.

Here is the CDC section about strains in the US:

https://covid.cdc.gov/covid-data-tracker/#variant-proportions

I arrive home on April 12 and then am unsurprised to see covid cases starting to rise again in the US. Here is the CDC tracker: https://covid.cdc.gov/covid-data-tracker/#datatracker-home

I am hoping that it’s more and more Omicron BA2.12.1, since it seems to be milder. I am reassured that covid did not make my lungs worse. Within a week I am better from covid and then get what seems like a normal cold. Covid testing negative. I am feeling well for the wedding and reassured that a normal cold does not force me on to continuous oxygen. I am feeling lucky about the version of covid that I have but I am NOT recommending that people get it on purpose, because even with mild covid, some people go on to develop long covid. Here is an article that I got yesterday through the American Academy of Family Practice:

https://www.healio.com/news/infectious-disease/20220425/global-prevalence-of-long-covid-substantial-researchers-say

Long covid is very worrisome and we don’t know what it will look like after a year or more. Many of the present studies are on unimmunized people, from the first year of covid, so the studies of immunized are still evolving. There is hope that there is less risk of long covid with immunization but there is still a risk.

Covid will continue to morph into different strains. We continue to get “colds” or “upper respiratory infections” because the viruses are very very good and fast at changing and avoiding our immune systems. Consider checking the CDC data tracker above regularly to see if your county or your destination has a high covid level and if so, mask back up.

One caveat: my local health department says we have a high level of transmission right now, here:

https://www.jeffersoncountypublichealth.org/1429/COVID-19

while the CDC says low, here:

Remember that all of these sites have to exchange data and update everything. My best guess is that the local has the best numbers, but that is a guess.

mountain 2

It is gracious of the mountain to show herself the day after my son and daughter-in-law’s wedding. I stay in a rental house with two aunts and an uncle (all in their 80s), my daughter, and two old friends and their son. The age range is 13 to 86. When the fog and clouds fall away from the mountain we all rush for our cameras.

For the Ragtag Daily Prompt: gracious.