Tag Archives: travel

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Covid-19: Good and Bad News

I am writing this on Christmas morning.

The good news is this: National Guard Empties Bedpans and Clips Toenails at Nursing Homes. “In Minnesota, an ambitious initiative is training hundreds of Guard members to become certified nursing assistants and relieve burned-out nursing home workers.” (1) Well, hooray, the National Guard is called out to help, because the nursing homes are out of staff and we aren’t supposed to abuse our elderly. I think this is AMAZING. And the National Guard may learn some things about work and the elderly too. Hoorah and Hooray!

The bad news is a snippet from New York State: Omicron is milder, BUT the exception may be children. (2) Child cases of Covid-19 are going up really fast and hospital admissions of children. ICU work is hard hard hard, but child and infant ICU is even harder. Blessings on the nurses who do this and the physicians too. When I did my pediatrics rotation way back in Richmond, VA, in a tertiary care hospital, I had children who were dying: one with a brain tumor, one with liver cancer, one with Wilm’s disease. Hard work. I chose Family Practice. I have still had pediatric patients die, including an 18 month old where I had taken care of mother through the pregnancy, but not terribly many. Even less in the last ten years since my average patient was about age 70. All of my kids in the last ten years were complicated: one with Down’s, another a leukemia survivor, others. Children can be very medically complicated. I had two adults who had survived infant heart surgery as well. They were set up with UW’s Adults who had Childhood Heart Surgery Clinic, though that is not the correct name. I am pretty happy to have that sort of back up only two hours away. They both had pretty awesome heart murmurs and that midline chest zipper scar. Ouch.

So, why post this on Christmas? If the cases are rising in children, maybe that will inspire some folks to get vaccinated or at least not yell at family who refuse to bring small children to an unvaccinated Christmas gathering. Judging by the posts on the doctor mom facebook group, there is quite a bit of family yelling going on. Stand down, folks, and respect other peoples’ boundaries.

The problem is, if enough children are sick, we run out of beds. And staff. “As of Thursday, there were 1,987 confirmed or suspected pediatric covid-19 patients hospitalized nationally, a 31 percent jump in 10 days, according to a Washington Post analysis.” (3)

Blessings.

1. https://www.nytimes.com/2021/12/22/health/covid-national-guard-nursing-homes.html?action=click&campaign_id=154&emc=edit_cb_20211223&instance_id=48593&module=RelatedLinks&nl=coronavirus-briefing&pgtype=Articleยฎi_id=165651500&segment_id=77808&te=1&user_id=c97a1a8547f511fe3bd45b0806ed713c

2. https://www.nytimes.com/2021/11/23/us/covid-cases-children.html

3. https://www.washingtonpost.com/health/2021/12/24/omicron-children-hospitalizations-us/

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hollow

The Ragtag Daily Prompt today is hollow. Hollow, halloween, hollow promises, and hallowed promises. Which is it?

My friend in Michigan was teaching his three children to use a fire extinguisher at Thanksgiving. What a wonderful use for the hollow rotting Halloween pumpkin! They each got a chance to use the fire extinguisher and put out the fire. Emergency preparedness on Thanksgiving Day! That is an example of wonderful parenting as far as I am concerned.

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Covid-19: omicron

So far, it looks like the Omicron variant is more infectious and less virulent.

“This is good, right? you say, “We can all just get it, then we are immune, move on with our lives.”

There are three, no, four major problems that I can think of right off the bat.

1. Long Haul Covid. We do not know if Omicron will cause Long Haul Covid. This is a big deal. The numbers right now are suggesting that one third of the people who get Covid-19, even a mild case, still have problems at six months out and twelve months out. Are you willing to take a one in three chance? Not me! We do not know how to fix Long Haul Covid-19, we don’t know what it is (even though I have suspicions) and some people can’t even get out of bed. This is bad.

2. Omicron will be happily playing with Delta and trading genes and making NEW babies. As one math joker says, “hey, don’t screw up Pi for us.” We could get a version with the infectious capacity of Omicron and the virulence of Delta. This is also bad.

3. We don’t know what it will do to small children and babies and the very old and the immunosurpressed and Covid-19 turns out to infect fat cells which is theoretically why overweight and obese people in their thirties are dying with it. The doc group I am in on Facebutt is reporting a 5% survival with long term ECMO (heart lung bypass machine) and that people may need to be on the machine for months. Like, eight months. This requires two nurses at all times, not to mention a specialist. A few places report 30% survival, but they also say that they say NO a lot and refuse people they think will not survive. Might as well pick the ones that might survive, right?

4. We don’t know if the drugs we have right now work against it. Some may, some may not. Starting over.

So, I still say get immunized if you haven’t and get boosted if you have. Get your influenza shot too. The masks are helping with influenza this year too, but if flu really got a hold, flu in post-covid would be a very very effective killer. And if you are 65* you should get your prevnar vaccine, for pneumococcal pneumonia. It used to be called “the old man’s friend” because it’s such an effective killer of people 65 and up. The new shingles vaccine, yeah, get that too. Do you feel like a pincushion yet?

No word yet from my immunologist. If I am not making antibodies to Covid-19, do I cancel my Christmas trip? Dunno. Will wait to hear.

Happy whatever you celebrate.


1. https://www.cnn.com/2021/12/02/world/south-africa-omicron-origins-covid-cmd-intl/index.html?utm_source=fbCNN&utm_medium=social&utm_content=2021-12-02T13%3A31%3A02&utm_term=link&fbclid=IwAR0NySrFr-I_ieYmVMQawstw6-oEGlxf32MgcbKyLz8RvpdHHGfzZ678XTY

2. https://robinschoenthaler.medium.com/everything-you-ever-wanted-to-know-about-omicron-that-we-dont-know-yet-d85bdd64d76e

3. https://longbeach.gov/press-releases/omicron-variant-of-covid-19-virus-found-in-long-beach/. Yep, in my state.

4. https://www.cdc.gov/coronavirus/2019-ncov/variants/omicron-variant.html

* Or are younger and have heart disease, lung disease or anything really complicated, like cancer, lupus, autoimmune stuff, etc, etc.

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My end of life plan

My End of Life Plan and Wishes are as follows:

1. My plan is that my life should end after a half day of skiing for free at age 125 or older.
2. My wish is to ski quite brilliantly, smoothly and gracefully, though not as aggressively as at age 110 and below.
3. My plan is that other skiers will ask who that brilliant skier is and that all the lift operators will know.
4. My plan is that I will have a delicious lunch, with a glass of champagne, in a condo overlooking the slopes.
5. I plan to have a hot tub and then a massage from one of the many handsome men who flirt with me.
6. My plan is that I will sit in a comfortable leather armchair with my feet on a foot stool, while three of my male friends vie to be the one to bring me the second glass of champagne.
7. My wish is that I will not need any cosmetic surgery or false eyes or ears or teeth or joints or heart valves and will retain my spleen, teeth, gall bladder, appendix and brain in full operating order.
8. My plan is that I will not be on prescriptions, medicines, vitamins, supplements, medical foods, or nutraceuticals nor under the care of any quacks of any sort.
9. My wish is that my male flirts will all think that I am not a day over 75.
10. My wish is that I will be listening to live music, a woodwind quartet or string quartet, just dropped in to say hello, along with three of my great grandchildren, showing off their olympic ski medals, summa cum laude graduation documents, or Nobel prizes.
11. My plan is that after the quartet leaves, I will fall asleep….
12. ….and not wake up, and that though my attendants are sad, none of them throws themselves off the balcony over the cliff and are all surprised at my true age and at the bountiful gifts I have left to each of them with proof that a long life and compounded interest have excellent results. My children, grandchildren and great grandchildren will live long and prosper as well.

http://www.nutraceutical.com/
http://www.fda.gov/Food/GuidanceRegulation/GuidanceDocumentsRegulatoryInformation/MedicalFoods/ucm054048.htm

The photograph is from 2014.

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The Introverted Thinker in New York

The Introverted Thinker is eight. Her mother takes her out of school for a week to go to New York City.

They leave her sister and her father behind.

Her mother complains about the school paperwork. “Never let school get in the way of your children’s education,” she says. “That’s what my father says.”

The IT is not sure what all this means. But she is excited.

They go on an airplane. She gets to sit by the window. She can see the ground and it is squares like a quilt with hills. It is so beautiful! She is amazed, magic!

In New York City they go to the house of an old friend of her mother’s. The old friend is old and wears dresses to the ground and a lot of jewelry. The house is dark and there are many things in it. The IT is told that the things are antiques and she must not touch anything. She walks around carefully in the dark places, looking at all of the strange things while her mother talks to the old friend. They talk about the past and people that she does not know.

Her mother takes her to museums on some days. Some are art museums. The IT is already used to art museums because her mother is an artist. The museum is like an art gallery only much bigger and the ceilings are very high. A lot of the art is very big too.

One museum is different. Natural History, says her mother. There are dinosaur bones. The IT can’t touch them either but they are wonderful. Huge animals from the past that are not here any more! She loves it.

They fly home. First she has to thank the old friend with the house like a museum, only darker. Then they go to the plane. This time there are some clouds so the IT can’t see as much, but she still gets to see the quilt of the land.

She decides that she likes museums and she likes natural history. Especially dinosaurs.

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DMV

I really did not want a tour of the DMV.

I arrive early, just as they open the doors, and there is already a line. We file in, each taking a paper number. The people in front go straight up to the desks. One window processes two people in only ten minutes each and then promptly puts up a closed sign. I guess it’s exhausting, working so fast.

Everyone waiting looks strained or sullen or stressed at the DMV. Shoulders hunched, heads down, the ones in power suits on their phones, but the phones keep cutting off in the DMV. Some sort of special shielding, I would bet.

I have number 17 and get to go to a window after 2 hours.

The clerk smiles at me. She is pale, pale, but has horns and pitch black wings, no feathers, like a bat.

“Unitarian!” she says, grinning.

“Um,” I say, eyeing the wings.

She looks wicked and then her wings are classic white feathered. She is browner and well, I’d guess Filipino. “Worried?” she says.

“No.” I say. “Tired. Sad. Curious.”

“What would you prefer to see?” she says and morphs. Now she has one bat wing that changes to black feathers then through rainbow feathers, to the snowy white feathers on the other side. Her skin tone is very dark on her right hand and then lighter across to pale with red freckles on her left hand.

“Nice.” I say.

“Which heaven would you like?”

“Unitarians do not believe in hell. Send me back.”

“You just got here. Violently and by surprise.” she wrinkles her nose. “Riots again. Sorry about that. We have opened a Unitarian space.”

“No. Send me back.”

She sighs and pulls down a heavy paper file. All the papers have gold edges, except for those with black. “You found your true love.”

“Yes. So what. We didn’t have time to make it work.”

“Don’t you want to wait until she dies so you can head down at the same time?”

“No. She’s only 32. And there is work to do.”

She is paging through the file. She snaps it shut. “Two week vacation. The minimum required. Go to the door on the right.”

I sigh. I want to argue but I’ve done that before. She will add on an extra week for every word I say.

My memories are intact here. Of all the lives. It’s always a bit overwhelming when I first arrive.

I go to the door on the right. A small page with grey tattered wings opens the door for me. I think it is a boy but he is wearing a Tinkerbell style tunic.

“I am your guide today.” No, it is a girl. I think. They may be able to morph that too.

We go in the door. My guide is shedding feathers, one every few steps. I pick one up. “Sorry.” she says. “Puberty. So, where do you want to spend your two weeks?” We are in a half circle shape hall, with hallways branching off. The hallways have no end that I can see and there are open doors all along them.

“I just want to go back.”

She pats my arm absently. “Oh, yes, they told me. You have to take breaks. You are wonderful, though, we love you.” She is leading me to one of the halls towards the left. We go past two doors and to the third. “See?” she says. “Unitarians. Of course, they can come in and out and go in all the others and argue with everyone. We wouldn’t want them to get bored.”

The room is empty at the moment. “And I guess they are all in other places!” The room across the hall seems to be a classic hell, with demons and pitchforks and a grim rocky landscape with pits of burning tar. I can see a dinosaur caught in tar, and a really huge crowd of people. There is a lot of screaming.

“Some people insist.” says my guide. “Where to next? Evangelical? Valhalla is rather fun for males and certain females, we’ve got fluffy clouds and harps, or are you more interested in touring Asian, African, Australian? We do have paleolithic sites and many people are interested in Egyptian themes. The cliff dwellers interest many as well. “

“Atheist.”

She frowns. “Of course, but that room shuts down consciousness and you have to have two weeks of consciousness before you can go back.” She is leading me back into the central half hall.

“Ok,” I say, giving in. “I am not trying to be difficult, you know.”

“Yes, and everyone told me correctly that you are difficult. All the ones that go back over and over are difficult. And there are more every year.”

“Take me somewhere new, ok?” I am looking now at the frieze over the door that will take me back. Two weeks. I can manage. I am resigned. The frieze is cupids and then male odalisques, then female, then leopards, and then they are cupid fauns with horns on their heads, morphing towards adulthood. Yet the carved letters stay the same:

Deus Machina Verum

and I follow my guide into another hallway to find a place for my two weeks.

_________________________

This poem inspires me to post today’s story: https://narble.blog/2021/08/17/if-there-are-no-dogs-in-heaven/

I think the hell in heaven also fits today’s Ragtag Daily Prompt: scorch.