Fall Reset

Return to school has come and gone without me.  As I toured Tennessee in late August, Virginia Tech, U of TN, and Vanderbilt had already moved in for the fall semester, leaving me unable to find a parking space near the bookstore at two of them.  When I returned home, Labor Day weekend got set aside with a higher priority, surviving highly symptomatic Covid-19.  I missed the in-person first week of OLLI.  Practicalities for my Designated Driver forced my follow-up EGD from the fall to the winter.  My vegetable garden did not have significant yield.  The Holy Days come late on the secular calendar.  It's been a tough transition.

While delayed a couple of weeks, I'm sufficiently recovered to engage in autumn activities.  This being a Presidential year, I voted in the local primaries, will learn more about the candidates, national and local, on my screens this week, and affirm that my preferences are sound.   I am ready for my mid-September Torah reading, then begin polishing the YK reading.  I have to greet electronically three old friends.  My kids plan to visit for RH.  I will need to assemble challenging dinners for RH and the Sukkah.  OLLI invited me to give a presentation which will need priority focus.  Exercise collapsed with travel and illness.  That needs restoration with judicious pacing.  

The final quarter of the calendar year brings a reconing of my semi-annual initiatives, some going well, others disappointing but salvagable. 

And throw in some recreation, fishing, maybe golf, drawing, photos.  Football has not engaged me as the NFL and colleges resume, but I should consider a live game.  And perhaps a day in NYC.

While our calendar year begins in January, our activity transition remains in proximity of Labor Day.

Calling In Sick

My Daily Task List, saturated with the Get Me Ahead, will need to take what I hope is a one day snooze.  My Covid booster got a week overdue.  Now, the Influencers from the synagogue could have sent be back to the parking lot, but for the last two Saturday mornings I was pretty useful to them.  And they have no way of tracking who is up to date with the congregational policy of up to date immunizations as a precondition for attendance.  There is still some Covid floating around, though the deadly form seems to have gone the way of cholera, plague, and influenza meltdowns through history.  Still, catching up on my immunization seemed prudent.  I picked a day and time.  After a rather pleasant Open House at OLLI, I braved the rain and drove to the Super G Pharmacy as a walk-in.  No problem accommodating me.  Within a short time, my left deltoid had been punctured with Moderna's latest.

About five hours later, shortly after supper, I realized that not only had I taken something, but that my innards had been primed to generate cytokines.  My arm got sore.  I got edgy.  I felt a little warm, though not feverish.  And nausea.  And no end of systemic symptoms, from sore muscles to unsteadiness of gait.  I toughed it out until my usual bedtime but could not get comfortable.  Eventually I must have dozed, at least until 2AM, then spent the rest of the night looking at the red numerals on the clock radio, experimenting with postures.  I felt thirsty.  So thirsty that I went downstairs to the kitchen and brought my best insulated water bottle to my bedside, sipping it a few more times during the night.  By my customary wake time, those cytokine symptoms were still dragging me to unsteadiness.  Coffee not only did not help, but my customary k-cup brand did not taste right.  Back to bed.  It would take until late morning for those systemic symptoms to abate.  No treadmill today.  No petty errands.  Effectively a loss-leader of a night and following morning.

While the innards feel better, the deltoid injection site does not.  That will have to wait another day.

And the ultimate irony.  My incentive for getting the injection was to maintain the honor system of eligibility to attend shabbos services at my congregation.  And I'm really looking forward to not being there the next two Saturday mornings.

Cancelling

My wife sang in a concert a few days back.  The principal tenor, present for rehearsals, cancelled out just a few days prior to the performance, having developed symptomatic Covid.  A replacement, a very capable one, was recruited on short notice allowing a magnificent performance of Mozart's Requiem to take place.  The church providing the venue overflowed its parking lot and filled nearly all its lower level.

Now a few days later, my wife develops respiratory symptoms and achiness.  Thermometer 101.6F.  Covid PCR +.  In my refrigerator I have a mostly thawed 17 pound Big Bird, $58 worth, but guests have been disinvited.  I now have sniffles myself, but no fever.  Still a colonoscopy looms in six days with my wife as designated driver and me on quarantine.  And air travel in two weeks.

Need to do some phone time.  Donate turkey, or make every effort to do that.  Reschedule endoscopic procedures.  Buy some more home covid tests or maybe have one done at the pharmacy for myself.  Having had a booster, only one, I do not have to self-isolate but do have to mask.  And see what happens to the sniffles.  Then next month, relent and get the next booster

To the best of my memory, I've not missed Thanksgiving before.  One year in medical school I purchased a reheatable kosher TV turkey dinner from Sol & Ely's Kosher butcher in St. Louis.  Even as a physician, since I worked every Christmas, I could anticipate being off for Thanksgiving.  

My own temperature is normal this morning, though I have subtle suggestions of early symptoms.  Just cancel whatever would get me in contact with anyone for the long holiday weekend.  And take advantage of some unanticipated Me Time.

Could Use an Adventure

Our Covid-19 pandemic becomes gradually less intrusive with each passing week.  Delaware Choral Arts held a live concert with restrictions on attendance.  In-person worship has returned to my synagogue.  Osher Institute plans to open its building and conduct live classes with the coming semester.  In-person dining remains shvok, though travel has become more commonplace.  I do not know how our theme parks have done or if campers, hunters, and explorers have resumed their personal challenges.  Thrill experiences were put on hold.  Those who seek them out must be eager to move forward.

I've never been a real thrill seeker.  I used to like amusement parks, especially the roller coasters, until my inner ear judged otherwise a few amusement parks ago.  At the water park, I will try a tame slide but devote more time to the lazy river or wave pool.  On the highway I drive at the speed of traffic and defer to the aggression of the NASCAR wannabes.  No hang gliding, bungee jumping, or parachuting.  No taking my chances as a pedestrian in an unsafe neighborhood to experience diversity up front.

It's not that I reject adventure, just define it in a risk averse way.  I regret not having set a day of white water rafting as one of my day trips or going out deep sea fishing, or even snorkeling at a resort.  There are suitable thrills that go beyond simply new experiences.  Covid-19 should not serve as an excuse for what is really being timid.  

Didn't Last Long

Staying at home for Covid-19 safety seems to be transitioning from what we do to an analysis phase that should generate a fair number of PhDs over a number of social and biological sciences.  I still cope with boredom mode at times.  Early in the pandemic I would go to stores, not that I needed anything beyond  but at least there were people milling around and I could protect myself with recommended public isolation measures while there.  Over time I stopped, partly for waning interest, partly for shift to online shopping for the few things I really needed or wanted other than groceries, and partly for an observation that the stores had less on their shelves to look at.

But now we emerge, with a real trip planned within a few days.  What better time to visit the Dollar Store even though I really didn't need anything.  I wanted to get away prepared.  I already have enough grooming products.  Can never go wrong with another set of $1 ear buds.  I really needed another cannister of coffee creamer.  But most of my $13 total went to munchies which I hoped would last for the ride to the Poconos but didn't.

Among my great successes these past few months has been modifying my diet to promote weight reduction.  No squishy bread, potato chips, 2 liter soda bottles, or cookies, though an occasional treat of a Big Gulp from a convenience store.  These happen to be the very items that Dollar General can purchase in bulk for a song in order to retail for a dollar.  Sardines at least have protein.  Unfortunately only one brand had a kosher certification, unusually absent on canned fish, so I only got one can, which turned out a great disappointment bordering on disgust.  Then Mrs. Freshley's discounted donuts and yodels, each packaged as four reasonably generous servings per box.  The amount of fig newtons that you can get for a dollar has gone way down so I got a package.  And fruit bars and discounted cheese crackers, all kosher certified as dairy and all pretty much consumed in three sittings.  Nothing to take on the trip unless I return for a refill, which I won't.  Weigh-in weekly on Mondays.  See if lasted longer than I though at the next session before I travel.

Maybe Give Florida Another Go

One full year has elapsed since Covid-19 altered our customary activities.  Had I not retired when I did, I would have functioned amid the medical fray, finding myself desperately in need of a vacation but limited to mostly a staycation, assuming they allowed their docs some periodic respite.  Even soldiers in modern warfare have some R&R provisions.  As a forced indoor cat, I probably did better than most.  My car counts as isolation, so a daily drive usually to nowhere became the norm.  For a while I went to stores but soon lost interest in being a consumer of anything other than food.  I never liked take-out, preferring a menu with the rituals of a waitress.  There not being many options for this, it became a special occasion, one whose absence became less bothersome as the months proceeded.  I had some destinations.  State Parks allowed fishing.  Two state beaches got visits without the deviants among us expressing their autonomy by endangering the public, as I saw in news reports from elsewhere.  I even ventured onto an airplane for my son's wedding, a much muted venture limited to puttering around my former campus and neighborhoods in St. Louis, eating outdoors twice, but not having the hotel amenities that add to previous short trips.  I also made three modest day trips, one to a Philadelphia's Italian Market, another to Ladew Topiary Gardens with grounds open but mansion closed, and another to a more distant state park while zipping briefly for coffee or pizza in the small town America that barely survives the nearby malls.  I even had a trip planned to the Everglades, but cancelled as the toll of Covid-19 peaked enough to make travel to the that part of Florida beyond prudent risk.  Now we have immunization, or will soon.  We also have places that depend on visitors trying to have their Second Act. Each day an airline or two tries to entice customers with air fares that undercut any other means of traversing that distance.  And Atlantic Florida being overbuilt, overscheduled by competing airlines, and without any need to transport cruise ship passengers, again emerges as an economical destination, though as safety improves, bargains have become more restrictive.

It's a place I never particularly sought out beyond making a trek to Disney World with the kids, something that has become largely obligatory one time, perhaps like the Hajj, for American parents.  My father lived in Boynton Beach for his final two decades, so a few trips worthy of Kavod Av got incorporated, though never truly what I think of as a personal vacation with that required element of escape for fun.  And I've been there in my professional capacity as a physician for two conferences.  It's not really the enticing destination where I would go to let my hair down let alone ride out my closing years like my father and some childhood friends have done, nor seek my adult destiny there, a venture taken by many friends as young adults.  Nobody who has done that seems to move on.  I found it a place where people like being catered to or having their entitlements reinforced, something that almost jeopardizes my pride of independence with the accomplishment that comes from doing as much as I can myself, mostly for myself.  

But a bargain is a bargain.  I have to look at the flights and places to stay.  What would I do if I were there for five days or so, or whatever length of stay qualifies for a discounted flight home?  The Everglades, which I have seen from the window of a small plane on a business related shuttle from Miami to Tampa, should be experienced at ground level.  I have a few friends there though with Covid still active, I don't know how receptive people are to guests.  When FB friends venture there and post photos, they invariably include gatherings of friends maintained over decades, and in far larger numbers, and likely in closeness, than my less gregarious nature has maintained.  There are beaches, but in the likely travel month of June we have wonderful beaches in driving distance. Hotels have outdoor pools there.  We have them indoors, though the outdoor ones are more likely to avoid suspension of activity by the regional health departments.  For parts of the area, there is a stronger Jewish presence than I have at home.  It would be pleasant to dine at a Kosher restaurant on some delicacy not readily duplicated in my own kitchen.  

Whatever is there that I might do, I think the strongest incentive remains being someplace other than here which has taken its toll.  My drive to nowhere to get me out of the house most days can be a drive to somewhere someplace else.  Check the airfares.  Check the calendars.  See who might be around.  But I'm ready for a more distant destination.

Without Laptop

My HP device was tried and true for its five or so years, meaning about $120 per year or $10 per month.  It failed twice, requiring some costly though cost-effective repair.  Once some settings went awry, the other time the hard drive reached the end of its life span.  It's terminal event was more ignominious, drowning in herb tea from a cup that got knocked over from an overfilled and off balanced desktop stand. Those Geeks at Best Buy were able to save its data but not its innards.

It had what I needed.  Ample ports, comfortable keyboard with visible letters whose keys responded to my multi-fingered touch.  I had personalized it with a sticker of an SLU Billiken.  If lost, as I would transport it to OLLI and often far destinations, it had a sticker with my name and address, though neither my phone number nor email contact which would have been more useful to an honest finder of lost objects.  It served me well until its abrupt end, surfing me through the world, enabling a few Power Point presentations, providing me a forum to articulate what I thought through social media responses, my blogs, or submissions for publications.

Among my many good fortunes has been a reasonable accumulation of wealth which enabled me to seek a replacement as soon as the Geek informed me of my pseudo-animate friend's demise.  While still at Best Buy I looked at replacements. I don't particularly like shopping there, though they have the best computer service.  Their selection of laptops, and even the option of an All-in-One, was placed by professional marketers who know how to make the expensive alluring but keeping the lower priced options either more obscure in the display or more typically placed adjacent to a gleaming model so the comparison becomes more obvious, even it the disparity in value isn't.  Staples did better.  It's where I had purchased my now departed device.  They had a very small display, which is good.  There are studies showing that people who choose from among a handful of options tend to prove more content with their selection than those who choose among dozens.  Too many thoughts of what could have been.  But I knew all that I saw fell short of what I had just lost, and the Staples Geeks did not distinguish themselves when I needed them.  Since Target had to be passed to get home, I stopped there too.  Mostly lower end Chomebooks, though I had to look up what a Chromebook was when I got home.  It's low price and portability would probably make it a useful second device for travel if I opted for an All-in-One desktop replacement.  Once home, my smart phone connected me to online Amazon and Staples, each reliable, though with an overwhelming array of choices.  By days end, I used the filtering devices to get something very similar to what I had both in features and in price.  Staples had a lower price but less desirable supplemental warranty, so I went with Amazon, paying the extra $50 for the item and securing a four year warranty that covers all unintentional mishaps. In my two decades of dependence on these electronics, this is my second unsalvageable liquid spill, the first being my first decent smart phone.  Worth the peace of mind.

These days without a real keyboard exposed me to a previously unrealized reality of our Covid isolation.  In the past, when I needed a keyboard with screen, our local library served as a good safety net.  I almost never had to wait for an available computer, though they limited each session to one hour and a total of three hours in any single day. While it was too public a place to log my finances on Excel, with a flash drive I could type away whatever I wanted to write on Word, keep my work in my possession, and transfer it to my home computer or pre-retirement to my at work desktop for further revision.  Alas, our library is closed.  My wife has a laptop which she offered to me but only used one time. It lacked a numeric keypad and the keys when pressed offered an insecure, maybe overused feel.  I could not type on it effortlessly as I could with mine, the library's, or my work desktop.  As a result, I only did a few time dependent essentials like renewing a medical license, but avoided creative expressions.  In the meantime I also obtained via online shopping a low end 10 inch tablet which replaced another tablet of similar generic vintage.  This one feels more substantial than its predecessor though less responsive.  I understand why it is of essentially disposable price.  Adequate for reading from the internet, maybe even pretty good for reading an e-book.  Not at all suitable for typing in anything more profound than a password.

So I found myself with the more verbal segments of my mind stymied a few days.  Fast and short tweets or FB responses dominated. My more weighty thoughts require longer words, more complex sentence structure, the ability to navigate between sources, a thesaurus to help me select a more precise word than my mind generated, and to copy and paste what I find via exploration.  All this had to be set aside, not really a form of vacation to be pursued with renewed vigor, but more like an illness that would require convalescence once Amazon delivered the replacement laptop and the salvaged contents of its predecessor restored.  In the midst of feeling deprived, though, an opportunity arose.  Without the keyboard, I resorted to taking notes on paper, jotting down fragments of my thoughts that could create more coherent compositions and sequence of thought than I have been able to do with keyboard alone.  It's how I was taught to think and transfer thoughts to paper.  Correction of composition was much harder with typewriter so having that outline has lost its importance, but these days with a note pad may have restored an important but overlooked skill.

I'm back.  New laptop up and going, though without a DVD drive which I use, but HP deemed obsolete.  My notes on what I want to write about some uneasy Jewish organizational relations appeared in my line of vision as I resumed my first Word initiative on my new device.  The days away were not a vacation from expressing what I think but forced some useful return to previous processes that I realize now had become underutilized.

Awaiting Vaccination

By state rules, I classify as Phase 1b, largely by virtue of age, on the state priority ranking for SARS-CoV-2 immunization. Despite having decent elected and appointed public officials, my FB friends from other states, whose officials are likely inferior to ours, have all received at least one dose of vaccine, some both doses.  I remain on a waiting list, bottom priority since I have the good fortune to remain in basically good health as my chronological age advances. By my own estimate I have moved up two places on the computerized queue, now languishing at  #74998.  Somebody ahead of me must have gotten Covid-19 and died while another ahead of me knew movers and shakers that I don't.  To usurp the turf of our local newspaper's entertainment critic, our state laid an egg.  Having met virtually all of our elected officials at least once, and chatted with many, they are as a group rather intelligent and dedicated, though really in over their head.  Their responsibility exceeds their resources, which lessens their authority.  From time to time an email appears to the tens of thousands of fellow seniors in limbo guiding us to pharmacies that administer these vaccinations.  We the People has shifted to the squeakiest wheel getting fixed first.  Within that 75K seniors like me, there are no doubt some alumni of Filene's Basement who have a lot of experience elbowing their way from the scrum to the alluring 70%-off merchandise in the bins.  Understanding that I may be the least in need relative to others on the waiting list, many with the chronic diseases or physiologic risk factors or lifestyle risks that I addressed daily before retiring from medical practice, I mostly have been waiting my turn, remarking on our Governor's Twitter posts with phrases that go for the jocular.  

Our officials added an Every Man for Himself cyberspace resource, linking pharmacies, some local, others national, with a presence in our state that have vaccine.  While I qualify as a 1b, I never get farther than entering my Zip Code before learning that no appointments are available. I stopped by my usual pharmacy, found it unusually filled to capacity with mostly female contemporaries, all waiting patiently in the SRO gathering, far more orderly than a Filene's Basement scrum. Somebody must either be getting through on the website or have a granddaughter who knows the system.  While my HS chums reconnected on FB seem to have found a pharmacy that would offer an appointment, perhaps residing in larger states and metro areas that have more pharmacies, their access seemed no more organized than mine, perhaps less as my small state at least has a list of people who both qualify and desire being immunized.

Perhaps most irksome to me personally has been my individual downgrade. At one time, not in the overly remote past, my institution would have labelled me essential.  Endocrinologists moved within the fray attending to diabetics whose chronic condition impaired their prognosis or who needed more insulin to adapt to dexamethasone.  Being at an inner city hospital, much of our community took the brunt of this pandemic.  The lady who makes sure we all get our mandatory flu shots would have sought me out, assuming I had the luck not to become among the many frontline stalwarts who got infected themselves. But off the payroll, an idle spectator, my communal value plummeted, perhaps along with any communal interest in keeping me alive more than anyone else.  So I wait my turn with patience and as much good cheer as I can maintain.

Tested Negative

A letter arrived from the Blood Bank.  They tested my blood for SARS-CoV-2 antibodies , detecting none.  I'm disappointed.  They had sent a notice that they would be testing all donor blood for this through the end of this month, so I had planned to squeeze in my next platelet donation a few days early to have this, but now it can wait until the following week when the new month arrives.

In the four decades that I have been a reliable donor, with a 50 donation lapel pin to show for it, this is only the second time the blood bank has passively notified me of my results.  The first came many years ago when they found me to be CMV-negative.  I have no idea why they tested for this, but with the notification, I became eligible for platelet donations, which I have maintained a few times each year.  Platelets with incidental plasma provides more value to a blood bank than whole blood fractionated to its components, as it is less readily available and the need by the recipients is usually more critical.  Donors in my category are usually honored to help out.

SARS-CoV-2 antibodies have less established utility, as the disease they treat is a newcomer to the world of health scourges.  There is evidence that large amounts of antibody can keep Covid-19 patients with ARDS on an otherwise unlikely survival path, so it can be a very useful thing to offer, though far less established in efficacy than platelets, RBC, or various plasma components.  I'm disappointed at not being able to help out more than I currently do, but the platelets and plasma still have people who will benefit from them.

Alas, my RBC have other antigens that limit recipients.  B-antigen, Rh+ so even my red cells have a restricted number of people who can safely use them.  Can't save everyone but can aid some people.  Not that I want to acquire Covid-19 even with recovery that generates natural antibodies.  I'll let the vaccine boost those when it's my turn.

Cancelling Vacation

Covid-19 has taken its toll on travel, though this Thanksgiving a lot of people took their chances to see trusted relatives in person.  When I went to pick up a few items at Total Whine for my own Thanksgiving, a lot of other shoppers had full baskets that they could not possibly consume themselves.  I felt a need to get away too, and began to act on it.

 

It's been a confining time.  I went on three small day trips this fall and air travel over Labor Day weekend.  My son's wedding was worth some prudent health risk, though far fewer attended than originally planned.  I went virtually nowhere, getting food at a supermarket on arrival and having two dinners, one outdoors, the other in a tent.  The hotel had closed its pool.  In lieu of a buffet, it offered a doggy bag, which I declined in favor of the munchies from the supermarket.

That vacation overdue feeling had arisen, emphasized by a goal I had set for myself to visit a National Park by year's end.  I could have driven to Great Smokies, probably a reasonable  Plan A.  It would take a lot of driving, but offered detours to either Asheville or Knoxville. But there didn't seem to be all that much to do at the park itself, maybe hike or drive on trails.  It is also the most visited of the National Parks, so undesired crowds might be expected.  As an alternative, I looked at the Everglades.  By travel standards, this looked too good to be true.  Airfare less than regional intercity train fare in the Northeast.  Hotels about a third less than I usually pay for a chain hotel.  Rental cars seemed something of rip-off with Florida gouging its visitors as best it could, but as a package, it could not be beat.  Reservations made, with a modest penalty for canceling the car.  Looked forward to getting away until the reports of accelerated infection rates starting making the news.  Most of the trip would not have been that unsafe.  Air travel requires masks and we would sit together.  Hotels and cars also leave us by ourselves.  The hotel district can be accessed on a variety of internet maps.  There is a cluster of them near ours, at the edge of a shopping center district with ample takeout.  And the Everglades have assigned roads and open spaces, far larger than any of the parks near home.  However, to see what's in the Everglades, the National Park Service franchises tour concessions who take tourists around in some form of land or watercraft.  The State of Florida has been a little loose about protecting it's inhabitants, with far more people than we have rejecting infection control precautions as infringement on their personal or economic liberties.  That part is not a prudent risk.  As reports of illness, hospitalization, and mortality disseminated, responsibility for the health of my wife prevailed.  Son's wedding, take a chance.  My amusement, no way.  I cancelled it all, forfeiting an auto rental deposit, accepting an airline credit good for nearly a year, and perhaps staying at a different hotel in an area where the people have a better level of regard for each other.

Almost Done

As I outline each upcoming day at 7PM the night before, I make some task notations.  A dash means I can complete it that day with a finite end point, a T indicates it requires less than ten minutes, a circle denotes a task that once done will not reappear for at least a week.  Most projects are bigger such as reading a book or replacing my bedroom curtains.  It is those segments that trip me up.  Appointments are usually fulfilled.  Making friends in a Covid environment is more amorphous.  Keeping in contact with old friends is very doable but not well focused.  More often it becomes an intersection of us each commenting separately to somebody else's FB posting, which post election have become tiring to me.  And a lot get worked on without a finite end point where it can be declared completed.  That leaves me with a lot of intentions not quite done, most significantly an article where the final paragraph before submission has shifted many times.  

I've wanted to join two organizations.  Got one of two.  Second never gets explored.  I have a trip planned to a National Park.  Don't know what I am going to do once I get there, though all reservations made.  I might even forgo it at a small financial loss if too high a medical Covid risk.  I am absolutely determined to not access social media today.  So far so good.  I've actually completed my fourth book for this half-year.  Quota of three done previously, but one more already started and probably another ten sessions until completion.  I do my two TED talks each morning, tackle my quota of two articles from The Forward with a comment on one.  I'm not as reliable at reading one article daily from The Atlantic, but once I start, I finish it.  I take my medicine and check on the indoor plants most days.  BP no longer needs measurement daily, though it is on my task list each day.  Weekly weight and waist measurements are Monday appointments, and my treadmill sessions are treated like appointments.  As much as I want to learn the harmonica, draw pictures, color with my colored pencils, go fishing and do some watercolors, those rarely get started.  

And then there is the house, a repository of partially completed efforts.  Currently I am filing and shredding papers, which relaxes me in a way. I emptied a box of papers, sorted into financial and other, and even made some folders.  Big project but seeing the once crammed cardboard box empty gave some satisfaction.  It's a milestone, but not completion.

One characteristic of ADHD's, which I might be a reasonably compensated but untreated one, is that we tend to have a lot of simultaneous projects but not a lot of completion.  From the review of my focus list, the end points need to become easier to identify.

Fluid Day

One of those fluid days, literally and figuratively.  Sipping my second cup of herb tea, one of the varietals that has a more inviting picture on the box than taste.  Spiced cider earlier today.  Reached my daily three cup ration of coffee long before it could affect my sleep.  Maybe some sherry before dinner.  And a beverage of some type with shabbos dinner, at least kiddush wine.

As of this morning I had no appointments other than having dinner ready before candle lighting, an easy task with all dinner defrosted and microwave suitable, except the broccoli crown.

An enticing AJC seminar came my way, following a similar themed The Forward seminar last night on addressing the robust presence of antisemitism on the internet.  My professional writing has to go through an editor.  I cannot just submit something to a print or broadcast publication and demand its appearance, though forums like my blog do not have a barrier to deter their appearance in cyberspace.  Eventually the online platforms will either need better accountability for what appears there, much like broadcast media's enforceable standards or they will need to be broken up by anti-trust law, which may have an undesired consequence of their competing with each other to see who is most accepting of submissions they receive.  At the very least, a regulatory agency and regulatory laws have to emerge.  Nobody addressed the elephant in the room, the use of these platforms by sovereign foreign governments to disrupt America.  You can negotiate a solution, but ultimately a credible threat of the military protecting American interests affirms that we mean business on this.

I had intended to do my writing and thinking today.  Medscape topic selected a month ago, a difficult one.  Did some of the background reading and pretty much decided how to package and present my essay.  KevinMD was a little harder.  Three false starts on Consult Maven. 

My medical subjects could include my alma mater's establishment of a business ethics program with a Sugar Daddy to support it.  This would mandate its inclusion in the curriculum starting with the first year.  We had such a project called Community Medicine which, while well intentioned, diverted us from the hard science that dominates early medical school.  It was obvious to us that the requirement was imposed by somebody who had the means to impose it, not because it was essential to study at that stage of training in the format offered.  I suspect the same now with the Business Ethics initiative, more predicated on its availability and authority of its funding source than its essential nature.  It is a very important issue, though, one that impacts every physician from medical school through retirement. My entries into the blog rambled in thought.  I could restrict the focus better, finish the blog entry, and repackage the thoughts for KevinMD.  Aborted effort on how Covid-19 effectively diverted endless essays about how badly our employers treat their physicians or autonomy lost to more noble subjects that make our obligations to our patients worth the travails of our EHRs, intrusive administrators, and burnout.  I scrolled back to pre-Covid KevinMD publications.  To my surprise, the focus on our professional troubles had seemed to be on the wane before Covid-19 captured the American medical conversation.  Finally, I settled on something separate from Covid, but an unsaid part of medicine, the lack of pricing transparency.  We all know the stories of insane itemized markups and providers and payers who concur that it is too disruptive to fix.  A TED talk from a journalist who compiles real pricing information from real patients documents the lunacy.  Whether the cure is worse than the condition makes for a good discussion.  Put in Consult Maven first, then repackage.  This one seems to be going well.

Was hoping to do more around the house but haven't.  And I still want to get my monthly Jewish donation to its destination before shabbos.

Reconsidering Shabbos

Since Covid-19 closed the synagogues, shabbos has been very different for me, some elements favorable, some increasingly destructive.  This has been magnified by the Holy Days.  First, I stopped driving and never used the computer or cell phone except for medical care obligations when I was working.   I did watch TV and listen to the radio, still do.  When I was working I used to go out for breakfast Saturday morning, a residual pleasure that started when I needed some alone time to study for upcoming Board Exams but remained as a respite destination for the remainder of my working years.  I stopped doing this at retirement, redirecting my mornings at the Hollywood Grill to an obligatory breakfast required for platelet donation.  When shul on shabbos morning disappeared, I didn't miss it.  I could stay home, see what's on TV, scrounge some breakfast or at least make keurig coffee.  No FB or email intruded.  I would read some, snack some.  Longer stretches, including some Thursday-Friday-Shabbos yom tovim became more of a sensory deprivation experience, leaving taste of eating as the connection to reality.  I got pretty bored, not realizing how dependent Covid-19 made me on the screen.  I still maintained scheduled exercise those days, a variant of pikuach nefesh, with an electric timer, but amid overall designated sloth, I found the chore of schlepping onto the treadmill more of an intrusion than destination or break from boredom.  And worst, I spent much of the day horizontal, some in a lounge chair in My Space, but too much on the living room sofa, or worst of all, in bed.  A reasonable 45 minute nap at mid-day became two hours, disrupting sleep for the next two days. 

Rosh Hashanah afforded me services both days, requiring 45 minutes of attentive driving each way. Even so, the absence of screens gave way to the horizontal posture again.  Yom Kippur services were more tentative due to possible rain, but they went on as scheduled.  Good thing, because I'd have gone stir crazy not eating for 26 hours at home.  Taste may be the last portion of sensation that survives these screen-free stretches.

Just as a matter of my own health, this will not do.  I am going to have to go somewhere each shabbos or yontiff.  The screen has always been suspended, but until Covid, it comprised far less of my usual day than it does now, greatly magnifying that sense of deprivation.  Going to shul occupied the morning.  Even if I didn't go, I would drive somewhere, maybe attend the West Chester University football game in the afternoon, and on occasion make a day of it by driving to Baltimore for Beth Tfiloh in the morning and some Baltimore area attraction afterwards.  What I am doing now is probably a form of false piety, not driving largely because I have noplace to go than a genuine desire to enhance shabbos.  For my own protection, this really cannot go on.  I will just have to decide what forms of exit from my house remain compatible with shabbos and yontiff.

The Committee Excelled

Rosh Hashanah at the Merion Tribute House has always exceeded expectations.  It is a Conservative service in that it gives women full participation and modifies the language to include matriarchs but has a complete and traditional liturgy, performed expertly by the participants.  Cost of attendance is nominal, largely to cover rental space and extra chairs.  Pulling this off from one year to the next, with one or two new participants each year, requires a lot of coordination, done by a small volunteer committee.  It moved from a challenging task to a daunting one this year as Covid-19 moved the Holy Days from the sanctuary to the screen for most congregations.  My home congregation, which does not stream on shabbos and yontiff, effectively moved the day of Rosh Hashanah to whichever day a person wants to watch the pre-recorded and diminished proceedings.  I think it is the wrong approach, as the day specified for our Festivals in Torah, read as the Festival Maftir, creates the time boundary that bestows the day's sanctity.

Despite the challenges, the Merion Tribute House Committee, opted to have a live option on the Torah specified day.  Safety required considerable alteration of logistics and minor alteration of content.  Our service was moved outdoors, under a series of canopies with folding and other portable chairs spaced at the corners of each canopy.  As families assembled, they could move the chairs to sit as a family as they would do at home.  This meant that the entire project could disappear in a downpour.  The liturgy was abbreviated to what the consulting Rabbi deemed Halachically essential.  Shofar blowing was limited to the portion assigned as a shofar service without the added blasts in the Musaf.  And in Conservative tradition, the proceedings would be streamed live for those who opted to watch from afar.

It went off flawlessly.  We arrived at the start both days, assisted with the set-up.  People who led the various segments presented their portions expertly, though sometimes challenging to hear without a microphone, which on the first day was offered only for a terrific Dvar Torah.  Outdoors had its own learning curve.  Typically Rosh Hashanah post-mortems from congregations financially dependent of the success of their presentation can expect gripes about the air conditioning.  The crisp outdoors under the canopy had very effective air conditioning.  On the First Day, the women wore coats while the men mostly had woolen talesim, which did not shield the wind very well.  On the second day, women all wore closed shoes, men were a little more layered, me with a sweater under a wool sports coat.  My seat was at the intersection of two canopies which allowed the sun to shine on my place part of the time.  Our cat knows to stretch out by the window facing south that receives the sun.  I am now a creature comfort disciple of my cat.  The direct sun felt refreshing amid a generalized chill.  And mandatory spacing of chairs greatly expanded the No Chatter Section  of the outdoor sanctuary far beyond what could be attained indoors.

As successful as the event turned out, some things cannot be replicated.  No handshakes or any other skin to skin, or even sleeve to sleeve contact.  No conversations, little chance to chat with people you've not seen for a year.  That's part of the Holy Days too.  We pray as individuals but amid a much contracted community this year.  As well as most of the participants performed, they will just have to assume my notice and my admiration.

All great initiatives begin with somebody's imagination and with a risk of not succeeding.  This committee had experience, a legacy of most things going well, a few that need revision for the subsequent year.  There's the inevitable checklist of inviting participants, notifying people likely to attend, asking for money to cover costs.  But this year brought more fundamental questions.  How important is it to protect the specified day?  Could we satisfy Covid-19 safety restrictions?  How badly do we need to serve food?  Is there an advantage to having less time at services?  Will people come?  After concluding that the Holy Days and their rituals are fixed in time, that the ability to gather Jews for worship at that time protects Judaism, then the rest becomes an assessment of logistics and of Plan B's, those elements of imagination that not all committees have ingrained in their purpose.  They could not have succeeded more grandly.

My Fellow Lost

 One of the pleasures of living in a small state has been meeting virtually all of my elected officials at one time or another, making conversation, telling what I think, and having them respond personally.  With a little luck, this may even include the next President.  The number of active dislikes approaches zero.  We elect decent people who represent a lot of views.  While everyone has been personable, not everyone has been capable.

I latched onto a contemporary last cycle, a man of significant accomplishment and expertise in health care.  We probably crossed paths, he as a senior hospital executive at a place I visited almost daily, but I did not get to know him until he ran for office.  He squeaked by in a multicandidate primary and since we really only have a Democratic Party in my district, and now largely in my state, he took his place in the legislature.

Since we share an expertise in health care, his on the financial end, me on the what happens to the patient end, our correspondence evolved, particularly in trying to address a devastating effect of opioids around our state.  We discussed this coffee and via email a few times.  My new friend also had prior experience as a community representative.  This enabled him to engage in some very direct constituent concerns from traffic lights to flooding or other safety hazards in individual developments.  

Covid-19 changed some of the personal contact.  Constituent coffee hours at the Brew HaHa on his tab ended.  Public gatherings where he could show up and mingle became fewer.  And despite his expertise in some aspects of health care, he never took much initiative on making our Covid lives easier, as these were more executive tasks of the state and county than legislative ones.

As a senior health executive, his strength was as a technocrat, something I greatly admire as a clinical maven myself.  When confronted with a choice of taking $100 now or risking it to get $200, he would go for the sure thing, which is what I think legislators should do, though executives maybe not.  His undoing may have been in his own area of expertise.  His principal legislative initiative was to have the state fund Obamacare expansion by reducing the risk to the carriers that were hesitant to enter this market.  Once the deal with state money became attractive to the insurers, they expanded availability, not massively, though importantly to the 21K citizens who benefited.  I happen to agree that those citizens who went from nothing to something benefited more than the insurers who went from having a lot to having an additional increment, though the sum expended could have been redeployed for projects that were less certain but would benefit more people.

The fellow who lost to my friend by less than 100 votes two years ago renewed his challenge, with the legislation as his issue.  I assumed, incorrectly as it happened, that people including me do not really understand the technicalities of this key legislation that requires some real expertise to assemble.  Moreover, prior to social isolation my representative had done direct constituent intervention capably.  I assumed the primary would not pose a major political challenge.

I met the opponent briefly but did not discuss issues.  He had volunteered at a Covid event.  Seemed like a nice fellow.  I wished him well as I handed him my diagnostic swab and drove off.

The election returns from the primaries had a theme.  Quite a lot of challengers prevailed and even the sure things had a quarter of the party voters opposing what I thought were popular and capable incumbents.  My friend got voted out by the man who handled my Covid specimen.  The mail in ballots totalled pretty even, but the get out to the polls turned out rather lopsided.

As I ran an errand to Shop-Rite, I turned a major intersection crammed with political signs, some now effective publicity, others visual clutter once ballots for the general election was established.  My friend's poster was the largest of the corner, anchored by two stakes.  There he was in plaid shirt, windbreaker and cap with a drill or electric screwdriver, the first to remove a sign from that corner.  Being a Senior VP at a mega institution must invite its own share of failures, not getting your way with the CEO, departure of key subordinates, or initiatives that looked great until implemented but were soon abandoned.  His stay in our legislature was only two years, but to me it seemed a very successful two years.  He did a lot for our community before and I don't expect that to end now.

Accessing TED Talks

When taking my courses at the Osher Lifelong Learning Institute during the Fall of 2019, a couple of the courses were designed around presentation followed by discussion.  TED Talks, because of their diversity and expertise, provided much of the focus, though I didn't know what they were.  Some of the speakers were known to me by reputation, all were articulate and presumably experienced at solo speeches to large audiences.  While I took a liking to them and included myself in the followup discussions, the resource remained dormant.  My Spring 2020 classes had a different format, mostly too large for meaningful verbal exchange or too lecture focused.  As Covid-19 became dominant with connection to the world primarily by screen, I again sought out some type of entry to the idea marketplace.  Zoom seminars became a destination.  And OLLI classes have resumed online in Zoom format.  But I missed the TED Talks, those presentations designed to stimulate thinking more than present factual material.  Many were experience based, experiences that we do not have ourselves but can still share.

I started exploring what has been assembled.  It's massive.  When subdivided by topic, most subjects do not stimulate me but they stimulate others.  The program allows me to select my own interests and sifts through lectures their algorithms think I might enjoy, though my own style has been more surfing and sampling, not entirely randomly but with enough curiosity to tap subjects that were really on my B-List, perhaps unfairly.  Nearly all are less than a half-hour, well within my restricted attention span.  A new addition to my daily task list.

Day Trips

Some time away from home has been a staple of my semi-annual planning.  There is usually an overnight trip and three day trips.  This cycle a variant again appears, with the overnight trip assigned to a National Park and three day trips.  I have rules.  The day trips need to be to sites, though not necessarily towns, where I have never been before and they have to be in different states.  I can probably handle a range of 150 miles but 100 seems more suitable.  NYC with the Chinatown Bus makes for an easy one as NYC has endless places I've not been before and travel is passive.  I've not done Philadelphia but should.  Running out of places in my home state of Delaware.  Baltimore and nearby Maryland has a lot of places.  New Jersey not so many.  Unfortunately, Covid-19 has closed a lot of museums and historical mansions.  Some factory tours are on hold.  Campuses that I've not been to before are only partially open with restricted access.  I don't know about wineries.  State Parks and natural wonders still offer access.  I could go fishing at one of the downstate parks or visit a nature preserve.  It is very possible to do this semi-annual initiative, though planning has languished.  Some attributable to Covid, some to me.

Long Pants

Covid-19 mostly at home this summer made me very casual.  On many days, particularly shabbos, I didn't bother getting dressed unless I had to go somewhere.  In the spring, at the start of the restricted activity, I made a point of driving someplace every day. But eventually there was no place worth going to and daily drive to nowhere for no purpose other than leaving my house waned.  I stayed home many days.  When I did venture out I typically dressed for summer: t-shirt with some type of writing, shorts, sandals.  As the summer transitions to cooler weather and more formal encounters, it's back to undershirts, long pants, and socks, though I won't package the summer wear until October.

There still aren't a lot of places worth dressing for.  Supermarket a couple times a week.  OLLI and Zoom presentations where I really only need to wear a shirt.  Maybe try to do more fishing this fall.  Maybe an outdoor shul event here or there.  Maybe I will work more diligently on my projects with a more formal appearance, maybe not.  Find out this week.

High Holy Day Mode

This September has its events, though Covid-19 makes them different.  I've done summer travel, this time to St. Louis for my son's wedding, far from leisure respite summer travel, though I did make it to the Delaware Beaches twice.  OLLI started online, excellent first sessions each class.  However, OLLI has been a lot more than classes for me.  There is college and pro football on TV.  Cutouts of fans in the stands is kinda phony.  About once or twice a year, I like being in the stands.

Our constant may be the Holy Days.  Selichot by Zoom probably is not that different than Selichot live, as the spectator element overwhelms the participatory experience.  It may be more difficult for the college crowd which uses the midnight assembly early in the school year to renew acquaintances for the coming academic year.  Rosh Hashanah, though, is a participatory experience.  Shul may be a spectator sport not a lot different than football for many, but there are meals and greetings.  Cyberspace has been an improvement over the Postal Service for conveying good wishes over distance.  But there is no surrogate for kissing the Torah with tzitzis during its procession, or for those who only come to shul on the Holy Days, those few handshakes that will not reappear for another year if granted another year.  My congregation has established what I think is a poor surrogate for the pageant of shul on Rosh Hashanah, though to be fair they had to sift through what they though the community would find most meaningful and the halacha most essential.  My offshoot assembly will try to make things more of a personal experience, weather permitting and with safety limitations.  It's not as good as the real thing of sitting adjacent to somebody you've never met before, negotiating the crowd to get to the kiddush table at the end, or watching somebody else's kids run around, but there is much to be said for following along live in the machzor as the prescribed ritual unfolds.

Some parts of the Holy Day experience may be strengthened by the relative confinement.  I seem to be more devoted to making a special dinner, especially if the live services proceed and I can take some to my sister-in-law.  I've pondered and explored various menus, willing to be a little more adventuresome.  I find myself less focused on clothing or appearance, though I plan to wear my finest things with attentive grooming, at least on Rosh Hashanah.  No point paying for a manicure if you won't be shaking hands, though.

What I've not done, and probably should, is any study for the upcoming season.  There are all sorts of insights from yutorah.org and many other online sources that I've just not been motivated to pursue.  There will only be one brief dvar Torah at Rosh Hashanah each day.  Our Rabbi's I can watch or listen to at my convenience though I have not been a great devotee of his public presentations.  This year I should have more of an incentive to explore the Holy Day season but haven't.  Maybe check out some options on this.

Each Torah mandated Holy Day will arrive on time and conclude as specified.  The Covid-19 reality seems to make those days more personalized and less programmed.

Wedding Weekend

Labor Day weekend away, highlighted by the marriage of my son, who I must say sparkled as he became a head of household.  His friend drove 12 hours at a fast clip to be Best Man and at the reception captured in a paragraph what has made my son special.

Covid-19 took its toll on travel, keeping wedding and airline related appointments left me little leisure time except for a precious two hours touring my old St. Louis haunts as the ladies got their nails prepared and my son and best friend did something secretive.  Our hotel, in a convenient location for the wedding festivities, lost its leisure travel allure.  No pool, breakfast buffet, help yourself to coffee.  Comfortable room but without housekeeping service.  And unrelated to pandemic restrictions, not a lot of drawer space so they probably did not expect people to stay very long.  Minor time zone change but not the reason I felt myself dragging.  More likely that was from impaired nutrition.  No food until we got to St. Louis and spent two additional hours on an interminably inept auto rental line.  Then to Schnucks, the supermarket I gravitated to in the 1970's, to pick up the very munchies that I had successfully avoided bringing into my own house. Plus a bottle of wine that I gave away to the Best Man rather than open for my own use.  Protein malnutrition but not calorie malnutrition.  

Got to tour my medical alma mater briefly, though primarily the main campus, but only drove through the medical campus.  Both have expanded considerably since my days there, not as much since my last stop there five years earlier.  For a Labor Day Weekend with classes in session, students seemed sparse.  The student center, fairly new when I attended but gutted and remodeled since, seemed mostly vacant.  the mini-cathedral across the street had people.  The quadrangles had few people.  Access to the Library was by ID card.  They did not charge me for parking in the garage that morning.  As I drove further South, the area seemed less shabby, even gentrified.  My National Supermarket had become a Schnucks and there was an Islamic enclave with its own mdi-sized supermarket.  Almost no litter, but that was true of St. Louis when I lived there.

Rehearsal Saturday afternoon.  Ceremony on Sunday afternoon.  It being an interfaith ceremony, by chance the Rabbi was a fellow who we knew as a brand new Cantor who did our daughter's baby naming.  He's successfully progressed to Cantor-Assistant Rabbi at a large Reform congregation where he has officiated for about 20 years while he raised two daughters, now both young professors.  He had been a serious athlete, an accomplished javelin thrower, and maintained contacts in the sport as a coach and consultant, to say nothing of still looking fit and trim.  A lot of picture taking, both at the ceremony and later in a park at an adjacent state university.  I really needed to be horizontal and headed back to the hotel to make myself supine once photographic posing was no longer needed.  Then the reception. Interestingly, I kept my entire weekend alcohol free except for sip of my wife's beer at a brew pub.

Return home mostly uneventful, though definitely tired and in need of adaptation time.  

I knew this was not really leisure travel, as it had appointments and purpose but the Covid-19 restrictions would have run contrary to my mindset of vacation.  I would like to take a trip for the purpose of tourism or recreation later this calendar year, probably to fulfill my intention to go to a national park by the end of the year.  However, I got to experience the absence of the things I seek when I travel for my own personal escape.  I opt for a hotel with a pool, even if I am not planning to immerse myself in it.  I usually find time to splash around.  Either the breakfast buffet or restaurant breakfast becomes a day-starting destination.  Of the things absent this time, I may have missed this the most.  Taking what I want, going back for more coffee, watching the weather report of even Fox News or whatever is on the big screen TV.  I rarely have lunch except on a cruise, but take pleasure in dinner with a glass of wine or mug of beer.  Both essentially absent, or really an ordeal to acquire, this time.  

Places that I visit have sites to access, from wineries to historical sites or occasionally a beach.  While not off limits, I have come to expect other people on similar tours.  The people were not there where I might have expected them to be.  Coffee in flight had been cancelled.  Coffee at the airport could be obtained though less conveniently than I expect.  

While I am getting tired of staying home, the new location imposes a different kind of strain, one that keeps it from being that escape and indulgence that makes vacations targeted destinations in place and in time.