Late Life College Mindset

While driving to a doctor's appointment, a top tier cardiologist who I had not seen in a year, I wondered how she would approach me in conversation.  Coronavirus had kept her and her group underworked for months but retirement has kept me underworked for just shy of two years.  How do I cope with not having to show up for work or not having the income that I once did?  As I pondered this while driving safely on the day that coronavirus restrictions were first lifted in a serious way, I saw stores that looked open, though not the ones I typically entered.  The medical building also appeared largely empty.  Yet other than missing my anticipated spring break trip and postponement of my son's wedding, I did not live very differently during the restrictions.  I dined out barely at all, gave up coffee other than made at home, minimized shopping, kept shabbos and yontiff someplace other than shul and really missed none of this.

In effect I had become almost a facsimile of the college student I never really had the chance to be, one with some discretionary money, not burdened by exams or lab courses or grades that will direct my future.  As soon as I retired I created My Space with nice desk, a big screen TV, and a stereo, though with CD player replacing the turntable.  I read books, take courses at OLLI, have a paper due each month for Medscape.  I could eat out when I wanted, had a car to take me where I wanted, spend a little extra on coffee or beer.  I exercised more, took a break when I wanted, read more, expressed an ambivalence for shul by sometimes going voluntarily, sometimes grudgingly, sometimes not at all, rarely enthusiastically.  My Space not only exists and functions, but it is largely personalized with some mementos in my line of sight, good lighting directed where I want it, a white board to my left with multicolored writing to inspire me.  In effect a freedom that arrives late in adulthood, sacrificed for other things more out of fear than greed early in adulthood.

I had to declare a major then, some area of expertise to master.  Now I don't.  I've already mastered a few things, probably more than most college students will in their declared major.  Eventually my classes will resume.  For now it's the eclectic upgrading my mind, socializing more in cyberspace than in person, and with the resources of time and funds to use late adulthood to my best gratification.

Taking Action

Maybe it was the resumption of naproxen but I feel better physically, still a little spunk deprived mentally.  Sending off my Medscape column offers one big monthly sense of accomplishment.  So did planting my 4x4 garden the day before, maybe even enough to proceed to the other 4x4 later on today.  Achiness limited my treadmill schedule which needs to hit the reset but get back to previously accomplished levels before long.  And I got some laundry done, enough to proceed with the seasonal transfer of clothing from storage to bedroom.  All this without bothering to get dressed at all yesterday.  I had associated looking ready to work with working, as had others.  Had outdoor activities been needed, I would have put on clothing appropriate to that, as I plan to today, but flannel bottoms are fine for working at my keyboard if I am dedicated to typing in My Space.  Today, though, I expand beyond My Space.

Email change

pol.net is no more.  Medscape withdrew the service that connected me to the outside world since 1996.  In that time, I have been able to impose my thoughts on countless unwilling recipients but also received responses to my queries from mental giants and the stars of Judaism who would have otherwise been inaccessible to me.  The archive grew and probably still exists on a zip drive.  Despite its emotional attachment I almost never accessed the saved weekly Torah insights, Pirke Avot Commentaries, Ramchal summaries and saved exchanges among many friends whose connection might have otherwise been lost.

And it was free to me in exchange for enduring some relatively unobtrusive medical advertising.  comcast.net which replaced it has a monthly fee, though bundled with cable TV which I would be subscribing to anyway. The archive has already begun.

Catch-up

Hospital billing, lab reports, sign charts, Medscape Blog entry.  All overdue professional activities.  Research project and office cleanup, neglected professional activities that really have no deadlines.  401K revisions and vacation reservations and exercise.  All neglected personal activities.  Upcoming long Torah reading, I better get on the stick.  I intend to do them all.  And assemble the new kitchen island, too.  Most are finite tasks where a box can be checked when completed.  They would all be completed were there no barriers, mostly something more urgent that has to be done instead.  Patients occupy the exam rooms.  There is a hospital census.  At home I am really tired and want to rest.  I thought of something clever to post on Sermo.  No shortage of diversions or momentary priorities.

Some real catch-up time came my way in the form of a hurricane that closed the office for a day and a half.  No office patients.  No phone messages.  Not much hospital activity.  I brought my billing up to date and edited all dictations.  Made progress on the lab box.  By week's end my blog was posted.  Some headway, still more to go but there is a sense of accomplishment for what got done.

Code of Conduct

Several weeks ago Sermo, the physicians' posting site established posting requirements for its participants, as did Medscape Connect, another physicians' web site before that.  Medscape's has been around long enough to see the individual I regard as the most in need of having to go through a moderator posting much less frequently and others who had been routinely verbally abused by wingnut ideologues returned, some of them in need of a little restriction as well.  The Islamists who used to post stuff that I do not think their patients would want them seeing have not returned but neither have the very delightful Muslims who tried very hard to teach the rest of us the principles of their faith.  

Sermo's Code of Conduct reads as far more stringent and far more enforceable than Medscape's.  There have been individual physicians suspended for infractions well under what Medscape tolerates and the flagrant violators of civility have been few.  What the managers noticed, quite correctly, is that people who were personally attacked, myself among them from time to time, give themselves a holiday from posting.  I did that for two weeks not long ago and many more times deleted notifications from my discussion list.  In tracking their data, they concluded that certain individuals deterred discussion to an extent that they had to be shelved to maximize engagement of the physician community.  

While there was some negative reaction as a form of censorship, I think of this more as going through an editor, which is true of most publication.  It is not the ideas that are being scrutinized but the effects of how they are expressed.

Derech Eretz Kadmah L'Torah.

Incomplete Tasks

This weekend I had devoted to catch-up on a very long list.   I managed to get my overdue lab results from my doctor and acted on it.  Mercy Philadelphia Hospital has its first week of Computerized Physician Order Entry, known as CPOE, which occupied much of my work week to the neglect of anything else.  I had a few deadline items such as doing shacharit at AKSE and learning the third aliyah of next week's Torah portion, which I got done.  There was a semi-deadline for a blog contract with Medscape that I pretty much did as well.  And then we have the many things that have to get done or should get done but do not really have deadlines and sometimes not even end points.  This week I will have to update the hospital billing and change the system around to make the billing more timely.  The Department of Labor has sending me notices for a year even though I have not had employees during that time.  I finally took my fifty year old Schwinn out of the garage, put air in the tires and took it to Sports Authority for a safety and function inspection with the intent of riding it for exercise.  I can sit at my desk.  My new briefcase has sufficient content to transport things that I need to keep in my possession.  There is a menu for Mother's Day and I even got a card.  So it wasn't a total non-productive week or even weekend.

Just shy of two months remain in my semiannual intentions.  I may still be able to bring a cleaning crew in next month if I get the Family Room more accessible.  My monthly outings remain on schedule and I have some growth to the culinary herbs outside the front door and in the aerogarden.  I've done nothing of note financially. I've written nothing even close to submission for public consumption.  My research project remains largely neglected.  I'll try to plod along with these in the coming week.

Physician Posting Sites

My colleagues have opinions, as do I.  We tend to be semipublic figures whose verdict means something, whether or not it is welcome.  Most of us are also dependent upon the good will of our patrons.  The need to enable candor while minimizing unfavorable retaliation for the opinions that we carry has led to a number of web sites that only allow physicians access, to express opinions to each other or ask for medical guidance that can be moved to patient care without formal consultation.  I subscribe to two, Medscape's Physicians Connect and Sermo.  Both are subsidized by some form of advertising, which is good since they would probably collapse if a fee were imposed on the users.  I post on both, but have greatly curtailed my use of Physicians Connect which I think needs to eliminate anonymous posting and obtain a moderator.  For an educated crowd, the physicians can be rather hateful, particularly those raised on revenge in the Middle East.  I do not think a lot of them would want that level of candor identified with them and conveyed to their patients.

Politically, the most dedicated come across as libertarian:  "Mine is mine and yours is yours, Average, though some say this is Sodom"  as the sages of Pirke Avot observed.  Sermo people have pseudonyms of their own choosing but not outright anonymity.  Politeness is valued a good deal more on Sermo than at Physician Connect and remarks belittling another poster are rare, even on the political discussions, at the former though common enough at the latter that I took my intellect elsewhere.

People can also run medical dilemmas and opinions by specialists.  While both contain a few medical loonies promoting their fringe agendas, the regular medical posters on each seem a reasoned bunch.  Still, I get the sense that people who fundamentally like being doctors opt for Sermo, the kvetchers congregate at Physicians Connect.

Physician Posting Sites

This summer I decided that I would no longer post comments on Medscape's Physician Connect, where I had been a regular for a couple of years, except at the Endocrinology division.  I tried replacing it with Sermo, where I found the physicians more congenial but for the most part these places do not really attract a lot of people whose goal is to be congenial.  Instead of finding it a place to exchange ideas, I found it a place to promote agendas, a place to express the desire for the gimmes whether that be removing the Israelis and any other Jews from Israel or removing the democrats from public positions or removing formularies from insurance so I can have my own way with no interference.  When somebody who a different view somebody will invariably respond that they are inferior in some way.  After maybe a year of this, doing my very best to be both erudite and polite, I found myself adapting to this environment more than I would like and offered myself a hiatus.

At first, I missed having a chance to express myself but that craving ran its course in a week or two.  A few days ago, I gave it another look, reviewing the political discussions on Medscape and the medical ones on Sermo.  I responded to Endocrinology on both but the political and practice of medicine subjects no longer held sufficient interest to open up the discussions to see what the medical discontents had to say about their never ending lists of real and perceived enemies.

Annoying Colleagues

Al Tifrosh Min HaTzibur or "Don't separate yourself from the community," advised sage Hillel in Pirke Avot.  But sometimes a respite of uncertain duration may hit the spot.  This morning I opted out of Medscape Physician Connect discussions, where I tend to function as a sage, though perhaps politically more liberal and definitely more scholarly than most of the posters.  There's been too many diatribes, too much pooled ignorance, too much intolerance of other people's ideas.  When I started responding in kind, I knew it was time to neither read nor contribute for a while.