Tuesday, March 24, 2020

On The Frontline In The War Against COVID-19

An ER Doctor wrote about a typical day dealing with this terrible pandemic.
Follow him on Twitter here: Craig Spencer MD MPH


Many of you asked what it was like in the ER right now. I want to share a bit with you.

A Day in the Life of an ER Doc - A Brief Dispatch from the #COVID19 Frontline:

Wake up at 6:30am. Priority is making a big pot of coffee for the whole day, because the place by the hospital is closed. The Starbucks too. It's all closed.

On the walk, it feels like Sunday. No one is out. Might be the freezing rain. Or it's early. Regardless, that's good.

Walk in for your 8am shift: Immediately struck by how the calm of the early morning city streets is immediately transformed. The bright fluorescent lights of the ER reflect off everyone's protective goggles. There is a cacophony of coughing. You stop. Mask up. Walk in.

You take signout from the previous team, but nearly every patient is the same, young & old:

Cough, shortness of breath, fever.

They are really worried about one patient. Very short of breath, on the maximum amount of oxygen we can give, but still breathing fast.

You immediately assess this patient. It's clear what this is, and what needs to happen. You have a long and honest discussion with the patient and family over the phone. It's best to put her on life support now, before things get much worse. You're getting set up for that, but...

You're notified of another really sick patient coming in. You rush over. They're also extremely sick, vomiting. They need to be put on life support as well. You bring them back. Two patients, in rooms right next to each other, both getting a breathing tube. It's not even 10am yet

For the rest of your shift, nearly every hour, you get paged:

Stat notification: Very sick patient, short of breath, fever. Oxygen 88%.

Stat notification: Low blood pressure, short of breath, low oxygen.

Stat notification: Low oxygen, can't breath. Fever.

All day...

Sometime in the afternoon you recognize you haven't drank any water. You're afraid to take off the mask. It's the only thing that protects you. Surely you can last a little longer - in West Africa during Ebola, you spent hours in a hot suit without water. One more patient...

By late afternoon, you need to eat. Restaurant across the street is closed. Right, everything is closed. But thankfully the hospital cafeteria is open. You grab something, wash your hands (twice), cautiously take off your mask, & eat as fast as you can. Go back. Mask up. Walk in.

Nearly everyone you see today is the same. We assume everyone is #COVIDー19. We wear gowns, goggles, and masks at every encounter. All day. It's the only way to be safe. Where did all the heart attacks and appendicitis patients go? Its all COVID.

When your shift ends, you sign out to the oncoming team. It's all #COVIDー19. Over the past week, we've all learned the signs - low oxygen, lymphopenia, elevated D-dimer.

You share concerns of friends throughout the city without PPE. Hospitals running out of ventilators.

Before you leave, you wipe EVERYTHING down. Your phone. Your badge. Your wallet. Your coffee mug. All of it. Drown it in bleach. Everything in a bag. Take no chances.

Sure you got it all??? Wipe is down again. Can't be too careful.

You walk out and take off your mask. You feel naked and exposed. It's still raining, but you want to walk home. Feels safer than the subway or bus, plus you need to decompress.

The streets are empty. This feels nothing like what is happening inside. Maybe people don't know???

You get home. You strip in the hallway (it's ok, your neighbors know what you do). Everything in a bag. Your wife tries to keep your toddler away, but she hasn't seen you in days, so it's really hard. Run to the shower. Rinse it all away. Never happier. Time for family.

You reflect on the fact that it's really hard to understand how bad this is - and how bad its going to be - if all you see are empty streets.

Hospitals are nearing capacity. We are running out of ventilators. Ambulance sirens don't stop.

Everyone we see today was infected a week ago, or more. The numbers will undoubtedly skyrocket overnight, as they have every night the past few days. More will come to the ER. More will be stat notifications. More will be put on a ventilator.

We were too late to stop this virus. Full stop. But we can slow it's spread. The virus can't infect those it never meets. Stay inside. Social distancing is the only thing that will save us now. I don't care as much about the economic impact as I do about our ability to save lives

You might hear people saying it isn't real. It is.

You might hear people saying it isn't bad. It is.

You might hear people saying it can't take you down. It can.

I survived Ebola. I fear #COVIDー19.

Do your part. Stay home. Stay safe.

And every day I'll come to work for you

You can follow him on Twitter here: Craig Spencer MD MPH.

Note: This thread is related to #Coronavirus #COVID19

Follow the World Health Organization's instructions to reduce your risk of infection:

1/ Frequently clean hands by using alcohol-based hand rub or soap and water.
2/ When coughing and sneezing cover mouth and nose with flexed elbow or tissue - throw issue away immediately and wash hands.
3/ Avoid close contact with anyone that has fever and cough.

Craig Spencer MD MPH@Craig_A_SpencerDirector of Global Health in Emergency Medicine @ColumbiaMed/@NYPhospital and Faculty in Forced Migration & Health @ColumbiaMSPH | @MSF_USA BoD |#Ebola survivorMar. 24, 2020

Tuesday, March 17, 2020

My Coronavirus playlist

In addition to the REM song in my previous post, here's some other songs to help you enjoy your social distancing/isolation/quarantine. I'll probably add to it as I think of new songs. In some cases I'm just picking the song based on the title alone.

Okay this is an obvious choice:
Hey Nineteen - Steely Dan

Here's one that is definitely appropriate if you enjoy bars and clubs:
Ghost Town - The Specials

Going along with the undercurrent of apocalyptic social change and basic survival:
Life During Wartime - Talking Heads

Yeah, this was an easy one:
Waiting for the End of the World - Elvis Costello

Although it's about Pompeii being destroyed by Vesuvius, it kind of goes along with the impeding apocalyptic feel of today's situation.
Cities in Dust - Siouxsie And The Banshees

Another obvious one. It's widely known as the theme from "Jackass", but it's called Corona, so...
Corona - Minutemen

...more to come...

Sunday, March 15, 2020

It's the end of the world as we know it

Yes, the world as we know it is ending.

We are all about to embark on a weird, dangerous voyage through a viral nightmare.

And if or when we come out on the other side, the world will be forever changed.

Our behaviors will change.

Our fears and hopes will change.

Our former feelings of security will change.

The future will smell of low-grade anxiety and lemon-scented hand sanitizer.

It's the end of the world as we know it...

...and I don't feel fine about it.

But here we are.

Welcome to the new reality.

Sunday, March 01, 2020

Sunday Night Music Club v.53

David Byrne of the Talking Heads performed a well-known hit from his work with the band.

The performance was on Saturday Night yesterday (2/29/2020) and it was the same as when I saw American Utopia in January at the Hudson Theater in NY. The show ended in early February but immediately after the run they announced a return engagement starting in September.

It was a terrific show, entertaining and captivating, and loads of fun! If you can't make it to the live performance, I'd recommend a viewing of the 1982 concert film "Stop Making Sense", which for my money is the best concert film ever made.

Here's Once in a Lifetime on SNL:

Monday, February 03, 2020

2020 Primary Calendar

Today is the day of the long-anticipated Iowa caucuses.

So I thought I'd better put up my quadrannual (I just made up that word) Presidential Primary Calendar!

I'm still checking dates and places, and I've largely omitted any Republican contests since Trump obviously has the Republican party locked down to within an inch of its life.

Here is it. Mistakes are likely, and all mine.
February 2020
3 Mon. Iowa caucuses
11 Tue. New Hampshire primaries
22 Sat. Nevada Democratic caucuses
29 Sat. South Carolina Democratic primary

March 2020

Alabama primaries
American Samoa Democratic caucus
Arkansas primaries
California primaries
Colorado primaries
Maine primaries
Massachusetts primaries
Minnesota primaries
North Carolina primaries*
Oklahoma primaries
Tennessee primaries
Texas primaries
Utah primaries
Vermont primaries*
Virginia Democratic primary
Democrats Abroad primary

10 Tue. Idaho primaries*
Michigan primaries
Mississippi primaries
Missouri primaries
North Dakota Democratic caucuses
Washington primaries

12 Thu. Virgin Islands Republican caucus*

14 Sat. Northern Marianas Democratic convention

17 Tue. Arizona Democratic primary
Florida primaries
Illinois primaries
Ohio primaries

24 Tue. American Samoa Republican caucus*
Georgia primaries

29 Sun. Puerto Rico Democratic primary

April 2020

4 Sat. Alaska Democratic primary
Hawaii Democratic primary
Louisiana primaries*
Wyoming Democratic caucuses

7 Tue. Wisconsin primaries

28 Tue. Connecticut primaries
Delaware primaries*
Maryland primaries
New York primaries
Pennsylvania primaries
Rhode Island primaries

May 2020

2 Sat. Guam Democratic caucus
Kansas Democratic primary

5 Tue.
Indiana primaries*

12 Tue. Nebraska primaries
West Virginia primaries

19 Tue. Kentucky Democratic primary
Oregon primaries

June 2020

2 Tue. District of Columbia primaries
Montana primaries
New Jersey primaries*
New Mexico primaries
South Dakota primaries*

6 Sat. Virgin Islands Democratic caucuses

July 2020
13-16 Mon. Democratic National Convention

Tuesday, January 07, 2020

Impeached President Tries to Start War

Trump has been impeached, so to throw off the spotlight he ordered the assassination of a demonstrably bad guy; but since this bad guy was like the number two guy in Iran (a nation we currently aren't at war with) they are understandably pissed.

In the few days after the event, Trump has taken a more war-like stance, by threatening total war if Iran strikes back in any way. Along with threatening to destroy historic and cultural sites in Iran, which by definition is a war crime.

My fear is that there will be one or more attacks on Trump properties, which will send Dear Leader completely over the edge and result in launching nukes. And the Republicans have ensured nobody will stop this mad man, so we'll soon be dealing with a post-apocalyptic hellscape because Trump is a douchebag.

Hell of a time to be alive! (currently 8pm EST on Jan. 7th 2020...I can't tell you if we'll be here tomorrow)

Wednesday, September 25, 2019

Round 1: Impeachment Inquiry

Well, all it took was Trump to make a dumb phone call to the President of the Ukraine, and finally we're at the start of something big.

For weeks I've been complaining about Nancy Pelosi and her so-called "long game", which I saw not so much as brilliant planning but more like cowardice. I'm still not convinced she had that much of a plan going when Trump made it impossible for her to delay any longer by pretty much indicting himself with his stupid "explanation".

Just wait until he starts throwing his closest advisers under the bus, like Bill Barr and Ol' Man 9/11 (Rudy, obviously). When they finally realize Trump is serving them up to take the fall, watch how fast they cut a deal to avoid jail and spill the REAL beans on our sociopathic president.

This is the very first step in a long, arduous process. Remember Watergate took over two years to take Nixon down. During that time he easily cruised to a landslide win for a second term. But things are very different now. Nixon only had five months from the arrests at the Watergate until election day, and that simply wasn't enough time to build a case against him that would do any damage to his reelection.

Trump, on the other hand, has been vigorously investigated for well over a year now. Keep in mind that Congress STILL hasn't seen the fully unredacted Mueller report. I'm sure that will change in the near future. And now that the House is moving forward with the inquiry, they have the power of subpoena to get documents and compel people of interest to testify under oath.

Yes, things are looking up just slightly for our democracy. We won't be fully out of the woods until after next year's election, and only if we win both the White House and the Senate, while keeping the House of Representatives.

So, there is hope. To be continued...

Thursday, June 13, 2019

The Ultimate Nightmare

I know it's been over six months since I've posted anything here.

Part of that is the fact that Facebook and Twitter have a much more immediate response.

Another part of that is outrage fatigue, which is a real thing and definitely a problem.

And finally, a small bit is sheer, unadulterated laziness. I will cop to that.

What finally got me to sit down and write something is a nagging feeling that we are witnessing the end of American Democracy as we know it.

Today's Trumpian outrage is indicative of what we can expect in the future, where he basically informed foreign governments that there will be NO penalty for them to interfere in our free elections, and in fact he is encouraging them to attack his opponents.

The way this is going, with it still 17 months to the election, we can assume that unless the GOP steps up and challenges Trump's legitimacy, we will likely have him around forever.

Here's how it will happen: Mitch McConnell will do nothing to prevent foreign interference in voting, as he has repeatedly refused to act on measures to ensure our voting machines are safe. He welcomes foreign hacking into the machine to ensure a Trump victory. And the foreign powers will be delighted at our leader being easily swayed by some cheap compliments and empty promises.

Unless the Democrats win BOTH Houses by overwhelming numbers, Trump will not be removed. Forget the presidential election for a minute; if he loses, he'll use his remaining four months in office to challenge the legitimacy of the results, and will refuse to leave office. If we don't have 2/3 of the Senate, we can't impeach him.

Regardless, he'll invoke an emergency order to suppress the results of the election, and when Congress challenges it, when it ends up before the Supreme Court he'll win with a 5-4 majority.

That's when we'll see "President-for-Life Donald Trump".

And the death of our democracy.

The infuriating thing about all of this is that it'll only take a few dozen men in the Senate brave enough to go against their party. But judging by their fearful actions so far, it looks like a very remote possibility.

I do know that the longer Nancy Pelosi balks at starting impeachment hearings, the more Trump is consolidating his power. If she waits too long, which will be not much later than the end of this summer, it'll be too late to stop him.

We need to hear Trump associates on the stand, under penalty of perjury, answering questions about the President and his family. The more people who testify, the more likely we'll see Trump's support in the Senate start to crumble. Especially when those witnesses realize that Trump will not be around to pardon them.

We are rapidly approaching a tipping point in our nation. I can see a time when the nightmarish fictional nation of Gilead will have a real-world metaphor right here in the USA.

I used to wonder how average people in Germany could sit and do nothing while their nation was taken over by a dictator.

Now, I can see how it happens. It simply takes good men to do nothing for evil to succeed.

Wednesday, November 07, 2018

Governor Ned Lamont!

It was a nail-biter last night, but today Ned Lamont is the Governor-elect of Connecticut!

I'll have more later, but right now I want to enjoy this win, and start working towards making Connecticut a great state for all of us!

Thursday, October 25, 2018

The final stretch

Today there's less than two weeks until the election.

The 2018 Mid-terms are shaping up to be a defining moment in the history of our nation. The outcome of this election will almost assuredly chart the path of our democracy for the next decade or longer.

Presently we're at a crossroads. The Republican-majority Congress will not only do NOTHING to limit the wildest excesses of Donald Trump, but they are actively participating in the escalating erosion of our national character.

The recent confirmation of Supreme Court Associate Justice Kavanaugh shows there is almost nothing standing in the way of Trump's vision for America. One that includes complete and total destruction of his enemies, real or imagined, and definitely including the Democratic Party. He's already well on his way towards a Constitutional crisis that may result in widespread suppression of our rights and a suspension of democracy.

We may actually see President-For-Life Donald Trump happen!

The ONLY firewall against this abuse of power is the ability to vote. We need to take back the House of Representatives in order to start the investigations and hearings that the Republican-led majority has been unwilling to do. Once the Democrats have the legal authority to investigate the countless abuses of law that exist in the current administration, only THEN will the pendulum start to swing back from extreme right-wing fascism towards a reasonable center.

But if somehow, through voter suppression, fraud, outright stealing of elections; if somehow the Republicans retain control of the House, it will inevitably spell doom for our nation.

Trumpism will be the new normal, and our ability to have any checks on his power will evaporate like a shallow puddle in Death Valley in August. We will see voter suppression, or even a suspension of voting. There will be justifications for martial law and other ways to control the masses.

And the hatred of the right will spill over into the streets and the nation will become a 3rd-world dictatorship.

I hope I'm wrong about this scenario, and I hope we don't have to find out either way. If the Democrats manage to win a substantial margin in Congress, we'll see a dramatic shift back to sanity and American values in the very near future.

This is why I'm having trouble sleeping lately.

One way to help ensure a Democratic win is to volunteer for campaigns. Go canvassing, stuff envelopes, make phone calls, donate to candidates in especially close races.

And for fuck's sake, don't forget to VOTE on November 6th.