espanadiarywriter

[espanadiarywriter]

Unengaged

As many of you know, I work in health care research. I’m going to do a little bit of explaining before I get to my central point. One of the things we are working on is a collaboration between community health clinics throughout the state and the health insurance plans that serve Medicaid populations in Oregon. Oregon has a fairly unusual model (compared to other states) of providing care to vulnerable populations in the state. Oregon has taken the lead in trying to pay the insurance plans (CCOs) for keeping a population healthy rather than just paying for services. So the CCOs (which stands for Coordinated Care Organizations) get paid for quality measures (like good diabetes care, or well-child visits). They get paid from the state per person rather than just for services that health clinics provide. This means a healthy person on their plan is cheaper to care for and thus more profitable than a sick person because they aren’t getting paid each time that sick person goes and gets care. They are trying to pass along this payment model to the clinics who actually provide the care, so they spend more time focused on prevention of illness. (And yes, you people in the industry, that is a simplification. Deal with it.)

Medicaid patients must be below a certain level of poverty to qualify for the coverage. Even with the expansion of Medicaid (aka Obamacare, which mostly happened in states not run by Republican governors wanting to make a political stand), the amount of income is extremely low to qualify. In most non-expansion states, a single person has to make less than $841/month or $10,000/year, but that number varies by marital status and other factors. Even in expansion states, the number only goes up to about $30,000 per year in income for a single person. As you might imagine, this group of people is very hard to engage in preventive health care because they have so many other priorities in their lives (housing, keeping the lights on, transportation, being able to buy food).

We are conducting an outreach program for cancer screening and it is a collaboration between the CCOs and rural health care clinics. One of the things we have to do first is decide who qualifies for the screening. One of the first disconnects we stumbled upon is that the list of people a CCO thinks is in a clinic is different than the clinic’s list. How is this happening? All people in an area who qualify for Medicaid are assigned to a CCO and then the CCO has to figure out where those people get care. In some cases, a person is already seeing a doctor in a clinic—that’s easy. But in many cases, the CCO has to take an educated guess and assign people to a clinic. CCOs call these patients “unengaged,” but the clinics call these patients “not ours”. It’s not terribly surprising that this would happen, just given the mechanics of the system. We don’t have universal health care, or a single payer, which would remove all of these barriers. What is surprising is that the amount of patients on our lists where this was happened was 40-50% of the patient lists. That is a shockingly high percent of patients.

I have been stuck with this in my head for a while now. It means these patients have never established care with a health care provider or they haven’t been into the clinic for over 18 months. (A small percent of these people had information that wasn’t up-to-date at the CCO.) This has huge implications for health care in rural America. And if you think about it, there are so many obvious reasons for this lack of routine care. Number one is cost and complexity of seeking health care in the US. Consider things like surprise bills for doctors if one person in the health care chain is not “covered” by insurance, the cost of co-pays for low income folks, or not having many providers that accept Medicaid coverage. We’ve basically conditioned people to not trust the medical establishment. Not to sound like a broken record, but we have laid the ground work for a vaccination effort rooted in large, big city roll-out, ‘trust the medical systems’ to fail spectacularly in an environment where people don’t even see a doctor once a year (or ever). They are only going to a medical professional for acute injuries or a health care emergency. When talking with these rural clinic staff, I hear the same themes. Their patients want to come if for care when they need it and not be bothered otherwise, and that the only messages they trust are one-on-one from their doctors.

If people aren’t engaged with any medical provider, then how do you stand a chance at reaching them? But maybe I am thinking of this phenomenon with too narrow of a lens. Is this symptomatic of a much larger ethos? The American myth of self-reliance at all costs. We don’t want government or other help because we help our neighbors (but only the immediate neighbors that are similar to us, maybe?). We don’t need help (until we do because a huge fire blows through?).

And I don’t really blame people for not using health care—it’s expensive even when it is supposed to be free. Most US systems set up as safety nets have huge holes in them. For example, most of the people (57%) who applied for FEMA aid after the Oregon fires received rejections and never got any support—they denied almost 14,000 people. Most of the people who use the health care system find roadblocks in payment or approvals to do anything. What else are people unengaged with? Society, politics, anti-racism, their own communities. The US has an “unengaged” population (and not just in rural areas). Is it a coincidence that the 40-50% of unengaged people is about same percent of people in the US who do not vote? Maybe, maybe not. If this week has shown us anything, it is that the lack of engagement can have massive, even deadly, consequences for American society. About 80% of Americans believe in a woman’s right to choose. And the number of people voting for candidates who can save that right is closer to 25%. In our study as in the US overall, people who are unengaged are more likely to have adverse health outcomes, be diagnosed at later stages of disease, and generally are more at risk. I don’t have a great answer, but I feel like we are all overlooking the general apathy that is the root cause of the problems.

[espanadiarywriter]

Hesitancy and sociology

I know I’m a broken record, but I can’t stop thinking about vaccine hesitancy. And it’s not like you think. Yes, yes—I am mad as hell at the people not getting vaccinated.

(Which is why this article from McSweaney’s resonated SO much with me. Do not click the link if you don’t like swearing…)

It’s just so much more complicated than that.

People honestly believe in the misinformation. Did politicians and local leaders make things worse? Absolutely. But ultimately they believe in the misinformation because they and their communities have been left behind or left out of medical progress for years and years. It’s actually the same phenomenon whether you are talking about urban African American neighborhoods or rural and frontier towns where there are fewer than 500 (or 6 for frontier) people per square mile. Health disparities are caused by multiple reasons: trust in health care, distance to care or lack of access, tendency towards riskier behaviors, lower income, food or housing insecurity.

https://www.ers.usda.gov/webdocs/charts/57758/urbanruralmetronon.png?v=2634.2

Just presenting facts about a healthy behavior (in this case a vaccine) doesn’t overcome all these other barriers to healthy actions. The community as a whole needs to be brought forward into an attitude that health matters, that prevention is as important or more important than treatment. Fear of anything medical is common and is an easy emotion for other people to play on.

Only 3% of NIH funds go towards rural communities or research on rural issues. Our establishment at a federal level has left these areas behind. It’s not surprising that people who live In Rural counties don’t trust the science when it has never/rarely considered them before. The issue of vaccine hesitancy must be looked at as a sociological problem, not a medical education problem. Trusted members of the community need to be reached out to, listened to, brought on board and then those people can carry the message. And people shouldn’t be shamed for not listening to an establishment that’s ignored them for years. (Now, the politicians who should know better, that’s a different story. ) Socially, people need a way to “save face” when they realized getting a vaccine is important enough to overcome their fears. Having a trusted voice talking about it gives them that opportunity.

I’m happy to be as angry as the next person. And also I want to actually improve things not just stand on my soapbox feeling smugly superior. Look at the root causes and address those. I promise it’s more effective than Facebook memes.

[espanadiarywriter]

Energy

Can we talk about energy and pain for a minute? As my pain has decreased, my mobility has increased. But my energy is still lagging behind. It takes a lot of energy to heal yourself for sure. But I still have mornings I wake up and just want to go back to bed, even though my pain levels aren’t constant anymore. So what’s up with that?

It could be that because I am married to the energizer bunny I have a false notion of what “normal” energy levels look like. We are at the mountain house, it is just 8:00 am, and I am drinking coffee listening to him run around doing house and yard maintenance. Whereas lots of people have a cup of coffee on a Saturday morning before rushing into their day, in my house I get asked ‘what’s wrong?’. But I think it’s more than that. I think I’m spending karmic energy on pandemic-related worries. How do we change the tide and convince people vaccines are safe and effective? What’s going to happen to our medical providers who are close to collapse?

I’m not sure how common this situation is, but it actually drains my energy when people around me are anxious or upset. It does not need to be something that makes me anxious at all. But the fact that someone else has those feelings is enough to affect me. What others can bounce right back from a few hours later, stays with me for days. It lingers in the back of my mind. This is probably why I haven’t been writing much these days. At the end of the day, I am tapped out. I am emotionally (and therefore physically) exhausted; one more request puts me over the edge and I close up like a clam. Typically people talk about wanting more connection with people around them, but in my case I need to find less emotional connection so I can protect myself.

Being in the woods, even abbreviated and for a day, pulled me back from the immersion in the news. I can’t change global political events. I suppose that’s why I have enough energy to write rather than get sucked into house improvement projects. I can’t change politicians in Texas or Florida or Southern Oregon. I can’t even convince one random dude on Facebook “with a good immune system” to get vaccinated. (Although I have been morbidly laughing at him for days.) But I can figure out how to incorporate the health related behaviors that worry me into my daily outreach work. I have the benefit of working with health care providers, so there is a path towards action for me. When I realized this, it was the first time I’ve felt positive in a while, like there is something I can do to help.

For all the medical folks out there, keep fighting the good fight. You are not alone even though it might feel like it at times. And those of us who care will keep working with you towards equity and a more caring society.

[espanadiarywriter]

Bar Mitzvah Wrap Up

My heart is so full it's hard to express. I couldn't have imagined things going as wonderfully as they did. Everything was perfect and we could not have done it without all the help and support of our amazing friends. It is rare to have a chance to "read my blog" out loud. We even got sent some Zoom photos and videos from people who joined from afar. For those of you who could not make it, here's what I said:

(JEN:) We are so, so proud of you today. Not just for your amazing work preparing for your Brit Mitzvah. In a pandemic, and during this crazy year. (We had about two or three meetings with Rivkah (his teacher) before the pandemic moved us to virtual lessons.) But we’re proud of you also for the amazing person you have become. Sometimes you will make a request when we are planning an event, and it seems kind of outlandish, and then I realize you were worried about including one of your friends who might have been anxious about something we were planning or allergic to a certain type of food. You are always wanting people to feel welcome and included. In some ways, even though you are 13, you are already a mensch.

And then you wound up having this Torah portion where G-d smites people who staged a rebellion against the laws of Judaism. I thought to myself –when I finally had a chance to read the translation—we could use some of that in modern times. If G-d came down and swallowed up in divine flame these religious leaders who use their influence to sew division and gain political power at the expense of others, it would solve a lot of problems. But not you; you struggled with it. Why should we only do things one way? It shows a lot of respect for many types of people. Maybe it’s because you’ve had your own plans for how to approach the world since before you were born—when you decided to be upside down. I love that you have your own way of seeing things. I hope you retain that creativity and empathy as you get older. And I hope you never stop trying to do things in your own unique way. (and I know because I’m married to your father that you probably won’t stop.)

(ROB:) - We also want to thank you for putting up with us as parents. We don’t make things predictable. The parenting advice books all recommend that routines are good for kids. Everyone here knows that don’t really have a typical day in our house—there might be different people dropping by for dinner, one of your parents or the whole family might be heading to the mountain house for a night or three, you might go into a Hebrew lesson thinking one thing, and come out of it hearing we are leaving for the coast in a half hour, go pack an overnight bag.

We moved you to Spain for a year. We learned in Spain and by traveling the world about the importance of Jewish community and what a blessing it is to be able to have a Bar Mitzvah without persecution.

(JEN): You’ve been helping me lead services since you were a baby in my arms. You always had distinct opinions about what songs I should sing and you would run to the front of the room and join in with me, completely unfazed by the rest of the congregation. You were even happy to read Shabbat prayers in Spanish for a year. I’m so glad you are bringing all of this… YOU to living your life proudly as a Jew.

(ROB:) We’re glad you are a part of team Coury - whether we are facing almost-charging elephants in Africa or looking for cats in Fez or getting into a sketchy ‘taxi cab” with Grandma and Grandpa Dugo in Budapest.

We also want to thank everyone who showed up in person and on the Zoom. We know it’s really hard to sit through a service in a language you don’t know, and we appreciate all of you coming and showing up for Nate today.

(JEN:) And we’re glad you can bring the love and confidence in your heart into your Jewish life. Finally, we want to give you one more tool with which to face the world, something you’ve now earned by becoming bar mitzvah. ….

https://dissentpins.com/collections/secret-jewish-space-laser/products/jewish-space-laser

[espanadiarywriter]

📝📣⁉️

Well it’s been a few months since I have felt like writing anything. It’s not you, it’s me. I just read an article in the NY Times about the near-end of pandemic lethargy, and I can totally relate. Except they interviewed a bunch of experts in the field on anxiety, as if that was necessary. You could just talk to anyone (or at least anyone who thought the pandemic was real in the first place). They are all ready to move on and travel and eat out, and mostly still waiting to do so. So close, yet so far. Anyway, I decided I should keep writing—it helps get things out of my head.

What topic do I want to talk to you all about? Emojis. I was inspired by an article I read back in February (see, I told you I was feeling lethargic…). It was titled: “Hey millennials, stop ruining emoji for Gen Z.” (And yes, I know I am not Gen Z.)

This article makes me think of a conversation I once had with my old boss when I was an editor. Anyone who knew Martie knew she was the kind of person who could have an hour long conversation about semi colons. (We both agreed you should only be allowed to use them if you were an English major, but I digress.) She thought emojis were both awful and hilarious. She really couldn’t see why anyone would even need them in the first place. Why use a funny face to replace words, which if wielded properly could describe anything you needed. (By the way, I’m pretty sure at the time of this discussion faces were still a colon followed by a parentheses.) I explained that emojis gave the context for the written sentence. It replaces body language since in-person communication was 50% body language—and we now had many more forms of informal written communication. Being a person who is fairly reliant on sarcasm, I found this useful in emails to Oregonians who might not otherwise recognize the obvious (to others) sarcasm.

But what this article about emojies and two generations of people younger than me made me realized is that while emojis started out giving context to words, now they just have replaced all the words. Which actually does make communication harder rather than easier. We have reverted back to the ancient Egyptians—pictographs meant to vaguely convey what is happening with no subtlety or context. Or perhaps it all subtle—after all what the hell does an eggplant have to with sex? That’s pretty subtle. And it can also lead to a total breakdown of communication, or misinformation. For example, apparently that syringe with blood coming out of it is suppose to symbolize vaccines? Uh, that’s not exactly what it looks like when you get vaccinated—no wonder people are terrified. And yes, I’m glad they are changing it. But why was it even a thing in the first place. Is the word vaccine so hard to write?

And then I started thinking, if we have replaced words with cute little symbols everywhere won’t we start forgetting how to use words at all? And that’s really where I’ve come down on the whole emoji topic. I think they have become just harder to interpret words, which makes our communication more challenging but I fully support using them in addition to words. I mean the meanings of words have always evolved from appropriate to inappropriate and sometimes back again. But outside of language evolving, changing words into symbols naturally makes language less precise not more precise. We have forgotten how to write in a way that has context and meaning. At the risk of sounding old fashioned (implied by the Boomers statement in this article), the skills of writing are even more important in a hyper-polarized world than they were back when people knew how to disagree but still have a conversation. 

Anyway, I expect this is why I don’t use too many emojis and when I do I spend way too much time staring at the list of them in my phone trying to figure out which smiley face exactly conveys the emotion I am trying to insert in my text. And it also explains why you won’t see me use a syringe covered in blood in place of the word “vaccine”. It turns out I sort-of agree with Martie after all; she knew what was coming down the line.

[espanadiarywriter]

Hope is an act of resistance

Well, it’s been quite a week hasn’t it? I feel like that time Rob and I came back from Christmas vacation in Florida and our friends asked us how it was, and we answered “What do you want to hear about first, the robbery or the hurricane?” (Okay, it was actually a tropical storm, but we were in a canoe, so it FELT like a hurricane.)

I’ll admit I’ve been glued to the news. I don’t watch TV news, so I’m definitely doomscrolling. I’m reading not just about the riot at the Capitol but also the vaccine roll-out. I read that as of last Friday, about 30% of the vaccine distributed in January has gotten into people’s arms. I wish that we had a federal roll-out plan so each health care organization did not have to decide how to become efficient at doing this. Every human vaccinated is one step closer to hospitals that are not overwhelmed and a health care system not on the brink of collapse.

I am still unspeakably mad at how people are willfully ignoring the danger of this disease. The fact that the federal government once again completely absolved itself of all responsibility, this time for getting the shots into people’s arms, is absurd. And the refusal of large numbers of front line staff to get the vaccine is also a reflection of the challenged public health response. We had months to plan a media and communications campaign targeting at risk populations with information about vaccine safety and side effects. (And it’s not just countering the C-19 deniers; we know certain messages work well for messaging to populations about preventive health care.)

Instead the massive effort of organizing a mass vaccination was pushed to the very hospitals and state agencies that are running on empty with no reinforcement. So rules vary state by state, hospital by hospital, and county by county. On Wednesday, while the country was in the midst of a violent act of white supremacist terrorism, I received my first dose of COVID-19 vaccine at OHSU. I am incredibly proud to be working for a health care organization that has been vaccinating ~150 people an hour seven days a week (~12,800 as of January 8th ) and is now trying to double that number and rolling out vaccination clinics to high risk groups in the community. I consider myself part of the test run of how fast, safely, and efficiently can OHSU put arms in chairs and deliver doses. And as soon as they have openings for non-medical volunteers to help, I’ll be able to sign up. (Someone needs to sit at a desk and point people to the right line after all.)

Honestly, I thought about not saying anything public about my vaccination—because the media has had a field day with the decisions about vaccine roll-out. But I also am a) not in charge, and b) so proud of the work that has gone into OHSU getting through their front line staff (who are now receiving Dose #2) and figuring out how to ramp up the doses administered daily. They are working with the state to coordinate outreach to essential workers and high risk groups outside the organization. They told me to sign up and help, and I signed up. The people working the clinic were so professional and efficient and giddy about each person getting a dose. Even if news of my vaccination gives one person hope they will get theirs sooner, or one person who is doubtful about safety the confidence to get the jab (as the Brits say), then it’s worth sharing my story. (Yes, my arm still hurts. No I didn’t have any other side effects.) It’s really easy to criticize, but ultimately there should have been a federal mobilization to distribute vaccines and without that, let’s support the organizations who came up with a plan and are executing it. (OHSU has distributed 70% of its vaccines and now has staff ready to outreach to the community and Kaiser has done 24% but with better PR—which is better? I’m not making that call. And it doesn’t matter, both organizations are trying with very limited federal support.)

Which brings me to my next point: the sheer gross incompetence of the executive branch has been staggering.  Something has been haunting me since Wednesday, that there’s a dangerous American notion that someone’s uneducated opinion is equivalent to someone who is an expert. It’s called the Dunning-Kruger effect and it is literally killing America. This is a cognitive paradox where people who have no knowledge of something overestimate their knowledge or ability in an area. So people who do not know a thing about health or immune systems, judge a vaccine to be unsafe because they saw a YouTube video about someone having a side effect. It’s tragic.

Ultimately, this is the heart of what is happening on a political level. The lack of respect for people with actual expertise in government has lead to the shambles of this political administration. And now even the incompetent people are leaving. Not to digress too much, but what kind of a statement are you really making if after months of blatant election falsehoods it takes a literal armed rebellion to make you leave Trump’s cabinet? You aren’t winning any awards, sorry. What did you think he meant when for weeks he was telling his armed supporters to descend on Washington? He has been stoking white supremacy since before he won the presidency. (I hope people who weren’t Jewish noticed all the Holocaust references on the t-shirts of America’s dumbest insurgents.) But I digress.

Hatred and fear are the product of years of sowing doubt about science, expertise, and good governance. If people doubt the real facts, then you can make up whatever facts suit your political position. The political situation at the federal and state levels in this country are in dire need of repair. But I’m going to circle back to the hope that I started this blog post with. The people in the room giving vaccines were all volunteers, and they and hundreds others are going to volunteer to distribute them to as many people as possible for as long as it takes. Is it going to be perfect? No. But it’s going to get done even with an uneven start. And let’s not lose sight of the fact that hundreds of other volunteers got out the vote in Georgia and took back their franchise that was being forcibly suppressed. One person can make a difference—each volunteer matters. Maybe you are like me, paralyzed by doomscrolling. But I’ve made a commitment to help support vaccine distribution in whatever way I can, and I’m grasping to the hope that change will come. Maybe it will come in fits and starts, but I can see it on the horizon.

[espanadiarywriter]

Breathing

Some years ago, I took a personal development class that had an exercise something like a vision quest. It was a very spiritual breathing exercise. During this exercise, you breathe for a long time in a certain pattern, and during this time I had a vivid recollection of a past memory. I’m going to share what felt like a profound realization, and trust me I have a point to all this.

My memory was of giving birth. I had a C-section and the anesthesia they give makes you feel like you can’t breathe. All the time the nurse assures you that you have enough oxygen, but you really do not believe her because you feel like you cannot get enough air in. During this breathing exercise, I was brought right back to that feeling of not being able to breathe, and then I felt like I had been hit by a truck. I realized that the moment I was giving birth, my own breathe was taken away. Think about that. At the moment another human comes into this world, the air was taken away from me.

Building on this moment, I was able to see that it became a pattern. I was always thinking first of the kid’s needs and then my own. I still figure out what he’s going to eat and then only realize I am hungry when I have physically driven away from the house. Even after this realization, I have had to actively work to overcome this instinct to completely ignore my own breath. All the time I have to focus to draw a line between the angst of those close to me and my own emotions. I do not have to absorb their angst. I can radiate my own calm internally. But I still feel better when I have a physical break from those who need me most.

So flip to today, when of course there is no leaving the house. I am constantly in the orbit of two extroverts, which leaves very little time to breathe. And my job is also mostly external facing, and I find Zoom meetings even more draining than in-person meetings. So after my work day, I want to unplug and do nothing productive. I can’t successfully read a book because I’m constantly interrupted. And I don’t like getting pulled out of a plot line and trying to read again. So the small amount of down time I have I spend on social media or I’ve taken up playing a mindless word puzzle game to keep me from obsessively reading the news.

Now I’m starting to look for ways to be able to breathe again. I put on a meditation with breathing exercises almost every night. I imagine that just about everyone feels a little more needy these days. The trick is to keep focused on gratitude for the things in your life. I feel lucky that we’ve had some scares, but they could have gone much worse. I’m not in the orbit with people who think coronavirus is a hoax. I feel grateful for my job, which is focused on helping people even though it is significantly harder to do amidst a pandemic. And my kid, who has risen to the challenge of remote school in a glorious way. And my husband, who keeps the household chugging along when I can barely move some days. I feel incredibly grateful that we have a bubble of friends to interact with who also treat the virus with respect. And outside places to go. We really have the outside entertaining down now. And ultimately, I’m glad that I know this about myself—that if I’m not careful I will forget to breathe. At least there is irony to appreciate: this disease spread by breathing makes it so you can’t breathe, on many levels.

So I’m few days late for Thanksgiving, because on Thanksgiving I was busy eating pie. But I wanted to send everyone positive vibes for making it through the winter, when it will be harder to be outside and more Zooms will be in our future. Remember to breathe (but not around other people).

[espanadiarywriter]

So. Much. Rage.

I have so much to say and so little time to say it.. For weeks I was honestly too despondent to write a blog post. I thought about it, but just couldn’t muster the energy. (Part of it is that I am still getting non-effective treatment for my back and hip pain that seems to make things worse. But that’s really another story.) Good news though: I’m angry enough to write again.

So what’s happening? In the last week, I’ve flown from a city where people are wearing masks and doing a wide swoop whenever they accidentally come close to a stranger, to a place where apparently COVID doesn’t exist. (Yes, Florida—the land of meth gators and Covid.) Because the governor said it was fine, people congregate inside restaurants as if nothing is wrong. People actively carry masks (but don’t wear them) waiting to be the next “Karen” that someone picks a fight with asking them to be a responsible adult.

Again, I ask, why was this politically beneficial? Why did one political party choose to shun public safety measures that are cheap and easy to implement—they just require people buying into the science of contagion. This willful ignorance just prolongs the economic pain as things get shut down repeatedly. It swamps the already over-burdened, poorly organized health care system in the country. And those of us who are being responsible are like the kids in the class who miss recess because the rest of the kids keep talking. (I get that it was a calculated risk to fly, but we did so following all the precautions we could take. In fact, the doctors we spoke to said we were going above the recommendations to be safe.)

It makes me so mad. Really, this is all because GOP Governors and Congress have to support a narcissistic President who doesn’t want to be told he did a horrific job? I want to move to 7 states simultaneously and vote against their Senators. Could the Democrats do a better job explaining what people should do? When Kamala Harris was asked what is their coronavirus plan, she barely mentioned expanding testing, contact tracing, and getting PPE to health care workers. How about a massive, overwhelming public health education campaign, including messaging from Community Health Workers and other TRUSTED voices in the community that masks are necessary? If no one understands why masks would help, or why and how to social distance, you cannot expect people to change. It took us years to reduce smoking rates, or wear seatbelts, or stop drunk driving. It took a combination of laws and consistent messaging. We need to save people’s lives! (I’m so angry I used an exclamation point. Look what you made me do.)

Which brings me to my next point of rage: the futility of political polarization. Even things that make sense for both parties have been turned partisan (like vote by mail). In Oregon, we have had vote-by-mail for about 20 years and BOTH parties support it. How is this even a thing, the 10-hour long lines to vote? And the gerrymandering, and the “poll watchers” to intimidate voters. We are like a banana republic led by an orange. I made the mistake of watching a little of the banana republic justice confirmation hearings. Senators are just talking, because they know the outcome before the hearing started. (The people thinking there is a chance the outcome will change are cute. Power does everything in its ability to retain power.) Our only hope was that five of the Covid-loving Senators got sick and the hearings were called off. But that didn’t happen.

I need to step back from reading about election coverage, but it’s just so tempting. At the risk of getting ahead of myself, the Democrats are going to have a long road ahead to repair the damage of the past 4 years. And if they don’t win the Senate, Mitch is going to allow exactly nothing to happen. There is so much beyond the two issues of taxes and abortion on the ballot this year. I’m not even talking about specific legislation, but the excessive tribalism. Let’s say you do accomplish all the fantasy items on the progressive wish-list (Puerto Rico statehood, add court seats, abolish the electoral college). Then what? How do you get people fundamentally opposed to changing their way of life, willing to change?

You can’t. You need to stop the ecosystem of fear—the Fox news media cycle feeding frenzy. Our government needs to stop being a night time soap-opera. It occurred to me the other day that I have been overthinking this. Conservatives simply do not want change, of any kind. That’s it. They picture themselves back on the homestead, killing anyone in their way and pulling themselves up by their bootstraps. It’s a myth of course. (I don’t want to digress, but how perfect is it that rally goers were left out in the Omaha cold and had to walk back to their cars. Freedom and independence! You don’t need those socialist busses.) But the myth of American individual freedom is so strong that people won’t wear a tiny piece of cloth on their face. So I think the new Democratic platform should just be, “Hey, you do you, and we will be over here moving the country forward without affecting your way of life. Enjoy the backwater.”

We are now home from the land of humidity and Covid (and family, of course—that’s why we went). Hopefully we did not expose ourselves or others to the virus on our trip. And there’s less than a week left until the big day. I’ve written postcards, donated money, and voted already. Now we wait. Good luck everyone!

[espanadiarywriter]

The sky is falling

I’ve had one glass of wine and the sky is orange, so I thought it was a good time to write a blog. In western Oregon, by September it is typically cooler and starting to feel like the rain is coming soon. Often I’m already in hoodies and jeans by now. But not this year. It’s September and we are in the middle of a week of crazy hot weather.

Last weekend, I dropped a crew off to float the irrigation canal that runs next to the mountain house. Remarkably, we’ve never done that before—although we have had renters talk about it in the guest book. It takes about an hour and a half of sitting in an uncomfortable tube and involves cold water, so I’m out. But I had a blissfully quiet house for an hour.

We have survived the first few days of “soft start” virtual school, which was really all orientation and figuring out which platform to go to for which teacher (i.e., Zoom or Google or Canvas). Who knew schooling would evolve into a frantic search for the right link to get to class. And just when he had figured out how to get through the halls to class on time. But it’s good that they don’t have real content in class yet, until the kids know how to log in to each platform consistently. And I’m pretty proud that I have stopped calling it “fake school”. Let’s give us a fighting chance to learn something this year.

Still I spent an hour yesterday on tech support in between work Skype and Zoom calls. We couldn’t figure out how to turn in an assignment because the “Submit’ button did not work. My real problem is that they keep scheduling the library book drop off for days when I have back-to-back meetings. Can’t they just put out a drop box like at the public library?

It’s still amazing to me that it has come to this. All because of the America myth of ‘individualism’ and that’s why people can’t wear masks? Because politicians cannot get elected on platforms and have to use fear and conflict? Because Americans think they are invincible? None of it makes sense. (I mean, it’s predictable, but doesn’t make sense.) Especially that people are not holding their leadership accountable for so many people dying. I don’t know about other people, but I will occasionally get this shattered feeling when I see something mundane that is now empty or closed, or when I see people on the street in masks because it’s the new normal.

I feel like everyone has a slightly different definition of how they are being “COVID careful”. Some people are flying again. Some people won’t get on a plane for another year. Some people won’t even leave their house. Others are seeing people outside only, or inside with masks, or after a test. Others are just avoiding crowded places or public places entirely but seeing friends in small groups. And of course there is the whole segment of the population who doesn’t even believe they can catch it and is completely acting like everything is normal. Preventive health care is difficult even when there is consistent messaging. It’s impossible when no one in leadership cares or is trying to fight a disease.

But here in Oregon we have even bigger problems this week than fake, I mean virtual, school and a raging pandemic. We have fires. BIG fires. They announced on the news there was going to be a “wind event”. What a strange way of warning people of the apocalypse hell scape that is our air right now. What does that even mean? “wind event” (Sing it with me: who’s tripping down the streets of the city? Smiling at everybody she sees. It’s windy.) Not exactly terrifying. But the crazy firestorm that is Oregon this week, that’s terrifying. It’s really hard to explain how orange and yellow it is outside. Like everything is bathed in an eerie Mars light. And I spent way too long trying to load interactive forest maps to see if my co-workers might be losing their houses as we speak. (They are evacuated or on standby.)

Part of the issue is the wind is blowing backwards from the direction it typically blows. (It is #2020 after all.) See, normally, the Jet stream brings weather from the ocean inland and the wind blows east. But this week, the wind is blowing with gusts up to 75 miles per hour, east to WEST. Guess where most of the houses are in Oregon? WEST. I just read that in Oregon and Washington 515,000 acres burned in 24 hours. How is that even a thing that can happen?

So we have bigger problems than the Submit button on the homework assignment. I’m frantically worried about people’s houses, the critters wild and domesticated, and not to mention widespread power outages on the first or second week of school for large portions of the state. (Several of our teachers had to go to the near-empty school to have internet access and power today.)

Praying the wind dies down and the sky is blue instead of yellow tomorrow because that will mean people’s houses are safe. But I’m posting this blog as a dispatch from the surface of Mars, because that’s how it feels tonight.

[espanadiarywriter]

Jersey Girl

Well, my birthday week is not exactly how I had envisioned it last fall when I expected friends to be flying in for a big party. But beyond the pandemic uncertainty, I’m also struggling with my pain lately. I suppose I am really turning 50 because the one thing I treated myself to for my birthday was a chiropractic visit and massage. I guess I’m not going into my 50s the way I expected, physically at least.

I have made the decision to not return to the PT guy I’ve been seeing since May. It is clear he is just trying the same thing over and over and has no concept of what a complex pain syndrome looks like. When I said if I need more sessions, the doctor said he would order them, he asked “what do you think more sessions would do?” As in, “I’ve already told you that you need to strengthen your core, so what more can I do? My hands are tied.” He’s right. He can’t do anything more for me.

Last Saturday my whole right side felt strained from the exercise we did because he “likes to show patients their deficiencies so they know what they are working to improve”. As if I don’t already wake up every morning feeling my deficiency by being in pain. I have an appointment with a new naturopathic doctor who comes recommended, but it is pretty clear to me that doctors don’t hold any answers for me. The Spanish health care system did not have any magic solutions. So I have decided not to keep wasting my time. I’ll find my own path. I know my own health better than anyone else at this point.

So I’m a bit run down, and I’m barely coping with the state of the country (like Kanye is really running for president?) like a lot of other people out there. And for sure I could be doing more to help if I only had an ounce of energy left at the end of the day. I used to joke that my husband was a curmudgeon before his time. And yet here I am getting annoyed that my son uses ‘lol” in sentences and that people use the expression ‘it’s been a minute” to mean it’s been too long since they did something. Even so, I do feel incredibly lucky. I have a great house (or two) to be trapped in, a smart and loving kid, a wonderful hubby who picks up where I can’t manage, awesome friends scattered throughout the country, and a rewarding job. Not too shabby. I even got myself some outdoor glass art and two new clematis for my birthday gift!

For my big birthday I am doing SOMETHING—which during a pandemic seems like a big deal. (At least for those of us who believe in science.) I looked at my playlist, the one I made for my pandemic-sized party, with the only rule being it was a song I liked that was fun and I didn’t care if other people thought it was cool or whatever. I found three predominant themes: love, independent women, and dance dance. Those aren’t such bad things to launch myself into “old age” with! (BTW, it helps that I have friends older than me, so I don’t really feel like 50 is so old.)

So here’s to crumbling bodies (accept them as they may be), lofty goals (the 20-year-old idealist will break free, just after this nap), and amazing friends and family that define and shape my life.  Here’s a playlist to enjoy—raise a glass with me to persistence, better health, and more sanity in this world.

https://open.spotify.com/playlist/2S6DG749tRyRjylHy0fJof?si=Q4S5Sa8qQA2hMsccatNsDw 

[espanadiarywriter]

The blessing of separation

It has been a long. long time since my last blog post. I had the following blog all teed up and just about ready to launch and then just everything went haywire. I was nearing the end of my huge work deadlines, (which were brutal but successfully completed) and then we got some sad news about an unexpected death, and everything went sideways. And then Covid cases went up again, and even the summer plans we were considering as safe were canceled too.

So now with a few weeks of distance, I can think about this again. I still think it mostly resonates, but have added a new ending...

Havdalah means separation. It is a short ceremony that marks the end of Shabbat (the sabbath) on Saturday night. We sing a sweet tune and then blessings recognizing the end of the sweetness of Shabbat and the beginning of return to the work week. It’s one of my favorite set of blessings even though our family almost never sings them at home. I only wind up doing them when we are at an event on a Saturday night. The tune is wistful, joyful, contented yet somewhat sad that the pause is over.

Shabbat is a time to pause from the week. Now more than ever the idea of separation is speaking to me—separation from the work week to have time with family. I am crazy busy right now at what is supposed to be a part time job. So I consciously took the weekend off. We attended two Bar Mitzvahs Saturday. One by zoom and one by socially distant outdoors with seating in the woods. And that’s where I got to sing the havdalah prayers together. Sunday was Father’s Day, and Rob has been carrying the weight of parenting for the last month. So I took time off.

But also I’m thinking about the separation of political and national events from my inner psyche. Without some separation from what is happening “out there” I can’t function. I’m not talking about the “I don’t do politics” type of statement. I mean the idea of “Put your own oxygen mask on first before helping others.” I am an empathetic person. I manage it pretty well with sarcasm and humor, but I internalize other people’s pain. If I don’t put some separation between me and the world, it can seriously bring me down so I don’t want to get out of bed. I had a few mornings in March and April where I had to pump myself up just to start my day. And it happens to me when the big tsunamis wipe out whole cities, racially motivated killings, Israel flare ups, you name it. So I have gotten better at building a space for me to feel joy with my friends and family. 

Week ago now, I got to sit in a group and sing, praying in a forest, after so many months of isolation. Everyone was in masks, and separate from each other physically, but not spiritually. I actually think my favorite Hebrew services have all been in forests: Jewish youth group trips growing up, once as an adult in California, and summer camps. Nothing like being in nature to remind you that we are part of something much larger.

Tragedy, whether on a national scale, city-wide scale, or personal scale can make it even more urgent to remember to take a moment out of your days to focus within. Especially for those of us with acute senses of empathy, we need to make sure things do not drag us under. Finding what brings you light in times of darkness is key. In my world, I know that I am at my darkest when I cannot find gratitude. So I start small. Grateful for the cats, a roof over my head, love in my life, and I try to spread the gratitude from there. Yes, things are really rough right now, and there’s always moments of joy and friendship still. And for that I am grateful. My challenge for you is to create your separation and find your gratitude.

[espanadiarywriter]

White History Month

Maybe I should stop thinking of myself as “white”. Because by being “white” or more precisely by thinking of myself as white, I am buying into the entire system. The entire system built on the backs of owned humans who were oppressively horribly cruelly punished for being humans who were wanted for labor. And if that’s where this American concept of race came from, then how do I deal with thinking of myself as “white”? Especially when I know that all humans are 99.9% genetically the same as everyone else. And that includes Trump supporters. Yes you are 99.9% genetically the same as a Trump supporter. Sorry. Deal with it.

But I don’t mean to imply that crazy argument “I don’t see color,” which of course is bogus and just a way that people negate that racial problems are rampant in this country. If you don’t see race then you imply you are blameless. It means you also do not see how many black people are systematically killed in this country. (I must have done a good job creating a social media bubble because no one in my life says this to me.) So I can’t just think myself out of this—I have an identity and I need to use it for good regardless of the history.

Also, I have never liked the term “privileged.” Again, not because I can’t see there’s privilege to do things safely with certain skin colors. My argument was always that I felt like it didn’t help the conversation. You have to understand I’m always about “what’s the next step?” In this case, what gets to a productive conversation about race? I never stop in the moment. Life is a constant exercise of stop, look, choose. First,  stop moving forward. Then look and see what is happening. Then choose your path. I choose my path without taking time to look. Always. Or rather it’s always my tendency that I have to fight against. Sometimes I don’t even stop. I just choose before something has even happened. I anticipate what will happen and choose my action. I’m rambling on about this because that’s how I chose to dislike the term “privilege”. I’m not thinking “is it true?” (that’s look). I know it’s true. White people have privilege. Instead, I’m already worried about how it will convince or not convince people to see their circumstances. And I already anticipate it makes people defensive. (You know the whole concept of white fragility, right?)

So I’m going to take a step back and look at this idea of privilege. Even a poor white person in America has privileges that every black person does not have. It doesn’t mean we are all richer, or more successful. It means we can walk down the street without getting shot. Now again, I still don’t like the word privilege because quite frankly that should be a right. (Or maybe it’s just that I’m an editor and I didn’t choose the word. Really. That probably explains everything.)

So this podcast I’m listening to does a great job of showing that this exact concept was very, very carefully constructed between 1680-1780 in slave holding US states. And then refined over and over again since then through US history. The rich landholders cultivated the idea that all “white” people had rights as citizens that black people did not have. They had privileges. The rich founders of America actually cultivated the notion of race. Sure, slavery was technically invented earlier and elsewhere, but here it blossomed and race became weaponized. Many of these people were America’s founding fathers and baked the ideas right into the Constitution and laws.

When people look at poor rural voters across the country and ask, “why are people voting against their own interests?” Here is your answer. Rich landowners in the 1600s and 1700s needed a coalition of a newly invented concept of white people that included poor farmers and day laborers in the same category as rich landowners. So that those poor “whites” would have allegiance to the rich people instead of people in their own situation. The rich were facing the real threat of a multiracial uprising of labor. So to retain power, they made up “whiteness”. And it is rooted not just in history, but in the very core founding principles of our country. Power and labor needs. Same story in 2020. Simple as that. Jefferson owned 130 humans when he wrote that “All men are created equal.” News flash: He did not mean all men. Another explanation is that maybe he just didn’t think of black people as men. By the time the Declaration of Independence was written, black men (and women) were already being carefully constructed as sub-human so people could better exploit them. Otherwise how do you keep the poor white working class on your side? Quite a dilemma for the founding fathers.

So here’s the idea that has my head nailed to the floor: if the very notion of whiteness is rooted in a history of oppression, can I even think of myself AS white without being complicit? I don’t have an answer. Just because a concept is constructed doesn’t it make it have less real social (and obviously life threatening) consequences. So then the question becomes HOW do I think of myself as white without being complicit?

Again, I have no answer. But here’s another idea that blew my mind. The Racial Equity Institute gave a lecture on whiteness and race, and they said: Racism doesn’t cause oppression. Oppression leads to racism. People see others in an oppressed situation and make up stories for why it is that way. Those people have no freedom and are forced into labor, they must be inferior. And then the notion of inferior races is born and reinforced and embellished and strangles more people (again, literally). Vicious cycle. This question feels more approachable because there are ways to fight oppression: Criminal justice reform, voting for candidates with progressive ideas, and winning back the courts with progressives.

How did we let the courts get so bad?  Wait, I just answered that question. Our legal system has always been systematically unequal. The courts, the voting structures, policing systems have always been set up to protect Americans who look a certain way (and even more so if you have money too). I mean Portland is this liberal hippie town with a horrendous history of redlining, racism, oppression, and terrible policing. To change these things you have to envision an America that has never existed before. Because (to bring it full circle) America was actually founded on an artificial construct of race. The very notion of citizenship in the 1700s was designed to build the idea of “white” people having privilege.

To think about an America that has never been, I’m going to rely on people who have more vision than me. Right now, I’m going to stop and look around. Then I will choose the path—supporting the things I mentioned above, led by people of color who know better than I do what needs to change. Unfamiliar territory for me for sure. Good luck on all your own journeys too.

For listening about race, I highly recommend at the least the first four episodes of sceneonradio.org Seeing White. They will nail your head into the floor--but in a good way.

[espanadiarywriter]

The great, unstoppable, heroic American individual. Or not.

I’m going to try to explain why I’m not a horrible person even though I don’t like the 7:00 pm clapping every night for health care workers. It’s not because I think health care workers do not deserve our admiration and are not going through hell in many parts of the country. (Or maybe in all parts of the country because even in the areas not yet hit by a COVID surge, health care delivery is being completely upended.) And I do love the community aspect of coming together with neighbors from a safe distance to cheer something important. So why has the 7:00pm clapping been bothering me? I was really trying to figure it out for a while and then it hit me.

It gives me a sense of powerlessness and futility. The American health care system is arguably one of, if not the, most broken, inefficient, and unequal health care systems among modern, industrialized (wealthy) nations. And coronavirus exposed the rampant disparities and profit-focused, everyone-for-themselves system for what it was. And what are we doing about it? Clapping into the wind, on our front porches, from balconies. This is our answer? Once again, we are asking for individual heroics to solve a systemic problem.  

Health care workers are always one of the most at-risk during a pandemic—in the SARS outbreak, for example, one-fifth of the victims worldwide were health care workers. We should have a system that gets them protective gear. Always. We should have a system that tracked and took seriously the pandemic when there were intelligence briefings about it at high levels in January. We should have health care coverage not based solely on employment and where you live (because only some States considered it important to expand health care access).

Quite frankly, it pisses me off. I don’t want to applaud individuals on the front lines because I don’t want to JUST applaud individuals on front lines. I want to make it so the front lines are safer. I want to acknowledge that a nurse working 12-hour shifts is limited in what she or he can do (and even limited in whether she can speak up when she has inadequate PPE or sees safety risks). She or he shouldn’t have to be heroic to do their day job.

We shouldn’t have African Americans and Navaho nations succumbing to a disease at X times the rates of White Americans because they have been systematically denied quality health care for their whole lives, and for generations before today. Hell, I’ve read articles about even at a hospital level, some hospitals have huge high-profile donations in Manhattan, while others in the Bronx are barely gasping for air. Your hospital shouldn’t need a celebrity PPE drive to be able to protect your employees.

Arguably nurses and doctors and medical staff in ICUs, hospitals, care facilities are heroic every day because they have been on the front lines of this broken, inadequate system their whole careers. Nurses and doctors deserve more than clapping into thin air. They deserve action, policies, and justice.

Besides the intractable complicated systemic challenges, everyone one of us can practice personal responsibility. Our front line workers deserve Americans being responsible for other people’s health instead of only caring about their own damn selves. This myth of individual freedom being greater than all communal good is FATAL. Last week, there were Covid-parties to spread the disease among young people. I’m going to say that again. Authorities in Washington State broke up a party specifically held to expose people to someone with Covid. Those people hadn’t even considered passing the disease along to someone more vulnerable—they just wanted immunity for themselves. What rock are you living under? WHY do you think governments across the world are tanking the economy? For fun? NEWS FLASH: It’s to save the lives of the most vulnerable among us in society.

So yeah, I guess I don’t really feel like clapping these days. Even for the heroes. Health care workers still serve people who might vote against better health care, stand in grocery stores without a mask because it’s too inconvenient to wear one, or have a Covid party. Those health care providers are still going to treat you when you come in and need a ventilator. Because maybe you were one of the people who lives in a food desert and must travel far to get healthy food. Or can barely make rent and has to keep stocking grocery shelves. I do not want to imply that everyone who gets sick is irresponsible! That feeds the exact same self-defeating myth of the great, AMERICAN INDIVIDUAL who can surpass all the inequitable systems, systematic racism, and structural problems.

To tell you the truth, I don’t know why all these pandemic problems aren’t solved yet. I have clearly solved them during all my thinking between 3 and 5 am every night. Also, I have devised a way to keep all the puzzle pieces on the too-small puzzle table and remembered I need to clip the cat’s claws. I am very productive in the middle of the night these days. But I digress. One of the reasons we returned from Spain was to make a difference here rather than avoiding the US (and also because our kid was sad, but that’s not relevant to this blog).

So, what to do? Here are 7 things to DO after you clap. If you want to suggest other great organizations working on these issues, please put them in my Tumblr or Facebook comments. Or DM them to me. 

1. Tell congress to increase protective equipment for nurses, now. According to the American Nurses Association, some nurses are being forced to reuse masks or other PPE in their facilities – creating unsafe conditions for both nurses and their patients. Call or write your Representatives and Senators and demand they #ProtectNurses.

2. Feed the nurses! Call a local nurses unit to arrange for a take-out delivery. This will require research and coordination—be sure to work directly with a medical office or nursing unit manager to arrange this. Or if you are in an area that is not hit very hard, check out this organization that is feeding nurses in New York City: https://www.feedthefrontlinesnyc.org/ or Google other organizations across the country doing this.

3. Feed other vulnerable communities. You can help #chefsforamerica safely distribute individual packaged meals to vulnerable communities affected by the Covid-19 shut down. The World Central Kitchen is providing needed work for restaurants while feeding people in need across the United States: https://wck.org/chefsforamerica

4. Tell the health care systems, hospitals, organizations and nursing homes in your area that you care about the safety of medical workers and patient caregivers. Send one of the following articles to your local large health care systems with a letter that you care about them helping their employees. They even argue my point “Organizations need not and should not outsource gratitude entirely to the public. This process starts with leadership”: 1. https://www.ama-assn.org/delivering-care/public-health/caring-our-caregivers-during-covid-19 2. https://www.contagionlive.com/news/how-organizations-can-support-health-care-workers-during-coronavirus

5. Make sure your local police responses to social distancing laws and opening the States are EQUITABLE. See this NY Times article about the NYC enforcement for example: Scrutiny of Social-Distance Policing as 35 of 40 Arrested Are Black   Hold your local police office accountable.

6. Volunteer with a Get out the Vote campaign for the national elections. This can be a small amount of your time. If you are an extrovert, volunteer to text or call people to remind them to vote. If you are in introvert (like me) find a post card or letter writing campaign (https://www.mobilize.us/swingleft/ or https://postcardstovoters.org/volunteer/) . Or look at the list of candidates in  Flippable and donate to some key races for Senate. Even small amounts make a difference.

7. Check in with your friends. Especially your friends who are teaching, or have small children, or anxious kids, or are older and isolated. Ask if they need a delivery of food, help with childcare (if you are able and they are comfortable), a coffee break shared from 6-feet away. We need these things too.

[espanadiarywriter]

YOU are definitely doing the pandemic wrong

I just want everyone to know they are definitely doing the pandemic wrong. You are clearly not staying 6 feet apart, and even if you were, you need more than 6 feet if you are jogging or if the wind is blowing SE at 10mph. You are wearing your mask too often and not often enough. In fact, you shouldn’t even need a mask if you are only staying inside. Also, you should be supporting small business by getting take out and groceries and doing home projects.

I want to point out that this is a great time to get all those projects done around the house. Our projects are working from home while supporting our son during a chaotic roll-out of homeschooling by overwhelmed teachers who also in many cases have kids at home to support. We have other home projects like not going insane and contemplating which of the many summer plans we will need to cancel.

On a related note, I can’t believe the teachers are not instantly great at transferring all their curriculum to online with extended support for learners who need individualized help. What slackers! Didn’t they see the video of that one math teacher who drove to a kid’s house to work through a math problem on a white board outside her front door? But don’t worry, it’s really not a big deal for kids to miss school. They can learn so many life skills around the house like cleaning the bathroom, which totally doesn’t require an extra hour to do it with a child than by yourself, or baking, which totally isn’t three times messier and more stressful than doing it by yourself. Or changing the tires on a car, which is much more interesting and calming when a 12 year old stands next to you asking when you will done every 5 minutes. What is important is that we should use this time to teach the kids LIFE SKILLS. Remember, we should all be kind to ourselves and practice self care by entertaining our kids 24x7 with fulfilling tasks (while working). Also, I want to point out that people who have jobs that involve leaving the house (like grocery store and health care workers) should not worry about their kids being home instead of in school. There are all these great home-schooling online resources out there! You can just put your kid online in front of BrainPOP or Khan Academy and they will sit by themselves for 8 hours while you go to your job. What a great chance for them to be self-directed and learn how to be bored.

Enough about being at home with kids—what about the rest of you? You aren’t being social enough. You clearly need more Zoom happy hours and dinner parties to have proper mental health. Remember this is physical distancing not social distancing. It doesn’t matter if you are filled with existential dread over the number of people dying alone or what will happen when the economy collapses in this country and with it our democratic governmental structures. Those extroverts need cheering up because they are cooped up inside their houses!

Remember to order groceries instead of entering the death traps, I mean grocery stores. But leave all packages and mail you receive for 24 hours, 3 days, or 5 days before opening them. And only open them after disinfecting them while wearing gloves. And don’t waste the gloves that the medical professionals need by using them on things in your house like groceries. But also go in person to the grocery stores because the warehouse people at UPS, USPS and Amazon might be spreading the coronavirus which could live on packages for 24 or 36 or 72 hours or five weeks. And you don’t know who picked up your produce and put it in a bag, so best to go to the stores in person. Remember the stores are least crowded first thing in the morning, or in the middle of the day, or just before they close. Thanks for listening. It’s very important that every single person do things RIGHT or we will all die.

If I may be serious for a minute, PLEASE remember that your experience is not the same as everyone else’s experience. Unless you are talking about a religious leader who is still holding a 100-person gathering, please do not tell other people they are doing things wrong. If someone is making lifestyle changes in good faith and muddling their way through this pandemic, just say thank you or hang in there. Our family is incredibly fortunate to have enough devices for work and school, and to have jobs that can be done remotely, and this is still incredibly challenging for us. The internet (and especially Facebook & NextDoor) is filled with people complaining about how others are managing things. These comments all stem from one thing: lack of empathy. Sit back, and think about how other people are experiencing things. Take a minute to learn about the situation from which someone is speaking. You might even expand your world view in the process. And when this pandemic is over, remember that these same  principles apply to the rest of political and social discourse. So THANK YOU everyone and HANG IN THERE!

[espanadiarywriter]

Lady Bugs

It’s the time of year at the mountain house where lady bugs just show up en masse in our bathroom. I can’t figure out if they are hibernating inside during winter or hatching in spring. Anyway, every morning we need to do a release and save the lady bugs before I shower or it is mass casualties. Somehow this feels appropriate—even the lady bugs need social distance to survive.

We are spending the weekend at the mountain, which is still away from people but somehow feels like we are doing something. It’s a more beautiful spot to sit around and do nothing. Also there are more projects to keep my extrovert husband busy. Plus this house has a puzzle table (although we just set one up in Portland too). That’s been most of my activity so far last weekend and this weekend. It’s very soothing using logic to fit pieces into place.

On weekdays, I’m working from home and trying to keep my son busy at the same time with mixed success. My son was quietly reading but my husband used the belt sander while I was on a business call. Also during my morning calls, the smoke detectors decided to start beeping every 30 seconds, so I had to time my replies carefully. (I must have seemed more quiet the usual...) All these things are minor problems comparatively speaking of course. I work in healthcare, so everything is upended in my job, but I’m not in direct patient care so not on the front lines. I am however, reading about the frontlines and it terrifies me.

Let me say that as someone who has worked in public health research and preventive care for 20 years, none of what is happening right now is surprising. The way to beat Covid-19 is to test people as soon as they have symptoms and even before they have symptoms. If you isolate cases and quarantine them, you stem the tide of new cases. Even now, with everything we know and months into this situation, we can only test cases being hospitalized or with symptoms. It really reflects the American attitude towards health care in general. Our entire healthcare system is structured to treat people after they have symptoms.

Let me give an example that might put this in perspective. One reason people give for not getting cancer screening is that they don’t want to know they have cancer. Even though if you catch certain types of cancer before you have symptoms, you have a better chance at survival and treatment. Just getting people to shift to prevention is something we are only having mixed success with, regardless of costs.

The US didn’t ramp up testing preparation or stockpile hospital supplies because we assumed it would not spread here. Like the US had some magic talisman to protect us. And then we didn’t accept the tests that already existed in other countries. It was just business as usual at the leadership level. So we lost a critical month (or more) where we could have been testing people in the community to see how widespread the virus already was in the US. But instead all our efforts went to response of the currently ill (overseas) instead of prevention at home.

And then the communications around who should stay home, or not, was so bad. Even as late as mid-March, when it was clear coronavirus was already in circulation in the US population, doctor’s offices were still asking ‘Do you have a fever or cough?’ and ‘Have you traveled to Europe or China?’ – which of course is a meaningless way to stop the spread of something clearly already INSIDE the US and being spread by asymptomatic people. What they needed to start saying is something like: Think of yourself as a ticking time bomb because asymptomatic people can spread the coronavirus and then it will explode in someone who is susceptible. See how much more effective that is? Instead we got messages like, ‘are you elderly’ and ‘wash your hands’. Sigh. News flash: people over 55 don’t think of themselves as “elderly”. The level of incompetence hurts my head to think about.

So instead of reading the news, I am working on a puzzle and freeing lady bugs. Probably because I don’t really enjoy baking, and that seems to be what everyone else is doing to calm their nerves. The next few weeks will bring the worst increases in terms of number of cases. But I’m going to keep arguing that number of cases is meaningless because we should be testing everyone possible so we know who has the virus, and we can stop it. You cannot stop what you don’t know about or how is it spreading. So say it with me, more testing. Stay healthy folks, and give yourselves some kindness.

[espanadiarywriter]

Coronavirus Update

No I’m not going to post a video of handwashing or a map of where the virus is spreading. I just felt like I should get on the bandwagon seeing as every single notification I get from organizations these days is titled “Coronavirus update”. On a related note, am I the only person walking around with the tune “The World Turned Upside Down” from Hamilton running on loop in their heads?

We canceled our March trip to Spain (we had canceled the Italy part earlier), either because we are ridiculous or because the world is ridiculous right now. It’s kind of hard to tell which. I mean, the virus is already in both Washington and Oregon states, so how could flying to Spain matter? But governments are shutting borders and I don’t want to get caught in the middle. Instead, we are heading back to Florida, the land of large manicured gates (see prior post). But this time fortunately I will not have to be in a hospital or Walgreens every day. (I will stop in to visit Walgreens once to say hi to my peeps there.)

I find it ironic that I left off my last blog post thinking all about connection. And now there’s COVID 19 circulating with advisors warning against connection. They are telling elderly people to skip religious services and gatherings, and to think twice about every group setting. We are encouraging people to get behind a screen (laptop or phone) to communicate with each other, which is never the same as in-person connection. But there you are; the virus forced our hand.

On the flip side, now that we canceled our two-week trip, we can go to a bunch of gatherings we were missing (more irony). I have been thinking two contradictory thoughts lately: 1) I really want to connect with people I haven’t seen in a while and its good to make time for coffees and lunches with friends. 2) I really want to keep my focus on making time for myself (including writing this blog) even though I am no longer on sabbatical. So here I am, writing and scheduling coffees in between working and taking care of the kid. I actually think it is going well and now that my main scientific paper is out the door I will have more time for my blog. If only I could travel to Europe again. So instead of pictures of falleras, look forward to another installment of Jen in Florida coming soon. And stay isolated with a stockpile of toilet paper, or to stay connected—your choice, just wash your hands!

[espanadiarywriter]

Gates

I’ve been driving around South Florida for 6 days. I think in terms of opposites south Florida and Portland Oregon come pretty close to complete opposite. It’s more than just the weather, sun vs. rain. But in Oregon, even when it’s raining you go outside. Here even though it’s beautiful in south Florida, everything was inside—like people go from air conditioned houses to air conditioned cars to air conditioned office buildings or malls. Given my circumstances for being here, I had to work hard to get some time outside. I sat outside having pizza today, and the only other two people were inside eating. I went for walks but didn’t see many people out walking. I saw one human on a bike the whole time I was here. I like to imagine there were roads with bike lanes I wasn’t on. Even if that were true, it was kind of surreal compared to Portland, where you cannot drive three blocks without almost running over a biker.

The Walgreens pharmacy is one hopping place. Everyone else was also picking up six prescriptions, just like me. I was in the Walgreens seven times in three days. The pharmacy staff said hello to me by the third day. I think they might be wondering where I am now that I’m back in Portland. Everyone had a story, and they had questions, so many questions. Paper work needed to be completed. There were people with stacks of prescriptions to fill: one for themselves, one for their spouse. There was a woman who’s husband had bypass surgery but she was picking up two prescriptions for herself because she had something but was no longer contagious. Turns out she knew the woman in front of her in line who worked at the cardiologist office but was picking up a prescription for her husband who had had such and such a surgery. So many stories.

Also the parking at the Kravitz arts center was quite the experience. You cannot imagine the confusion caused by simply parking in a parking garage. You see, the spots were angled, so you could pull in head first easily and back out easily without the difficulty of parking in a spot that is perpendicular to the lane of traffic. (I know you are thinking, isn’t that normal parking? What’s hard about that? But you haven’t seen the Walgreens parking lot, and I’ve seen it seven times.) Anyway, because people are impatient here (after all, they all come from NY), they try to back into the spots. Theoretically if you back into a spot you can pull out quickly when the show gets out. The flaw in this plan is that the spots are angled, and then to back into the spot is hard because it’s kind of backwards. So as we went into the show, there were three people standing in the lane of traffic guiding people in to a spot that is exactly not designed for backing into it. When the show let out they all had to pull out at exactly the wrong angle and make a wide turn when everyone is trying to leave at once. They blocked the whole lane. And of course the new cars make it look like if you get closer than 4 feet to another car you are for sure going to crash because they light up and beep at you. So. Much. Honking.

Also, there are a lot of gates in South Florida. Where I was driving, the roads were lined with elaborate and large gated entrances to neighborhoods. The gates are high tech; they have lights that flash green when you are cleared to enter as they open automatically, and in some cases you don’t even need to talk to a real person to get in. And they are beautifully landscaped with trees, bushes, tropical plants, and decorated with white and colored lights. It’s all very pretty, and designed to give an exclusive feel. The country club entrances are even bigger and more intimidating than the neighborhood entrances.

It’s just so opposite of my neighborhood in Portland where the houses all have front porches that people use and I always see people walking around and biking. I couldn’t help feeling, I don’t know, but I think sad. It feels like people are insulating themselves from their neighbors. To me it sends the message that the real community is inside the gate to the country club, or this particular neighborhood where people exactly matching my income bracket live in very similar looking houses.

I realize that not everyone inside the neighborhood wants the gate. But if it’s there, and paid for, that means a majority of residents feels it’s needed. I suppose it’s being too dramatic to say people feel the need to block themselves off from the outside to feel comfortable. And yet, as you drive along and pass gate after gate after gate, it feels like you could be in some sort of crime ridden city instead of a wealthy south Florida enclave. It reminded me of the places in Africa or Costa Rica, where anyone middle class or higher had a strong fence around their property. But you know, this was landscaped prettier.

Of course those are all superficial gates. The real gates are the ones no one sees unless less they look hard. Isolation leads to loneliness, which amplifies the fear and distrust of other people. Day after day these things can make people put up barriers to friendship. I’ve realized how hard we work at maintaining our friendships with people near and far—and how lucky I am to have the ability to do that. So if I had a theme for the year that I keep coming back to, it’s connection. Look around you and ask yourself what you are doing to increase your human connections. Because in the end, a palm tree in front of a barrier isn’t really going to keep you protected from the things that matter most.