purplekow

Something about this is poignant and haunting and more moving than any vocal version I have heard

https://video.search.yahoo.com/yhs/search?fr=yhs-dcola-015&hsimp=yhs-015&hspart=dcola&p=halledluha+hauser+youtube#id=1&vid=1cab65edc2bf7f363eaef8fda809fbdf&action=click There is a summer one on Instagram but I cannot post it.

That is my local bank

After 4 straight months of the general medical service for the uninsured and underinsured, I am on administrative duty for two weeks. I admitted patients every other day and night and I estimate that of the more than 200 people I admitted and of whom I took primary care, about 60 were CoVid patients and about 12 of them went to the ICU. Two came back, which is about average for this disease. Up until this week, two had come back, 5 had passed and 5 more remained in the ICU. Those numbers do not tell anything of the lives of those people. The numbers about coronavirus in the media tell even less about them because as the deaths pile up, the faces get lost, the stories get lost, the humanity gets lost. Todays media star, the sad 8 year old who lost both her parents, fades into the emotional support dog no longer with a target for its emotional support, turns into the police officer who contracted Covid while delivering a baby in the back of a squad car. The stories are told heartlessly heartfelt with wholehearted dispassion hitting a discordant note on the heartstrings. None of those stories tell the look of fear in the eye of the breathless, the tear in the eye of the pained, the tremble in the voice as the realization of the reality is spoken. So, I was not looking forward to this administrative respite, but I really am now. The last week has seen nothing but heartache and death for my patients and there does not seem to be an end in sight. The last of the five patients I had in the ICU took an unexpected turn for the worse just as I was posting last night that he was doing somewhat better. Euphemistically called the man in the black bikini, he had an unexpected turn at midnight and he did not survive the night. I did not know these five people who died. In most of the cases I met them on the night they were admitted to the hospital and within a day or two, they were off to the ICU. Still, in each case, I felt a part of me was lost in their passing. Maybe that is always true and I am just more aware of it in these intense times. In some cases, I was the last touch they felt, the last voice they heard, the witness to the last moments of their life. And at that time, that seminal moment, it was a stranger trying desperately to get them back from the edge. So I ask you to take a moment, perhaps quietly contemplate how the lives of the Mexican mother whose last words were "Te amor mi amor", the man in the black bikini, the senior man with Parkinson's, the stocky wide shouldered landscaper gardener, were abruptly taken. Give thanks for the 37 year old man who continues to move forward and whose laugh brought hope to me and, as it would happen, also brought hope to the intensive care doctor with whom I was discussing his care and who told me: I told him a Joke and when he laughed, I felt like maybe we would all be okay". This without knowing of my similar encounter. Life, I guess you need to be in on the joke.

This is a critical decision in people's lives but it a difficult one to face and as a result people put off even considering what it is that they want. In NJ at least, there is a POLST form, Physician Orders for Life Saving Treatment, that delineates what the person wants and who should be making the decisions. This form only comes into play at the time the death has occurred or is imminent and plans for invasive life extending treatments are being made. This is a brief, codified form of a living will. Living wills may include things which are not covered by this document. For example, if someone has opted not to have life extending treatment and they are being attended to in a way to allow comfort to be the goal, a living will might include such things as the kind of music the person would like to be playing in the room, or the specific visitors one would want to see. The POLST only deals with medical issues. The main questions ask things such as do you want to have mechanical ventilation, do you want a feeding tube placed, do you want CPR to be done, who is the person you want to be making your medical decisions should you become incapacitated, The form we use is one side of one page. I have seen living wills which have 15 to 20 pages of instructions.

Thanks to all of you for your support and kind comments. On a day such as today, it is particularly difficult to keep a positive outlook Believe it or not, I think that despite all this tragedy and illness, I have kept a positive outlook. I am not sure that comes through in the accounts, but when I consider how we were doing at the beginning of this and how we are doing now, my spirits are lifted and I do have hope; Though today was probably one of the more difficult days to work and to have hope and then one small thing changed that. Starting at the beginning of the week, I had transferred five patients to the ICU who were still being treated in that unit. Today, a little more than three days later, there is one left. Three have succumbed to their illness. I have related the story of the healthy middle aged gardener and his struggle for 30 days on a ventilator and who slowly slipped away. Another patient was a man in his 60s with Parkinson's disease who had been in the ICU for less than a week and who seemed to be doing well, until he was not. The end came quickly for him, quickly enough that his passing was surprising even to the ICU nurses who are heroically attending to each of their patient's every need. The third one to pass was and elderly man who had spent nearly a month in the ICU. His passing, while tragic for his family and friends, was expected. He had Covid and was 94 years old. Religious beliefs prevented anything less than a full out onslaught of medical treatment and invasive procedures. In the end, 94 years was his allotted time and his death was treated with care for the patient's family but otherwise perfunctorily by the staff who have seen many 94 year olds pass from a variety of illnesses in their experience. This may sound callous, but the efforts with this man were extraordinary and the outcome was as expected, except in the length of time the combined medical caregivers gave to what was seen as a largely futile effort, The patient who remains in the ICU is the man in the black bikini underwear. Well who was in the black bikini underwear, I am not sure where they are now. He is hold on and there is hope for his improvement. Still, setbacks are a sad reality and in this setting almost an eventuality. So he will be attended to carefully. I hope he joins my team back on the regular CoVid unit. The fifth patient was the 37 year old man who was transferred out of the intensive care after a month on the respirator. The one who had been cleaned and shaved and propped up for his photo meeting with his wife and who was able to tell her that he was okay. Today I spoke with him. He was more alert and awake than he has been and he was started on liquids by mouth once again. His voice is still a whisper, probably related to trauma from the endotracheal tube being in his throat for almost 30 days. I reminded him who I am, and asked if he remembered me from when he first came into the hospital. He said he did not. In fact, when asked if he remembered anything from the time in the hospital, he said no. The medically induced coma had been kind to this man. Sometimes patients in that state still dream or have nightmares or are awake enough to be aware that they are there but they are unable to move or do anything at al except think and lie there. It is reminiscent of a book I read in high school "Johnny Got His Gun." about a soldier who finds himself in that space between life and death. I told the patient not too worry about the missing time and why he had no memory of it. I told him I had been monitoring his progress all during his hospital stay. I asked about pain. He had none. I asked about other symptoms of shortness of breath and nausea. He denied those as well but the numbers told a slightly different story. I always try to believe the patient rather than the numbers. Numbers do not account for personal strength, desire to improve, ambition and willingness to succeed no matter the odds. How could you accept the numbers when this man had all of those things in abundance, So after examining him, I prepared to leave, knowing I would have to watch the numbers, but that there was an indefinable quality to this man which had gotten him to this point. On the way out, I said: "Adios, y portanse bien." It is a phrase I usually use with Spanish speaking patients and roughly translates as: Go with God and Behave yourself. I sometimes forget that this is not something everyone would understand and I will say it to patients who do not speak Spanish. The patient then said, straining his voice to be heard: Now I remember you. I smiled and said: "who could forget a doctor this good looking". And then much to my delight,, he shook his head and laughed. I do not know if it is the first time he has laughed but it was the first time I had heard it and it feed my soul. I firmly believe that this man is here, not because of every single medication we gave him, or every second of care or the technology that kept his lungs moving even when they should have stopped. All of those things are never enough. I believe he survived when others had not was in his ability to laugh at a bad joke and in doing so, lift the sagging spirits of a fatiguing physician. I look forward to seeing him tomorrow. I have lots of bad jokes and for right now, he is a captive audience.

I am ready for a break from patient care. Since mid January I have been doing clinical round. I see patients every day. I admit patients every other day. I am on call every other evening. And over the four months I have had one 6 day break. When I finish this week, I have two weeks where I will be doing some of the other aspects of my job. Mine is an academic position and in July we start with a new group of interns with the other years moving up to more repsonsible positions. With the CoVid drain on the hospital, most of the educational component has been restructured or abandoned. Lectures have been moved to on line conferences. Small group mento sessions have centered on CoVid and keeping the residents up to date on the ever changing policies and plans. July first will bring a new group in, maybe. Many of our incoming interns are foreign nationals. Many of them have a J1 visa, which is basically a work visa. CoVid spurred changes in immigration as well as government work changes has made getting these visas much more problematic. So far, only 3 of the 13 interns have managed to get their papers in order. The residents who are staying on also need to update their paperwork and several of them have been caught up in red tape. It is conceivable that we will be down as many as 10 or 36 doctors in the program. Add to that the inexperience and CoVid may be even more problematic to handle come the summer. My responsibilities will change from clinical to educational and administrative. Usually I find this aspect of the job tedious at best and torturous at its worse. Now, I am looking forward to the work because it gives me a physical and emotional break from the patient care. It also allows me to try to structure a program that will insure that those patient get an excellent standard of care, even with manpower shortages and inexperienced doctors. It seems this part of the job may be more important than ever. Meanwhile, I am still working with patients and I have managed to send a few people home, CoVid and regular patients both. Last week I had five patients on ventilators in the ICU under the care of the intensivists. Now there are three, The 37 year old was officially transferred today and while physically he is doing about as well as can be expected, he has suffered some setbacks. Attempts to feed him failed. Usually failure of this type is related to difficulty swallowing water an endotracheal tube has been in place for a long time, injuring the structures that allow for swallowing. The patient underwent a swallow test (get your mind out of the gutter) and he passed. However, once he was fed, his gut did not handle the food. He has been receiving nutrition by vein and now, his system is not up to handling the intake. He will have to be slowly readjusted to eating. He has been up to the hair but he remains weak and unable to stand. His mental functioning which seemed to be at the level expected when the tub was first removed, has not improved that much. There are several possible reasons for that and right now it is unclear if or when he will start to be more of the person he was before all this. So, after a hard fought victory, the battle to return this man to himself goes on. Unfortunately, the battle for another one of my patients does not go on. The landscaper who came in looking like the picture of health with a mild flu and quickly went downhill has died. After 28 days of intensive care, there were no more tricks in our armamentarium. His blood pressure stopped responding to strong medications given to allow his limited oxygen to get to the organs. His lungs transferred less and less oxygen. His kidneys failed. Ultimately, there was no more to be done except the phone call to his anxious family. His. wife, 3000 miles away screamed out when I told her. I am still not sure if I heard the scream through the phone or across the continent. It was a deeply pained scream that oscillated and reverberated and ultimately faded off into the universe to haunt other planets and other solar systems. Most times when I have told families of the passing of a loved one, there is a gasp and then a muffled cry and then a turn away to sob as privately as possible. Usually they have stopped hearing anything said after the opening "I am sorry to tell you..." So while it may seem dispassionate or cold to basically say "I am sorry your relative has died. My condolences on your loss" and then nothing more. Experience has told me that any explanations will go unremembered. Any information will not be retained. The pain overtakes every aspect of the brain and the kind thing to do is to allow the survivors time to regroup. Usually I tell them I will be back and then go off. Frequently when I return they are surprised to see me as they did not recall that I had told them I was coming back. Then there are the cases where the pain is so intense or the shock is so severe that a scream is emitted that seems to take every molecule in the persons body and transfigure it into sound and then reach a pitch so intense that it causes anyone in the area to have a skipping of their heart beat and a temporary sensation of their own lives in empathy. The scream that the gardener's wife let out was a difficult to hear and absorb as it must have been for her to hear the news of his passing. Tomorrow, I will be seeing the patients who were admitted during the evening and night and I will hope that I never have to hear that scream from one of their loved ones.

Well he did not actually lay anyone just gave a few blow jobs.

Today was an interesting day. Spent an hour on the golf course this morning. Wait, a doctor on a golf course, its unheard of, well on a Tuesday anyway. Wednesday is usually doctor gold day. I was on my way to work and I have been taking slightly different routes than I usually would because the traffic is light, some routes are more scenic and due to the decrease in cars, the trip is not any longer. Well this morning, I took a new route and about half way there there were workers doing tree trimming and the road was closed with a detour marked. Now they do seem to be doing a lot of road work here, which is probably a good idea. It keeps people working and it is not as inconvenient as when the traffic is usual. Well I took the detour and it went through a golf course. This was only about 8 minutes from my house and I never knew there was a golf course there. It was a nice day, I had the oldies station on and was singing along and just relaxing and trying to have a bit o peace on the way to work. The phone rang and I briefly looked to press the dashboard to answer the phone call and in that moment, I now know, I missed the sign that indicated that a turn was needed to continue the detour. So oblivious, I continued to drive. It seemed like an unusually remote detour and I realized that I was probably off course. There were people walking, but when I pulled up to ask how to get out, the response was basically a shrug and a sorry. I continued driving. I made a turn that I thought was about to take me back but it just didn't. 45 minutes later, I happened upon the detour sign and followed it and eventually wound up just where I had started. So my usually 20 minute ride to work took more than one hour and 15 minutes. It was a welcome break. Usually I would have been cursing or at least anxiety ridden about being late, but this seemed like a well deserved respite. I suppose I could have used Google maps, but that would presume I know how to use Google maps, which I only kind of do. My resident team did not seem disturbed by my absence, Today was a changeover day and so I had a new group and they took the time to catch up on the 10 or so patients we had. We had a lull in CoVid cases so all of our patients were either CoVid negative or Covid suspect with a low level of suspicious. One still needed to dress up in medical battle gear but the sense of foreboding is a bit less when the suspect is low risk. I do try to be fastidious about the technique of approaching these patients. Gown. Mask. Overmask. Face Shield. Gloves. Double Gloves. I t is routine but there is usually some glitch. My glasses fall of or the mask string breaks or I pull too hard and the neck of the gown opens up. It is usually more annoying than it is serious but one cannot be cavalier when gearing for battle. Today was kind of a coast day. The patient's got slowly better with little assistance from us. The notes got written and the needed conversations were held. I got a nice thank you from an older woman who is slowly improving from her breast cancer and the pneumonia the cancerous spread to the lungs had caused. She is still very sick for the long run but in the short run she is much more comfortable and she should go home in a day or two. So a mundane day. These are rare these days and though I have only golfed rarely, I enjoyed telling my patients that I was late getting to see them because I was out on the golf course. Most of them were actually happy for me, though I did correct the misdirection I gave them. Those course corrections went a lot more smoothly than my ride to work corrections did. Hope all of you had a nice day on the course, whatever course you are taking these days

I always liked his movies, especially Roamn Holiday with Andy Hepburn.

Rutgers University has a FDA approval pending saliva CoVid test. It can be done at home in about 2 hours. If the time for testing was down to less than an hour, would you hire an escort with the proviso that you both get tested at the time of the visit. Do the spit test, have dinner, read the test and then go from there? If so, who should pay for the cost of the tests since they are likely to run 30 to 50 dollars at the onset? Dutch?

Well today was back to the grind. Very surprisingly, I had ten new patients in the hospital and none of them are Covid patients. Two were tested and were negative and the rest came in for other reasons. It felt strange to see patients without all the gear and it took a bit of getting accustomed. I had mentioned that on Saturday, one of my patients in the ICU was being weaned from the ventilator after 30+ days. It was by no means certain that it would work. 37 years old and healthy when he came into the hospital, he has been through every treatment and every kind of manipulation. His body has been wreaked by the virus and yet he is hanging on, He is still CoVid positive. He has a step blood infection, he has failed weaning in the past, he had been in a medical induced coma for a month. But his respiratory status had improved again after the last failed attempt to wean him. His kidneys and liver were still intact. He did not appear to have any heart damage. So early Saturday afternoon, they disconnected him from the respirator. He was getting supplemental oxygen by high flow through the endotracheal tube and once he was connected, there was nothing to do but wait. Either he would fatigue and need to be placed back on the ventilator, or he would be able to sustain his own respirations. This is usually a very tense time in patient care, but in a patient who had been on a ventilator for as long as this patient, this was a critical time. The drugs from the medically induced coma will need to be stopped if he can breath and only then will we start to learn if he will have a return of mental functioning. The tube has been in place for thirty days and he will need to be tested to see if he can swallow and talk and if he is able to control his oral secretions. His musculature has been ravaged by inactivity and the process to return to even minimal functioning will take weeks of work. All that lies ahead if, and it is a big if, he can breath on his own. This morning I encountered the ICU specialist who has been caring for this patient. I congratulated him on having successfully gotten the patient off the ventilator, off the high flow oxygen and onto a simple nasal cannula. I said that he must feel that his efforts of the last month had paid off. He said that it was just his job and it was nothing special. Then he turned to me and said that every day for the last month he had gone in and greeted this patient, as he does with all his patients no matter their level of functioning, with a good morning or a good evening. This morning, two days after the tube came out, one day after it was clear that he could swallow again and hours after his oxygen was lowered to a simple nasal cannula, he told me he went in and said good morning and the patient hoarsely said good morning back. With that his voice broke and he turned and walked away. I think he may have been lying about it just being his job and nothing special. Intensivists deal with the sickest patients in the hospital and many of their patients do not do well. They are trained to keep an even demeanor. Successes cannot get you too high because failure is certain to follow and the fall from heights to depths can be too much even for these experienced doctors. But once and again, the words say one thing and the crack in the voice says another. Later in the day I read this doctors note. It read something to the effect of: He is alive. He said good morning when asked. No other history was available. The first three words of that note were totally out of character and they were as much of celebration as his doctor would allow himself to have. My guess is that he did not even sing along with Fight Song when it played over the loud speaker in response to the disconnection of this patient from the ventilator. This afternoon, the nursing staff washed and combed his hair, shaved his beard, changed the sheets and sat him up in a chair. They called his wife and for the first time in a month, she saw him up and alert and responsive to her tears. The nurses told me that he strained tightly to say: Honey Don't Cry. I am Ok. He did not say anything else, but really what else was there to say?

I binged all seven hours from midnight to 7AM. Enjoyed the first 5 episodes and then 6 and 7 just got too far from the narrative. The idea that some of the things done, particularly in the last episode would ever have happened is beyond belief. I guess when you make a movie about a movie with an unhappy ending and you change the ending of that movie, you need to make your movie about the movie, which should have a poignantly sad ending, have a happy ending as well. At the least, in the last episode they could have brought back some of the naked USC football players. That way I could have had a happy ending.

I agree, the only way to know is to ask. Something to the effect of: "I give great head and I expect to choke on your come at the end. Will you be able to come by oral alone?" One might even offer an incentive to help him along. If there is a dripping tip in my mouth, there will be a ripping tip in your wallet."

You may take the boy out of the hospital but you cannot take the hospital out of the boy. I have the weekend off but felt compelled to peak in on the computerized records to see how my patients are doing. I also made a quick call to the covering doctor just to be sure. This morning I had 14 patients in the hospital. 9 of them were actively on my service and 5 were in the ICU and under their care. Still, though I am not taking daily care of those five, I feel an obligation to know what is going on in their care for when they eventually return from the ICU to the regular floor. I have sent more than a dozen to the ICU, only two have returned. Well of the 9 I was caring for currently, I was hoping that two would go home, including a young man with Covid who has been in the hospital for two weeks but who avoided the ICU. He is a Mexican construction worker who has never really looked ill in the full two weeks he has been here, but who has continued to need large volumes of oxygen and who has been treated with the now standard regimen of Tocilizumab and Remdesivir and Convalescent serum. If fact, he has been in the hospital long enough to have been on the previous standard treatment of Zithromax and Plaquenyl. He is also getting anticoagulation and the newest kid on the block, Famotidine. Well, he is finally off the oxygen but for reasons unknown, he remains in the hospital. I expect he will go home tomorrow. Big victory for him and a welcome bit of good news for the team. The other man, who did not have Covid was discharged to home after a brief and uneventful hospital stay after passing out in the bathroom. This is the kind of patient who was the typical admission in the time before time stopped. Getting anyone out of the hospital is a victory now because hospitals are particularly dangerous places to be nowadays. The rest of the group are doing reasonably well and I expect several more to leave before the coming week is over. In fact, after the discharge of the CoVid patient tomorrow, the only Covid patients I will be following are the five in the ICU. So perhaps there has been a leveling off here in this one hospital, but NJ in general is still a major Covid center. I checked in on the five patients in the ICU. All are male including the man with the black bikini underwear. All are on ventilators. Three have been one ventilators for more than 3 weeks and the other two for less than a week. The persistence of this kind of distribution of ICU patients has me convinced that the only patients who will leave the ICU are the ones that do so in the first week. I scrolled through the patients and that conviction held up until the last patient. This is a 37 year old man who has been on a ventilator for 30 days. Each day I look in and each day nothing much has changed. Today though, for the first time, a glimmer of hope. His oxygen requirements have dropped. He has been breathing on the ventilator but on his own. In other words, he is making enough of a coordinated respiratory effort to trigger the ventilator rather than the ventilator persistently giving a breath every three to four seconds. He has had the medications for the medically induced coma reduced. Tomorrow, they are planning to stop those drugs, allow him to waken and test out his ability to breath off the ventilator. Should he pass that test, the endotracheal tube will be removed and he will be breathing on his own with supplemental oxygen. His kidney function is good. He has not had any discernible neurologic events. He has received supplemental nutrition through a feeding tube. All of this has kept his body fit enough to sustain itself. should he be able to breath on his own. When I read the note that this was all planned I gasped. The routine has been just about unbroken. Only 7 patients have made it off the ventilator at this hospital since this started. If he becomes the eighth, he will have been on the ventilator for the longest period of time, more than one month. His road is far from easy to travel from this point. But it looks as though he has crested the mountain. I hope he gets to enjoy the view. If he does, he will be returning to my team for the final parts of his treatment prior to going home.

You probably never danced with the love of your live as she wore a sexy red dress at a Black Tie Charity Event and sang the song softly into her ear as the only couple of the dance floor, If you start a thread that asks what song makes SamHexum emotional, I will be certain to include those two for you.

You probably never danced with the love of your live as she wore a sexy red dress at a Black Tie Charity Event and sang the song softly into her ear as the only couple of the dance floor, If you start a thread that asks what song makes SamHexum emotional, I will be certain to include those two for you.

Wow. This is amazing. A coverup or at the very least interference with the public's right to know. Someone should sue, preferably a relative of someone who died of Coronavirus.

Wow. This is amazing. A coverup or at the very least interference with the public's right to know. Someone should sue, preferably a relative of someone who died of Coronavirus.

Friday and I have the weekend off. I was looking forward to the break. Unfortunately, I have been having a difficult time with my own health. So many little things going on with me and with each one, I think, I got it. I got the virus. This rings a distant bell for me as I took care of many HiV patients back in the early days of the epidemic. Young men would tell me this as they came into my office. My office was not really a medical office but it served as the AIDS clinic because the nurses in the hospital clinic of which I was the director, refused to work in an AIDS clinic in 1984. So along with a few like minded physicians we started seeing patients in my administrative office which had a single exam room attached. They would come in, terrified. A look of fear and desperation that any of the people here who lived through that period saw on the faces of their friends, neighbors, lovers or relatives. I recognized it but I did not know it. I was not sleeping with men and so I felt a bit invulnerable to this particular human ravager. Now in 2020, I find myself thinking and even saying out loud when no one is around, "I think I got it." Fuck the numbers and the plans and the politics of it, when you think or say: "?I think I got it". all you have is fear and hope. One will win out in the long run but in the short run, it is anyone's guess what is going to take control of your thoughts. Today, fear won out in my cas, at least in the short run. After several hours of rounds and wearing a face mask almost continuously for 4 hours, I sat down to eat lunch. I took off the mask and felt a bit short of breath and with it a little bit of the cough I always have but now drives me crazy with doubt. Is this cough the same or slightly different, Is this just my allergies, or ACE induced cough or post nasal drip or is it more? Am I really short of breath or is it just exhaustion after walking around the hospital for hours when I am carrying far too much weight and after far too little sleep? The more I thought about it, the harder it was to catch my breath. I tried some meditation tricks, controlled breathing and extended breath holding. That seemed to do it. I ate s dry chicken salad sandwich and talked to a friend on the phone as I did. Were my words a bit more winded than usual? Did my friend notice it? Should I ask him if he noticed it? If I did ask him and he hadn't would there rest of the conversation be colored by his listening to see if I was winded? And what if he had? What would I do with that information? I finished lunch most of it in the garbage and walked out to my car. Lunch was at 2:45 so I decided that 3:30 was a good time to leave and I would write my notes on my computer at home. I got to the car and I felt a bit nauseated, a tiny spot of a headache, a slightly runny eye. Spring had sprung and pollen was everywhere. Probably just allergies. Probably just allergies. Probably just....allergies. And then I heard myself say it. I had heard it dozens of times from dozens of men who left this earth far too young and far too beautiful in every way and now I had said it out loud: " I think I got it" I got in the car and drove home. I called a friend and tried to distract myself with the conversation. Instead, I had a distracted conversation and begged off the phone before I blurted it out. I finally arrived at home. I tuned off the car and closed my eyes. I awoke an hour later. I felt better. I chastised myself. Do not put yourself through this. Worry is useless. Concern is appropriate and at this time, at that concern level, it was appropriate to go into the house, say hello to the dogs. Get naked at the door. Get into the shower and wash the remains of the day off of my body and get a nap. The shower was warm and revitalizing. I turned the water temperature up a bit higher and let the wall shower head pulsate on a sore spot on the lower back. I used the wand to thoroughly cleanse every hard to reach spot on my body. I let the rain head wash over me like baptismal waters and then, I got out to dry myself. I was looking for something in a drawer, it was important at the time and now I cannot even recall for what it was I was searching. The drawer had a thermometer tucked way in the back. This is not the one I use each morning to check myself but a different one. I decided to check if it worked and washed it off and popped it in my mouth. It beeped. I casually took it out expecting my usual 98.3 but it read 100. 100 fuck. I looked in the slightly steamy bathroom mirror. I saw it in my eyes. The fear. The trepidation. The desperation. "I think I got it". Now in that minute every patient I had seen who felt well and died soon after came to my mind. I could see them all. Fuck Fuck Fuck. Well maybe this thermometer was broken, let me go to my standard. I popped in my lucky thermometer. What an age we live in that one needs a lucky thermometer. 99.9. I had one other episode after a hot shower when I took my temperature and it was elevated, it was 99.5 but it quickly went down. I sat down. Probably the hot shower, I said out loud while the voice in my head said "I think I got it". Holy hell, "I think I got it" why else am I seeing these people? Are they here to comfort me or scare the bejeezus out of me? My bet was on bejeezus. My phone rang. My supervising MD was calling. I answered coolly. " Hello." "How are you doing I have a question for you". She started to ask about a patient from work and I just blurted out...."I think I got it". Then the whole story came out, the headache, the shortness of breath, the cough, the chicken salad, the car nap, the body aches, the sneezing and most damning of all, the fever. I left out the faces, even I could not face a public face to the faces. A calm voice of reason was not what I needed then, but that is what I got. It is probably just fatigue and the hot shower and the terrible dried out chicken salad you had for lunch. (The chicken salad was pretty dry). Take it again. Take your temperature again. I better use my lucky thermometer I said, as if that would make sense to her. We sat on the phone silently waiting for the beep like some ancient answering machine: "I may have contracted a really horribly deadly disease, please leave my temperature at the beep." And then. Beep. we both heard it. There was no denying it. 99.5. Two minutes later....99.3......one minute later,,,,,99.1,.....just to check again 10 second later.....99.0. Three minutes later 98.7. I knew that thermometer was lucky. At some point, she had hung up and I vaguely recall her saying to call her back when I regained my sanity and got some sleep. I closed my eyes, there they were, all the faces of 2020 and all the faces of the 1980s. There they were, in my head and in my heart and thankfully I was able to say goodbye to them as I fell asleep. An hour later, I came here, because "I thought I got it" but I wanted to tell someone: "I don't think I got it". And by telling you here that is what I think, I will think it. Thanks for listening.

Friday and I have the weekend off. I was looking forward to the break. Unfortunately, I have been having a difficult time with my own health. So many little things going on with me and with each one, I think, I got it. I got the virus. This rings a distant bell for me as I took care of many HiV patients back in the early days of the epidemic. Young men would tell me this as they came into my office. My office was not really a medical office but it served as the AIDS clinic because the nurses in the hospital clinic of which I was the director, refused to work in an AIDS clinic in 1984. So along with a few like minded physicians we started seeing patients in my administrative office which had a single exam room attached. They would come in, terrified. A look of fear and desperation that any of the people here who lived through that period saw on the faces of their friends, neighbors, lovers or relatives. I recognized it but I did not know it. I was not sleeping with men and so I felt a bit invulnerable to this particular human ravager. Now in 2020, I find myself thinking and even saying out loud when no one is around, "I think I got it." Fuck the numbers and the plans and the politics of it, when you think or say: "?I think I got it". all you have is fear and hope. One will win out in the long run but in the short run, it is anyone's guess what is going to take control of your thoughts. Today, fear won out in my cas, at least in the short run. After several hours of rounds and wearing a face mask almost continuously for 4 hours, I sat down to eat lunch. I took off the mask and felt a bit short of breath and with it a little bit of the cough I always have but now drives me crazy with doubt. Is this cough the same or slightly different, Is this just my allergies, or ACE induced cough or post nasal drip or is it more? Am I really short of breath or is it just exhaustion after walking around the hospital for hours when I am carrying far too much weight and after far too little sleep? The more I thought about it, the harder it was to catch my breath. I tried some meditation tricks, controlled breathing and extended breath holding. That seemed to do it. I ate s dry chicken salad sandwich and talked to a friend on the phone as I did. Were my words a bit more winded than usual? Did my friend notice it? Should I ask him if he noticed it? If I did ask him and he hadn't would there rest of the conversation be colored by his listening to see if I was winded? And what if he had? What would I do with that information? I finished lunch most of it in the garbage and walked out to my car. Lunch was at 2:45 so I decided that 3:30 was a good time to leave and I would write my notes on my computer at home. I got to the car and I felt a bit nauseated, a tiny spot of a headache, a slightly runny eye. Spring had sprung and pollen was everywhere. Probably just allergies. Probably just allergies. Probably just....allergies. And then I heard myself say it. I had heard it dozens of times from dozens of men who left this earth far too young and far too beautiful in every way and now I had said it out loud: " I think I got it" I got in the car and drove home. I called a friend and tried to distract myself with the conversation. Instead, I had a distracted conversation and begged off the phone before I blurted it out. I finally arrived at home. I tuned off the car and closed my eyes. I awoke an hour later. I felt better. I chastised myself. Do not put yourself through this. Worry is useless. Concern is appropriate and at this time, at that concern level, it was appropriate to go into the house, say hello to the dogs. Get naked at the door. Get into the shower and wash the remains of the day off of my body and get a nap. The shower was warm and revitalizing. I turned the water temperature up a bit higher and let the wall shower head pulsate on a sore spot on the lower back. I used the wand to thoroughly cleanse every hard to reach spot on my body. I let the rain head wash over me like baptismal waters and then, I got out to dry myself. I was looking for something in a drawer, it was important at the time and now I cannot even recall for what it was I was searching. The drawer had a thermometer tucked way in the back. This is not the one I use each morning to check myself but a different one. I decided to check if it worked and washed it off and popped it in my mouth. It beeped. I casually took it out expecting my usual 98.3 but it read 100. 100 fuck. I looked in the slightly steamy bathroom mirror. I saw it in my eyes. The fear. The trepidation. The desperation. "I think I got it". Now in that minute every patient I had seen who felt well and died soon after came to my mind. I could see them all. Fuck Fuck Fuck. Well maybe this thermometer was broken, let me go to my standard. I popped in my lucky thermometer. What an age we live in that one needs a lucky thermometer. 99.9. I had one other episode after a hot shower when I took my temperature and it was elevated, it was 99.5 but it quickly went down. I sat down. Probably the hot shower, I said out loud while the voice in my head said "I think I got it". Holy hell, "I think I got it" why else am I seeing these people? Are they here to comfort me or scare the bejeezus out of me? My bet was on bejeezus. My phone rang. My supervising MD was calling. I answered coolly. " Hello." "How are you doing I have a question for you". She started to ask about a patient from work and I just blurted out...."I think I got it". Then the whole story came out, the headache, the shortness of breath, the cough, the chicken salad, the car nap, the body aches, the sneezing and most damning of all, the fever. I left out the faces, even I could not face a public face to the faces. A calm voice of reason was not what I needed then, but that is what I got. It is probably just fatigue and the hot shower and the terrible dried out chicken salad you had for lunch. (The chicken salad was pretty dry). Take it again. Take your temperature again. I better use my lucky thermometer I said, as if that would make sense to her. We sat on the phone silently waiting for the beep like some ancient answering machine: "I may have contracted a really horribly deadly disease, please leave my temperature at the beep." And then. Beep. we both heard it. There was no denying it. 99.5. Two minutes later....99.3......one minute later,,,,,99.1,.....just to check again 10 second later.....99.0. Three minutes later 98.7. I knew that thermometer was lucky. At some point, she had hung up and I vaguely recall her saying to call her back when I regained my sanity and got some sleep. I closed my eyes, there they were, all the faces of 2020 and all the faces of the 1980s. There they were, in my head and in my heart and thankfully I was able to say goodbye to them as I fell asleep. An hour later, I came here, because "I thought I got it" but I wanted to tell someone: "I don't think I got it". And by telling you here that is what I think, I will think it. Thanks for listening.

https://video.search.yahoo.com/yhs/search;_ylt=AwrEZ7bOsKxeSVwAqAIPxQt.;_ylu=X3oDMTByMjB0aG5zBGNvbG8DYmYxBHBvcwMxBHZ0aWQDBHNlYwNzYw--?p=you+were+wonderful+tonight&fr=yhs-dcola-015&hspart=dcola&hsimp=yhs-015#id=1&vid=90bcbbfb7e945696522b6fb4ab402462&action=view The first few strains on the guitar on You Were Wonderful Tonight by Eric Clapton makes my eyes well up and soon after the tears flow. Lady in Red by Chris DeBurgh also gets me from the first notes. Both of these are tied to very special moments in my life and those first notes take me right back there.

https://video.search.yahoo.com/yhs/search;_ylt=AwrEZ7bOsKxeSVwAqAIPxQt.;_ylu=X3oDMTByMjB0aG5zBGNvbG8DYmYxBHBvcwMxBHZ0aWQDBHNlYwNzYw--?p=you+were+wonderful+tonight&fr=yhs-dcola-015&hspart=dcola&hsimp=yhs-015#id=1&vid=90bcbbfb7e945696522b6fb4ab402462&action=view The first few strains on the guitar on You Were Wonderful Tonight by Eric Clapton makes my eyes well up and soon after the tears flow. Lady in Red by Chris DeBurgh also gets me from the first notes. Both of these are tied to very special moments in my life and those first notes take me right back there.

Pete Alonso of the NY Mets. He has a good head on his shoulders and his has a great set of shoulders. Power hitter, Rookie of the Year and a leader on the team, Won a million dollars during the All Star Game Home Run Derby and gave the money to charity. His salary for the year is 525,000. I am sure he has endorsements and big money will be forthcoming but still, at 25, an amazingly generous act.

Pete Alonso of the NY Mets. He has a good head on his shoulders and his has a great set of shoulders. Power hitter, Rookie of the Year and a leader on the team, Won a million dollars during the All Star Game Home Run Derby and gave the money to charity. His salary for the year is 525,000. I am sure he has endorsements and big money will be forthcoming but still, at 25, an amazingly generous act.