THE NEW NORM PART TWO

I had gotten used to my new body norm.  I’m quite obese.  My friend, Will Power, left town last year and is finally back.  I am so happy to have Will Power by my side once again.  I’m 3 pounds down, only 32 to go.

If I were one of my patients, I would have read me the riot act a long time ago.  In fact, the other day, I stood by the mirror with Will and did just that.  I talked about the negative effects my current weight was having on my back, my knees and my heart.  I added in a bit of old fashioned guilt and shaming reminding myself that eating massive quantities of bad food was like cheating on my family. My weight was surely going to contribute to my eventual death.

I read my own book and started on my “Wellthy Plan.”  I’m sure I’ll be a success.  If I falter and fall, I’ll get up and do it over again until I get it right.  My biggest obstacle is the fact that I love southern food and I’m moving to the south.  Will Power promises to stay at my side.

Meanwhile, my days will be full of packing, saying good-bye to old friends and patients, and walking around my property lamenting leaving while at the same time being excited about moving to NC.

Covid-19 will be around a long time. Renee and I will pack a cooler so we won’t have to stop on the road.  We’ll continue to practice social distancing.  I hope you will as well.  As it turns out, Sweden’s experiment leaving businesses open is failing.

Many of you have asked me for an opinion on the Bakersfield Docs and after watching Zdogg’s report on their news conference, I watched the whole video again.  I have to agree with Zdogg. Open the hyperlink and tune in to Zdogg.

As always, if you have questions you would like me to answer, call or drop me a note.  I’m hoping that one of you will arrange a Zoom reunion of LZFTC patients and staff.  It would be nice to see you guys again.  I think that privacy rules preclude me from arranging it but ya’ll are free to do so if you can figure out how to get the word out.

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THE NEW NORMAL

Have you heard the phrase, “The new normal?”  You will.  There is truly going to be a new worldwide normal, and I’m not going to like it. Sure, some things will be good.  Last night my children arranged a “Messenger” party. My children, grandchildren, Renee and I signed onto video messenger and goofed around.  The little kids loved it.  Messenger has an emoji function that turns your face into something else.  I loved being a slice of pizza with an enormous tongue.  The phrase, “Try it, you’ll like it” comes to mind.

Being with my family on the internet will never be as good as being with them in person, but it’s better than nothing.  In the end, the new normal will further divide us and isolate us.

Telemed and video conferencing are taking over as the way medical care will be delivered in the future.  They represent the new normal and appear to be here for good. Millennials appear to be very comfortable with telemed.  Of course, many of them were already more comfortable with texting than talking.

Personally, I can’t figure out how to practice telemed.  When I greeted you in the hall or in an exam room, I immediately started assessing how you were doing.  When shaking hands, your skin turgor, hand grip, skin moisture and affect relayed mountains of information about your health.  As you answered my questions about past and present history, I automatically recorded your physical response.  Doing a telemed physical is never going to be as good as doing an actual, live exam.

The new normal will have to work without all of those clues.  I’m sure artificial intelligence (AI) will join telemed in the not to distant future but for now, “Open your mouth and lean closer to the camera will just have to do.”

I’m old and will never get used to the idea that the doctor patient relationship can be eliminated without compromising care.  Of course, as a doctor, I was supposed to be aloof and clinical.  But as your doctor of 20 years and part of your family, you allowed me access to your most intimate fears and problems giving me a chance to help you.  It was a symbiotic relationship.  Helping you and your family fulfilled my needs as a doctor.

Nonetheless, the new normal is here and we’ll have to make the most of it.  Tonight, have a messenger party with your loved ones.  Drop me a note letting me know how you are doing.  Before I leave for NC, perhaps we can have a Lake Zurich Family Practice Zoom party.  Of course, I’ll have to figure out how to use Zoom.

I’ll also have to shave and dress.  One of the best things about the new normal is not having to shave or dress.  I’m not a pretty sight!  Luckily, I married a true beauty who does not need makeup or other adornments.

One of the other good things about the new norm is being able to play anytime during the day or night.  10,9,8,7,6,5,4,3,2,1, ready or not, here I come.  Oh Renee, where are you?

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MY GREAT ADVENTURE

Sometimes when I think about my past, it seems like it wasn’t real. It could not have been real, but it was.  It was a great adventure and it was mine.

In 1974, at the age of 23, I said goodbye to my parents, got into a yellow 1972 Ford Galaxie and drove (by myself), to Guadalajara, Mexico.  At speeds in excess of 100 mph, I made it to Guadalajara 3 days later. I didn’t speak Spanish and I didn’t know anyone.

I did have the phone number of Alan Goodman and, having never met me, he was gracious enough to let me stay with him until I got situated.  They say it’s a small world and as it turned out, Alan was a distant relative of Dale (my girlfriend at the time) and Renee (my future wife).

Guadalajara was a tremendous adventure leading to my marriage to Renee and our settling in Lake Zurich and practicing medicine.  I had always planned on living on the outer banks of NC, but Lake Zurich won my heart. 

Now I’m about to go on a new adventure.  My new life starts May 29 when the movers pack and move me to the land of Ya’ll, North Carolina.  Once again, I don’t speak the language (southern drawl) but I’ll learn.

I’ll be starting a new career.  I’m going to be a full time Zadie.  Zadie is the Yiddish word for grandfather, and I can’t wait to start my new job.  I’m getting a huge increase in pay with hugs and kisses every day from my children and grandchildren.  I get 3 days off a week and unlimited sick time. I’ll be a short distance from Jeremy, Allyson, Riley and Erin’s family.

So, I guess this is the beginning of goodbye, a month-long celebration of the years we’ve had together.  Up until now, moving has not seemed real.  It’s real and coming up fast.  I’d love to see each and every one of you guys before I leave but I can’t figure out how.  Covid-19 has made meeting, as a group, impossible. Of course, you could always move to North Carolina.

Meanwhile, I’ll keep writing on this blog as long as there is something to say.  I’ll keep my old phone number so that I’ll always be just a phone call away.  Feel free to suggest any topic you’d like me to write about.  

If you know any one looking for a swimming pool with a magnificent house, send them my way. https://www.realtor.com/realestateandhomes-detail/5230-Hilltop-Rd_Long-Grove_IL_60047_M70018-59879

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WELCOME TO HELL

If you don’t believe in hell, you should!  We are all in a living hell.  All infected by a horrible virus.  Some have respiratory problems, fever and fatigue.  Some require hospitalization.  

Qualifier – I do not believe that all of us have the actual virus.  I do believe that having or not having the virus is a moot point.  The damage that 6 feet of separation does to our souls is real.  Parents and grandparents worry about their progeny.  They see each other on the internet or through their car windows.  There are no actual hugs or kisses.

Under the strain of social isolation, child and spousal abuse increases.  Depression and anxiety worsen or show up for the first time.  Businesses and careers are lost.  The food chain is compromised. The entire fabric of society has started to unravel.

Worst of all, the dying die alone, among strangers.  The strangers who act as stand-ins for your loved ones, have their hearts ripped out as they pronounce their patients dead.  There are no more shiva’s, and wakes. Funerals are held online.  Six feet of separation might as well be a mile.

I can go on and on.  The effect of this virus is to send us all to hell.  Will we ever be rid of this scourge?  Certainly, we will learn to control the virus or kill it.  What is less certain is what the long-term effects of social distancing will have done to the survivors and their progeny.

In a famous song by the Rolling Stones, Sympathy for the Devil, they make a pivotal statement.  “Please to meet you . . .Hope you guess my name.”  Listen to the following if you do/don’t remember the song: https://youtu.be/GgnClrx8N2ken

I’m no biblical scholar but I think the first step to ridding ourselves of this plague is to guess his name. After all these years, I finally know what his name is.  It’s Covid-19.  Now to figure out what the nature of his game is.

The answer we need to fight our way out of hell is embedded in the title of the song.  SYMPATHY  for your fellow beings is key to our survival.  Sympathy will allow you to touch another without breaking the 6 feet of separation rule.  Sympathy will stop you from flaunting the separation rules long enough to rid our society of the virus.  Sympathy will remind you we are all in the same place and need each other to dig out.  Only when we act together will we find the faith necessary to survive this latest attack on our souls.

The song ends with, “tell me baby what’s my name; one time, you’re the blame.”  I know who you are.  You call yourself COVID-19!  Now that you’ve been identified, I refuse to be the blame.  I will alert my brethren and we will dig our way out of hell together.

We will once again feel human touch, hugs and kisses.  We will mourn together and celebrate together but first we will name you and drive you back to the hole you came from.  WE WILL ISOLATE YOU!  ISOLATION IS THE NATURE OF YOUR GAME AND WE WILL PLAY THE GAME LONG ENOUGH TO SEND YOU BACK TO HELL, AND YOU WILL GO ALONE!Where did this article come from? I awoke with it in my head.  It was a gift from GOD.  I’ve found my faith again.  Find yours and we will all be fine!

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AMERICAN INGINUITY

First, a qualifier.  Note that the doctor in the video starts off by warning you that his wife’s design has not been tested.  His faith in the mask produced by his wife is “anecdotal” based on his sniff test and use of the mask.  I think her design is brilliant and, if you are going to use a home-made mask, makes a lot of sense.

THIS VIDEO SHOULD GO VIRAL, IT’S THAT GOOD! https://www.youtube.com/watch?v=W6d3twpHwis

PUTTING ON A MASK AND TAKING IT OFF CORECTLY IS VERY IMPORTANT.  HERE IS A VIDO EXPLAINING HOW TO DON AND TAKE OFF A MASK CORRECTLY. https://www.youtube.com/watch?v=z-5RYKLYvaw

WHILE WE ARE AT IT, LET’S DISCUSS CORRECT REMOVAL OF GLOVES.  WHEN TAKING OFF YOUR GLOVES ALWAYS TREAT THEM AS IF THEY ARE COVERED IN POOP.  WATCH THIS VIDEO PLEASE.

Improper use of mask and gloves puts you and your family at risk.  Please remember to safely dispose of old masks and gloves in the appropriate garbage receptacle.  Do not recycle potentially infectious materials.

One last point.  I do not believe that simply making a mask out of cloth has any real protective properties.  If I were to pass gas, you would smell it!  Assuming I were fully clothed, that gas would pass through underwear and pants.  If gas can pass through, virus probably can as well. The following video is for those who can’t sew.  I would recommend using a HEPA bag as a middle layer in this type of mask, always remembering that none of these designs have been tested and proven helpful. https://www.youtube.com/watch?v=r51YroAFPds

Prior to using any mask, it may be worthwhile to pass smelly gas as your own sniff test.  A healthy serving of corned beef and cabbage should help!

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QUALIFIERS

In my world, recognizing qualifiers is very important.  Qualifiers are words like “could,” “may,” “might,” and on and on. Personally, when I hear a qualifier, I pay attention to how it is used and then put it on the back burner.

Could ultraviolet light help eradicate Covid-19?  The answer to could is always yes.  Anything could happen.  I could get lucky, but that’s another blog for another day.   In science and medicine, qualifiers are good for formulating theories and running research.  What a doc wants to know is how certain are you that UV works. How did you come to that conclusion? Was the study blinded or double blinded and what’s the P value? According to Wikipedia, “In statistical hypothesis testing, the p-value or probability value is the probability of obtaining test results at least as extreme as the results actually observed during the test, assuming that the null hypothesis is correct.[1][2]

I know it sounds complicated, but a practicing physician is taught to analyze P values and a host of other statistical terms so as to be able to evaluate how trustworthy the results of any test are.  I often frustrate my friends when they present with anecdotal stories about the benefits of vitamins, medications, UV light, alkaline water, etc.  It’s not that I don’t believe them.  The heart of the matter is my profession requires proof before we accept any therapy or test.

What qualifiers are good for is avoiding the wrath of the press.  Had President Trump said, “I’ve heard/read that UV light might be beneficial and think that further research might be helpful, no one could have criticized him.  Had he said sanitizers do so well at killing the virus on surface that I wonder if we might be able to find a potentially effective and safe sanitizer to use on humans.  No one would be able to criticize him.

Maybe I’ll hit a hole in one someday.  Anything is possible assuming I start playing golf.  Using qualifiers when you put forth an idea helps in assessing how reliable an idea is.

By the way, when you quote research such as the very small study done in China, be careful not to take it as gospel.  In college, I was in charge of a rat lab and my research was worth 12 credits if done right.  I screwed up!  My results were not good and it looked like I was going to flunk 12 hours of credits.  As a pre-med, it was a disaster.  I spent an entire week in the library studying statistical analysis and came up with a statistical test that gave me a good “P” value.  I got an “A” for those 12 hours.

While I could fool most of you, I did not fool my professor.  Nor was my work ever published.  Dr. Best gave me an “A” for my ingenuity in finding a valid statistical test that turned shit into gold. I learned a valuable lesson and have never screwed up again.  Thank you, Dr Best!  I participated in over 30 clinical trials in my lifetime and enjoy each trial.  Research always kept me on the cutting edge of medicine. 

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FREEDOM

Thank God!  I can finally get a tattoo.  All I have to do is fly to Georgia.  Now to decide what tattoo I want and where to put it.  I thought I’d tattoo instructions on how to intubate me so that when I get a Covid infection, the ER doc would know how hard it is to intubate me and what he should do in order to get it done before I stroke.

Welcome to a world taken over by madness.  Keep us at home, watching bad TV, worrying about the future and we will go mad.  I’ve lost it.  I’ve started surfing between CNN, MSNBC and FOX.  My mood shifts with each channel change. Who do I believe?  I’m really not sure.  What I do know is that there is not a right answer.

If I were about to lose everything (my business, my savings and my home), I would want to open up for business and depend on my customers to be responsible enough to stay 6 feet apart, wear mask and self-quarantine if they were sick.

I’m glad I don’t own a business.  As I am old and frail, I’ll choose to shelter in place until this is over.  As a doctor, I know that opening up business will prolong the misery and lead to a spike in deaths.  I know that many will not take this seriously and will spread the virus.  As a doctor, I am furious that nothing my colleagues need to do their jobs is made in this country.  I’m pissed that supplies of critical protective gear are so deficient that our frontline doc’s are dying in the field.  We knew this was coming.  Knowing and believing are two different things.

As a retiree, I need the economy to grow and flourish.  I need a healthy stock market.  If we stay closed, that will not happen.  The longer we stay closed the longer it will take for the stock market to recover. 

As a human, I need to eat.  I need to be sure our food chain is strong.  I need the government to invest in securing the food chain by encouraging innovative ways to allow workers to safely return to the fields and factories.  Securing the food chain is critical and no one seems to be talking about it.  I need human touch, hugs and kisses.  I need to be with family and friends.

As a parent, I worry about the effects of social isolation, economic distress, home schooling and a host of other problems facing my children and their children.  As a parent, I worry about everything.  Most of all, I worry about how I’m going to get to the east coast and see them.

I’m actually in good enough shape that, barring getting infected. I can weather the storm.  I can’t imagine how my patients, some of whom were living on the edge to begin with, are going to make it through this.  

So, I’m not going to criticize those who push to get back to work.  I’m not going to call them names.  Instead, I’m going to support them.  I’m also going to support those who choose to shelter in place.  As free men and women, it’s time to exercise that freedom.  It also time to become innovative.  If you are going back to work, figure out how to stay safe and keep your customers safe.  If you are going to be a customer/client, don’t let your guard down.  Be responsible whatever your choice.

If you’re going to get a tattoo in the midst of a pandemic, I have nothing more to say.

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COVID CONFUSION

I just viewed a video sent to me by one of my former patients.  IT WAS HYSTERICAL!  The video consists of a young woman standing in front of multiple TV and News microphones as she explains the Covid-109 rules.

She starts off stating that she could not understand why everybody is not following the same rules as they are very clear.

“First, you must not leave the house, for any reason; unless of course you have a reason and then you can leave the house. All stores are closed except those that are opened.  All stores must close unless they have a reason to stay opened.  This virus is deadly, but don’t be afraid of it.  It can only kill people who are vulnerable and also those who are not vulnerable.”

She goes on to say, “We should stay locked down until the virus stops infecting people and it will only stop infecting people if enough of us get infected so that we build immunity, so it is very important that we get infected and also do not get infected.  Also, do not go to the doctors’ office or the hospital unless you have to go there or are too sick to go there.”

The video goes on for another two and a half minutes making statements and then contradicting them.  IT’S HYSTERICAL!  IT’S SAD!!  It represents exactly what you are being told in the news.  Wear a mask.  Don’t wear a mask.  No, I told you to wear a mask.  By the way, a mask won’t protect you.  It protects people from you.  If that’s true and we all wear mask, then no body should be able to infect you.

Along with social isolation and anxiety, we have to deal with mass confusion.  Who do we believe?  Believe me!  The authorities don’t know what they are doing.  The news media doesn’t know what they are doing.  The scientist and doctors know what they are doing.  They are learning on the fly, collecting evidence and designing the kind of research that leads to treatments and vaccine.

Unfortunately, docs are becoming talking heads/celebrities and, rather than treating patients and seeking truth, vomiting suppositions and half formed theories on any reporter that will talk to them.  The reporters air these opinions widely, the internet picks up on it and, in the end, a preposterous idea becomes reality.  Did you hear about the patient who got miraculously well after her nurse spilled a urine sample on her? 

While that would be absurd, if enough of you quote me as reporting that peeing on a Covid-19 patient is harmless and may well help them get better, we’ll see it in the news.  President Trump, not being a doctor, might even suggest that if we pee on each other, we can end the pandemic.  “What have you got to lose.  People are dying. It sounds right to me.  Give it a try”

Of course, Congress has been peeing on us for years (or dumping on us) without any apparent benefit.  Enough said. 

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MY FAVORITE DAY OF THE YEAR

Just as kids get excited Christmas morning, I get excited the day my pool opens.  Yesterday, we opened the pool.  Even though the water is cloudy and I cannot swim yet, I still relish awakening in the morning and looking out on my own private heaven.  I’ve been awakening to the sight of an expanse of clear blue water since I was five years old.

My parents built an inground pool when I turned 5 and most of my fondest memories are of growing up at Camp Segal.  When I moved to Long Grove, I reopened Camp Segal and treated my children to the joys of having a pool, volleyball and basketball court and bags in their back yard.  My memories of summers past in Long Grove are fond ones with many groups of teenagers and adults reveling in the sun and water. 

Whomever said all good things must come to an end knew what he/she was talking about.  We have a “showing” today.  On the one hand, I’m excited about my move to North Carolina and starting my retirement stage of life.  I am sure whoever buys my house will enjoy the screened porch and pool.  Whether it takes on a country club like environment as it did with my family or a peaceful, private escape, I know they will love it.

On the other hand, I want to stay and enjoy one more summer at Camp Segal.  The one place where the Parkinson’s does not bother me is in the water. Lunching on the screened porch and lounging in the pool is my kind of heaven.  Lucky for me that my 55-year-old and older community in North Carolina offers me a similar experience.

There will be one clear difference, the laughter of little kids playing will be replaced by old people complaining or telling jokes.

Paul: “o… o… o… y… y… y, o… y”

John: “I thought we weren’t talking about the kids today!”

Three old men sitting at the breakfast table drinking coffee.  Max complains, “I’m so constipated.  I wake up in the morning and push, push, push.  Eventually, after an hour or so, I have a little B.M.”

His friend Paul says, “I don’t have any problems with BM. My problem is peeing.  I strain and strain for hours.  Finally, I get some relief.”  The third guy says, “I don’t have any problem pooping or peeing, I just do both 1 hour before I get up.”

I’m already boning up on my jokes.  Renee and I are learning to play bridge and Mahjong and settle into old age.  Just as Renee and I are going to settle into a new way of life in NC, so must all of us settle into the new rules of life caused by Covid-19.

The sooner we accept change, whether good or bad, the sooner we can get on with our lives.  The better we comply with the rules of our new way of life the happier and healthier we will be.

Be happy, be healthy and pray for a vaccine or a therapeutic approach that works.

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WHAT DID YOU SAY?

Renee and I have the most fantastic conversations!  The problem is that neither of us can hear the other.  First, a little background.  Renee is a speech pathologist.  When we first got married, she taught me to modulate my voice.

I used to talk very loudly.  In a lecture hall of 500 students, I did not need a mic.  Everyone could hear me.  Ever hear the expression, “Happy, happy life?”  I quickly learned to tone it down and, for many years, my wife was happy.

Flash forward to 4 years ago.  Renee’s hearing got progressively worse.  I had to relearn how to talk loudly.  It was not an easy task, Parkinson’s naturally soften your voice and, to make matters worse, there is a fine line between talking louder and yelling.

Renee admonished me for yelling.  She taught me to look her in the face when I wanted to talk to her.  She taught me that if I was behind her and trying to communicate, she could not hear me.  Eventually she got hearing aids and things got marginally better, but, she began to mumble as her aids amplified her own voice.  The only time I could truly hear her was if she was on the phone.   On the cell phone, she projects her voice over many miles.  The neighbors could hear her.

Flash forward to today.  My hearing is now bad.  Even with hearing aids, I miss much of what she says.  The funny part is that now I’m admonishing her for the same things she accused me of.  Isn’t getting old fun?

Communication between spouses is so very important that we all should take care that we understand what our spouse is saying, and we follow Renee’s rules.  If you or a loved one has hearing problems, talk face to face.  Speak slow and verify that what you said is what they heard.  Be patient with your loved one particularly since one day in the future, your hearing may be just as poor.

One of my favorite sayings is attributed to Alan Greenspan:

“ I know you think you understand what you thought I said but I’m not sure you realize that what you heard is not what I meant”

Think about it!  If you or your spouse or loved ones are hard of hearing, take care that you verify what you think you heard.  Remember, “Happy wife, Happy life!” Hearing what your spouse said and meant will lead to a happy spouse and life.

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