Written July 7, 2020
CW swearing and sarcasm, opinions about Covid decision making

Ohio has turned into a 5th grade pandemic classroom.
 
To my right is the kid who supplies the entire school with Mad Magazine, Playboy, and cigs.  He wants the class to know that people die everyday from car crashes, smoking, and drinking. Just last week he crashed his bike into a whole mess of kids and infected all of them with his budding addiction and cognitive dissonance. From there his idiocy spread like wildfire. There’s no vaccine. And even if there were, he won’t take it.
 
To my left is the kid who explains that death is good for the economy. He knows people who died of Covid or who are living with organ damage from it, but it’s mostly their fault for getting it to begin with.
 
Way in the back is the kid who’s figured out that the bare minimum one must say in public and on social media is that one is pro mask. If one says that then maybe one can go ahead and enjoy cover when one explains how this virus is still a hoax.
 
Next to that kid is the kid who doesn’t give a fuck and absolutely loves that we have a president who is an extraordinarily horrible human being. She doesn’t actually watch the president speak or really read the news, but she’s enjoying herself.
 
At the front left of the room is an assault weapons wielding fiend who thinks that it’s a great tactic to intimidate public officials with, you know, weapons. He spends lunch and recess telling people the accurate terms for all of the parts of assault weapons. All his best conversations have happened at gun point in public.
 
Right behind that kid is a kid who just wants everyone to get along and thinks the world is a real shame and social media is a bully. If you ask her a question or confront her she’ll tell you to enhance your calm. She’s mostly unaware how our government functions which is fine because politics are mean. She votes however she was raised to vote. No matter what.
 
Next to the window is the kid who thinks that the greatest strength of capitalism is that no matter what it’ll never run out of other people’s labor. He needs meat. So fuck those workers.
 
He’s best friends with the kid behind him who’s parents for real will not vote for Joe Biden until Joe personally tells his parents that they’re right about everything. His parents also think critical infrastructure should fucking turn a profit so fuck the post office. His parents have no idea that Republican-controlled House and Senate and President George W. Bush manufactured a crisis for the postal service in 2006. No clue they required the USPS to prefund its future healthcare benefit payments to retirees for the next 75 ridiculous years. No clue the PO was required to divert more than $5 billion annually to prepay the health benefits of retirees who have not yet been hired. Down with stamps.
 
At the end of this row is a kid explaining how his freedom is under tyrannical attack. He’ll see you later at his vector, I mean church.
 
His BFF is a kid whose best ability is his ability to exist in a world made fresh each day with no collective memory of what the president said the previous day. He does not do Twitter and sees no reason to consider any of the 50,000 tweets the president has vomited up as actual words to consider at all. He’ll only consume heavily edited Fox News videos of the president. He has a velvet picture of Elvis and Sean Hannity on his bedroom wall. And an autographed pic of Rush on his night stand. Fuck Kaepernick. And Greta.
 
If you look along the back of the room you’ll see the gang of people unconcerned with per capita testing or testing at all. They say Taiwan is doing well with the virus hoax because of Confucianism. When someone explains to them that Taiwan is doing well because their Vice President is an epidemiologist with previous experience with SARS and they have a strong public health sector with an emergency command center they all chorus, “Libtard.” Except that one kid who just “lols” because he’s not that smart and he’s worried someone might ask him something he can’t answer.
 
Then there’s the kid whose utterly convinced the world is a worse place because she’s learning about an injustice. She’ll give you selected topics you’re allowed to discuss. But not respond.
 
Confused by things that cannot be turned off, put away, declared a hoax, or shot, the kid who sits behind me and over one seat has apparently been trained to expect instant gratification at all times and since pandemics are long, and boring and horrifically tragic and the benefits of interventions aren’t immediately obvious in real time, it must mean that nothing is working, it’s the deep state, and she doesn’t WANNA do it anymore. Bless her heart.
 
Her best friend sits next her. She’s against statistics. And vaccinations. Her FB page says, “Nothing is ever knowable definitively. Down with the Scientific Method.” Have a blessed day.
 
The kid on her left spends all day doodling tattoos on her desk, arms, and hands. “Let natural selection sort it out,” is today’s doodle. She’ll see you later. She has to go pick up her dad’s rheumatoid arthritis prescription and her little sister’s heart medication.
 
She hangs with the kid who believes there is one operational definition of liberty and part of that definition is forcing other people to comply with her demands and act like everything is normal no matter what.  She posts about how the constitution is a document for her to consume personally and to apply to her personal set of circumstances. Her personal set of circumstances are that she does not want to wear a mask. And she really wants to be angry about that. Also her boyfriend hates government. He thinks a national response to a national problem is stupid as fuck. He’s super fucking pissed he has no bleach. He wants you to watch Plandemic.
 
Sitting by the wall over there is the kid who loves false choices and shuns nuance. He hears your questions, but his default setting response bares zero relation to what you say. He employs the worst of all bad-faith assumptions in assuming that those of us obeying our state's restrictions and supporting the making of science-based policy are enjoying this shit show and don't care how long it goes on. He’s a vocal trump supporter, but also not registered to vote. Cuz voting is stupid.
 
Hanging in the hallway during class cuz learning is dumb as hell is the loudest group of kids. They think you get less economic damage by letting the virus spread. They demonize what they can’t understand, especially anything related to science. They think hospitals are enough of a solution. Hospitals that many times are working with inadequate PPE and lack of testing materials. They’re okay if you die at your shitty job so that other people can have minimal interruptions in their lifestyles-it's the right thing to do. They think using the DPA to supply this country with all the supplies Covid testing requires, with N95s, and bleach is insane. They just can’t wait for things to go back to the way they were. And they’ll pray for you.

Written on July 15, 2020 
 

 
This is Hard, This is Fragile
 
This is hard, like my diamonds
chipped at strange angles
caved in on themselves
 
etched loud with love
and disappointment
resilient against the noise
 
of approaching black holes
but fortified with forces
bold enough to change the course
 
of waves and always hoping
to make long things shorter
leaving to time to leap rather than to fall.
 
This is fragile, like my diamonds
loose gravel all around slippery edges
reality shifting with the stuff in
 
gravity wells marking us deeply
so we assessed damage at times
on the way down
 
and I used to fucking worry
about the landing but some surfaces
never regain their composure
 
after a fall like that. This is hard
in a world that duplicates and takes
everything along for the ride.
 
My 'I' at one moment derives
from your 'you' of the previous moment.
In self locating uncertainty
 
I hover and no one sees me but you
spinning up or down with nonzero
strangeness. By the time anyone
 
notices us at all the wave has collapsed. And then the surface really has calmed.
There’s just the observation, then,
 
that this is hard
and this is fragile
exactly at the same time. 

*Pic is of my 25 year old wedding ring. We replaced it because it wasn’t really something we could renovate. It’s seen over this thing we’ve been doing, Dennis and I, for longer than 25 years now. It occurred to me that the remnants of everything my hands have touched or done are all over this ring and it shows. Happy Anniversary, Really Tall Guy. 

CW chronic disability/illness

Written March 31 2020

For Steel
 
In the morning my broken parts come for me before I’ve had a chance to form sentences, to make muscles into memory, and to forge steel for my backbone. There is no easy way to hold space through these wordless moments. They stretch out forever right up to the border of me.
 
This morning I ready my medication and use some left over Fiona Apple for strength. I glance at my phone as my stiff fingers and slow wrists spill powdered medications and pills all over the kitchen cutting board, onto the floor, and into the cuffs of my pajamas. My borders are easily breeched.
 
I look at my dinging phone notifications with today’s memory on my Google pic app, where my heart is held lightly, where my days leave tracks across my time, where my children are yesterday, and where my tendency to not delete digital content isn’t even remotely intimidated  by threats of full storage.
 
My fingers pick up dozens of pills, pink, peach, red, striped, all stuffed with life giving forces. I wipe up fiber. My amygdala argues some lies with me. My fatigue begs for more air time and my hips fairly scream as they bear my weight. I think it must be my photo app that steadies me, my hands, my legs, and my heart. I wonder at the power of it. It offers nothing really, just a few images, a couple whispered moments in passing as I hurtle onward through my existence.
 
There is no easy way to hold space through these wordless moments. They stretch out forever right up to the border of me. All the way through my breathing, deep into my most valuable heart beats, all along the floorboards where the pills hide and the powder is gritty and irretrievable, where days of stale crumbs and dried up shredded cheese remind me of how many months it’s been since I could cook or sweep, where lack of sleep has changed me, and where stretched out in both directions as far as my will could possibly reach, are these pieces and parts of me that are at their most vulnerable when they try to exist in the real world. I scatter easily. I am full of words that I cannot take back.
 
I gather me up and I hold me.
 
In the morning my broken parts come for me before I’ve had a chance to form sentences, to make muscles into memory, and to forge steel for my backbone. But now, this morning, I’m holding some raw material for forging. For when I’m ready. What happens at that forging will depend on who I am when I get there. 

*pic is of my dog, Luna, hiding from life

The Captain of All These Men of Death or Why You Aren't Infected With Mycobacterium Tuberculosis

In 1992-1993 I was treated for tuberculosis. Tuberculosis is caused by the bacteria, Mycobacterium Tuberculosis. You aren’t infected with the Great White Plague in the United States of America because TB control in the United States is a success story. It’s a success story that highlights the importance of public education and of funding promising research. The story of people taking action to stop the spread of TB is long and it started a long time ago in 1904 when Dr. Edward Livingston Trudeau founded the National Association for the Study and Prevention of Tuberculosis. He realized the treating and funding disease prevention means understanding how interconnected our world is. Although the disease is largely controlled in the United States, it remains a tremendous problem worldwide.

On March 24, 1882, Dr. Robert Koch announced the discovery of Mycobacterium tuberculosis, the bacteria that causes Tuberculosis (TB). During this time, TB killed one of out of every seven people living in the United States and Europe. TB was known as the Great White Plague due to the paleness of the patients infected with TB. You might know TB as Consumption. It was also frequently known as “Captain of all these men of death.” Today, our names for TB tell us where TB is located, pulmonary or extrapulmonary. Our names also tell us how to treat it, drug susceptible, drug-resistant, multi-drug resistant, and extensively drug-resistant.

I lived in south Florida during the Tuberculosis (TB) outbreak of the early 1990s. The incidence of TB in the Unites States was steadily increasing in the late 1980s. Florida ranked fourth in the nation with 1,707 tuberculosis case reported in 1992 for a rate of 12.7 per 1000,000 population. The Florida Department of Health and Rehabilitative Services in collaboration with allied agencies utilized several initiatives in their response to the outbreak. There were latent TB infections (LTBI) driving new case infections as well clusters of multidrug-resistant TB (MDR-TB) in the state of Florida at the time. Identifying and treating people with LTBI is an important public health measure since it not only prevents active TB from developing in LTBI infections, but it also prevents the interpersonal spread of the disease. These MDR-TB strains of TB were resistant to Isoniazid, Rifampin, and Fluoroquinolones. Those are our big gun antibiotics that we use to save lives. The goal of treatment is to keep resistant strains of TB from establishing here in the United States.

TB is spread from person to person through the air. If an infected person coughs, speaks, or sings, then the bacteria is expelled into the air. The bacteria settle in the lungs of people who breathe in the bacteria. Once inside the person’s lungs, the bacteria begin to grow.  From there the bacteria can move to other parts of the body. It usually affects the lungs, but it can also affect other parts of the body such as the brain, the kidneys, or the spine. The hallmark of a fully established TB infection is thick and bloody discharge from the lungs.

Not everyone who is infected with TB bacteria becomes ill upon infection. When a body keeps the growth of the TB bacteria somewhat in check for a while, we call this Latent Tuberculosis Infection (LTBI). Sometimes TB bacteria can overcome the defenses of the immune system and begin to multiply making a person sick after infection has occurred. Sometimes this happens relatively quickly, sometimes it occurs years after infection, or sometimes this happens later in life or during a time when the immune system is weak.

When I moved from South Florida, where I was working for The American Swim Coaches Association (ASCA) to Cleveland Ohio in 1993, I was hired for a job with MetroHealth Hospital in their family planning counseling and HIV counseling/outreach program that was funded through several public health grants. I underwent an extensive physical that included TB testing and titer testing for other diseases for which I had been vaccinated.  One of the results from my physical was a very positive Mantoux test, also known as a PPD test or TB skin test. The test was repeated. It was still very positive.

A positive Mantoux test is indication of two things: latent TB infection (LTBI) or active TB infection. I had been exposed to a person who had the TB bacteria and I was infected with it. My doctors did several things at this point. They sent me for a chest X-ray, and a sputum sample test. When they realized I had been living in South Florida for a year and a half, they referred me to the Ohio Department of Health for extensive risk assessment, contact tracing and testing/treatment monitoring. The goal of TB and LTBI testing and risk assessment is to identify people who are at increased risk for developing TB and who would benefit from treatment of the infection.

I delayed the start of my job while the Ohio Department of Health worked with the Florida Department of Health and completed contact tracing efforts in South Florida. Back then, this took quite awhile because there was no internet and no really easy ways to communicate rapidly. Using my daily planner (which was on paper back then), I listed all of the places I had been in South Florida. I was in my early twenties then, so I had been plenty of public places. After extensive investigation, hundreds of phone calls, it was clear that I had been several places where there was an increase in active TB infections and I had been several places where the Florida Department of Health was tracking folks who had not been compliant in treating their active TB cases.
Because of the resurgence of TB in the United States in 1987, the Advisory Committee for the Elimination of Tuberculosis recommended strengthening of TB surveillance to improve monitoring and to assist in targeting groups at risk for disease. I was really at risk for disease given where I had been, who I had been exposed to, and the level of compliance of these individuals in their TB treatment regimens.

In addition, because of outbreaks of nosocomial (hospital acquired infections) multi-drug resistant TB (MDR-TB) in New York and Florida during 1990-1992, the National MDR TB Task Force recommended that drug-susceptibility testing be performed on all initial and final Mycobacterium tuberculosis isolates from each TB patient and that the results be reported to the CDC. In January of 1993, in conjunction with state and local health departments, the CDC implemented an expanded surveillance system for TB. Following the resurgence of TB in 1985 and the recognition of nosocomial (hospital acquired infections) outbreaks of MDR-TB in 1991 the Public Health Service increased funding to state and local health departments for TB prevention and TB control activities including directly observed therapy (DOT). DOT means that you meet with a healthcare worker every day or several times a week so side effects of medication and health problems can be dealt with quickly. Also, they ensure compliance of medication regimen.

Lastly, because of my compliance with the Ohio Department of Health and the Florida Department of Health we had a ton of very specific information about me, the status of my TB infection,  and the people I had been around. The daycare workers I had worked with upon arriving in Ohio and the babies and toddlers I cared for during my time as a daycare worker had a chance to protect their own health appropriately. For this, I am eternally grateful.

Because of the requirements of my public health job, because of the actions of my doctors, because of the cooperation between the Ohio Department of Public Health and the Florida Department of Public Health, and because of the requirements of the Advisory Committee for the Elimination of Tuberculosis and the CDC, I recovered. It was a ginormous pain in my ass, but I recovered and I did not infect anyone from that point on because my infection was identified and treated properly.

Some of my life was delayed because of this infection and the treatment. I was on a regimen of several antibiotics for twelve months. There were side effects to be managed. I had to stop wearing contacts because my bodily fluids turned orange (side effect of the meds). My clothes were pretty easily stained as well when I exercised. I didn’t have much in the way of money at the time for replacing ruined clothes. I had to stop taking oral contraceptives (OCs) that were treating my painful ovarian cysts and what would be diagnosed as Stage 4 endometriosis two years later. I had several ovarian cysts that ruptured that year because I was unable to take OCs. I missed a lot of work because of this and suffered quite a bit as well. I had to start using a diaphragm for birth control, which caused a series of other problems that needed coping with. Luckily, I had health insurance coverage for the first time in my life through my job and I could finally get consistent and reliable treatment for these issues. I couldn’t drink any alcohol for a year and I had to have my weight, hepatic enzymes monitored frequently. I participated in DOT for a year and I don’t regret one minute of it.

There was a substantial decrease in the number of reported TB cases from 1992 to 1993 reflecting the effectiveness of prevention and control measures implemented during the 1989-1993 time period when the United States Public Health Services realized the threat from TB nosocomial infection and drug resistant infection that overlapped with the HIV outbreaks at the time in New York and Florida and California. Most states during that time period required that laboratories notify the health department about patients with cultures positive for M. tuberculosis. In response to an initial report, local health departments conducted investigations to verify diagnosis of TB and to collect information needed for completion of reporting. In 1993 79% of all reported TB cases were culture positive for M. tuberculosis. Public health intervention was absolutely effective at containing the outbreaks during that time period.

We shouldn’t fool ourselves into mistaking the world as we think we are experiencing it for the world as it really is. The two are related, but the relationship is complicated and its real work to figure it out. Fear is not part of that process. Fear is not a decent response to the world and the diseases that live in it. Any fear that comes upon you sudden enough will unfit you for thinking straight. Embracing bootstrapping or stark individualism wrapped in disconnected pseudoscience is also not an effective intervention for disease management.

I think its’s tragic how so many people embrace the notion that the biological world, the physical world isn’t an interconnected whole, while tiny bits of trees that were burned up a continent away lodge in their airways and a virus variant born on the other side of an ocean changes everything from their national economy to their personal health.

All of this happens while photons from a star 93 million miles away, captured by plants, animates the computer inside their heads to reject evidence of interconnection.

All of this happens while people first deny any mistakes, disasters, and even pandemics that descend upon them. When denial is no longer possible, then the mistake or disaster or the pandemic is assigned a source. I say source because usually the source is nothing of the kind.

Its just blame and blame is a form of make believe. I knew that even when I was very little. People who believe that the world is a disconnected mess and who take these ideas personally enough, will interview and air their grievances in excruciating detail, humiliating detail, spinning the narrative to create blame where none exists. To acknowledge this pandemic, to acknowledge the sickness, to acknowledge the tragedy of long Covid, to acknowledge death means that we must take another shape. We must acknowledge that we are interconnected. 

*The photo of the painting is called Sick Child by Edward Munch. It draws upon Munch's memory of his sister Sophie's death from tuberculosis at the age of fifteen. The model was a young girl who Much had observed sitting distraught when he accompanied his father, a doctor, to treat her brother's broken leg. Munch worked on the painting for a year, developing the rapid brushwork and vivid color that suggest the painful memory of his sister's death. He made several versions over a period of about forty years. This was his fourth version.