Monthly Archives: December 2020

One good thing: People going back into health care right now

(Photo by Go Nakamura/Getty Images)

My friend’s Facebook feed used to be a collection of pictures of her with her family, her husband and two kids. Then came the traveling–the living overseas. The posts about how good it can feel to be a doctor who retired.

And then the Covid happened. She recently communicated that she was going to let her credentials lapse, but she said God told her to wait until March 2020. And then she knew what she had to do.

My friend isn’t alone in going back to help after she’d stepped away. It’s a dated article, but this talks about people returning to work. Most of the news coverage on this topic is similarly dated. That doesn’t mean their decisions are any less amazing.

To volunteer to be in the front line is to risk your life, especially if you’re old enough to be in a risk group yourself. It’s raising your hand to care for a tsunami of risk and death.

That’s absolutely worth recognizing.

You made it through 2020. That ain’t nothin’.

For a minute think the challenges of 2021. Think about what happened this year.

Three major things emerged that have strained our mental health and relationships.

The first is the Covid. At the very least, most people have been isolated by it. Out of context, that type of isolation is a major life event. In context, it’s the low end of a spectrum that includes job loss, severe illness, and death of a loved one.

The second is the political disruption. Without picking sides, it’s been a tough year. Whether you support President Trump or not, very few have been untouched by people who feel very strongly that you’re wrong.

The third is the racial upheaval. As a white guy, I don’t know what it’s like to be concerned that you might be the next Breonna Taylor, Botham Jean, Ahmaud Arbery, or George Floyd. But even I see and understand the damage that was done in downtown Minneapolis or even here in Tampa near the USF campus.

And those three things don’t include the wildfires in California, the wildfires in Australia, the locust plague in Africa, the Christmas day bombing in Nashville, murder hornets, an overactive hurricane season, and whatever personal travails you may have processed.

It probably hasn’t been pretty, but here you are.

It took me five years to understand what I accomplished in 2015. I was sick with a disease that doesn’t typically go away. I was neck-deep in a project from hell with one other person. The product we implemented didn’t work very well and there was much ass-kicking. Our boss died. I couldn’t go any more and went on partial disability–then got my claim denied. Then I spent a lot of time and effort and won my appeal.

And heading into 2016, I felt beaten up and professionally diminished. That was inappropriate.

In a year like this, showing up every damn day, doing the best you can–even if it doesn’t feel like enough–is victory. There are no style points in a year like this.

That’s not just a easily typed platitude to make you feel better. That’s from someone who’s gotten a small taste of hell and made it to the other side. The biggest mistake I made was not taking a little time to look at that year as if my best friend had just survived it–and be impressed with that friend’s tenacity and resilience.

This morning, that best friend is you.

You made it through one of the hardest years ever.

That’s a hell of a lot more than nothing.

One good thing: my idiot-proof hydroponic garden

This summer, I decided to grow a tomato plant. That experiment ended after we went away for a week and it didn’t get watered. So this year for Christmas, my wife bought me an idiot-proof hydroponic garden for Christmas. In a few short weeks, we’ll have cherry tomatoes, dill, basil, and parsley.

Even I can’t screw it up. The base contains water in which the plants grow and it alerts you when more water or plant food is required. It even includes its own light source, so you don’t need to worry about moving it so it gets more light.

If it works out, we’ll be having some awesome salad, Italian food, and…I guess pickles.

Sometimes the gifts that didn’t come from your Christmas list are the best.

President Trump’s pardon of nursing home fraudster Esformes is a slap in the face to a key constituency. And it won’t matter.

Smokin Hot Fraudster Philip Esformes is out of prison after steeling $800M – $1.3B of your money.

The fact that President Trump commuted the sentence of Philips Esformes isn’t shocking. The fact that friend-of-the-court (amicus) briefings have been filed by four former Republican Attorneys General (Ashcroft, Meese, Mukasey, and Gonzalez), along with former Clinton prosecutor Kenneth Starr is enough to make you want to vomit.

Esformes was sentenced to 20 years in prison for reportedly filing $1.3 billion in false Medicare and Medicaid claims. Over 18 years, Esformes oversaw fraud involving a shell game of cycling patients through his phalanx of facilities and charging the government for unnecessary procedures and addicts promised doses of the very drugs they were addicted to, to extend their stays in his facilities.

Over a four-year period, more than 20 wrongful death lawsuits have been filed against Esformes-run facilities in Miami-Dade County. In an Esformes facility in Florida, a mental health patient who prosecutors said should never have been in a nursing home to begin with, was housed with an elderly patient. The mental health patient beat the elderly patient to death.

Now, after being incarcerated for four and a half years, Esformes won’t spend another day in prison on these charges. (He was charged in early 2016 and convicted last year.) The conviction still stays on his record and he has to pay as much as $5.5 million in restitution. But this is a man who was worth $80 million and who once owned a $360,000 watch. He also bribed a University of Pennsylvania basketball coach, paying him $300,000 to get his son into the school as a basketball recruit.

In other words, $5.5 million to him isn’t likely to be the same big deal it would be to most people.

Esformes is hardly the only questionable recipient of a pardon or commutation from a president known for randomly tweeting LAW & ORDER. While his desire for elimination of violent crime in the US is noteworthy, he also pardoned four Blackwater employees of the massacre of between 14 and 17 unarmed Iraqi civilians in 2007. Blackwater is owned by Erik Prince, a Trump ally, who happens to be outgoing Education Secretary Betsy DeVos’s brother.

But Esformes is unique in that his crimes targeted and victimized the elderly, a key Trump demographic. Some of his most vocal supporters are located in The Villages, a massive retirement community a short day’s drive from South Florida, where many of Esformes nursing homes are located.

None of this is likely to matter to those voters. But Esformes screwed the government out of between $800 million and $1.3 billion. Now he gets to walk away relatively unfettered while people whose rent is due and whose businesses are on the line have to wait to see if they get $600 or $2000 in a one-time payment from the government, in part because President Trump spent the month after the election pouting, when he could have been making it clear the $2000 was a priority to him.

There is no scenario in which commuting Esformes’s sentence is defensible. If a Democrat did it, Rush Limbaugh, Hannity, and the like would spend days proclaiming top-to-bottom corruption.

Because it’s Trump, to his followers, it’s not an issue.

One good thing: Strangers who make you feel like friends

If you drive south of Richmond, Virginia on I-95, you pass through Chesterfield County. That’s were several hundred people gathered on the side of the road to thank UPS driver Anthony Gaskins for all his deliveries. Residents said Gaskins not only delivered packages–some from grandparents who haven’t seen their grandchildren in more than a year–he always did it with a smile and wave and they wanted to thank him.

He was moved to tears as they lined up along the road to think him. One resident said he makes you feel like a friend when you see him.

Last week, I posted about on Twitter about Gary and Shannon, two people I’ve never met, but who do a radio show and make me feel like a friend when I listen to them. Another listener thanked them for helping us stay sane. I added the following tweet.

I also sent them cookies and a Christmas card. Most days I work at home alone and other than work calls, I don’t have a lot of personal interaction. They give me something to look forward to. They also taught me the proper way to cut a turkey breast and guided me to the LA microbrewery where I saw the following:

Today’s good thing is strangers, no matter where, who make you feel like friends. It’s something I’d like to get better at doing myself in 2021.

I’ve been wrong about Coronavirus (not completely). I’m sorry.

About a week ago, I went to Lowe’s and saw a lot of people walking around without masks. I got in the car after I finished, furious.

That was the beginning of my change of thought. Not about wearing masks and doing so correctly. You’re unlikely to convince me that’s wrong. I will do so when I’m around other people going forward. I’m not doing it forever, but I don’t have an end date in mind.

I was wrong in appointing myself the mask police. I never wound up being an active asshole about it. The closest I came was telling a guy in Publix that I hoped he wasn’t infected as he walked through naked from the neck up.

My assholishness–and I am a recovering asshole–was more covert. I became Judgey McJudgerson, swiftly dispensing swift and righteous judgement of the mind on anyone who didn’t measure up to my mighty standards.

No mask? Guilty. Mask below the nose? Guilty and annoyingly passive aggressive. Gathering in groups? How dare you do something I want to do but can’t.

Worst of all, I wore my judgement as a badge of Deep Concern, which immediately trumps any silly problems you might have with my infallibly science-based view of the world.

It’s possible that my attitude has damaged relationships; time will tell on that. I hope not, but my actions, like all others, have consequences.

It’s also very likely that I’m not alone in my inflexibility. It seems to be a time for that. Wear the mask or you suck. Or Forego the mask or you’re cowering in fear. My superior worldview has spoken, dammit.

I’m right and you know it.

I wasn’t as melodramatic as the Trader Joe’s lady, but I was just as unyielding. I was flexible and brittle and the very opposite of the type of person I want to be.

Kind of like me, except for the outward display of melodrama, the hair, and the bra.

In my opinion, if you don’t mask up and socially distance, there’s an increasingly rising chance that you’ll regret that decision. You might get infected. Your loved ones might. And the range of symptoms is stupifying. If you made something like this virus up for a book or a movie, it would’ve been dismissed as contrived.

But nobody’s perfect. I don’t see the world the way you do. And if I judge you for things if or when things go south, I need to first judge myself for the phalanx of horrible decisions I’ve made in life that I was lucky enough not to pay for.

And, in spite of my protective measures–the staying in, the masking up, the social distancing–I could wind up catching this stupid thing anyway. And considering the fact that I live with someone, I could transfer it.

So I’m sorry. Not for advocating for masks, not for asking you to considering wearing them, not for stories aimed at changing your view. I’m sorry for being a judgey schmuck about it, and violating the most repeated graphic on this august website.

If you ask people to wear a mask, it should come from a place of caring, from the realization that we’re all connected, especially in this. Haughty pronouncements of mask purity will only drive more people away from that.

So please follow the guidance. But if you don’t and things go sideways, we’ll deal with that if and when the time comes. And I won’t be a schmuck about it.

One good thing: Zoom, etc.

Imagine if this had all taken place in 1980. Or even in 2000.

This year has been horribly difficult because of the Covid and for a lot of jobs, it’s been a show-stopper. For a lot of workers, it hasn’t made a difference.

But for a lot of us, work’s gone on. We’re just having all those meetings virtually. Zoom. Google. WebEx. Even Facebook. Pick your poison.

Those tools have allowed us to connect in ways that wouldn’t have been possible a couple decades ago. I’ve been able to have a weekly card game with friends and we attend church every Sunday morning because of the tools that’ve been developed over the past several years.

We can even make it festive–and avoid cleaning up before calls–by adding custom backgrounds.

My preferred Zoom background. In an unrelated note, I have a meeting with HR first thing Monday morning. Not sure what that’s about.

No one wants to experience a pandemic, but if you have to experience one, this is the time to do it.

Why are there no pictures of the Covid front lines? Trump admin suppression or something else? Maybe both.

The article appeared yesterday on a website called The Intercept. Its headline breathlessly proclaimed the conclusion: How the Trump Administration suppressed photography of the pandemic. The facts in the article are slightly more complex.

On May 5, Roger Severino is the director of the Office for Civil rights in the Department of Health and Human Services, issued guidelines advising that it’s not sufficient for media or film crews to film patients even if they mask the patients’ identity. This presumably includes still photography. The prohibition is waived if each patient provides authorization first.

In other words, if you want to photograph an overwhelmed ICU, you must first get a signed HIPAA waiver from every patient in that ICU and you must also get them from anyone else whose Protected Health Information could be revealed. The implication is that the Trump administration is suppressing coverage of the pandemic at its ground zero–hospitals where the patients are suffering and dying.

Its case would be stronger if there were some internal communication that showed HHS specifically stating an intention to suppress coverage. It does not satisfy the headline’s statement that the Trump administration is suppressing media coverage. That doesn’t mean its not. Donald Trump’s disdain for any media coverage that doesn’t incessantly fawn over him is well-known.

The article points to a reality show called NY Med, starring Dr. Mehmet Oz, that showed a blurred-out patient in the emergency room who later died. The family later recognized his voice. The hospital, New York-Presbyterian Hospital, was later fined $2.2 million. By 2016, HHS had put the guidelines in place that Severino confirmed in his May 5 guidelines. But it dismisses this case because the images were shown on a reality, show, not news coverage.

The Intercept re-enforces that distinction, asserting that journalist tend to be more responsible than Dr. Oz and company. It says that the Trump administration, through Severino’s guidance, is suppressing coverage that would make the administration look bad and change the public attitude toward how we handle Covid-19.

The article then quotes a number of medical personnel who want the pictures and the story out there. Given the stories of people dying of Covid while denying its existence, that makes sense.

The articles also points out the risk involved with potential for liability involving leaks of personal data. Anyone advising hospitals around risk would be hard pressed to allow that level of risk. By relaxing the guidelines, Mr. Severino could presumably reduce that risk, by making hospitals less responsible for sanctions should a breach occur.

There’s no question that pictures of the suffering from inside hospitals would add emotional impact to the stories of what happens. Most of the images so far have been of exhausted medical personnel with mask lines imprinted on their faces from wearing them while they worked.

But the concern over patient privacy isn’t trivial, either. No one knows what the long-term impact of Covid cases may be. It’s possible (not necessarily likely) that in a few years, residual effects of the disease could make a Covid patient less attractive as an employee. If that happens, and if information leaked through that could identify someone who was suffering in an ICU, that would harm that patient and create a liability for any facility that allowed that information out, innocuous as it might be.

As much as Dr. Oz slinking around ERs in New York City looking for real tragedy to make money on seems distasteful, given 2012 guidelines, blurring a patient but not masking his voice might seem reasonable. However, it caused pain for his family and cost the hospital more than $2 million.

And when this gets sorted out, there are any number of personal injury attorneys who’ll broadcast their selfless mission in life to fight for your rights at your most (tears forming now) desperate hour.

While it’s possible (maybe even likely) that the administration is trying to limit coverage, the article doesn’t fully make the required connection. And you can’t just wipe away privacy concerns with the assertion that most media would handle things responsibly–especially considering that the media is not covered by HIPAA, but the care facilities are.

One good thing: Chico the clubhouse attendant (who gunned down Dodgers baserunners)

When the Dodgers had summer camp getting back to work this summer, they were short position players in the outfield, so clubhouse attendant Francisco “Chico” Herrera played. After misplaying a ball hit by Chris Taylor to a triple, Taylor disrespected him by trying to tag up from first to second on a fly ball. He nailed him at second.

Until the outfielders reported, Chico was an internet sensation. You don’t run on Chico.

Covid is a completely different experience when it happens really close to you

“So many people are dying from this and it’s a totally horrible thing, but when it happens really close to you it’s a completely different experience.”

That’s a quote from a former student of Clearwater (FL) High School music teacher Rosemary Caldwell Collins, who died from the Covid early this week. According to her family, she was fine Sunday. She died Tuesday.

In Douglas County Oregon, one person went to work sick. Later, he tested positive for the Covid. Within two weeks, seven people died and three hundred others were placed in quarantine. The article that described this didn’t indicate whether that person survived.

Until November, I didn’t know anyone who tested positive. Between Thanksgiving and Christmas, that number increased substantially. Now I’m personally connected to someone who died from it.

There’s been a lot written about living in fear–and how we shouldn’t do it. But actions have consequences. Rosemary Collins caught the Covid from someone. Seven deaths have been traced back to a single person in Oregon. And those three hundred quarantined–who knows how that’ll work out?

And if you infect someone and they infect two friends and they infect two friends and so on and so on, you have the shampoo commercial from hell. It’s like multi-level marketing where you have a piece of the action for the entire tree you create.

I shared the Covid with two friends and they shared with two friends and so on and so on and so on.

It’s a different experience if it happens to you.

Even now, the odds of my catching and transferring the Covid are small. I live in a suburban-rural area north of Tampa. But the odds of my encountering someone with the disease are increasing. While the Thanksgiving bump is starting to recede in a few places, most numbers are still higher than they’ve been. And even here, it’s been cold, which means people have been inside together.

So as New Year’s approaches, don’t be afraid, but while you assume your risk is minimal, consider the impact of what might happen if you let down.

Like the woman said, when it happens really close to you, it’s a completely different experience.