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Dr. Darrell White's Personal Blog

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Archive for November, 2020

The Heart of Thanksgiving: Sunday musings…11/29/2020

Sunday musings…11/29/2020

“This is my family. It’s little and broken, but still good. Yah, still good.” –Stitch

My professional buddy Mark sent a WhatsApp chat to our little group this morning, a picture of his family reunited after many, many weeks apart. It began with “After social distancing on steroids”, very much a universal sentiment in the days leading up to Thanksgiving, don’t you think? It certainly was for us. 

We had it going both ways in our little family. One child distanced out of town, imposing guidelines on everyone so that they could make it home. They were rewarded with a plane containing only two other passengers and a nearly empty airport on both ends of the trip. Sadly, our gathering with another child was delayed because of the contact of a contact. Despite everyone in the household playing by the rules a chance encounter at work by a contact’s contact forced everyone to wait on a test result (which blessedly came back negative). My Mom self-quarantined for 10 days so that she could enter my brother’s bubble. 

There’s nothing special about any of these stories, just that they are mine. Both of you reading my stuff did the same, and your people did, too. The “why” is really quite simple: Thanksgiving is about family. Not the turkey and the fixin’s. Not the annual Thanksgiving Day high school football grudge match played every year since 1920. Just family, and if you’re lucky, being with your family or what stands in for family (like Stitch). There are no gifts involved, no commerce or commercialism. The gift you give is in the effort you make to be present with and for family.

Thanksgiving is when you choose to be together. Hardships are understood and forgiven. Warmth is the abiding feeling, at least after you come home from that football game. The only thing burning is the fire in the hearth, and perhaps the garage where your uncle was frying a turkey. Burning issues are set aside for another time. Heat in the room comes from the blanket that’s been on your grandmother’s couch since you were a toddler. 

At least once on Thanksgiving you find yourself in a quiet place and you just sit and watch. And listen. You close your eyes for a moment and you feel 10, 20, maybe 50 years younger. Everyone is there. Everyone from forever. There’s your Gramp finishing the crossword puzzle. Mom is finishing the dishes while your Gram puts away the stuffing. Grampa is putting an old album on the record player. Grammy is passing out pieces of pie. A crowd is gathered around the pot where your brother is making turkey soup, the annual battle over how much to put into the soup vs. leave out for sandwiches is in its full glory. Cards are snapping off the deck, each new log explodes as it hits the fire, Dad is snoring. It’s every year, right there in this year. You open your eyes and just for a moment you can still see them all. 

Thanksgiving is that one time each year where you gather family together, in person or in spirit, and celebrate that you have each other. All families are little in more ways than not, even if they have many members. Likewise, all families are a little bit broken in some way at some times. But for the most part Stitch is right, all families are still good. Thanksgiving is when we remember that. When we give thanks for that.  Being together is wonderful if it’s possible, but this year teaches us that Thanksgiving is not at a football game or on a table. 

This year and every year Thanksgiving lives in our hearts. 

I’ll see you next week…

Time, Timing, and The Times: Sunday musings…11/22/2020

Time, Timing, and the Times: Sunday musings…11/22/2020

1. Flights. I misread a sentence that began with “flights of fancy” as “flights of decency”. Kinda like that old bumper sticker about “random acts of kindness”. 

Should be a thing, flights of decency.

2. Letters. Beth has an “uncle” who is an artist (as an aside, it’s still hilarious to remember when our kids discovered that Jay wasn’t really related to them). Over the years he has gifted me many times with stationary bearing his work. In truth these cards are so beautiful that I really haven’t had the heart to send them to anyone. It’s sorta like having a case of wine you really love and you just can’t bear the thought of running out.

Still, in these fraught times, despite having bad handwriting even for a doctor who once actually wrote in medical charts, I believe it is time to use Jay’s gifts for what they are intended. Perhaps I will take the opportunity to re-learn cursive, a skill that I might then be allowed to pass on to my Littles as a kind of social gift. 

And maybe, just maybe, Jay will pass on to me the rights to at least one of his drawings so that I can continue to enjoy his gift once the gift of having him here is no longer. 

3. Teleoanticipation. The science of finish lines. Another in the long line of Twitter finds for me. As creatures we seem to be wired to aim for the finish line. Not only is this goal-directed stance productive, but we also gain a sense of structure that leads to a reduction in stress and anxiety no matter how weighty a particular finish line may be. Just the fact that we know something will end, something other than a life that is, brings us a kind of peace. 

If we endure, if we can just carry on, we will make it to the finish line. 

This, as it turns out, is one of the great challenges we all face now as we soldier on through the Pandemic (seems like that should be capitalized). We have no finish line in sight. Not only that, but in something which nearly every public leader has compared to what societies have only faced before in cases of warfare or other devastating plagues, we’ve not received the kind of leadership that prompts one to forge ahead without any finish line in sight. Please note that this statement is not directed at any particular leader or leadership group in any particular city, state, or country. Churchill’s figurative progeny has yet to show their face anywhere on the planet. 

Without inspirational leadership we are left with a challenge without an end in sight. The challenge of living with the Pandemic, both for ourselves and others, is made all the more difficult because we don’t know how to pace ourselves. On Monday I was quite sure that I could see the end after a second company announced the success of their vaccine trial. Today’s newspapers are awash in analyses that explain why the vaccines will have little impact on the race just ahead. The finish line still lies somewhere ahead, out of view, with no guidance as to how far away it might be. 

I have played the game of delayed gratification before. Several times, in fact. Every doctor does so; we give over years of our younger lives to our training in favor of many more years of practicing medicine. Every parent does so as well; the joys (and travails) of raising our children come before most of our personal desires in most cases. But in both of these examples you can see the finish line, at least the finite finish lines of graduations and the new races that begin with them. 

It’s clear to me that a significant part of the anxiety we all feel now is the uncertainty we feel about not being able to see a finish line.

By any account I am in the last 3 innings of my own game of life. There’s just less time left, you know? I’m not saying that I have any strong fear of being sick, getting lifted in the 6th inning, and sent to the last locker room; like everyone I know and love I’m doing my best to stay healthy in all ways. No, what I’m feeling is this sense of running out of time. And not just time in general but the very specific time of being with the people I love. Family and friends here and afar. I see this in tiny decisions I barely know I’m making. I have always loved to read. My brother used to get so mad at my folks when I would get a book for Christmas or my birthday. “Now I won’t get to play with him until he finishes that stupid book.” Just this morning as I cut out the book reviews of my next reads I realized that I’m not really having next reads but rather choosing to do stuff I’d always read through because that other stuff means I am fully “playing with” those around me. 

Listen, I know that it is more than somewhat disingenuous to think of “stay at home” orders as in some way analogous to gathering in shelters during the Battle of Britain. I know that. Still, like those courageous souls who dutifully descended into the darkness to escape the hell raining down from the skies, randomly taking from them their futures, stories abound of the additional challenge those people faced in not knowing when their nightmare would end. Pheidippides did not know how far away he was from Athens when he began his fateful run, but he knew where his finish line was. 

“The last thing we run out of is the future.” Michael J. Fox. 

It is time that this Pandemic is stealing from each of us. The obvious theft of a life lost but also the theft of time that we have always chosen to spend among those we love. Time that we cannot spend in that way. Not knowing how long we will go without those connections, not being able to see the finish line, makes it all the more difficult. There is little comfort here save this: not knowing how long we will be about this is something that is real, something that is hard. It’s OK to feel that.

But as hard as it is, for most of us there is still some future out there. Still some time. Still more miles to be traveled, however near or far our own Athens may be. The most important step is not the next one, it’s the one we are taking right now. We run our race today, with or without seeing the finish line. We own only today. We stand on the mound, the ball still in our hand, ready to make our next pitch. Today.

Our future is the next step. The next pitch. We’ve never really known when we ran out of future, never really seen the finish line. All we’ve ever really had is today. All of our finish lines depend on us staying in the race today. Run today’s race. We can endure. We can carry on. We can reach all of our finish lines.

We can keep on running. 

I’ll see you next week…

“It Tastes Like a Memory”: Sunday musings…11/8/2020

Sunday musings…11/8/2020

1 Consilience. Knitting together of sciences and humanities.

Actually a word. 

2 Polymath. No, not many maths. A person who is knowledgeable or accomplished in many fields or across many disciplines. 

Good at consilience.

3 Single. As in single-payer healthcare. Prepare to hear a whole lot about this. Yesterday on Twitter I was taken to task by someone who works in the NHS system in the UK (not sure if they are a doctor as they did not say, nor does their handle give any indication). As we begin 4 years of the Biden presidency with at least 2 years of a Democratic-led House I predict that financing healthcare will be among the first 5 issues tackled. 

For the record I’m OK with addressing healthcare financing. 

What I won’t be OK with is the condescension leveled at me yesterday by the NHS employee. Their position is basically that as a private practice specialist who has worked under a pure fee for service system, I have no standing in the discussion. I am not a voice to be heard, pre-cancelled, nullified. For two reasons this individual could not be more wrong. As a taker of the Hippocratic Oath I am honor bound to advocate for that which is best for my patients. Every doctor has a seat at this table. 

The second reason my voice should be heard is because of the length of my tenure working in our present system. No, simply being an old guy doesn’t get me a seat. Being old enough to have worked in the system during HMO v1.0 in the 90’s does. You see, HMO’s as constituted in the 1990’s were a very good experiment in how a single-payer system a la the NHS or the Canadian system might work in the U.S. Top-down administration. Financial decisions rather than clinical decisions with regard to covering entire segments of disease, entire classes of medications. Patients and physicians quickly came to loathe how these HMO’s functioned; we actually have data to examine that should allow us to see how NOT to do it if it is to be done. On the positive side we could look to the highly successful Kaiser systems in place in Colorado and California, American models in which there appears to be much more satisfaction on both sides of the care relationship. 

This is a conversation that is worth having based on data that is available. It can be had without resorting to ad hominem and broad-stroke nullification. I intend to participate. 

4 Gizmo. “It tastes like a memory.” Beth, after her first sip of our family version of the Gimlet. 

Memory is a funny thing. We don’t really remember details all that well, we humans. Oh sure, some of us are blessed to be able to remember certain things better than others (I remember most of what I have read; Beth remembers most of what she does with her hands), but the details fade for even those so blessed if we look back over a long enough period of time. What we do remember, and what actually is likely to help us remember more details, is how we felt during a memory. Our emotions are like a kind of glue that secures at least some of the objective details of an event. 

As I walk my little dog Sasha I find that we are joined on our tiny journeys by memories of all sorts. As an aside I don’t really know why it is that memories come while we are walking rather than times of quiet repose. In any event, how I felt at the time of any particular event is what comes to me first. Be it happy or sad, triumphant or despondent, each memory is carried to me on a wave of emotion. I have lived–indeed I am living–a lovely little life; most of my memories are quite nice. Sasha and I are most often borne ahead under a rainbow festooned sky. 

The Gizmo is just such a memory. One evening Beth had a yen, but just couldn’t place the name of our drink. “Gimlet” insisted on hovering just outside her conscious memory. “Could you make we one of those Gizmo’s we like so much?” Equal parts hilarious and precious, our house Gimlet had a new name. It became a standing part of Friday night family meals, the first course in countless evenings that I now remember only by how I felt. Warm. Happy. Home. For a long time, I would order a Gimlet in any restaurant I visited, trying to start a meal out with those same feelings of a meal in. No one made a drink quite like a Gizmo; each meal out was fodder for new memories only. 

Last night we lingered over our Gizmo’s, awash not so much in the details of those long-ago dinners but in the emotions. Each sip bringing back to us the laughter and the love as we savored our memories. 

I’ll see you next week…

You Are More Than Your Vote: Sunday musings…11/1/2020

Sunday musings…11/1/2020

1 Fall. Back. An extra hour to your day in 2020. I slept in.

Why take a chance?

2 Election. Two. More. Days. Then we all learn a new word from the lawyers.

Admit it, last time you thought chad was a fish or the name of a guy in a silly commercial. 

3 Sports. At the moment I am pretending to watch the Browns game. This morning I pretended to care about yesterday’s OSU football game, and I was honestly curious to see if Padraig Harrington had held on in the PGA tournament being held in the Bahamas (he did not). There’s a rumor that high school football and soccer games are happening. One of the local parochial schools came in second in the state golf tourney. 

Sports are happening. Sports are a thing. 

Midway through the initial nationwide lockdowns the New York Times declared that there were no sports being played and therefore there was no need for a separate sports section in the national edition on Sundays. You kinda got the feeling that the editors and writers for the paper were happy to drop sports, or if not fully dropping, to demote them to a level several steps below the wedding announcements. You got a strong sense that the NYT, former home of giants such as Anderson and Berkow, writers whose prose was worthy of any subject whatsoever, was somehow embarrassed that they had a sports section. How else to explain the continued absence of a Sunday Times sports section.

When I was a relatively naïve college athlete who thought everyone liked sports I came into contact with this point of view. During one of my years in school there was a movement among a significant percentage of the college’s faculty to pull back from athletics. It’s been many, many years so what I remember is not so much the details as how it made me feel as a member of the college community. Unwanted, frankly. Mind you, this was many years before we became nationally renowned for our teams’ successes. We were competitive; games were fun. Then we all went to class. Still, a part of our faculty felt that athletic pursuits were somehow lesser pursuits. 

I’ve led a largely intellectual life since leaving college. Funny how I still seem to have the soul of an athlete. 

4 Wednesday. The day after election day is highly unlikely to bring closure to the election. Good, bad, or indifferent, we are unlikely to get the landslide victory that will head off the stampede to the courts for which both campaigns have been girding for many months. Eventually, though, a result will be certified. A president will have been elected. No one knows precisely when that point will have been reached, but it will come. When it does, I’d like to ask that each one of us pledges that we will do two things that Americans have done time and again during ages in which there was both deep alignment and profound disagreement about where our country should head.

I’ll start: Regardless of the results I will accept the outcome of the election. Regardless of the results I will acknowledge that there will be people I know and care about who are deeply saddened by the outcome; whether we agreed or disagreed on the issues I will affirm our friendship and do what I can to comfort them. 

In the end we do not live our lives within the confines of a ballot box. While there are definite effects of elections in our lives, how we live amongst each other, with each other, is so much more impactful. Your vote certainly counts, and I hope that you will have voted. But how you treat your people counts more. Indeed, how you treat people with whom you simply come into random contact counts more. 

Come Wednesday or whenever, I pledge to see you as who you are and who you’ve always been. Still.

We’ll all still be here, so I’ll see you next week…

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