It is hard to think that anyone is getting through this Covid-19 crisis unscathed. Even the super rich have fled and tried bunkering themselves, only to discover that they can’t get ventilators and the specially trained operators on site too if they are felled by the disease.
Most people are looking at at best, interruptions to income. Last week’s unemployment filings, 6.6 million, came after 3.3 million the week prior total and considerably exceeded the most dour forecasts.
Blood is in the street everywhere. From the Financial Times:
About 4m French workers — equivalent to a fifth of France’s private sector employees — had applied for temporary unemployment benefits during the past two weeks, according to data released on Thursday.
Spain, which has the third-highest number of confirmed coronavirus cases after the US and Italy, recorded the biggest jump in unemployment in its history, with more than 800,000 people losing their jobs last month. The country was already grappling with joblessness of 14 per cent and almost all the job losses came from people on temporary contracts, who represent more than a quarter of the workforce.
In the UK, almost 1m people have applied for universal credit, a state benefits scheme, while in Ireland about 34,000 companies have signed up for a government wage-subsidy programme in less than a week.
As readers know, big companies like airlines took bailout money and still fired staff. Gig economy workers are largely idled or barely working. A note from a well-known writer who lived in NYC:
Moved the family up to a rental upstate, it’s been exhausting. 2 kids (4 yr and a 7 month) + 2 cats + wife in a rented minivan. Precarity takes on new meaning.
While small companies are in line to get payroll support, banks (enlisted as the government’s agent) still don’t know enough about the program to set up documentation, let alone process loans. How many small businesses are flush enough to keep advancing payroll checks when they don’t know when Federal rescue money will hit their accounts? And keep in mind Treasury has threatened it has only a fixed pot, meaning some applications might be denied or pro-rated by being deemed to be on the late side.
And as the pink paper warned, it’s already too late to save jobs:
“It is and continues to be an eye-watering number. It continues to confirm our worst fears about the speed of lay-offs,” said Torsten Slok, chief economist at Deutsche Bank Securities. “[Job claims] tells you that government programmes are too late, and companies have already reacted.”
Many criticized the top-down approach, of funneling money through companies to workers (as opposed to individuals and households) as misguided, since trying to prop up businesses won’t preserve activity in a consumer-led economy. Admittedly, with so many stores shuttered and people frightened about their futures, it’s not as people would spend as if it were the old normal. But getting money to people faster would at least allow them to pay mortgages and rents, food, utilities, and other necessities and hunker down in place.
The IRS is planning to get its “$1200 a person” payments out to those who gave the IRS direct deposit information starting the week of April 13, but on a monthly basis, that’s barely above the poverty line. Those who will get a check probably won’t see it until May.
Even so, businesses are starting to fail. For instance, North Dakota’s Whiting Petroleum, a top oil producer in in the Bakken Formation, filed for bankruptcy on Thursday.
And that’s before considering those at health risk: the elderly, particularly people in nursing homes. Front-line medical workers, who are also exhausted and traumatized. Individuals with auto-immunine diseases, or weakened immune systems, like chemotherapy patients or HIV sufferers. And even though people who are relatively young with no co-morbidities may consider themselves to be at risk of only getting nasty flu symptoms, that is not always true. For instance, the CFO of Jefferies, in good general health, died of coronavirus complications at age 56.
But these are all facets of the huge shock to how we once lived. Most people idled at home, some working remotely but most not. Parents having to entertain and educate school-aged children now at home. College students at loose ends, with graduates looking at un or very serious under-employment. Those that are “essential” are burdened by having to do their jobs while minimizing disease risk to themselves and others, with many like doctors and nurses enduring extreme hours, hazardous conditions, and emotional distress. And the backdrop is that many businesses won’t make it or will survive only as shrunken versions of their former selves, due not just to the immediate impact of the crisis shutdowns but also to long-terms changes in habits, such as diminished tourism and business travel. And that charitably assumes we don’t have additional dislocations, like meaningful drug shortages.
So many are experiencing personal crises, or are worried that one is just around the corner. And even those who aren’t in distress can’t help but feel weight of needing to take new precautions (and doubts as to whether they are sufficient), the sense of dread about the new emerging order, which is shaping up to be even more hostile to ordinary workers, and a sense of powerlessness.
In most respects, I am vastly better situated than most people. I work at home. I reduced my fixed costs by moving to Alabama. NC revenues will take a hit and I don’t seem to be eligible for the Payroll Protection bailout.1 However, the state is project to have the fourth worse death rate, so it is not as if I escaped being in a hot spot.
As readers have no doubt inferred, I am not exactly the most emotionally well-regulated person even in the best of circumstances. I have lost my stress outlet of going to the gym regularly. Having my nose in the news all day isn’t exactly conducive to staying calm and cheery, particularly now.
However, what is really upsetting what little equipoise I have is keeping people from killing my 92 year old mother, who also has COPD. When I did go to the gym, long before anyone here was taking coronavirus seriously, I was Miss Alcohol Spray Bottle, letting the spritz sit for at least ten seconds on everything I would touch, on top of washing my hands multiple times during a workout.
But it has been a real struggle to get people who consider themselves to be medical professionals to take adequate precautions. I should have seen this coming. My gym has a high level of doctors in its membership, yet even after the state closed all schools, only a very few were taking additional precautions. And no one was remotely as stringent as I was.
For instance, my mother’s home health care aide agency has mainly nurses as managers. I had to put a sign on the entry door regarding +20 second handwashing and send the WHO video a month ago. I got a patronizing response although they do seem to (finally) be doing it, I suspect due to all the MSM messaging.
I sent articles and instructions about cleaning cell phones early on. I am pretty sure that is not happening.
The aides are supposed to clean countertops and sinks as part of their daily duties. They don’t in the bathrooms. A hospital journal says all frequently touched surfaces (like handles and switches) need to be wiped down 2x a day. I do it myself in the evening but they need to do it during the day. I’ve pressed the agency on that (sending supporting studies and articles). They don’t appear to have instructed the aides even though they said this was “good information.” Help me.
I then sent on the video from the Michigan doctor on cleaning groceries before bringing them into the house (which was validated by being featured on NBC Nightly News a few days after it ran on NC). The agency said they’d send it around but I didn’t have the sense they’d make this protocol a requirement, even though most aides now are shopping only once a week for their clients and hence have more time than they once did.
Oh, and the aides are not wearing masks even though I put them out with another note on the outer door in super big font about them. I have been providing masks made along the lines of ones used in Venezuela, which by virtue of being under US sanctions, cannot obtain surgical masks. I have been wearing them every time I go out, for the safety of others as well as to prevent me from touching my face between hand washings. You can see a short video on how to make them:
Nice primer from @vtvcanal8 in US-blockaded Venezuela on making your own #COVID19 mask pic.twitter.com/yG9dD0K3FW
— Max Blumenthal (@MaxBlumenthal) March 15, 2020
They are made from disposable washcloths, which are adequate to impede droplets and hence spread.2
I have not been able to find large enough scent-free washcloths locally. The smell is obnoxious but not harmful (unlike alcohol, which as Miss Alcohol Spray Bottle I can attest to personally, or bleach fumes). I have ordered scent free ones and they were supposed to arrive earlier this week but are late. Most of the aides are refusing to wear theses masks.
Thank God, since the CDC is now recommending masks for community use, I will finally be able to insist that the agency provide them if the aides won’t use ours.
But this is the sort of thing I am dealing with, people coming in every day who simply don’t take good enough care. One regular is actually good about cleaning (but hasn’t implemented the grocery protocol, grr) and we just got rid of another who wasn’t (I was going to send in a note about her failure to do clearly mandated cleaning but she snapped at my mother, my mother told her to leave, and she didn’t want to come back, which was fine with us).
And before you say we are asking for too much, these aides sit next to my mother watching TV or their phones for more than six of the seven hours they are here, maybe only 5 1/2 hours if they pick up groceries.3 It’s not as if doing the cleaning, some of which is listed as job requirements but is not getting done, is a huge ask. And my mother feeds them lunch which she is not required to do and she does not ask them to cook, which they would be obligated to do if she asked.
But what frosts me isn’t the aides per se, since I understand in a business like this, it is hard to get good people. What bothers me is the agency’s apparent indifference to the issues I am raising. Don’t they recognize that they have liability? Don’t they recognize that they have reputation risk? Don’t they recognize they have a moral obligation to at least try to get the aides to protect their clients?
And it isn’t just the agency. Worse, it’s also my mother’s doctor.
Without belaboring details, twice in the last month we called his nurse with two minor issues. My New York MD would have handled one and likely both over the phone. Remember my mother has mobility issues, so even under normal circumstances it is hard for her to go in and this is now a new normal. Oh, and my New York MD has her own practice, while my mother’s MD works at the Kirklin Clinic, a ginormous outpatient clinic affiliated with the University of Alabama’s medical school, meaning he is salaried and thus should not have financial incentives at work.
He insisted she come in both times. The most recent time was late last week, after Birmingham proper had been put on shelter in place.
Mind you, Kirklin Clinic is a massive disease vector. It’s a huge facility where you line up to check in for tests (no social distancing!), have to talk to an intake clerk for a few minutes, sit in a waiting area downstairs (lots of people nearby, chairs not cleaned during day), go into a test room for a blood draw (room not cleaned between patients), take an elevator upstairs (!!!), use a touch screen to check in (!!!!), sit in another waiting area with people all around on who-knows-when-if-ever cleaned chairs, into yet another exam room where nurses take additional readings (room again not cleaned between patients) and then into the MD exam room.
I tried to get a private duty nurse to come out to do a blood draw but the MD insisted on inserting himself and then being dilatory about it. 4 I got the message the doctor didn’t think this was urgent, and I didn’t like the idea of anyone new coming in the house any later than this week (our infection rate is doubling about every four days) so I told them if we couldn’t get the nurse out on the 2nd, to forget it.
No one got back to me.
In the meantime, I came up with a treatment which is working and a friend with an elderly mother has a similar condition and gave further clues. I have a good guess as to what happened and what to do to prevent recurrence.
But this is a short way of illustrating that I am dealing all the time with people who seem cavalier about coronavirus risks, which is simply stunning among supposed medical professionals. Then I have to waste more time and energy containing my choler in my communications with them so as not to blow up the relationship.
Nevertheless, given my comparatively privileged position, I feel guilty about up my degree of upset and my inability to contain it.
For instance, due to yet another screw-up, I had to go to the grocery store yesterday (we are trying with limited success to reduce how often we go). The store was quiet and one of the employees was in the entry. I pulled out my magic Alcohol Spray Bottle to treat the handle and the parts of the cart near me and dug into my bag to appear to be doing something while waiting for at least ten seconds to pass.
The store employee seemed upset that I was cleaning the cart and told me, with a bit too much energy in his voice, that it had been sanitized.
Unfortunately, in a sister store, I had seen what this sanitation amounts to. They use a bottle of something which I could tell from the smell was not very strong, certainly not 60-70% alcohol, which is the fastest pathogen killer. And they were wiping down the carts again and again with the same dirty rag.
So instead of being a mature adult as I should have been when everyone is under stress and just given a genteel blow off, like “I feel better by doing this,” I instead had to say, “I’m sorry, I’ve read hospital journals and I’ve seen your sanitation and it isn’t adequate. I know you are trying to do your best.”
I felt like an utter jerk. I walked into the store, with paper towels between my hands and the handle. I then grabbed plastic veggie bags, put one on each hand, and did my shopping.
I was disconcerted to see none of the checkout clerks wearing masks when I had read this chain was putting up barrier between the cashiers and patrons for their mutual protection. But this time, I kept my thoughts to myself and exchanged pleasantries.
___
1 The attractive feature of the PPP is that loans are supposedly forgiven if you maintain your payroll level. However, I only take a teeny payroll and on top of that, just once a year, in the fourth quarter, which I gather is not all that uncommon. But not having paid payroll in the spring of 2019 appears to make me ineligible.
2 We don’t have old clothes we could cut up for masks because we’ve given them to a local charity.
3 The pay is almost certainly lousy, but this agency provides health insurance, and some of the aides work enough hours to get it; one early on was shocked at the idea that another agency in town does not provide coverage. I am pretty sure our aide who likes to clean is booked enough to qualify.
4 Even though my mother had already spoken to the MD about her issue, and he said he wanted a blood test without stating, he then wanted to have a phone talk late next week as a precondition of having the nurse come out. Mind you, my mother was prepared to pay the private duty nurse personally, and there is a Labcorp less than a mile from here, so all we needed from his was an Rx for the tests and a way to get vials to Labcorp. But no, we had to do it his way, apparently through his clinic’s lab.
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Yves, why should you feel guilty about all this? Society is collapsing around you, and your fellow citizens are selfish assholes who don’t understand that their behaviour is killing the weakest and the old. They just DGAF. It seems to me contempt, or at least outrage, or at least “a troubled visage” is called-for. And who knows? Maybe those grocery store clerks will get the idea that they need to up their cleaning protocols, and maybe their management will listen to those clerks, and it’ll happen.
I’m still waiting for my pony. But if I were in your shoes, I’d be pissed-off at these idiots, too.
Contempt is a good word. When my wife was going through various cancer treatments, so vulverable immune system, it amazed me how many personnel coming through her door didn’t bother with the hand sanitizer. Doctors, nurses, assistants… some simply didn’t care.
When on chemo last year, the nurses look after 3 or 4 patients at once. Always washed and new gloves and mask, sometimes new paper gown, always. But, that was when supplies where plentiful I guess.
One session, there was a woman from audit who sat for 3 hours and watched the nurses and doctors, making sure the protocol was being adhered too.
And, yes, Yves, stop feeling guilty while others around you fail to take the situation seriously. It’s your very life we are talking about here.
What this crisis will show very very clearly is the type of a society one lives in.
Here in the CZ where I’m during the lockdown, the masks in public were mandated two weeks ago (19/3) a week after the movement restrictions went in place. There were no surgical masks available, so people sewn their own, and the slogan was “my masks protects you, yours protects me”.
All shops must provide one-off plastic gloves for shoppers, and all shoppers must wear them (I have seen security in a shop telling people to do so, and ejecting them when they didn’t).
But it’s getting on to people, especially as the economy is closed down a lot. My neighbor is self-employed, and she still has to pay rent on her premises (fortunately she shares it with others, so it’s not a killer), but she says her younger colleagues had no financial reserves at all (because, you know, a fancy iPhone is more important). The govt tries to help both employment and self-employed, but it’s slow in kicking in, and a lot of hospitality/tourism businesses will kick the bucket – and are unlikely to recover anytime soon.
It’s going to be rough.
I’m very sorry to hear you are going through all this, Yves, its so infuriating when people don’t follow basic rules or just failing to use common sense.
I commented here before that I’ve noticed a sort of cognitive dissonance sometimes in ‘experts’ in a topic – somehow, they don’t think lessons learned apply to them. To take a general example, the number of doctors and nurses who smoke is pretty shocking. We’ve seen a few examples of experts (like the Russian virologist who infected numerous colleagues) who act as though they are immune through their own superior knowledge.
I believe this is where it’s really really important on the message the authorities send. In the US, and the UK, the message sent was “do this, but you see, we’re not doing it” – until Johnson got infected, and since he’s still not recovered, I suspect it may be worse than they are letting out. Only then they did start distancing and all.
In the CZ, I believe one of the reasons people are actually pretty good a this is not some innate betterness, but because the authorities from the moment they announced it started practicing it very visibly. All talking heads on the TV have masks. When they do a new conference, they are very far apart – from each other, as well as journos.
You see things cleaned immediately, and definitely not with some dirty rag. That all tells people that if the powerful (and visible) do that, there must be something to it.
Where it was ignored here were, as we discussed a few days back, was nursing homes, at least some. The small town I am in has a small town run nursing home, and from what I’ve seen they were pretty good at this, including trying to help seniors living alone by say shopping for them. But there were new very publicised cases of rather appaling nursing homes “care”
The TV presenters wear masks??? Totally cool.
not just TV presenters. Pols, any live programmes (for exmaple, the public TV is trying to broadcast some school lessons. 3 kids + a teacher. When one of the small kids today pulled his mask below his nose, he was immediately told to put it back up), EVERYBODY.
All masked like bandits :D. I had a ski mask I used to wear in the winter for motorbike, and was thinking of wearing that to the local bank branch :D.
But joking aside, you literally won’t find a picture of ANY public figure that is less than two weeks old w/o a mask.
Could I prevail upon you to send a vid or two? This is really important and worth a post or at least a feature in Links.
in an email.
I saw part of a CZ video on Oz TV tonight. Just went looking and here is the full video which features the Minister of Health of the Czech Republic. Just not sure why it is in English unless it is for international consumption-
“How to Significantly Slow Coronavirus? (featuring Minister of Health of the Czech Rep.) #Masks4All”
https://www.youtube.com/watch?v=jZtEX2-n2Hc
That appears to be the English version of the Czech video.
CZ has a reasonably large English-speaking population, but I believe this video was made by the group of people who were behind the Czech move to do home-made masks, as the “I protect you, you protect me” is the Czech slogan which went viral as this was happening.
I meant to write “was made for international consumption”.
Eric Garcetti, mayor of Los Angeles, now wears a mask at his daily briefings and urges everyone to wear one when outdoors:
https://www.nbclosangeles.com/news/coronavirus/watch-live-mayor-garcetti-holds-daily-briefing/2339922/
I am just listening to a Coronavirus briefing from Canberra and the health official just said that masks are not recommended at the moment. Same old spiel of how they are uncomfortable and can be dangerous if worn incorrectly. Exasperation does not cover what I am feeling at the moment.
Some more on the CZ. The govt here acted fairly aggresively when after midterms it appeared that a lot of people holidaying in northern Italy, who wer supposed to go to a mandatory home-quarantine were ignoring it. The mandatory quarantine was on midnight from Fri to Sat, on Wed next week schools were closed, Fri all non-essential travel banned. Next Fri mandatory mask instituted. That was three weeks from first identified case detected (March 1). And after the govt more or less ignored it in Jan/Feb (which lead to massive shortages of PPE).
Don’t know whether that helped, but CZ so far has a fairly linear infection progression, not exponential. It’s about 6% of tested, with about 60 cases on ICU and about <300 cases hospitalised. On per-capita basis, it's really good. (I'm not counting deaths, as the methodologies of death-by-CV differ a lot).
Yves you are right to do everything you are doing. I am a HCW and have been “flu shamed” by colleagues and yelled at by patients for recommending any precautions up to 3 weeks ago when NYC got hit. The “only the flu” message got a lot of people sick already and was a huge mistake. I believe it was meant to protect the economy and corporations but we see how well that worked sadly.
The experts are being asked to work in either ideal conditions or terrible conditions. HCW I speak to are either getting adequate PPE or are assuming everyone will get sick (seriously). The cognitive dissonance is real because some of their trusted sources have been guarded about the seriousness of this situation, partially to protect valuable PPE which is running out here.
I know a few HCW taking low dose vit c and/or zinc as insurance. I am taking both with a little vit d to enhance immunity for the duration. Vit C deficiency can make the severe pneumonia worse. Supplements in high doses can cause kidney stones in some though.Thank you for the video on making masks. Just everybody remember they need to be sterilized (wash in hot soap and water and dry thoroughly for cloth) after each use or dispose of them.
Thanks for your comment.
Soap for washing (in a washing machine) looks not to be high enough concentration of soap or heat to kill coronavirus. Hand washing with a higher soap concentration would presumably work.
The other alternatives are to let the masks sit in a bag for a few days (so the virus dies, it appears to die faster on cloth than on surfaces) or dampen them and nuke them in a microwave for a couple of minutes and then wash them.
When I was a nurse tech about a quarter century ago, I called the Infection Control Manager with some concerns about protocol. She said, “It’s a buggy world.” And that’s the reality. I took it as, do what you can to decrease viral load.
I worked night shift, so I was able to spray door handles with my homemade 65% ethanol. I had looked into the disinfectants the hospital used and found them lacking. An older nurse told me about alcohol efficacy, but the hospital wouldn’t use it due to concerns about fire hazard around electronic equipment. Fair enough. But the manual also had us washing down everything during the night shift, an absolute joke considering staffing. Pure CYA.
The virus is now in a class with politics and religion, subjects I don’t talk about except in controlled circumstances, with people I really care about. Janet and I are already considered tinfoil hatters among some we know (actually it’s silver-lined clothing). But Janet is a 40-year RN, with a patient with respiratory problems as well as cerebral palsy, who will be triaged out in an instant. The patients mother is committed to safety; the daughter had been in the hospital about a month ago, they’d seen all ICU units converted to negative pressure, two people had died of likely Corona. The mother had a cousin whose father died of cardiac (which turns out to be involved w Corona), was tested positive post-mortem, and then the mother was taken off the vent last week. None were counted as Corona deaths.
So we are isolating almost as much as we can. I wore a mask last time I was out, saw another non-oriental in a mask, so that made three at the time, a couple days ago. I still felt weird, and I am elite in my capacity to be publicly foolish. We don’t have insurance, and have taken steps to isolate at home if any of us get sick. The hospital is vector central, and if you’re put on a vent, you’re probably going to die anyway, those percentages look very bad.
As for the Federal government:
“The enemy,” retorted Yossarian with weighted precision, “is anybody who’s going to get you killed, no matter which side he’s on”
Have to say that we are in the same boat here. My wife also has COPD and if she gets Coronavirus, it will be a death sentence. By ourselves we could do a full lockdown fairly easily but two of our adult kids have no idea about virus security and are almost ignoring events simply because they have not experienced it yet – and one does not even live here.
I am hoping that soon the government will mandate face-mass in public as perhaps that that will make them realize how serious it is but till then we are compromised isolation wise. And I too have noticed the cognitive dissonance that PlutoniumKun talks about. I have met no-one who has any idea that there was a global fl pandemic a century ago and too often the attitude seems to be that it can’t happen here.
People seem to live in bubbles, larger or smaller, that deflect or screen out impacts from reality. How much of that is due to a type of Alvin Toffler’s Future Shock, or if one prefers, of a more modern Information Overload?
We’ve seen small examples of a type of forced learning, most recently at a grocery store. We ask the checkers how they are faring, and if the shoppers are being nice. One yesterday said that a previously surly shopper apologized and mentioned that his kid was now a checker so he heard stories. That type of personal experience may be what it takes to pop or deform the bubble(s) at least a little bit.
The above reminds me of an old expression that begins: Experience keeps a dear school. We must try not to arrive after the tardy bell.
Here is a link about Toffler’s book.
Sorry to hear about your situation. For a point of reference, my wife and I are still just about the only people wearing PPE (mask, glasses, gloves) when we go out to shop in Great Falls, MT. My mom also has COPD, and we managed to convince her to self-isolate. She lives by herself here in town, and I “scrub in, scrub out”, each day when I check on her. Same protocol for groceries or anything else that enters her house.
The amount of polite snark we get about the PPE is pretty ridiculous. Was uncomfortable at the start three weeks ago, but I’m over it now. I used to ramble off something about how having worked with wildlife diseases made me paranoid, but my go to now is:
“What did the the comedian say to the corpse? You should have worn a mask.”
Pretty good conversation stopper. I hope some of them get the point.
I wish y’all the best of luck.
I’m not sure if I should say “saddly” or LOL, but you might find this apropos…
https://www.fastcompany.com/90479846/the-untold-origin-story-of-the-n95-mask
It appears the origin of the medical mask was a Chinese doctor who upon display during an epidemic in China was told by a French doctor is a very racist fashion, “What can we expect from a Chinaman?” The French doctor proceeded to visit the sick without a mask and ended up dead himself.
Great story. That Chinese doctor was quite a guy. I bet he had never heard the word ‘schadenfreude’ when that happened, but I bet he couldn’t help feeling it.
I feel your pain Yves. You must be so worried about your mom. You have a right to be.
I’m at higher risk because of age and lung issues and I’m terrified. Example: a guy showed up yesterday in our yard (the front gate was locked) and I was stunned until I realized that he was there to mow the lawn – I’d given the gate key to the landscaping service last year but hadn’t asked them to start yet this year. He probably saw the abject fear in my eyes as I told him behind the closed front window that I’d call his boss when I wanted the lawn cut.
We pick up our groceries at a drive-through and I see people hanging around in the parking lot chatting away. No masks, no gloves. Some are keeping their distance.
I don’t know if I’m overreacting but I really don’t want to suffocate to death.
If it makes you feel better, I’m 28, having less contact outside the home than anyone I know, have about 0% chance of catching it considering I don’t plan to leave the house until at least May 1st, and I’m *still* terrified.
You’re just practicing what should be common sense. The way I see it if anyone is reacting differently than you, the problem isn’t you.
Don’t feel guilty. You have some pretty good reasons to be annoyed and angry. Almost everyone is affected by the virus in one way or another. It has imposed drastic changes on most people. Your experiences may not be as severe as some, but they are still worse than many.
In more than a decade of blog writing you have written about the many the political and economic injustices in the world. This is one which is threatening the life of somebody you love.
(The damage that Trump has done by not acting on this is incalculable. It boggles my mind that people still aren’t taking this seriously.)
“Then I have to waste more time and energy containing my choler in my communications with them so as not to blow up the relationship.”
that’s the hardest part, innit?
I feel very fortunate that the medical people in my life…including stepdad’s nurses—4 in all—one of whom comes each day appear to be on top of it….and terrified.
(stepdad wouldn’t make it a day with this stuff.)
my son had an online consult with our regular doctor yesterday(20 year relationship, first name basis)…with his usual banter, he iterrogated us on our quarantine procedures
and the oncology clinic and everyone in it.(by now, we know all the staff…and last summer i brought buckets of cherry tomatoes for them all, every time we went, throughout the season), are above and beyond.
All of these folks are taking this very seriously….and they’re obviously worried as hell.
But:
in my town…and the only 2 other towns i’ve been to in 2 weeks…few are wearing masks…and they look at me with my bandana(in addition to my mountain man/druid appearance) like i’m something out of a movie(i’m well used to this, of course, as it didn’t start last month….it IS, however, a wonderful and effective social distancing technique, especially if i can remove any traces of a smile from my eyes(see: Glamour, in Wiccan thought))
it feels as if this is mostly a Warding gesture…denial that it’s happening, because they cannot deal with it.
I get that from my brother, too..
I’ve run across some who are likely still thinking it’s all a big sham…a hoax…just by the smirk when they see me being extracareful
(wife=cancer/chemo, mom, old, not as robust as she used to be–stepdad, paraplegic, ill health, a long term bedsore problem—-and me+ likely beginnings of copd(damned cigarettes), terrible allergies(like everyone out here), and rather severe arthritis)
i’ve heard very few instances of public expression of this alleged hoax-hood, which means that—like uttering the N-Word—this is regarded as uncouth.
sadly, being rough with your healthcare people might end up being necessary…and sooner, rather than later.
They, above almost everyone else, simply must get the derned message on this.
It’s obviously and very simply Malpractice…which once was a word that sent chills into the spine of the management.
We’ve fallen very far in my lifetime.
Good luck Yves…and remember that on planes, it’s recommended that you first put on your air mask, before tending to your kids’.
oncology clinic
They are the best staffed and have all the resources they need. It shows where priorities are. They are massive profit centers.
Watching my parents deal with that was unreal. Lots of crowded, understaffed hospitals with old equipment. Then walking into an oncology center with lots of staff , brand new equipment and Leather easy chairs with a flat screen TV for each seat. This was over 10 years ago, so it was quite impressive then.
Neither of them survived, but thankfully they had very good health insurance. I’m not even sure if you could buy what they had today.
amen. we’ve done the in-hospital chemo, too…waiting for medicaid to kick in fully.
much better at the clinic…although no tv’s in the Chair Room.
I’m just happy as a clam that medicaid covers that stuff.
Otherwise, I guess i’d be growing opium or something….and mixing up tumeric tea and rhino horns.
the clinic is Texas Oncology…big outfit…all over Texas.
and while , like the Methodist Hospitals, I’m certain the ceo’s and shareholders make out like bandits, it’s not obvious at the patient level. The financial person we got dealt is most definitely on our side… and the one Suit I’ve met at the clinic seemed to actually give a damn.
many Suits i met at the hospital did, too.
the shenanigans are passed off to the System, that hovers, god-like, over a flaming bush somewhere, and must be satisfied.
They(especially the financial person) try to navigate and game that system as best they can.
Pure anecdote, of course…random people I bump in to.
from the month or so of before-medicaid, we’ve got around $10K in debt that will likely never be paid.
blood from a turnip, and all.
but i learned to live without a credit score long ago.
they do not take green beans and yard eggs(i asked)
Opium poppies are easy to grow, at least here and probably there. It’s a winter annual – plant in fall, blooms in spring. Fairly common in gardens, since it’s big and very showy; but by the same token, hard to hide. My work partner suggested eating the leaves as a mild analgesic. You can make tea from the dried pods, too – the seeds are food – but scoring the pods would be a good way to get in trouble.
Corona is bringing out weird behavior in lots of people. And highlighting the stupidity of some.
My 78-yr-old mother with weak lungs and other pulmonary problems, who is normally a germ freak and an insane cleaner [the type who gets out alcohol and a toothpick to get nooks and crannies such as the edges of the faucet handles–even before coronavirus] and hyperconscious about these things, went out to the supermarket by herself the other day. GAAAH!
I found out when I was badgering her not to go visit her brother in the rehab center, which is full of cooties. WTF ma? We know she feels guilty about him, although she has no reason to. She confessed she had hatched the plan due to her own cabin fever as much as anything. She is a PhD economist lady from a generation when women didn’t study Econ, so she is smart, but in this case kinda dumb.
Corona is bringing out weird behavior in lots of people.
Yes, it is. I have seen a few people I’ve known for years exhibit weird-for-them behavior. I’ve seen some longtime social justice, peace and love folks, who are suddenly worried about themselves, turn into selfish, raging pricks about other sick people ‘clogging up’ the health care system. Really, one said ‘they should just let old people die and save ventilators’ (presumably to save a ventilator for him if he gets sick). I was shocked! Mr. Peace and Love, eh?
I’ve also seen some longtime conservative, quiet, taciturn, America First folks become generous, community minded, and extremely helpful to even strangers during this stressful time. I was equally shocked.
It’s a funny old world.
In this part of AZ there are a lot of retirees. It’s like a scene from Dawn of the Dead, with so many of them shambling around the grocery store. One chap I see from time to time seems to go to Costco every single day, just to check it out. Maybe they are tired of life, and are secretly hoping to get the illness?
If AZ is like here, he might be checking to see if TP is back in stock yet. Lots of people here visiting stores more often than usual just to see if they can buy TP. It’s starting to resemble the old TV news footage of “empty Russian stores, where people queue daily for a chance to buy
breadTP.” I wish this was a joke. sigh…As an aside: the lack of TP is leading people to use materials that shouldn’t be flushed, materials that damage waste treatment facilities water flow. So, if the TP supply chain doesn’t get sorted out soon a lot of municipal waste treatment plants could need expensive repairs.
Have you seen any information about what’s going on in the TP supply chain? Is it totally broken, or is it getting bought up as soon as they restock?
I reported a chance conversation I had with a treatment plant engineer many months ago. He said that some of the worst problems with pumps, valves and seals are the result of America’s Conditioned Reflex to “throw it away,” in this case those effing “convenient” “flushable” wipes of noon-woven fabric material. Perfumed and aloe’d butt wipes, disinfectant-laden counter wipes, “Handi-Wipes” indeed, he would love to strangle the Mad Avenue and P&G people who drive this stuff into the “market” with their skillful adeptness at “manufacturing demand.”
Takes two to tango, of course, there are more than enough really special or time-pressed or uneducated
citizensconsumers who have no problem tossing all kinds of stuff in the toilet, including of course all those “disposable” diapers (for some definition of disposable).Heedless, careless, till the cows come home and the crows (and vultures come home to roost…
You are no alone Yves! I have two good friends (both married with children) and I had this same conversation with both of them yesterday. We complained about people who insist on walking in the middle of the sidewalk instead of moving to the edge. And how I got snickered at when I went shopping with a mask on just two days ago. We decided that we have to face the fact that we are outliers and do the best we can and still be the freaks we are.
It is intelligence and hyperawareness that makes us angry and there is nothing wrong with expressing it. Anger communicates more than words do. I yelled at a woman who, coming from behind me, decided to jog 3 inches next to me when she passed. She needed to know what she did was stupid and HA, boy did she. I do not care what she thought of me because the risk she puts everyone at is more dangerous. Being anger at someone does not mean you hate them or do not care about them!
We think we are not animals but we are and we need to embrace it. A mother bear will not act calmly if someone starts walking by her cubs.
On my end, this is all huge trigger for my OCD. I have spent years doing CBT to minimizing my checking behaviors. (I used to have to check every package at the store to make sure it was not tampered with and a lot of times I could not even pick one). So going out is so stressful to me I rarely do it and when I do I need to take a klonopin. It is hard but I know it will help me in the long run. Part of my practice is telling myself “it is fine if I die”. It is not that I want to die, but pulling myself closer to that thought lowers my stress but still allows me to access the hyper-vigilance.
But I ran out of vodka so off to the ABC store today….
Yves — You’re doing everything you can do, and I’m sure your mother appreciates your efforts.
Having just recently lost my mother (non-COVID-19), I can sympathize. You want to do everything you can, even in the face of an indifferent universe (including unprofessional ‘professionals’), but there are limits. No one alone can turn a mountain into a pebble.
What matters most is the time you spend with that person while they’re here — right now, today.
My mom died in an instant, but her body was kept alive for days. I try not to dwell on that part.
I try instead to remember the things I shared with her before she died, including the inevitable goodbye.
Last year my 82 year old Mum in England had one very bad fall, breaking her hip, shoulder & arm which she managed to get over although she had to have a 2nd op on the shoulder as it was grinding & seizing up. She was then diagnosed with the early stages of Alzheimers. Despite all of this she steadfastly refused to move in with my sister, until she had another fall that we were first told had broken her back as she lay in hospital, while a doctor asked us about shutting her off for good….just in case.
Remarkably the old warhorse recovered had the shoulder op & finally agreed to move in with Sis, where she had physio come in & a fella who helped her in the shower, both of whom instructed my sister so she could maintain the regime – it was hell for me not being close & I could only manage 3 visits across the Irish Sea.
Now looking back if all of this had happened this year rather than the last, she would likely end up very dead & I imagine that there are going to be very many others out there who will suffer similar trauma in various ways who will not due to C-19 get the care that Mum was fortunate to get. It’s very tough on my sister but Mum’s dementia appears to be having the effect of role reversal with the latter increasingly acting like a mainly happy child who has the odd tantrum, with the former now becoming the Mother figure.
Am glad that the retirement home option suggested by another sister was hardly considered at all & that Yves escaped NYC, perhaps just in time.
In the last few years I’ve come to realize that guilt is really suppressed anger turned on oneself. From what you’ve said, you have every reason to be angry about what’s going on in your life but please don’t turn the anger on yourself; it will just turn you into a pressure cooker that will leak random uncontrolled blasts of steam that will make you more angry at yourself. Go punch a pillow or yell at the TV or take a warm bath or quiet walk or jog or, since you miss the gym, try these Muller exercises. Whatever works best for you to release that anger in a way that makes you feel you have it under control and not vice versa.
Sorry, not my place to tell you what to do but (there is always a but) I know from firsthand experience what that guilt/pressure cooker feels like and can do to your health, hate to see others dealing with it. To paraphrase Monty Python, no one expects callous indifference to those we love.
Take care of yourself and your Mum.
Such a wise comment from Jane, with which I completely agree, from my own and several friends/acquaintances’ experience. When I feel the same frustration with idiocy, I try to use bemused irony and gentle sarcasm in my reactions–when it is perceived, it has just almost as much immediate effect as anger, and perhaps even more long-term effect, when the receiver has had time to reflect on it. When it isn’t perceived, at least I’m not so worked up, and can take a bit of solace in chortling over how cleverly I channeled my anger :)
But of course I don’t always succeed–so the trick is, when you fail, to just note it (successes, 10; failures 4), like a missed shot in basketball, and move on to the next play. And of course the trick doesnt always work, either…
Hang in there, Yves, you’re doing your best on a long and difficult journey, but we all have miles to go before we sleep…
I got a couple of pairs of light-weight cotton blend gloves at Ace Hardware. They cost around $2/pair. I wear them when I’m out and have to touch foreign surfaces (that would be everything). When I get home I wash the gloves in soap and water. The next day I switch them out and use the other pair. So fah’, so good. As they say in Maine. Unfortunately, employing this strategy may necessitate a singular trip to the hardware store, and you gotta’ weigh the costs and benefits of every single trip these days.
I’ve had my own deeply distressing experience. Moved upstate NY from NYC in Dec. Had to change PCP and my downstate physician gave me some transitional refills on the blood pressure med I take. It was incredibly hard to find to find a PCP up here and I ended up with one who used registered nurses to take care of patients. This doctor has a few offices and uses nurses to do the patient encounters almost exclusively. So made an appointment and went in to see them late Feb before the virus lockdowns occurred. They advised they would give me a prescription but wanted me to come in for a full physical in a month or so – even though they had all my medical records from my downstate doc. When the lockdown occured a couple of weeks later, I called them and asked for additional refills until all this was hopefully over. I told them I would come in for a physical in June or so. They put in for one refill, but called me two weeks later and told me I would need to come in for a physical. It was completely unnecessary and outrageous. The med I am on does not need lab work drawn for monitoring and I am relatively healthy. Plus, my sister and her husband both live in the area, and they are only seeing patients when it is absolutely essential. I ended up speaking to this irresponsible doctor who was not only rude but insisted that I tell him my sister & her husbands name. When I refused to come in for a physical in order to get a refill, he said he was discharging me as a patient….lol, I guess he thought I’d be bothered by this. Sure – I want a physician who is willing to put my health at risk, as well as his staff, just so he could make a buck. Really is the epitome of a for profit health care system. Luckily I have a few months of the med on hand so I do have time to make other arrangements, but it is very sad to see the worst of humanity during this time.
Re: the pills, while in Canada, I had a premonition about what was about to happen. I was able to secure a 1 year supply of my BP meds. And I also rescheduled my flight to The Netherlands. The change was worth every penny as 2 days after I left, all flights to Europe were cancelled.
Now I’m at my brother’s little place in heaven. His large garden looks out on a huge bulb field. And the ocean – which has the best air to breathe – is a 20-minute walk away.
Keep safe everyone.
My wife of 54 years died last September. She had several morbidities and the principle cause was congestive heart failure. Rosie’s medical history included 4 open heart surgeries and 3 pacemakers. Our experience with the medical community has been generally favorable; however, long ago we learned that it is extremely important to educate yourself and to question everything that the doctor and the nurses want to do. The circumstances that we all face today seem to have a common predicate that appears to be unrelated to the pandemic. What I see is the long standing movement away from personal responsibility, a desire to achieve an equality of incomes and/or wealth. In pursuit of that equality we have accepted the idea that there should be no penalty for stupid choices. Many will assert that our medical services community is the best in the world, I don’t think so. It may be that we have very good training, but we don’t have is very good delivery services. And that is because we, as a society have been willing to accept large short term profits over more modest profits that are sustainable. What I’m suggesting is that it’s time that we consider saving to consume that which we cannot afford today. COVID19 is a medical problem that will take two or more years to contain and over the course of that two years we will lose a great many people who might otherwise have enjoyed their full allotment of tomorrows. The lesson being taught is that it’s time to have a discourse on what we have to do to preserve the republic, our grand experiment in political economy that has given us material wealth and social mobility and which at present is beset by a mindless cancer of self serving crap think. COVID19 is a medical challenge; and, it is also bringing to fore the challenge to our dying republic.
Who was it who said that where people stand depends on where they sit? Or, put differently (and paraphrased) that one cannot understand a situation if their job requires them not to? It may take a while, Yves, but I am confident your vast NC following will DO THE RIGHT THING to support you. Especially all your silent readers. The time is NOW.
Yves is why we’re here, folks! Time to step up with your donations!!
Thank you for the reminder! My wife and I had agreed to give a donation for NC’s amazing coverage when (if) the paycheck came through for this month, and it did, but my head has been elsewhere.
The best overall coverage and discussion of this virus has been right here, and I, for one, am very grateful for everything the NC team has been doing.
As a silent reader I second that. I will also send a cheque.
I am sorry to hear of your troubles.
I know I feel guilt when I don’t go to any of my beloved local restaurants for carry-out.
Yves, your Mom is lucky to have you take such good care of her. Don’t lose heart and be sure to take care of yourself.
I have been in your situation and you have my total sympathy. Rather than expand on the many painful details I’ll just say that doctors and our American medical system in general seem to view old people as a bother and they’ll constantly push you to put aging parents in nursing homes where they can conveniently be managed until the inevitable happens–often sooner rather than later. The money angle means that doctors are not going to waste their valuable time doing house calls and yet they insist that elderly and immobile people come to their offices even if an ambulance is necessary. A good home health aide, if you can find one, is a treasure.
Good luck with this difficult task.
I was curious about the Venezuelan homemade masks: isn’t having a moist towelette on your face really uncomfortable? How long until it dries out?
On the other hand, maybe something that is damp like that and clings to the face would provide a better seal at least until it dries out (I have no medical knowledge)?
They aren’t that moist. The moisture isn’t bothersome, it’s the ghastly scent on the scented ones.
The situation is bad — horrible — and in the short-term it’s only going to get worse; there will of course be middle- and long-term consequences as well. Something just occurred to me today: humans being humans, as a result of all these lockdowns and ‘stay at home’ orders, in about nine months from now, right smack-dab in the middle of the middle-term consequences of the corona, there is going to be a big baby boom.
Yves, under no circumstances should you allow yourself to feel guilty. That said, it’s greatly to your credit that you even think to question yourself in the first place. As several people have suggested, much of the human race at the moment is either sleepwalking or issuing instructions to others which they aren’t following themselves. I think it may be worth unpacking both of these cases a little.
For most people these days “guilt” has no personal significance at all, unless, perhaps, they think they have chosen the wrong word as defined by some IdPol group. Forty years of (neo)liberalism) have created a mentality where if we want something, we think we should able to have it (and the reverse) either because we can pay for it or we can exert our right as we see them. The idea that we can be obliged or constrained not to do something we want to do is seen as an unacceptable challenge to our autonomy. For many people in many countries, I suspect, being asked to do something to protect others and not necessarily in their short-term interests, must sound deeply unfamiliar and even threatening. But this is only true at all because our society has cultivated a zero-risk approach, where mistakes, even if allowed, don’t matter. People have grown up with a view of the world which is essentially unthreatening: you can eat and drink without the risk of poisoning , there are no wars, hunger and disease are largely absent. You may be genuinely frightened of things like terrorist attacks or child molesters, but in your everyday interaction with the world you don’t expect to be put in any danger.
In the past, it wasn’t like that, of course. Even today, many of us, I’m sure, have been in environments where there are threats from conflict, disease, crime and so forth, and we accept that under certain circumstances there can be forces out there which are inimical to us. But most people haven’t had those experiences, and for them the world remains a kind of supermarket of products, experiences and rights. This Covid thing doesn’t compute . No wonder they are sleepwalking.
More speculatively, I think our elites, used to issuing instructions, have not adjusted. They still have this atavistic feeling that they are spared the real problems of life and that they are thus not themselves bound by the behavior they try to impose on us. They are only now realizing that this time it’s different .
And indeed I think we are moving through a period of state change, into a world whose contours we can only dimly see, but which will not be a linear progression (or regression) from where we are now. Thanks to Yves and co we have a forum in which to try to anticipate this future and interpret it as it comes about.
I have immune-suppression from drugs needed to fight dermatomyositis, and was on the isolation protocol since November last year. Therefore I have first-hand validation of everything Yves has written in triplicate.
Yes, the nation is populated with egocentric, opportunistic, partly-educated upright apes who insist on their “rights” as they see them, not as society deems them. Of course, to say that is to understand that our society has built itself in this way to elevate the egotistical, raise up the sociopathic, and inculcate worship of the above due to money=power=I wanna be….
The major worry I have is with the development of health care as a tele-communication method. If you have what I have, the first indication that myositis in its muscular-organ phase has set in is trouble swallowing. Of course, without any actual examination of the throat to see what is actually happening, any prognosis over the phone or video is, at best, a guess. The number of such cases that come to mind needing similar hands-on treatment number quickly into the hundreds. The truncation of medical service currently is going to lead to mass death numbers that are NOT from Covid-19 or any such concern. I’m sure the statisticians will have a field day, but those of us at the point of no return will only have the possible comfort of knowing we leave behind concerned relatives and friends who may (emphasis upon MAY) take to action to do something about this travesty that does not include transmission of money into the coffers of the sociopaths in charge.
Health, education, welfare, corporations, government, work — all need a complete rethink and revamp to fix what is a systemic issue at heart.
My father had dermatomyositis. It’s nasty. I hope your treatment is going well
He did well with antimalarials for the first few years but I assume your doctor considered that.
I agree with your concern re telemedicine. I was going to see a doctor in NYC but it seemed to risky to go given the severity of the contagion. His staff suggested a teleconference. WTF? For a multi-site orthopedic problem? He needs to see how I walk and stand and do mobility tests. And this is a lot less complex than many medical issues.
Being responsible for a 92-yr-old in these conditions would send ANYONE up a tree – let alone someone who knows too d**n much. Go easy on yourself. We worry about a 90-yr-old friend, but we aren’t responsible for him; he’s married, fortunately (for him) to a much younger woman.
And please take care of yourself, too, for our sakes. No reason to be embarrassed about that spray bottle. You’re setting a good example. We just keep one at the door at home, but we aren’t going into stores at all. Fortunately the Co-op is doing both pickup of prepared boxes and delivery. It’s what I’d expect from them, but still gratifying. I actually miss shopping, as it’s quite the social occasion in there.
Try the blue shop towels for home-made masks. Apparently a company did some testing and found a couple of brands that worked very well at catching small particles, better than cotton T-short material. They are available at many hardware stores and probably even at Walmart https://www.businessinsider.com/homemade-mask-using-hydro-knit-shop-towel-filters-better-2020-4
Yves, I am sure you have heard of caregiver burnout. When I was working as a nurse for doctors who were treating many patients with chronic and often devastating disabilities and debilities, it was pretty obvious when the people who daily care for them, family members and friends, were suffering from caregiver burnout. You are in a particularly difficult way, given the load you have been carrying keeping this site going. There’s a lot published on the situation, here is one article that at least gives something in the way of advice, beyond the scholarly recognition of the problem and the often shallow advice and distant empathy:
https://www.aginginplace.org/caregiver-burnout/
Given the realities as you outline them, it’s hard to find trustworthy medical care let alone respite assistance you can trust. There may be a group or groups near you that can give some help identifying reliable assistance.
I recall what it was like when my mom was slowly succumbing to ovarian cancer, and know only too well how many careless dopes there are in the medical “care” business. Here’s hoping you can find some decent people to assist. My wife and I are seeing the need for for ourselves, it’s scary to contemplate…
All good wishes.
What a daunting task you have, every little incident possibly monumental but so hard to calmly explain that to others, and no exit, no place where you can really let go and say, “time out.”
Whether this makes any sense at all I leave to you, but in a situation with similarities – excepting no covid-19 to deal with – regarding getting the doctor or a nurse to come out to see my aunt who was too exhausted to move, and being told again and again that was impossible, they played around with me so badly that I finally went beyond the tipping point and told the person who happened to be on the other end during that particular call, that they either send someone immediately, or I call my lawyer. I didn’t say it in bluff and I was deadly calm when I said it and I fully assumed I was going to have to go through with it. Boy did that produce results (which I wasn’t expecting). First, my aunt’s doctor suddenly materialized as if by magic on the other end of the line (I’m sure she had been listening in) and then after yet another description (that I had been telling the people at the practice for two days before finally going “lawyer” ), she promised to get hospice nurses over that same day to check the situation out. There was a good (not happy) ending to that, but that I had to go through it at all, really meaning that my aunt and I (and her care givers who actually cared) had to go through it, was just stunning. And I thought she was a good doctor.
Yves, at the beginning of your post I read that you had moved yourself and your mother to Alabama, apparently from New York. Given the responses (I didn’t know that!) of the Governors of Alabama and Georgia to being told that Covid-19 was apparently transmitted even by asymptomatic individuals and the generally poor reputations of the medical care systems in those states, weren’t you concerned that you might be jumping from the frying pan into the fire?
There are 2 approaches to dealing with the virus. One is to “lockdown.” This will not stop the spread, it will only lenghten the time-line and reduce the chance that medical facilities will be overwhelmed. Assuming that the local medical care systm is competent and capable, this will result in care being available, but not capable of saving everyone. The other approach is to keep open the infection paths recognizing that until we get to a 65% (approximately) level of everyone being infected, we haven’t a chance in hell of stopping the spread. Many will die in both cases.
Simple network theory shows that these are the only options. Which one is chosen is the issue.
I came to see how you were doing. Haven’t been to the site lately. Too busy with practice, but I’m glad to hear you aren’t in NYC anymore.
I am sooo happy that I’m in private practice. Happy that no administrator was able to tell me not to wear a mask, or muzzle me when I warned the nurses to get ready a month ago. Happy that I was asked to help brief the Medical Executive Committee and that we (the doctors) cancelled elective surgeries weeks ago, in spite of it being a couple weeks ‘early’ (we only had a couple of cases and the peak is still weeks away). Happy that the surgeons supported it in spite of the huge hit we all took to our incomes. Happy that we did what was right and even though our CEO gave us all a pained look (our hospital has been losing money) he didn’t even try to stop us.
I think there is a distinction to be made between for profit health care by individual doctors or small medical groups and for profit health care by corporations. Individuals have flaws and make mistakes, but corporations are profit maximizing machines.
The biggest advantage to private practice is that I can and do take moral responsibility for my patients. I realize I’m a bit of an outlier, but my colleagues stepped up and did the right thing against their financial interests. I think that part of your dissatisfaction comes from dealing with health care workers who are punching a clock.