Shredding a Life

Mortality is on my mind. So is storage space in my basement. I have a 3 drawer file cabinet that is hard to stuff more into. I decided it was time to make room.

I started with old check stubs and check registers. I had saved them forever. I had tax returns starting with the first year I paid taxes. I saved that one, but the rest of the last century (and some of this one) were not necessary.

Work and school-related stuff came next. I had course notes that I’ve never looked at. In round one I saved my Anatomy and Physiology drawings because they were the first evidence that I could draw something representational. (They got tossed today.) Anybody need a bunch of 3-ring binders? I don’t plan to be working much longer so a lot of work stuff went; much of it was outdated anyway.

I found reference letters people wrote for a job I didn’t get 25+ years ago. Reading them brought a tear to my eye and made me wonder how anyone could not hire that guy. I found the Strong Interest Survey that I completed during a job search 30 years ago. It told me I had very little in common with people who chose careers in sales or the military. Was I surprised?

There is stuff from an organization I helped start nearly 50 years ago. I already lent it to them to scan on their 40th anniversary, so the original paper may not be necessary. I trimmed that file but couldn’t part with all of it.

Bonus! Shredded paper is compostable. If your compost is mostly vegetable scraps, paper adds needed carbon. Compostable materials are thought of as green (e.g. vegetable scraps) and brown (e.g. dried and shredded leaves). Most of us have too much green in our compost. Paper adds some brown.

Doing this helps me let go of my identity as a worker. I can admit that I will be retiring soon and don’t need that stuff. It helps me realize that life is unpredictable. Any of us can die at any time. None of us are getting younger, so the probability of death increases. Do I want to make my kids sort through this? Might what I choose to save have meaning to them?

On the other hand, I found my book of county road maps, useful for planning bike rides. It is old, but town roads and county highways tend not to change much. I kept it. I have route maps and cue sheets for dozens of bike rides. I didn’t try to cull those.

Since we were talking about mortality, I received an indirect death threat for a recent COVID-19 post. I had already blocked the commenter, so the comment went to my trash file, but it warned me to delete this blog “before the villagers with pitchforks and torches head towards your house.” I thought that was all I as going to say about that. I was wrong. Hang onto your hats…

Stroke Week

Since we raised the topic, let’s talk about COVID-19. Many of you read these posts before the comments appear so won’t have seen the exchange I had with the person who calls themself “covidpilot”. They referred to the vaccine as the “COVID clotshot”. Ironic, then, that my move from the ICU back to the intermediate and general care COVID units this week brought me face-to-face with a bunch of young (as in, young enough to be my children) people with strokes.

Mostly, the COVID posts herein have been to highlight the personal experience of working with the COVID-19 population. Since misinformation in the name of “following the science” has reared its ugly head here, we will delve a little more deeply into the literature. (For each journal article I have noted the source and year of publication. Full citations available on request. Since this is not a scholarly article, I don’t want to take up a lot of space with citations.)

Strokes in people that young aren’t unheard of, and the journal Stroke (2020) lists a number of risk factors for stroke in the young. Stroke occurs in about 0.01% of the population under 40 in the US (Vascular Health Risk Management, 2015). So it could be merely coincidental that I saw several young people with strokes this week, way more than I ever saw when I worked on a neurology unit regularly. But I don’t think so.

“Just the facts, ma’am”

The International Journal of Stroke (2021) published a meta-analysis of 61 studies of COVID and stroke. The articles were all before the advent of the Delta variant, which has, at least anecdotally, affected younger people more than the earlier variants. Even before the Delta variant, the meta-analysis concluded that “individuals with COVID-19 who developed stroke were significantly younger” [than non-COVID patients with stroke]. [Emphasis added] They found that “pooled results…suggest a particular profile of COVID-19-associated strokes, characterized clinically by severe NIHSS [National Institutes of Health Stroke Score] and poor outcome and radiologically by large artery occlusion and multiple arterial territory involvement. ” In plain English, COVID patients are younger and have more severe strokes than non-COVID patients. It cannot be conclusively proven, at this time, that COVID caused the strokes, but the high correlation “suggests a causal relationship.”

covidpilot referred to the vaccine as the “COVID clotshot”. A search of PubMed for data re: risk of clotting after vaccination vs after infection revealed “The risks of most of these events were substantially higher and more prolonged after SARS-CoV-2 infection than after vaccination in the same population.” [Emphasis added] (BMJ, 2020). The European Medicines Agency (referenced in Saudi Medical Journal, 2021) found “the number of observed thromboembolic events in vaccinated patients are much lower than expected as calculated in comparison to the incidence of events in general population.” [Emphasis added] In other words, while some people had strokes after the vaccine, the numbers are lower than would be expected in the general population – so the vaccine does not appear to be a factor. Taquet, et al (2021) looked at the relative risk of clot after: 1) COVID infection, 2) mRNA COVID vaccination, and 3) influenza infection. They examined over 500,000 cases and found the chances of serious clotting (they looked at CVT – cerebral venous thrombosis – as this is one of the adverse vaccine effects that has been reported anecdotally, and PVT – portal vein thrombosis) were 6.67 times greater from the disease than from the vaccine (for CVT) and 7.4 times greater from the disease than from the vaccine (for PVT). Patone, et al in Nature Medicine (2021) found: “In summary, although we find an increased risk of neurological complications in those who received COVID-19 vaccines, the risk of these complications is greater following a positive SARS-CoV-2 test.” [Emphasis added]

So yes, covidpilot is correct that there are reports of neurological and clotting complications following COVID vaccination. Most of the papers reporting those complications are case reports – reports of a single person having a complication temporally related to the vaccine. No causal relationship is demonstrated, though occasionally implied, and sometimes claimed (though more often by readers than writers). The papers claiming increased risk showed a much greater risk from the Astra-Zeneca vaccine than from the mRNA vaccines more common in the US. The papers which compare the relative risks from the vaccine vs the infection universally find that the illness carries greater risk of complication than the vaccine.

For those who missed the prior exchange, here it is:

thecovidpilotsays:m
In the news…Covid clotshot kills covid cult cardiologist who said that he would shed no tears for the selfish unvaccinated at their funerals. Poignant irony

thecovidpilotsays:
I follow the science, not the pharma narrative. Antwerp ICU covid patients are all vaccinated.

halffastcyclingclubsays:
Not sure where you’re going with this. It appears that you are calling the vaccine the “COVID clotshot”, while also claiming (in your next comment) to “follow the science”. If you can show us science that shows risk of death from the vaccine to be greater than the risk of death from the virus (even if you limit it to the relative risk of death from clotting disorders) I would be more inclined to take you seriously.

thecovidpilotsays:m
if you could show good science that the risk of death from the virus is greater than the risk of death from the clotshot, I might stop needling you. Of course, then you’d have to actually have some autopsy sampling of VAERS covid vaccine death reports by the CDC, but they don’t seem very interested in doing actual science that might question their narrative that vaccines are “safe and effective.”Hence, we don’t know much about the actual risk of clotshots. It looks like VAERS reports are the best science we have. Accordingly, we should use it.It looks like adverse event underreporting runs about 30x actual reports (1). Let’s use the CDC figure of 9,367 covid vaccine VAERS death reports. So it looks like there have been about 270,000 covid vaccine deaths, which is a small fraction of total vaccinations.As of now, the risk of death from covid is tiny for two reasons. First, it looks like we may have achieved herd immunity in the US. Second, the risk of death is small when antiviral treatment is used–20% of baseline. So my plan requires that early antiviral be given to high risk patients. Maybe 1% of the US population is actually at high risk from covid. But probably 90% of that group has some sort of immunity to covid. So we are talking 0.1% of the US population being seriously at risk. But antiviral cocktails given early–yes, I am assuming early treatment–will reduce covid mortality by 80%. So that looks like maybe 25,000 deaths from covid per year, which is in the range of flu. The clotshot so far this year has racked up 270,000 deaths, based on our estimates.It looks like continual boosters would be required if we followed your plan–with the undiminished risk for each booster–resulting in continual, straight-line vaccine deaths in all age groups.So, now, the risk from vaccination looks to be far higher than the risk from covid–especially for younger cohorts.(1) https://academic.oup.com/cid/article/61/6/864/451758?login=true

halffastcyclingclubsays:
To thecovidpilot:Your “science” is lacking. First, the VAERS system is notoriously unreliable. In their own words: “Reports may include incomplete, inaccurate, coincidental and unverified information. The number of reports alone cannot be interpreted or used to reach conclusions about the existence, severity, frequency, or rates of problems associated with vaccines.”

Second, the citation you offer does not support your conclusion of underreporting by a factor of 30, nor do the underlying articles cited in that source.

Third, even the data you cite are not specific to your assertion that the risk of death from clotting disorder is greater from the vaccine than from the disease.

Fourth, correlation does not equal causation. In randomized, double-blind, placebo-controlled trials, adverse reactions to the placebo are reported routinely.

Fifth, the article you cite is from before the COVID vaccine. There are clearly political factors at play here that were not at play during the period studied. There is a large and vocal anti-vaccine group, much more so than with any single prior vaccine. That group has a vested interest in reporting adverse effects. One could assert that there are those with an interest in falsifying reports of adverse effects for political gain. One cannot ignore that public health officials have received death threats for their work.

Sixth, as Stephen Wright told us, “42.7% of all statistics are made up on the spot.” I have seen no evidence to support your dual assertions that only 1% of the US population is at high risk and that 90% of that group has “some sort of immunity” to COVID. This leads to your next false assertion.

Seventh, you assert (due to your “calculation” above) that 0.1% of the US population is “seriously at risk” from COVID-19, though the death rate to date is already 2.5 times that.

Eighth, Johns Hopkins has confirmed 762,972 deaths from COVID-19 in the US as of 11/13/2021. They have confirmed 47,050,502 cases of COVID, for a death rate of 1.62% The reported (unconfirmed, and subject to the biases VAERS cites) deaths attributed to the vaccine total 7793, while 439,034,461 doses of the vaccine have been administered. This yields a death rate of 0.002%. Even if you limit the count to those fully vaccinated (which would eliminate anyone allegedly killed by the first dose and anyone who chose not to get the second dose due to an alleged adverse reaction to the first dose), the death rate is 0.004%. Thus the risk of dying from the virus is at least 400 times greater than that of dying from the vaccine, and probably considerably higher than that. [emphasis added]

Ninth, since this is my blog, this is the end of this discussion. If you would like to continue to spread misinformation, disinformation, or misleading conclusions from incomplete information, you are free to do so on your own site.

I left out a few points from that exchange. covidpilot asserts that we “may have achieved herd immunity”, yet still expects 25,000 deaths per year into the future. cp wrongly equates this to the number of deaths from influenza, a disease for which no one asserts we have herd immunity. covidpilot has a “plan” to give early antiviral treatment to high risk patients, though their own numbers show that all high risk patients are already dead two and a half times over.

Since the people I have seen the past two weeks have not been in cp’s “high risk” category (unless the anti-vaccine covidpilot considers unvaccinated people to be high risk) they would not qualify for cp’s early intervention. Since the set of people who oppose the vaccine and the set of people who don’t take this disease seriously appear to have a high degree of overlap, and have historically avoided presenting to hospitals until near death (or post-stroke), the proposed “early treatment” would likely not reach those people.

Nonetheless, I have decided to give covidpilot the last word. Here is their last message, the one that I blocked:

“You might want to shut down your blog before the villagers with pitchforks and torches head towards your house. People are VERY angry about all this and they are waking up.

Words we love to hate…

In general, we hate new words that take the place of perfectly good words we already have. I welcome your examples.

First, let’s just say that English is a difficult language, and none of this is to denigrate English language learners. This is for adults, especially college-educated ones, who don’t understand their native language and aren’t curious enough to look something up if they don’t understand it; and those who make up words when we already have perfectly good ones with the same meaning.

* “To gift” (“I gifted him a horse.” You gave him a horse. It was a gift, which is implied in the word “give”. If it wasn’t a gift you’d say, “I sold him a horse” or “I lent him a horse.” The word “gift” replaces the perfectly good word “give”.)
* Misusing “reign” for “rein” (example “giving free rein…”, which has to do with letting your horse run, not holding it back with the reins – reign has no meaning here); Also “they’re”, “their”, and “there”; “its” and “it’s”. If you’re not sure which it is, look it up.
* “Borrow” for “lend” or “loan”, as in, “I borrowed him my book.”
* Apostrophes where they don’t belong – a favorite is the sign in front of a house: “The Smith’s” – do they mean multiple people named Smith live there? (The Smiths) Do they mean it belongs to the village blacksmith? (The smith’s) Do they mean it belongs to the Smith family and they are asserting ownership? (The Smiths’) Also apostrophes for plurals in general.
* “Step foot in” for “Set foot in” or “Step in”.
* “Hair-brained” for “hare-brained”.
* “Literally” for “figuratively”. (“I literally died that day.” No, you didn’t. You are still alive to tell me that you figuratively died that day. Literally, you are still alive.)
* “Ask” as a noun. (“That was a big ask.” It was a request. We already have that word.)
* “I could care less” for “I couldn’t care less”. (If you could care less, that means you do care.)
* “Irregardless” for “regardless”. (“Regardless” means “without regard”. “Irregardless” is a double negative, which would mean “with regard”.)
* “Functionality”
* “Positionality”
Adding “ality” to a word seems to give it new intellectual cachet. I guess we could refer to its “intellectuality”.
* “Operationalize”.
* Business jargon and cliches in general (“at the end of the day”, “circle back”, “lean in”, and all of those other phrases that you use to try to impress upon senior management that you’ve read the latest book by the currently-fashionable entrepreneur. I know, all of those are now old. )

P.S. If you play this game with me, I have more of the same – things I started writing long ago when bored one day and kept as drafts. They’ll be better with participation from you.

Sign o’ the Times

I went to a family wedding over the weekend. It was the first time I had seen my siblings in nearly two years (longer in one case). It was mostly outdoors. There was a basket of masks at the beginning of the food line in case you forgot yours. Weddings used to have personalized items like napkins and matchbooks. In this case it was bottles of hand sanitizer with a drawing of the couple and the date.

Looking west from the wedding site – fire to come after dark. To the left, behind the woodpile, is a corn crib, in case you’re not from corn country.
Looking east from the wedding site

As we drove down the narrow town road to the site, my wife remarked at what a great road this would be for a bike ride. I guess I’m rubbing off on her. After dinner a few of us sat around the fire. The silent disco for dancing in the barn made the fire a peaceful spot. My nephew (from fire country in northern California) was nervous when he saw sparks rise from the fire. As you can see, there is a large open area surrounded by rocks and it is pretty green beyond that – but 30 years years in fire country will do that to you.

After century rides on consecutive weekends and the “Cycle September Challenge” through work (the website for which tells me I rode 780 miles last month), I may not get on my bike until Monday, when I drop the car for its 180,000 mile service and ride home…unless it is too nice out and I ride the other direction, out of town.

Lost in Translation

I used to tell people my specialty was English-to-English translation. We have so much trouble understanding each other even when two native speakers of the same language talk. Expectations and what we want to hear often get in the way. Wanting to be heard (instead of wanting to hear) and planning your response before the other person speaks get in the way. I would hear two people talking past each other and quickly rephrase for each of them and they would come to an understanding.

This is not to say that I don’t have the same problem with some people. It is though we speak two different languages which contain the same words.

In my work I spend a lot of time translating medical into English. Doctors tend to forget that normal people have no clue what most medical terms mean. People don’t want to seem dumb so they smile and nod. When the doctor leaves, I’ll ask what they understood of that. Frequently the answer is “nothing”, so I translate.

This was prompted by someone else’s post about actual language and cultural differences, which prompted this memory [cue harp music for a flashback].

I was in Nicaragua and our regular interpreter was unavailable. One of our group leaders offered to translate. Someone asked a local farmer how life had changed since the revolution. She said it was harder to get food now. The interpreter said something completely different, vaguely and rhetorically in support of the revolution. Two of us called her on it. She tried to say that the woman didn’t really understand the question. We argued that she clearly did understand the question but the answer was not the one you wanted to hear. After a bit more discussion, with the interpreter and the farmer (who made it clear she understood the question) in Spanish, then the group in English, we agreed to continue, with the translator knowing that she couldn’t get away with that degree of “interpreting” another’s thoughts and statements.

This also led to thoughts about language, fluency, and on-line translators. On-line translators are handy if you know both languages and are uncertain of the nuances of a particular word choice. They do not work if you think you can get the gist of a large work from an algorithm. If in doubt, listen to this:

“Let it Go” run through Google Translate through multiple languages and back to English. If you want the original English lyrics, they’re here.

I used to get asked if I were fluent in Spanish. Usually I just said no. Sometimes I answered that I wasn’t sure I was fluent in English. Other times I thought about what fluency meant.

After five weeks of language school I took a week off to travel and try to incorporate what I’d learned. Standing on a train, I started chatting with a local school teacher. After we’d talked for a while, he went to get a bottle of pop and asked if I wanted one. While he was gone I checked my watch and realized we’d been talking for two hours; a wide-ranging discussion that made me realize that: 1) I was thinking in Spanish and conversing naturally; 2) I had just fulfilled the goal I’d set five years earlier in Ecuador when the owner of the hotel where I was staying tried to initiate a similar conversation and I was unable to carry out my half.

I thought I had told this story before but, searching through the archives, I can’t find it. It was about January 1977. I was going through a home and roommate-related crisis. I called a friend in Berkeley, who knew the issues and people involved. He suggested the best solution was to join him and a friend (who had just arrived from Australia) on a trip to Colombia and Ecuador. On that trip, I could sort things out, and things here could sort themselves out.The idea had merit. A week later, I met them in Miami and we flew to Barranquilla, Colombia. We stepped off the plane and into customs. Since S & C had met while traveling extensively in Guatemala, I presumed they spoke Spanish pretty well. The customs agent asked C how long she would be in the country. She smiled. He repeated the question. She smiled more sweetly. He turned to S with the same question. He smiled, more broadly and sweetly than C. I realized: 1) they had gotten through Guatemala on friendliness and smiles; 2) they knew not a lick of Spanish; 3) I was now responsible to communicate for three. I told the customs agent that we all wanted 90 day visas, he stamped our passports, and we were on our way.

My Spanish got us through shopping, getting meals, finding our way, renting hotel rooms- all the basics of being a traveler. One rainy day (in Baños, Ecuador), while S & C were in another town, I was sitting in bed reading. The hotel owner stuck his head in the door, said hello, came in, sat down, and struck up a conversation. Within minutes (seconds?) I had my English-Spanish dictionary out. [It was years later that I bought a Spanish dictionary, recognizing that knowing a language meant learning to define words, not translate them.] Within a few more minutes I realized I was over my head. I did not know how to talk to anyone. I could conduct business, but I couldn’t talk. I apologized, he left, I cried. I felt shallow. I vowed that I would learn to speak Spanish and have that conversation some day.

After a week of vacation I went back to school for three more weeks. Was I fluent at that point? How about five years later when I went back for a refresher course and, as my final exam after three weeks, I gave a 45 minute slide presentation (on my work in Nicaragua) to the school in Spanish? Or when I returned to the school for a visit after 3 months working in Nicaragua and someone told me that the secretary said I was back in town and now spoke with a Nicaraguan accent? (I’ll admit I was flattered. For a Mexican to say I sounded Nicaraguan and not North American was one of the best compliments I had ever received.)

I realized that we have word-finding difficulties in any language. If the language is familiar enough, we find a way to talk around the missing word if it doesn’t come to us. There are words that we may not know, but we can discuss the concept in a way that gets the meaning across without the missing word. Ultimately, I discovered that fluency is a continuum, not a point. I’m pretty fluent in English after speaking it for more than 65 years. I’m less fluent in Spanish and considerably less fluent than I was when I was cutting down trees in the forest and miscommunication could mean death from falling tree.

Daddy, what’s money?

You’ve heard all of the COVID-19 conspiracy stories. I don’t need to relate them here. But there is a conspiracy you may not have heard of. The conspiracy to get rid of money.

Once we traded things, deciding their relative values. Then we traded precious metals for goods. We melted metals and formed them into coins. The metals became more valuable than the coins so we switched to cheaper metals. Quarters, instead of silver, are made of copper and nickel. Nickels are mostly copper, not nickel. Pennies are now mostly zinc, not copper. We developed paper money, symbolic of those metals – cheaper yet. US dollars used to be “silver certificates” and promised that the US held silver equal to its value to guarantee it. Then we made the dollar wholly symbolic, with the US government’s trustworthiness the only guarantee of its value.

Banks started making it harder to go inside. Cash came only from ATMs – once you could get $5 bills from them, then only twenties. Bills became harder to find. I rarely see a ten any more. The banks wanted you to use plastic cards instead of money. It cost them more to handle actual cash than virtual transactions. Then the virtual transactions became more virtual, with phone apps. And if they could charge you a service fee for doing it the way that was cheaper for them, so much the better.

Gas stations put card readers outside and didn’t want you to come in and use money any more. Just swipe a plastic card. The pandemic came and my neighborhood grocery store no longer accepted money. Soon the only place I could still use cash was the hospital cafeteria. Then they wanted me to use exact change, saying there was a coin shortage. And now, the one cashier who still took real money quietly told me that, starting tomorrow, I would no longer be able to use cash. I could use a phone app, a payroll deduction, or a credit/debit card. Is the money in my pocket about to become obsolete?

Time was, when someone opened a store, they would frame their first dollar. How soon will it be that storekeepers frame their last dollar? As U. Utah Phillips (The Golden Voice of the Great Southwest) wondered aloud 50 years ago about a child wondering what a train is after they disappeared, I now wonder if my son’s child will one day ask, “Daddy, what’s money?”