COVID ICU

It’s time for my next round on a COVID-19 floor. This time it’s the ICU. I have been on General and Intermediate Care on my previous tours. ICU is for the sickest of the sick. My patients are on ECMO (Extra-Corporeal Membrane Oxygenation). This isn’t merely a ventilator that assists you to breathe or breathes for you. This is an artificial lung. Your blood leaves your body via a ½ inch or so diameter line, runs through a machine to remove CO2 and add O2, then sends it back into your body via another line. (That’s what “extra-corporeal” means – outside the body.) One line comes out of your neck and the other your groin. Mobilization is a bit tricky. You don’t want any leaks.

Ready for action as soon as you add gown and gloves. The conehead look isn’t the most comfy, but it’s cheaper than the 3M PAPR (Powered Air-Purifying Respirator). There is no patient information on the wall behind me.

Some of these folks have been in this hospital for two months. They came from smaller hospitals that didn’t have the means to provide the treatment they need, after exhausting all options available to them. At least one has been sick since August – 3 months and counting. They are young and unvaccinated. Will they survive? Beats me. Are they anti-vaxxers? Beats me. My job is to help them, not to second-guess them.

(But since you ask, let’s just say that, if I were a betting man, my money would be on “yes” to surviving. As to whether they are anti-vaxxers or just think they are immortal, that one’s a tossup. This batch of patients are young enough to be my children and have survived two months in the ICU.)

A friend and spouse are vaccinated. One of their two adult children is vaccinated. The other is not, along with spouse and kids. We’ll call my friend Vac and the child Not. Vac was at Not’s house and Not confessed (after several hours together) to feeling ill. Vac had a home COVID test handy – Not was positive, confirmed by another test the next day in a health care facility. Not’s spouse and children are all sick. Vac remains well and has tested negative twice since that exposure. Vac’s spouse and other child are also fine. Do you think maybe the vaccine works?

One of the anti-vaccine arguments is based on “natural immunity”. People want their own immune systems to fight it out with the novel coronavirus. Note that name: novel. Our immune systems work by developing antibodies against invaders. If an invader is known, we have the means to develop a specific defense rapidly. If the invader is unknown (novel), we toss stuff at it while we try to figure out what to do. If the virus is strong enough, we may die first. (Or, in the case of the polio virus, just some motor neurons die. If enough die, we die. If we’re lucky, we’re paralyzed.)

What does a vaccine do? It enables our body to recognize the invader and develop specific antibodies. If we then come in contact with the disease, our immune system is up to the task. The vaccine enables our natural defenses to work.

Did you go to public school? You probably had a bunch of vaccines before you were allowed to attend. We don’t want you to come into close quarters with others and infect them with measles, mumps, rubella, diphtheria, pertussis, poliomyelitis, etc. It’s what we call Public Health. That’s why you should get the COVID-19 vaccine. On one level, I don’t care whether you get the disease. You are “free” to get sick and die if you so choose. Should you also be free to infect others or use scarce resources by running to the hospital when you get sick? Should you be free to demand that said hospital treat you with horse dewormer or a “cleaning” with an injection of a disinfectant like bleach?

Don’t tell me you “did your own research“, like a certain professional football player. Those of us who use research in our lives know that research involves experimentally testing a hypothesis. Before you do your research, you do a literature review, to see what has already been done. Is that what you did? A lit review? Did you actually read the literature, or just listen to a talk radio host talking about the literature? When you do a critical review of the literature, you appraise it against a set of criteria. There are what we call “levels of evidence”. Some evidence is better than others. No study is worth a lot before it has been replicated by someone else. Did you believe one person who runs counter to the mainstream because they say they are a doctor?

If you’re against vaccines (or at least this one) because they’re “unnatural”, are you against soap and water or antibiotic ointment if you get a cut? Why not just let your body’s natural defenses go to work? Maybe you’ll live, maybe you’ll die. Maybe that cut finger will result in being faced with the choice of death or amputating the arm. Amputation is unnatural. Death is completely natural. Decision made.

After all, life is 100% fatal. Why wait?

[Editor’s note: Sorry, it has been a rough week at the hospital. The writer apologizes to those who do take care of themselves and others and is not wishing an early and painful death on anyone. He is tired of reading about people refusing help until it is too late and then demanding their own particular choice of help. He is tired of reading about people looking for lawyers to sue hospitals for employing the standard of care instead of listening to their half-baked theories. He is tired of reading about people who refuse to take action to protect themselves and others, then beg for your prayers and money for funerals and to raise the children of stupid people who refuse the vaccine, refuse to wear masks, and think they are standing up for freedom. He is sick and tired in general this week – and he hasn’t even finished the first week of this rotation.]

If you could have dinner…(redux)

If you could have dinner with anyone, living or dead, who would that be? What if you could get a small group around a table?

While cleaning our adopted highway, I thought of two such groups. The first has already been published here . I realized that all of the participants were dead men.

Sugar maples – sap for syrup in the spring, gorgeous color in the fall…

For my second, I thought about women in music. The Women’s Music movement of the 1970s changed how we saw women in music. Women like Carole King helped to make that movement possible.

Carole King (1942-) King got her start as a songwriter in the famous Brill Building in New York. Among other writers there were Leiber and Stoller (about whom I have written before), Burt Bacharach and Hal David (multiple hits for Dionne Warwick, movie themes for “What’s New, Pussycat”, “Alfie”, and “Casino Royale”), Doc Pomus, Jerry Ragavoy, Barry Mann and Cynthia Weil…). She wrote “Up on the Roof” for The Drifters, “Pleasant Valley Sunday” for The Monkees, “Will You Love Me Tomorrow” for The Shirelles, “One Fine Day” for The Chiffons, and “(You Make Me Feel Like) A Natural Woman” for Aretha Franklin, among many others. In 1971 she released the seminal album “Tapestry” which spawned numerous hit singles for herself and others, spent 15 weeks at #1, and earned 4 Grammys. The Singer/Songwriter movement of the 70s (James Taylor, Jackson Browne, etc) owes much to Carole King. In 1994 she appeared on Broadway. She appeared as a guest on The Gilmore Girls and is mom to singer/songwriter Louise Goffin.

There isn’t a weak song on “Tapestry”, and what happens when the songwriter sits down at the piano and plays her own work after others have interpreted it just sounds special.

June Millington (1948-). Millington was lead guitarist in the band Fanny. Treated as a novelty act by the industry, Fanny was an all-woman band, active from 1970-74. They weren’t a novelty – they could play! In 1970 they opened for The Kinks and Procol Harum in LA. They were apparently more appreciated in the UK than the US. In a Rolling Stone interview, David Bowie said of the band, “They were extraordinary: they wrote everything, they played like motherfuckers, they were just colossal and wonderful, and nobody’s ever mentioned them. They’re as important as anybody else who’s ever been, ever; it just wasn’t their time.” In 2021, the film “Fanny: The Right to Rock” opened in limited release. June and her sister Jean began playing in rock bands in 1965. Millington was one of the founding mothers of the Women’s Music movement of the 1970s and contributes lead guitar work to many albums of the era.

This session, recorded warts and all, features Fanny on Marvin Gaye’s “Ain’t That Peculiar”. The song starts at about 1:45.

Since that video can’t be embedded, here they are covering “Badge” by Cream.

If you still doubt that women can play rock and roll, here’s one more.

Cris Williamson (1947-) The Women’s Music Movement encompassed many styles. Some artists appealed to a small niche audience, others had more mainstream success. Cris Williamson came out of Deadwood, SD, recording her first album at age 16 and becoming a local sensation in Wyoming after moving there. In 1973 she was instrumental in the founding of Olivia Records and her 1975 recording “The Changer and the Changed” became Olivia’s top seller and was the first album to be produced entirely by women. Her most recent album “Motherland” was released in 2017.

From the same album, but with a different sound featuring banjo:

Diedre Buckley – For the local angle, we look to Diedre Buckley. Buckley is a classical and jazz violist with an MM from The San Francisco Conservatory and a DMA from The University of Wisconsin. She is in the Madison Symphony Orchestra, Wisconsin Chamber Orchestra, and the Madison Opera Company. She has played at the National Women’s Music Festival and worked with various jazz ensembles. She has performed jazz with Hanah Jon Taylor and Jane Reynolds and maintains an active teaching schedule. Buckley has performed for Steven Spielberg, George Harrison, and Studs Terkel. Her doctoral dissertation was on jazz singer Betty Carter.

Diedre Buckley image from Madison.com

Here is Diedre playing Arnold Rosner’s String Quartet No 5 in D minor, Op 66, with the Ad Hoc String Quartet (Mark Ottesen is a guest on a duet with Diedre on this album. She is the violist here):

For a change of pace, here is Douglas Hill’s “Blues in E” with clarinet, viola, bassoon, piano, and bass.

So why this particular group of women? You’ve heard their music. The connections are probably less obvious than the previous dinner party post. I want to hear Carole King talk about writing music at a time when the industry was dominated by men (as though that weren’t the case now 😉 and how she made the transition from writing for others to performing her own work. I want to hear June Millington talk about being a woman in rock and roll and the transition to the women’s music movement; about the barriers and the sense of fulfillment in each; and about how music influenced her adjustment to life in the US, arriving here at the age of 13 – not the greatest time to come to a new country and try to find your place. I wonder how Cris Williamson found a primarily urban movement when she went from an upbringing in South Dakota and Wyoming to Washington, DC (where Olivia Records was founded); and I wonder how it felt to be part of what was a profound movement and then to settle in for the rest of life after that wave crested. I want to ask Diedre about crossing the lines between classical music and jazz – one highly structured and one improvisational; and about making a living as a musician outside of the major cities for music. As well, Diedre crosses the line between performance by, with, and for women, and with mixed ensembles and mixed audiences. In a sense, we have come full circle. The women’s music movement and 1970s feminism created space for women in the mainstream.

Mostly I want to hear the cross-pollination. Here are four women, whose paths may have crossed and are clearly not parallel. Each was, in her own way, a pioneer; and each built on the work of the women before her, though all are more or less contemporaries. The Women’s Music Movement changed the way women thought about themselves in the music world. It showed that an industry could be developed by and for women. In the 1970s, the idea that women could produce an album without the involvement of men was revolutionary. The children’s book “Firegirl” (Gibson Rich, Feminist Press, 1972) talked about a young girl and her dream to grow up to be a firefighter. She was widely ridiculed because that was “men’s work”. It was the women’s movement of the 1970s that changed that. The Michigan Womyn’s Music Festival (which had a 40 year run) was a women-only festival; planned, produced, performed, and attended only by women. I attended women’s music concerts in the 70s both in the audience and (for concerts that were held as women-only spaces) as part of the Men’s Childcare Collective, providing on-site childcare for the children of women in the audience. Clearly on the fringe, I want to hear what it was like in the middle.

If you could have dinner…

with any person, living or dead, who would that be? The last time I addressed this question, I chose Donald Trump – dead. While cleaning our adopted highway today, I gave the matter more thought.

My favorite spot from a few feet further back, so you can’t see the road – but that’s our adopted highway just beyond the framing trees.

Another version of this posits it as a dinner party, allowing you to invite more than one person. Two of my heroes died recently, so I started with them.

Ernesto Cardenal – poet, priest, mystic, revolutionary (1925-2020). In Hora Cero (Zero Hour), he addressed the assassination of Augusto Cesar Sandino. In Cántico Cósmico (Cosmic Canticle), he addressed the history of the universe in 581 pages of verse, beginning with the Big Bang. If you think about it, that in itself is revolutionary – a Roman Catholic priest acknowledging that the universe was not created in 6 days by a god, but evolved and continues to do so. He also wrote shorter works (Epigramas and Salmos – Epigrams and Psalms). Among my favorites is this (written pre-ordination):

 Ésta será mi venganza:
Que un día llegue a tus manos el libro de un poeta famoso
y leas estas líneas que el autor escribió para ti
y tú no los sepas.

My own translation:

This will be my revenge:
That one day a book by a famous poet will come into your hands
and you will read these lines the author wrote for you
and you won’t know them.

He studied at the Gesthemani monastery in KY with Father Thomas Merton. He founded the peasant contemplative community Solentiname on an island in Lake Nicaragua. He served as the Minister of Culture in the Sandinista government. He left the government and the party when it was taken over by Daniel Ortega and ceased to be a revolutionary movement.

Image from Commonweal Magazine

Robert Marchand – bicyclist, logger, firefighter, trucker, union member, communist (1911-2021). He worked on three continents. In his youth he wanted to race bikes. At age 22 his coach talked him out of it because he was too small (5 feet, 115 pounds), so he became a gymnast and boxer. As a cyclist in 1946, he finished 7th in the Grand Prix de Nations, the unofficial world time trial championship (later won by such luminaries as Fausto Coppi, Jacques Anquetil [9 times], and Bernard Hinault [5 times]). At 81 he rode from Paris to Moscow. At 100 he set the 100km record for the over 100 age group and at age 102 he broke his own record. At age 106 he set the hour record in the over 105 age group and rode his last race in 2018. I hope to break that record. It may be my first race.

Francis Hole – Agronomist, Quaker, conscientious objector (1913-2002). For a local angle, I added Professor Hole. As a soil scientist (agronomist) he was responsible for Wisconsin adopting a State Soil (Antigo silt loam – the soil responsible for the potato industry of central Wisconsin, but also providing sustenance to our pine forests). He completed a Bachelor’s Degree in Geology and Biology (Earlham College), a Master’s in French (Haverford College), and a PhD in Soil Science (University of Wisconsin). He was a conscientious objector in WW II and did alternative service clearing trails in the Great Smoky Mountains. He also served as my draft counselor and he played the violin. He signed his name Francis Hole, TNS (Temporarily Not Soil).

Giulio Girardi – Priest, philosopher, professor of metaphysics (1926-2012). Girardi is is the author of Sandinismo, marxismo, cristianismo: la confluencia (1987). You can probably translate that into English yourself. Written in Italian, a Spanish translation followed quickly. To the best of my knowledge it has not been published in English. The book helped shape my thinking and understanding when I worked in Nicaragua. Girardi compared the teachings of Jesus with the teachings of Marx and Sandino, asserting that putting the teachings of Christ into action on a societal level is the aim of a Marxist/Sandinist system and that we need to live in a Christ-like way individually in order to do so as a society. (I am paraphrasing some 35 years after reading.) I (very) briefly worked on a response: Sandinismo, marxismo, buddhismo: la confluencia. I compared the Marxist/Sandinist concept of the “new person”, with the Buddhist experience of the four Noble Truths and the Eightfold Path.

Image from El Nuevo Diario

Marxism/Sandinism recognized that transforming society requires more than transforming government. We have to think and interact differently if we are going to form a truly egalitarian and inclusive society. We cannot be free of oppression until we learn not to oppress others and how to live without oppression. Buddha experienced that (my wording):
1) All life is suffering.
2) Suffering arises from desire.
3) To end suffering requires letting go of desire.
4) This is possible.
People tend to rebel at this, insisting that they lead a happy life. Another way to look at this is that we spend life chasing after things we want and avoiding things that we don’t want. We might call the first “pleasure” and the second “pain”. But is pursuing pleasure the same as experiencing it?
He posited the Eightfold Path to let go of desire. Briefly, this is:
1) Right Understanding,
2) Right Thought,
3) Right Speech,
4) Right Action,
5) Right Livelihood,
6) Right Effort,
7) Right Mindfulness and
8) Right Concentration.
This was to be a book, not a blog entry, so I will leave it at this. It is not enough to want to be a “good person”. Transforming self and transforming society, require actual transformation, not just incremental change. Why do you think they call it revolution?

This was one of two dinner parties I thought of that day. The other will follow. How about you? Who would you choose to talk with, if it could be anyone from any time?

[Addendum: While reading someone else‘s blog, I thought about another person to add to the mix. My recently-retired State Senator, Fred Risser, was the longest-serving legislator in US history. He was first elected in 1956 and retired in 2020. He authored the state’s “Clean Indoor Air Act”, which restricted indoor smoking. In an expansion of the “Wisconsin Idea” he authored a bill to allow those over the age of 60 to take university courses free of charge. He annually rode his age for his birthday. Here is an excerpt from his 2018 press release: “State Senator Fred Risser, who turned 91 years old May 5th, said that on Thursday, May 17th, he had completed his annual ritual of biking his age in a single day. Risser said he started his 91-mile biking trip at 7:15am at the State Capitol and returned at 6:15pm after an 11-hour ride, stopping only for lunch and rest breaks.”]

Home: a love story

One of the half-fast cycling club graduated from UCLA. It was tough getting through college with dyslexia. He told me they gave him a sweatshirt. It looked like this:


Image from Pinterest

That’s not what we came to talk about today. We were riding in the Baraboo Hills and it got me thinking about places. Much of what I know about the place I call home came from the book The Physical Geography of Wisconsin.; and the physical geography of this place is one of the reasons I love to explore it by bike.

A question from a reader led me to realize I live in paradise.

Fifty miles to the west of me is Spring Green, home to Taliesen (the home of Frank Lloyd Wright) and American Players Theatre (one of the great classical theatres in the US – one of the founders was Randall Duk Kim – you may know him as The Keymaker from The Matrix Reloaded. I know him for playing Puck in A Midsummer Night’s Dream and the titular Titus Andronicus on back-to-back nights).

Spring Green is in the heart of the driftless area. Much of north central North America was covered by glacier in one or more previous ice ages. The driftless area in the southwest corner of Wisconsin was missed by every glacier. It is a land of steep and craggy hills. The eastern edge of the area is rich farmland (hence the town of Black Earth), whereas farther west it is too steep and irregular to support much farming and leans more toward wooded hills and dark valleys. The driftless area is home to the Dells of the Wisconsin River, known to geologists for its rock formations; known to the rest of the world for its waterparks. Much of my time on a bike is is the driftless area.

Stand Rock (WI Dells) image from Science Source. Don’t try this at home.

Fifty miles to the north are the Baraboo bluffs, home to our annual fall ride. This is on the edge of the driftless area and home to Devil’s Lake and the Circus World Museum, as well as Dr Evermor’s Forevertron. Devil’s Lake (roughly translated from Tewakącąk, the Ho-Chunk name, which may be more accurately translated as sacred lake or spirit lake but, due to the racism of European settlers who deemed anything sacred but not christian to be the work of the devil, was translated as “Devil’s Lake”). The lake was formed by a terminal moraine which trapped its outflow. While the bulk of Wisconsin drains to the Mississippi River and then the Gulf of Mexico, this lake drains slowly into the underlying bedrock. A drain was added in 2002 to remove years of accumulated phosphorus from runoff. The hills are Baraboo pink quartzite, and estimated at 1.3 billion years old.

Devils’ Doorway -Devil’s Lake. Image from journaltimes.com
Dr Evermor and the Forevertron image from Madison.com

Fifty miles to the east is the Kettle Moraine State Forest. A “kettle” is a depression left by a melting ice block as the glaciers receded, while a “moraine” is a ridge of rock pushed along by a glacier, then left behind as the glacier receded.

Ride one way and I can see what Wisconsin looked like before the ice age. Ride the other way and I can see how glaciers changed the landscape.

Hiking along a moraine. Image from u/alrobertson on reddit.com

Fifty miles to the south is New Glarus, home of my favorite of the Wednesday Night Bike Rides. (Actually, this one is closer. Fifty miles gets you past Monroe. New Glarus is only about 25 miles.) New Glarus was settled by Swiss immigrants who found the verdant hills and valleys reminiscent of home. It is one of the few places you can still find dairy cattle that are not Holsteins.

Contour farming near New Glarus. Image from halffastcycling.club.

Smack dab in the middle of all that is Taychopera or DeJope, AKA Madison, WI, AKA home sweet home. I can walk less than a mile to see an effigy mound that reminds me that this was sacred space long before I (or anyone who looks like me) was here.