Age

Another blogger I follow refers to himself as a “middle-aged fathlete”. I wondered, what am I? Not fat, no longer middle-aged unless I plan to live well past 100. What is “old”?

Many years ago I was on a rare Saturday ride. (I’ve worked Saturdays for longer than I can remember.) We were climbing Mt Hamilton outside of San Jose. I was training for the Death Ride. I was riding next to a guy when a ~75 year old rode up next to us. We chatted a while. He was doing a warm up ride for a century on Sunday. After a few miles he rode on ahead. I turned to the guy next to me and said, “I hope I’m that strong (or fast, I don’t recall which I said) when I’m his age…hell, I wish I were that fast (or strong) now.” I was under 40.

When my daughter was in middle school they asked if I was old. I said, “You can call me old the day you can beat me one-on-one in soccer.”

Some time later I heard a ball bouncing on the front porch. I went downstairs and said, “What’s up?” Bouncing a soccer ball, they said, “Let’s go to the park.”

We set up some goals and established boundaries. When I was ahead 5-0, we called it. One of their friends was in the park and they took off to join her. A friend of mine had been watching from his yard and asked, “What was that all about?” I said, “When she walks by, ask if her dad is old.” (They were she back then.)

I may have been cheating because my soccer cleats had worn out and I was playing barefoot.

That child is now a college graduate and they call me “elderly” but not “old”. They have just arrived back in town for grad school. We’ll see if this post brings the ball back out…

Robert Marchand set the hour record for the >105 year old age group a few years ago. He then announced his retirement, stating that he would only cycle for pleasure from now on. I guess I retired a long time ago. Unlike that middle aged dude above, I’m not big on goals. Beating the >105 age group hour record is the only cycling goal I have.

I work in a hospital. When I worked primarily with sick people (I now work mostly with injured people), I saw a lot of people with chronic illnesses. I realized how uncertain the term “old” is. I saw 50 year olds who were clearly older than my brother who is 12 years older than I. I saw people my age who were older than my mom. What is this “old” of which we speak?

Robert Marchand – From CapoVelo.com

News

A week in the woods with social distance camping meant I mostly used the outhouse instead of the flush toilets and stayed away from the overcrowded beach. No internet access for a week. I was surprised by how much email could go straight to the trash when I got home.

The long bike ride was called by rain so we rode only in the park. The bike trails were way more crowded than the roads. Distancing was easier in a kayak. Pouring rain on the last night meant we decided to go into town for takeout. The first place we tried had a huge line of cars and the seating area was packed and maskless. We moved on. The place we got food had a masked server who passed the pizza through a car window. When the door opened, the din from inside made it clear they were packed. I saw no masks on customers. No one coming in or out (except the server) was masked. On the way home the next day it was hot and sunny. We thought we’d stop for ice cream. The ice cream line was long, tightly packed, and maskless. We moved on. Ice cream could wait until we got home, where the neighborhood ice cream stand is in a trailer on a patio and everyone wears masks, they take only credit cards (that they don’t touch), and they set your ice cream down for you to pick up.

Yellowjackets are out in force, which I learned the hard way. (Image from doyourownpestcontrol.com) Coming home at sunset last week I was attacked in my driveway. Yellowjackets, unlike bees, can sting more than once. They are not shy about doing so. They also give chase. Once I made it to the front porch I was able to swat a few. One still followed me into the house where my daughter killed it. After dark I donned coveralls (taped at the wrists and ankles), a balaclava, gloves; and went back out to retrieve the glasses I had swatted off my own face trying to get the wasp stinging my ear and cheek.

Honeybee stings (to me) are a mild annoyance for a few minutes. Yellowjacket stings hurt and swell; then they itch. After 5 days the swelling is subsiding and so is the itch. I counted 20 stings, but some of them are so close together that I may have undercounted.

It is pouring rain and I just went to close some windows. The yellowjackets are still out. They appear uninterested in the trap I set out. I can’t imagine spraying the nest with insecticide because I expect any that didn’t die instantly would attack and I don’t think I’m ready for that until the late effects of the current batch of stings is gone. I no longer have a head net so, while I can cover most exposed flesh with fabric that might stop them, that still leaves my head vulnerable. (The nest is under the lowest “board” of the neighbor’s vinyl siding.) I don’t ride my bike in or out of the driveway – I come in through the front door now. They have taken over territory.

What’s the score?

My local newspaper (the handling of which is deemed a low-risk vector for infection) interviewed a medical ethicist (whose work I know and respect) about the allocation of resources in a time of scarcity.

In other words, if there aren’t enough ventilators to go around, who gets one? How do we decide? I suddenly feel old. My mind totes up the score. I’m over 65. That’s bad. I rode my bike across the country at 65. That’s good. I have asthma. That’s bad. My asthma is well-controlled; requiring no medication in years except for once last month. That’s good. I work in health care. That’s good, for being someone who should be saved. That’s bad, for being someone who can stay home and stay well. I’m not just resting on my laurels as someone who rode across the country a couple of years ago. I rode the Horribly Hilly Hundreds last last year and am scheduled to ride the Death Ride this year. That’s good, isn’t it?

In other words, I don’t want to die yet. Most of us don’t. While I accept death as part of life and as something that will happen to me, not just everybody else, I don’t want it to be now, as part of this pandemic.

But this keeping score is scary. I don’t want to think about whether I deserve to live more than someone else. What’s the difference between a person with diabetes, coronary artery disease, and COPD; and a healthy person with no chronic diseases, but paraplegia? What about someone with quadriplegia who already uses a ventilator? Disability is not the same as chronic illness. Living with one or the other is not the same as dying.

There is a disability rights movement called Not Dead Yet. They have grappled with these questions for years. Their website contains a link to a paper from the Disability Rights and Education Fund addressing the question of rationing care. Not Dead Yet lists two primary goals: 1) opposing the legalization of assisted suicide and; 2) ensuring that withholding or withdrawal of life-support is truly voluntary.

On the other side of the assisted suicide debate are Death With Dignity and the Hemlock Society (which no longer exists. The death of the organization is chronicled by its founder here). They look at the notion of being able to choose the time and manner of our own death if we have a terminal condition. Not Dead Yet is concerned about the slippery slope of assisted suicide becoming euthanasia, and about the idea that some have more right to live than others.

While these questions are separate, they are often seen as intertwined. By “these questions”, I mean: 1) prioritizing care, 2) assisted suicide, and 3) euthanasia. Peter Ralston talks about the word “confused” as “fused with” (“con” from the Latin word for “with”, and “fuse” “to blend as if by melting together”). While I find no evidence that this is the literal root of the word, it is useful, when we are confused, to see if we are melting together things that we could tease apart and look at separately.

“I can’t think for you, you’ll have to decide…”

Some questions are easy to answer. If the disease has a choice between taking me or taking one of my kids, take me. I may have more to offer the world, but not as much as they do, with potentially 40 more years to do it in than I have.

Some questions already have rubrics. We have a scoring system in place to decide who gets a new liver when one becomes available. We may not always like the outcome, but it seems to work. In the same way, ethicists can design a rubric to decide who gets the ICU bed or the ventilator. We just don’t have the luxury of time in which to figure it out.

“Cross contamination” – what does that look like? Check out this Facebook video.
This is even better if you listen without watching.

Since I had trouble finding his name, I want it out there: J-L Cauvin.

Exile

My wife works from home. As her work is confidential and involves talking, I am exiled for the day. I was forced to go for a long bike ride. A popular route since I was on training wheels is to the town park in Paoli. Usually I refill my water bottles there. Not today. I wasn’t going to since I didn’t have a way to disinfect the handle, but that wasn’t an option.

The pump don’t work cuz the vandals took the handles.
The handle may have been removed to prevent spread of infection

Social distancing was easy. There was no one out there. I rode past a bunch of loons out on the lake. They are also adept at social distancing. Ducks hang out in groups, but loons are introverts. Only once did I see two close enough to get them in the same frame. After the ride, I went home to get the “real” camera and went back to take pictures. Loons are wily. They dive to hunt and may pop up anywhere. They tended to stay away from me when I had the camera out. If I quietly moved down the path to get closer, one would pop up in the spot I just left. If I focused on one in the distance, another would pop up right below me. After I put the camera away, I swear one popped up directly below me and looked me in the eye.

Social distancing is easy when there’s no one out there.