Yesterday was a ludicrous illustration of the human (or at least my) brain's ability to completely misprioritise threats. It was the first day of 'distance learning' for la p'tite, and we'd received boatloads of instructions through the school with regards to schedules and links to packets of work for the kids and on-line tutorials for stuff, and in my head I was thinking I'd be able to set her up in front of the computer at the beginning of each hour, press go on whatever activity she was supposed to be doing, and then get on with what I was supposed to be doing (which was telephone visits with patients; I set her up in the other provider's empty office, meeting requirements of both social distancing AND HIPAA, so there). However, it wasn't quite as seamless as I'd imagined; every few minutes she would somehow manage to click out of the Zoom meeting with her teacher, or the online tutorial thing she was supposed to be doing, or she would accidentally hit mute, or (etc. etc. etc.) and would distress-yip for rescue; so much for her being a digital native - perhaps I have done her a disservice by previously insisting on limited screen time, since apparently, even though the revolution will not be televised, we'll be spending 98% of Armageddon on the internet. She even complained at the end of the day that it had been "very screen-filled." But here's the stupid part: I was more stressed out physiologically (elevated blood pressure, constricted pupils, sweaty palms) at the thought of not getting her logged in on time and successfully to the Zoom meeting with her Chinese teacher (we were four minutes late) than I was on reading the new update from the CDC that people in their 40's infected with coronavirus are way more likely than previously realised to require hospitalisation; my autonomic nervous system is seriously crap at threat triage.
In any case, I can see that I am going to need to rethink my romantic notions of enjoying homeschooling, since we somehow have more to do schoolwork-wise than we usually do during regular school. B. reports from Barcelona that school there is just straight-up cancelled and they are spending their days playing video games, working out on the stationary bike, playing with the cat, etc., and occasionally doing some reading, so I'm grateful for the structure that school is providing.
In the afternoon we had virtual piano lesson, which was hideous - while she's routinely low-grade horrible about practising, usually she pulls it together quite well for piano lesson in person, and sits up and plays properly and doesn't race through stuff and is more or less polite to the teacher. Yesterday for virtual lesson, however, she was frankly vile, lolling around on the piano bench, being offhanded with the teacher, racing through everything at breakneck pace with frequent excruciating collisions into wrong notes that she made no attempt to pretend to care about, etc., and I kind of wanted to murder her. (Wait, not 'kind of'. I wanted to murder her). But! It is a truth universally acknowledged that it is my choice to inflict piano lessons on my unwilling kid, so I decided my penance was to suffer in silence (although, ha, after the lesson was over she kept playing on her own for half an hour without any prompting). Mostly I am putting it in writing so that, if we all survive this, twenty years from now when she comes back and says thank you for making me take piano lessons, I can feel smug.
After that I let her bugger off to her room and play Lego while I sanded down the dining room table in preparation for dragon fabulousness, then dinner online with trophy BF (who should by rights have arrived on the plane last night and be lying next to me while I type this, but coronavirus), and then a chess game with Grandpa by phone while I (eek) ran back to clinic to rescue my laptop charger without which (see above comments re: Armageddon happening online) we are screwed. I returned in time for the last half of the chess game, which was pretty great: we'd labelled the board A-H and 1-8 down the sides so they could describe their moves to each other down the phone, and by the time I came back they had developed a large-animal variation on the military phonetic alphabet, and madam was gleefully calling out 'Queen to crocodile 2! Knight to gruffalo 8! MUMMY, come look how badly I'm beating Grandpa!" I am hoping to institute a regular weekly chess game, if only for the comedic relief.
They finished while I watched a helpful video sent by E. (hello, E!) on, exactly as requested, vent-settings for dummies in the event that primary care doctors get drafted to help in ICUs, and I also texted and emailed various friends, and generally felt that so far, coronavirus has provided some fairly seriously ironic silver linings in terms of connection with others. And then to bed, with an icepack for my poison oak rash.
Thursday, 19 March 2020
Wednesday, 18 March 2020
Day 4: urgent care shift
An eerily quiet day at urgent care; I had arrived early, expecting for it to be absolutely bursting, and that I would need to be briefed on whatever new policies and procedures were in place as of the last time I was there... and it was empty. Anyone with any respiratory symptoms whatsoever was being diverted to a special testing tent at one of the other sites, and anyone without respiratory symptoms was, for the most part, staying put at home. I saw five people in the whole shift - a lady with an ingrown toenail, a lady with a possible ectopic pregnancy, a guy who needed his stitches taken out, a guy who needed a TB test placed, and a young woman with a bruised thumb (whose bruised thumb did not, hilariously, stop her from texting the whole time I was trying to talk to her; while I was examining her thumb I snuck a peek into her lap to look at her phone screen to see what it was that had her so engrossed: "I never kissed him or made out with him u have to tell her that it aint me i dont even like him that much..."). The rest of the time I sat and read the internet - often good things, about how the canals in Venice are actually running clear, with fish, and with the bottoms visible for the first time in decades, and how the skies above China are already clearing with all the factories shut down, and about all the kind things that neighbours are doing for each other and the creative ways people are finding to help each other and fill their time while self-isolating.
I suspect that, just as my phone calls with students from Friday do not require really any specialised knowledge (otherwise healthy person + fever/cough = stay home and self-quarantine), having a patient on a ventilator for coronavirus is not going to be hugely medically complicated for the bulk of them compared to what the average pulmonary/critical care doctor is used to, and that with a minimum of additional training it should be possible to get family practice doctors up and running to take care of some of the really sick people, leaving the really really really sick people for the pulmonologists and ICU doctors. Can someone please write the Idiot's Guide to Vent Settings for a Coronavirus Patient Who Otherwise Doesn't Have That Many Medical Problems?
I fell asleep while listening to a Margaret Atwood lecture on creating believable dystopias. Hm.
I suspect that, just as my phone calls with students from Friday do not require really any specialised knowledge (otherwise healthy person + fever/cough = stay home and self-quarantine), having a patient on a ventilator for coronavirus is not going to be hugely medically complicated for the bulk of them compared to what the average pulmonary/critical care doctor is used to, and that with a minimum of additional training it should be possible to get family practice doctors up and running to take care of some of the really sick people, leaving the really really really sick people for the pulmonologists and ICU doctors. Can someone please write the Idiot's Guide to Vent Settings for a Coronavirus Patient Who Otherwise Doesn't Have That Many Medical Problems?
I fell asleep while listening to a Margaret Atwood lecture on creating believable dystopias. Hm.
Tuesday, 17 March 2020
Day 3: Bay Area officially on lockdown.
I had a dream last night that I went to a medical conference and there was an ER doctor there who brought the heads of two accidentally-decapitated patients that she had been trying to reassemble, which is pretty much a metaphor for how a lot of the day went (example: right before I got home I managed to drop a tin of exploding paint on myself; don't ask).
On the plus side, wheels are turning at work to try and make the clinic flow slightly less insane with regards to keeping patients and staff as COVID-free as possible (although at this particular job there is a layer of head-games from the administration that is getting bizarre, along the lines of not trusting the providers to wipe our own arses and then providing us with live porcupines as the officially-approved material for arse-wiping).
I did a bunch of telephone visits with patients that all went the same way:
Me: Hi! So tell me what's been going on?
Patient: I've had several days of a cough, some fever, some sore throat, and chest tightness.
Me: I'm so sorry to hear that. Any recent travel or known exposure to a COVID+ person?
Patient: no.
Me: OK, well, you're going to need to self-quarantine completely for two weeks, and we'll give you a ring in the meantime once we're up and running with COVID testing for patients who don't meet travel history criteria. Wash your hands whenever you touch a doorknob, your face, or anything else, wear a mask, stay at least 6 feet from every other human, and in your room if at all possible. Call if your symptoms get worse and we'll try and help you decide whether you actually need to go to hospital.
Patient: Supercalifragilisticexpialidocious.
Me: Byeeee.
Then I went to get fit-tested for the type of N95 mask that we have in clinic... and possibly thanks to recent gum surgery, or the medications I am taking for poison oak (opportunities for self-pity are thick on the ground at the moment) I couldn't smell the testing chemical thing, which means I still have not been fit-tested for the N95 masks we have at that clinic which means I still can't see anyone who has any respiratory symptoms at all. Except for invariably what has happened with the patients that I have been seeing who supposedly have already been screened and confirmed not to have respiratory symptoms is that those conversations go like this:
Me: Hi! So tell me what's been going on?
Patient: Well, I've had a sore finger ever since I jammed it in the door last week.
Me: I'm so sorry to hear that. Anything else going on?
Patient: I've had several days of a cough, some fever....
At which point I ask them to go outside, I don my ridiculous space outfit, including the mask that hasn't been properly fit-tested, and we go finish the conversation sitting on the bench outside the clinic, making sure that no one else is listening because HIPAA compliance! I swear, the world could actually be ending, and we're all so twitchy about HIPAA we'd still be requesting that people sign to get their medical records sent over so we could see whether they'd discussed with their previous provider their plans for the afterlife.
I think not infrequently of the most shocking experience of my career in medicine, as a third year student on my surgery rotation, when a young man pretty much exactly my age came in with what turned out to be a ruptured aortic aneurysm. I scrubbed in on the surgery, at one point taking over for the scrub tech, frantically handing instruments to a monosyllabic and clearly stressed surgeon, and it was a bloodbath of the most horrifying gothic proportions. At one point near the end when the anesthesiologist realized that she was having trouble ventilating the young man's lungs because his chest was literally filling up with blood, the surgeon ripped the sterile drape off the patient's chest, threw it to the floor, and slashed his chest open with a scalpel to release the accumulating blood, which sloshed all over the floor. I had a little prissy moment of wait, you can't DO that, what about infection risk if the operation isn't kept sterile?? and then realised, oh god, of course, he's going to die anyway, infection risk is meaningless. So. Let's hope that we continue to have the luxury of prissily worrying about HIPAA regulations, since that will mean that Coronageddon isn't all _that_ bad.
On the plus side, wheels are turning at work to try and make the clinic flow slightly less insane with regards to keeping patients and staff as COVID-free as possible (although at this particular job there is a layer of head-games from the administration that is getting bizarre, along the lines of not trusting the providers to wipe our own arses and then providing us with live porcupines as the officially-approved material for arse-wiping).
I did a bunch of telephone visits with patients that all went the same way:
Me: Hi! So tell me what's been going on?
Patient: I've had several days of a cough, some fever, some sore throat, and chest tightness.
Me: I'm so sorry to hear that. Any recent travel or known exposure to a COVID+ person?
Patient: no.
Me: OK, well, you're going to need to self-quarantine completely for two weeks, and we'll give you a ring in the meantime once we're up and running with COVID testing for patients who don't meet travel history criteria. Wash your hands whenever you touch a doorknob, your face, or anything else, wear a mask, stay at least 6 feet from every other human, and in your room if at all possible. Call if your symptoms get worse and we'll try and help you decide whether you actually need to go to hospital.
Patient: Supercalifragilisticexpialidocious.
Me: Byeeee.
Then I went to get fit-tested for the type of N95 mask that we have in clinic... and possibly thanks to recent gum surgery, or the medications I am taking for poison oak (opportunities for self-pity are thick on the ground at the moment) I couldn't smell the testing chemical thing, which means I still have not been fit-tested for the N95 masks we have at that clinic which means I still can't see anyone who has any respiratory symptoms at all. Except for invariably what has happened with the patients that I have been seeing who supposedly have already been screened and confirmed not to have respiratory symptoms is that those conversations go like this:
Me: Hi! So tell me what's been going on?
Patient: Well, I've had a sore finger ever since I jammed it in the door last week.
Me: I'm so sorry to hear that. Anything else going on?
Patient: I've had several days of a cough, some fever....
At which point I ask them to go outside, I don my ridiculous space outfit, including the mask that hasn't been properly fit-tested, and we go finish the conversation sitting on the bench outside the clinic, making sure that no one else is listening because HIPAA compliance! I swear, the world could actually be ending, and we're all so twitchy about HIPAA we'd still be requesting that people sign to get their medical records sent over so we could see whether they'd discussed with their previous provider their plans for the afterlife.
I think not infrequently of the most shocking experience of my career in medicine, as a third year student on my surgery rotation, when a young man pretty much exactly my age came in with what turned out to be a ruptured aortic aneurysm. I scrubbed in on the surgery, at one point taking over for the scrub tech, frantically handing instruments to a monosyllabic and clearly stressed surgeon, and it was a bloodbath of the most horrifying gothic proportions. At one point near the end when the anesthesiologist realized that she was having trouble ventilating the young man's lungs because his chest was literally filling up with blood, the surgeon ripped the sterile drape off the patient's chest, threw it to the floor, and slashed his chest open with a scalpel to release the accumulating blood, which sloshed all over the floor. I had a little prissy moment of wait, you can't DO that, what about infection risk if the operation isn't kept sterile?? and then realised, oh god, of course, he's going to die anyway, infection risk is meaningless. So. Let's hope that we continue to have the luxury of prissily worrying about HIPAA regulations, since that will mean that Coronageddon isn't all _that_ bad.
Monday, 16 March 2020
Day 2: last social contacts
Sunday. No cannibalism yet. We were more social than is probably advisable - P's godmother came for a very disorganized lunch, and we ended up having dinner with the M's, who are currently camped out in our back garden en route from Argentina to the wilds of northern California. It would be very helpful if someone who knew something about viral spread and computer modeling could provide some guidelines w/r/t 'social distancing': I know that being within six feet and more than a few minutes increases your risk of respiratory exposure, but in terms of fomite spread from surfaces - what if you remain at least six feet from each other but moving around the same house? using the same tea-towels to dry your plate? who knows.
It is hard, I am finding, not to consider the more meta-view: a virus that removes up to 10% of the human population (mostly sick and elderly) relatively quickly and painlessly, discourages casual air and large cruise ship travel, and takes developed-world hubris down a serious notch or two, sounds like it would start to address the one problem we have that's even bigger than coronavirus, i.e. environmental damage and climate change. However, the cruise companies and airline industries will get bailouts at taxpayer expense, and Jeff Bezos will profit enormously from everyone doing all their shopping from the coronavirus-free comfort of their homes rather than braving the outside the world, and more and more people will become homeless because they can't go to work because they're sick or their kid's school is closed or the small business they work for folded or any number of reasons, and on and on until end times actually come. (Incidentally, I can't find easily isolatable mortality statistics for homelessness, but I'd bet on average it's more lethal to be homeless than to have coronavirus, since in California average life expectancy for a homeless person is, according to a Kaiser study I just found, age 48 (women) and 51 (men) respectively.) So there's that cheerful thought to start the day with.
Today I am headed back to clinic, to see if the nonsensical policy of Friday has been replaced with any less nonsensical policy. I would much, much, much rather stay right where I am, which is tucked up on the sofa in the dark with my lovely girl warmly snoozing next to me (we had a living room campout last night, mainly an excuse for cocoa and to sleep by the fire), dreaming of the dragons I have promised her we can repaint the dining table with later this week when we are home together on Thursday.
It is hard, I am finding, not to consider the more meta-view: a virus that removes up to 10% of the human population (mostly sick and elderly) relatively quickly and painlessly, discourages casual air and large cruise ship travel, and takes developed-world hubris down a serious notch or two, sounds like it would start to address the one problem we have that's even bigger than coronavirus, i.e. environmental damage and climate change. However, the cruise companies and airline industries will get bailouts at taxpayer expense, and Jeff Bezos will profit enormously from everyone doing all their shopping from the coronavirus-free comfort of their homes rather than braving the outside the world, and more and more people will become homeless because they can't go to work because they're sick or their kid's school is closed or the small business they work for folded or any number of reasons, and on and on until end times actually come. (Incidentally, I can't find easily isolatable mortality statistics for homelessness, but I'd bet on average it's more lethal to be homeless than to have coronavirus, since in California average life expectancy for a homeless person is, according to a Kaiser study I just found, age 48 (women) and 51 (men) respectively.) So there's that cheerful thought to start the day with.
Today I am headed back to clinic, to see if the nonsensical policy of Friday has been replaced with any less nonsensical policy. I would much, much, much rather stay right where I am, which is tucked up on the sofa in the dark with my lovely girl warmly snoozing next to me (we had a living room campout last night, mainly an excuse for cocoa and to sleep by the fire), dreaming of the dragons I have promised her we can repaint the dining table with later this week when we are home together on Thursday.
Saturday, 14 March 2020
Coronavirus day 1
Of course it's not actually day 1 of coronavirus, but it feels close enough to the beginning of our personal mini-Armageddon that I have decided to call it day 1: school is officially closed as of yesterday, and so la p'tite and I are now holed up at home, shunning contact with the plague-ridden outside world as best we can (sort of). Next week starts home-schooling, or something approximating it; for now it is a question of embracing our cabin fever and making the most of it.
I am secretly looking forward to the home-schooling aspect of things - madam, it should be said is most definitively _not_, but we have at least managed to make a list of 'things we want to learn about while at home together next week': we are going to
- do a report about volcanoes,
- do a calligraphy project
- learn about the American revolution, and
- write a story each. Her writing prompt is, 'what if a kid found a bomb under the teacher's desk?' prompted by an exhaustive, disorganized, gleeful, improbable search for bombs throughout the house this morning, mainly, we suspect, in an effort to avoid the family meeting. Trophy BF attended the meeting remotely (note to self: buy stock in Zoom; it will be the only stock not in freefall at the moment) and was very game: he too was given a writing prompt ('what if a sorbet jumped into the pool while crying?' which he will doubtless manage to do something brilliant with), participated in the long-distance gym lesson organized (I use the term loosely) by madam, and suggested a science project for us to do, which we may or may not get to (we are currently reading a book while hiding inside the massive furniture-and-blanket fort that dominates the living room, and have shown no interest in coming out). I am not totally sure how exactly I'm going to convince her that we should sit up at the table Learning About Volcanoes, but this feels like an opportunity to try out what home schooling would be like, so I'm tentatively excited. We have gotten as far as making ourselves a plaster of Paris volcano, which needs painting before we do the vinegar and baking soda trick on it; the kit came with a geode (which we dutifully cracked open) and a pumice stone (which I will use to scrub my feet in the bath tonight).
The interesting thing is that as long as I leave her alone to get on with her projects, she's perfectly content: she's been reading in her fort (quote: "I love books! the reason books are better than screens is that the batteries never give out") in her pyjamas most of the day, and has been quite lovely, without apparently any need for external input. She has come up several times requesting food, hugs, or, twice, 'a tango competition,' but otherwise she's been quite self-entertaining.
(As have I: I have dug out a monster load of crabgrass and oxalis from the front garden, cooked meals for the next three days, and re-read the first half of La Sombra del Viento, actually looking up the words I don't know this time round; the majority of the vocabulary I am pleased to report is gratifyingly obscure and I am learning some English words along with the Spanish. Google gave me 'groyne' as the English translation for 'espigon,' for example, which turns out to be a low sea wall constructed to check erosion; likewise 'sortilegio' is 'sortilege,' which (duh, if you didn't know) is the historical practice of fortunetelling by drawing a random card. So there.) I should also say it's been chucking it down rain all day today; it's not just coronavirus.
Anyway. A moment to reflect on the whole coronavirus thing: I understand that the point currently is to slow down transmission so that we can avoid overwhelming the health care system's capacity with a huge dramatic peak in cases and possibly, maybe, give the CDC time to develop a vaccine for this thing before too many people die of it, but given that the healthcare system can't actually do much about it except for Tylenol, oxygen and a ventilator if it gets really bad, it's hard not to wonder whether we should be concentrating our efforts on getting everyone in the country a home O2 sat monitor and a thermometer so that they can just call the oxygen delivery company when they are ready for home O2, and 911 when the home O2 isn't enough and a ventilator is in order; ditto Tylenol. Likewise, despite all the efforts to develop a PCR test for viral RNA to figure who has live virus, a test for COVID19 antibodies - which would identify both who has an ongoing infection plus who has recovered from it and therefore can go out into the world and do their work - might ultimately be of more utility.
The situation at work feels ludicrous: the official word on Friday was 'phone triage all patients; if there is anyone you can't rule out COVID19 by phone, then refer them to public health,' which is deeply, deeply nonsensical on several levels. (The only way, given that we know there is community transmission in asymptomatic people, to 'rule out' COVID19 is with a lab test, not a phone call, ergo if we followed this policy, we would be sending literally every patient to Public Health, and Public Health would be sending them right back to us because they are still completely overwhelmed and therefore only testing people with known exposures plus symptoms; therefore the policy makes zero sense, but all the administrators keep repeating it as if it does make sense and I am apparently just being difficult and unhelpful). It is very, very tempting to just quit my job and sit at home and wait this whole thing out, except for I need to go out there and pretend there is something we can do about COVID19 in order to earn money to pay for the house to which I would dearly love to just retreat).
We do not (no surprise) have anywhere near enough N-95 masks at work (five, at last count; they are technically meant to be disposed of between patients, ha, no news on when more will be forthcoming), and the fit-testing didn't happen until yesterday (finally organized by the medical assistant, NOT the administration), so our pants are well and truly down. What I have done is filch one N95 from each place I work thus far plus a small one for la p'tite should the need arise, seal each one in a ziploc bag labelled with each day of the week, and I will reuse each mask weekly for the whole day at work, covered with a surgical mask (or a plastic face shield, if I can get one, since there's limited evidence to suggest that this might prolong the life of an N95, but of course these are also not available for love or money in any of the places I work), and then reseal them in their ziploc baggies, leaving 7 days for the virus to hopefully die until the next time I need to reuse the mask. It's a faff, and it's far from perfect, and I will doubtless get sick with this eventually, but hopefully I will not take anyone down with me. On the plus side, the lack of air travel is probably brilliant for the environment...
I am secretly looking forward to the home-schooling aspect of things - madam, it should be said is most definitively _not_, but we have at least managed to make a list of 'things we want to learn about while at home together next week': we are going to
- do a report about volcanoes,
- do a calligraphy project
- learn about the American revolution, and
- write a story each. Her writing prompt is, 'what if a kid found a bomb under the teacher's desk?' prompted by an exhaustive, disorganized, gleeful, improbable search for bombs throughout the house this morning, mainly, we suspect, in an effort to avoid the family meeting. Trophy BF attended the meeting remotely (note to self: buy stock in Zoom; it will be the only stock not in freefall at the moment) and was very game: he too was given a writing prompt ('what if a sorbet jumped into the pool while crying?' which he will doubtless manage to do something brilliant with), participated in the long-distance gym lesson organized (I use the term loosely) by madam, and suggested a science project for us to do, which we may or may not get to (we are currently reading a book while hiding inside the massive furniture-and-blanket fort that dominates the living room, and have shown no interest in coming out). I am not totally sure how exactly I'm going to convince her that we should sit up at the table Learning About Volcanoes, but this feels like an opportunity to try out what home schooling would be like, so I'm tentatively excited. We have gotten as far as making ourselves a plaster of Paris volcano, which needs painting before we do the vinegar and baking soda trick on it; the kit came with a geode (which we dutifully cracked open) and a pumice stone (which I will use to scrub my feet in the bath tonight).
The interesting thing is that as long as I leave her alone to get on with her projects, she's perfectly content: she's been reading in her fort (quote: "I love books! the reason books are better than screens is that the batteries never give out") in her pyjamas most of the day, and has been quite lovely, without apparently any need for external input. She has come up several times requesting food, hugs, or, twice, 'a tango competition,' but otherwise she's been quite self-entertaining.
(As have I: I have dug out a monster load of crabgrass and oxalis from the front garden, cooked meals for the next three days, and re-read the first half of La Sombra del Viento, actually looking up the words I don't know this time round; the majority of the vocabulary I am pleased to report is gratifyingly obscure and I am learning some English words along with the Spanish. Google gave me 'groyne' as the English translation for 'espigon,' for example, which turns out to be a low sea wall constructed to check erosion; likewise 'sortilegio' is 'sortilege,' which (duh, if you didn't know) is the historical practice of fortunetelling by drawing a random card. So there.) I should also say it's been chucking it down rain all day today; it's not just coronavirus.
Anyway. A moment to reflect on the whole coronavirus thing: I understand that the point currently is to slow down transmission so that we can avoid overwhelming the health care system's capacity with a huge dramatic peak in cases and possibly, maybe, give the CDC time to develop a vaccine for this thing before too many people die of it, but given that the healthcare system can't actually do much about it except for Tylenol, oxygen and a ventilator if it gets really bad, it's hard not to wonder whether we should be concentrating our efforts on getting everyone in the country a home O2 sat monitor and a thermometer so that they can just call the oxygen delivery company when they are ready for home O2, and 911 when the home O2 isn't enough and a ventilator is in order; ditto Tylenol. Likewise, despite all the efforts to develop a PCR test for viral RNA to figure who has live virus, a test for COVID19 antibodies - which would identify both who has an ongoing infection plus who has recovered from it and therefore can go out into the world and do their work - might ultimately be of more utility.
The situation at work feels ludicrous: the official word on Friday was 'phone triage all patients; if there is anyone you can't rule out COVID19 by phone, then refer them to public health,' which is deeply, deeply nonsensical on several levels. (The only way, given that we know there is community transmission in asymptomatic people, to 'rule out' COVID19 is with a lab test, not a phone call, ergo if we followed this policy, we would be sending literally every patient to Public Health, and Public Health would be sending them right back to us because they are still completely overwhelmed and therefore only testing people with known exposures plus symptoms; therefore the policy makes zero sense, but all the administrators keep repeating it as if it does make sense and I am apparently just being difficult and unhelpful). It is very, very tempting to just quit my job and sit at home and wait this whole thing out, except for I need to go out there and pretend there is something we can do about COVID19 in order to earn money to pay for the house to which I would dearly love to just retreat).
We do not (no surprise) have anywhere near enough N-95 masks at work (five, at last count; they are technically meant to be disposed of between patients, ha, no news on when more will be forthcoming), and the fit-testing didn't happen until yesterday (finally organized by the medical assistant, NOT the administration), so our pants are well and truly down. What I have done is filch one N95 from each place I work thus far plus a small one for la p'tite should the need arise, seal each one in a ziploc bag labelled with each day of the week, and I will reuse each mask weekly for the whole day at work, covered with a surgical mask (or a plastic face shield, if I can get one, since there's limited evidence to suggest that this might prolong the life of an N95, but of course these are also not available for love or money in any of the places I work), and then reseal them in their ziploc baggies, leaving 7 days for the virus to hopefully die until the next time I need to reuse the mask. It's a faff, and it's far from perfect, and I will doubtless get sick with this eventually, but hopefully I will not take anyone down with me. On the plus side, the lack of air travel is probably brilliant for the environment...
Saturday, 8 September 2018
In defense of a language that can defend itself just fine, thanks.
Trophy boyfriend and I had an argument this last weekend, and it was one of those really satisfying arguments where you know exactly what you are arguing about, there are no actual emotions involved, and you are thus able to bring the whole thing to a prompt and satisfactory conclusion... not. It started with my irritation at his overuse of the word 'whimsical,' or to be fair, my perception of his overuse of the word, and spiralled from there into the murky depths of overgeneralized and slightly hysterical accusations of what, exactly, I couldn't say, but it wasn't comfortable and the resolution will only come, I suspect, when we both decide to just forget about it and go back to whatever it is we usually talk about.
But the whole episode has got me thinking about language, and English in particular, and trying to puzzle out why the vagaries of language are so acutely personal. Is it just tribalism in disguise? An attempt by Strunk & White (and me! me too!) to lord it over the unlettered unwashed masses so we can temporarily feel better about ourselves while we contemplate the dark void that awaits us after we die? Do I disdain the incorrect (or "incorrect") use of a adjective where an adverb should go because I like the dopamine rush of educated superiority? Is it elitism? (The rise of Donald Trump depends on trashing elitism, so clearly elitism isn't all bad, but...)
Full disclosure: I was inoculated at a deeply impressionable age (thirteen) by a living caricature of a women's college bluestocking who taught me (joy!) how to diagram a sentence, why it is logical for gerunds when used as nouns to go with possessive pronouns, and the various uses of a semicolon, and (surprise!) I ate that shit UP. (We also read our way through the high points of the old-white-mostly male English-language canon: Chaucer to... I think Katherine Mansfield was probably about as modern as she could stand to teach. Obviously incomplete, but she only had us for a year, and given the students she had to cope with, an ambitious start.)
So anyway. Fast forward to a few years later, when the following questions appeared on a marine biology seminar final exam:
Q. What is the correct plural of the word 'genus'?
Q. What is the correct singular of the word 'algae'?
There was some wailing from all the other students about how the question had nothing to do with marine biology knowledge, and wasn't fair, etc., and of course, little Hermione Granger that I am, I wrote 'genera' and 'alga' in my neatest, smuggest handwriting and thought how great it was that the professor gave a shit about things I knew and other people didn't, then spent several years feeling embarrassed about what a little prissy brat I was, and now I'm more grownup and everything's gone all shades of grey on me. I can see and agree with (you will all be relieved to know) the other students: they're right. The question wasn't about marine biology. And there are way more important things to worry about. But which word _do_ you use? Are you a data/datum person? or do you even know that this is a thing?
Specifically on the subject of Latin plurals, there is plenty of vitriol and ridicule being hurled across both sides of the line, (making the 'who cares, move on' point of view seem much the most attractive), but really we all know who's going to end up winning the argument. Both sides are of course perfectly right: the winning side, the side with way more people on it, would say that Latin plurals are outdated, elitist, ridiculous, inefficient, and make it harder to learn English for non-native speakers (viz the late, great Tom Lehrer making fun of Harvard football teams playing at various 'stadia' rather than 'stadiums'). And the losing side protests, but but but, Latin plurals can be elegant, precise, a reminder of the etymology of a word, and it's weird and wonderful and beautiful to have different ways of making a plural depending on which strand of English the word came from.
I think for me ultimately this is the argument that pushes me over the line into the arms of the heroically stupid defenders of a static language. To use the word 'genera' rather than 'genuses' is not just to adhere to an outdated silly rule just to prove you know more than the people who don't (although yes, it can be that as well). It's lighting a candle on a Day of the Dead altar: on the highest shelf is a picture of a Roman centurion, far from his Mediterranean home, shivering in the bloody awful weather in some fort along Hadrian's wall in the second century; lower down, here is a group shot of English schoolboys swotting away at their Latin prep before they grew up to be (bottom shelf) the mustachio'ed Victorian gentleman scientists responsible for the propagation of the taxonomic nomenclature, all because, wow, how crazy is that, that there were all these proto-Italians running around in England at the beginning of written history.
Likewise, I was given a gag gift for my birthday recently - a pair of socks inscribed with the motto, "Thou hath balls," with a frankly awesome picture of a guy arm-wrestling a medieval lion - and, yup, it's deeply, deeply obnoxious to point out that it should be, 'thou hast,' not 'thou hath,' and again, really who cares anyway. But getting it right is also a way of saying, hey, Shakespeare and whoever you were who wrote the King James Bible, and all you other Tudor-through-Stuart bookish types: thank you. That was a lot of gorgeous rich fantastic stuff you gave us. We still read it and remember it with at least a tiny bit of accuracy. What's more important, to just say thank you to my friend for the socks? or to say thank you to Shakespeare for the language? I don't know. I want a graceful way to do both, and if the sockmakers had just run 'thou hath' through their Renaissance grammar checker (Google: get on that, please) and put 'thou hast' instead, I could have saved myself a paragraph's worth of angst over how much of my own small-mindedness I'm willing to reveal in a public blog.
There are a lot of things that the English took in their nearly successful attempt at world domination that were not right, not fair, not OK, and which have contributed to a lot of people in the developing world living in dire circumstances, but language - you can take it and still leave it with its owners! How terrific is that? No guilt or apology required! English is both omnivorous and voracious, and as a result we famously clock over half a million words, compared to 100-200k per Romance language. (A quick internet search just told me that Arabic, meanwhile, has got over 12 million words, which is amazing and makes me want to try and learn Arabic immediately right now so I can find out what can they say that we can't). I am sure speakers of Swedish, Inuit, Tagalog, etc. would say the same about their languages, blah blah blah, but I feel a patriotism about the English language that I have never felt about an actual country. English is sprawling, agile, muscular, magical, volatile, dirty, soaring, miraculous. English is fucking great.
Here is the writer A. A. Gill talking to a group of schoolkids, and I suspect him of secretly being on the fence himself with regards to language use: in grammatical, correctly punctuated, eloquent sentences packed with SAT words, he makes the case for everyone being allowed to do whatever they want with English.
"I told them this was their language, this English, this most marvellous and expressive cloak of meaning and imagination. This great, exclamatory, illuminating song, it belonged to anyone who found it in their mouths. There was no wrong way to say it, or write it, the language couldn’t be compelled or herded, it couldn’t be tonsured or pruned, pollarded or plaited, it was as hard as oaths and as subtle as rhyme. It couldn’t be forced or bullied or policed by academics; it wasn’t owned by those with flat accents; nobody had the right to tell them how to use it or what to say. There are no rules and nobody speaks incorrectly, because there is no correctly: no high court of syntax. And while everyone can speak with the language, nobody speaks for the language. Not grammars, not dictionaries. They just run along behind, picking up discarded usages. This English doesn’t belong to examiners or teachers. All of you already own the greatest gift, the highest degree this country can bestow. It’s on the tip of your tongue."
His point is terrific, and salient, and... would not come across nearly so well were he speaking less articulately. So here's what I think my own philosophy towards language is going to be: Add words. Find new meanings. Build new and more colourful phrases. Be flexible. Allow language to grow. But also: know and use lots of words, honour old words, understand how the different parts of language work, and let's encourage our kids to do the same. It's not elitism, it's gratitude for the astonishing wealth we have inherited.
Thursday, 8 September 2016
No princesses allowed
I recently read a precis of a study which analysed various Disney princess films by percentage of words spoken by male and female characters, and was both unsurprised and horrified to read that, on average, the male characters get a substantial majority of the lines spoken (roughly 60-80% in the so-called "second-generation" princess films), including the ones in whom the central character(s) are female. The Little Mermaid, which has a female protagonist AND a female villain, still gives 68% of the lines to male characters - perhaps because (this isn't icky at all) Ariel literally gives up her voice in order to be with her man. My daughter's obsession with Frozen, before either of us had ever seen it (such is the power of marketing) forced me to set a daily limit of five minutes' conversation about Elsa and her ice powers lest I start howling with boredom, but I was convinced by an otherwise usually sensible friend that Frozen was better than most Disney films from a feminist perspective. So I watched it on the plane and... despite being about the (frequently pouty, histrionic) relationship between two (predictably Barbie-pretty teenage) sisters, Frozen clocks in at 59% of the dialogue spoken by male characters. Here's the weird part: this is an overall increase in male dialogue over the earliest Disney films (Snow White, Sleeping Beauty, Cinderella), in which female characters at least got to talk a bit more, even if there is plenty of disturbing chauvinism to be found in the content. The researchers attributed this to modern Disney films' having a larger cast of characters these days than in the old days, and nearly all the supporting characters with lines are male, because....drumroll.... "laziness."
I am confused by this. Laziness? Really? Men have an average of 1.9 m2 of skin, as opposed to women's 1.6 m2; thus it should be _quicker_ if anything to draw a female character, especially an underweight teenager, even if you do take up a little of the difference with attractively displayed cleavage:
Maybe it's not the drawing that's more difficult - maybe it's really hard to find unemployed young female actors in Hollywood to do the voices.... Um, not. Or maybe, just maybe, whoever is making the artistic decisions at Disney is walking around with a special helmet strapped to his head which filters out the voices of all women, and the appearance of all women other than anorexic pretty teenage girls, such that they believe themselves to be living in a world mostly populated by other men and voiceless teen girls, and gosh, yes, it would take a lot of work to remove that helmet and recognize that the world is actually populated half by women (!), many of whom are not anorexic pretty teenagers but who are nonetheless doing interesting and valuable things.
Which gets to another beef I have with Disney princesses, besides the fact that they don't get to say quite enough (although interestingly, all except Aladdin pass the Bechdel test): why are they all teenagers? I have done some poking around the Internet and this doesn't seem to be something that has caused that much comment in the blogosphere, but it seems obvious to me that if you are making films for children, that they should be _about_ children. So, why are all the princesses physically developed adolescents rather than straight-up girls? Obvious answer: so that you can sexualize them. This is presumably more fun and titillating for any heterosexual males involved in the process of making Disney films (boobs are always more fun than no boobs, right?), plus you don't have to do any hard thinking about what to have as a happy ending ("I know! A handsome prince can fall in love with her! Our work here is done. Let's go for coffee.") Happy endings for bona fide kids, I suspect, would be much more interesting and varied; my daughter's goal for this kindergarten year, for instance, is to meet a unicorn; a classmate would like to be a panda wrapped in a taco - and I do see that finding a happy ending that all small children could unilaterally agree was awesome might be difficult. Surely, however, some compromise could be found - a taco party with pandas and unicorns? Disney, make that movie, and I will promise to take my kid to it.
Here's my totally predictable feminist-rant theory: the conspiracy to make girls feel ugly and incomplete without a male, and to be willing to submit to dominant male voices in their lives, has to start early in order to get it really stuck in their psyches, because if it's not really truly entrenched in their little brains before they hit sexual awakening, then you might not be able to make quite so many squillions of dollars down the line selling them eye-liner, push-up bras, botox, boob jobs, magazines advertising 10 best blow-job tips, wedding catering services, and diet pills. I'm open to other theories, but until I hear a more convincing one, or until Disney starts making movies that are better for girls, our house is going to stay a no-princess zone.
I am confused by this. Laziness? Really? Men have an average of 1.9 m2 of skin, as opposed to women's 1.6 m2; thus it should be _quicker_ if anything to draw a female character, especially an underweight teenager, even if you do take up a little of the difference with attractively displayed cleavage:
Maybe it's not the drawing that's more difficult - maybe it's really hard to find unemployed young female actors in Hollywood to do the voices.... Um, not. Or maybe, just maybe, whoever is making the artistic decisions at Disney is walking around with a special helmet strapped to his head which filters out the voices of all women, and the appearance of all women other than anorexic pretty teenage girls, such that they believe themselves to be living in a world mostly populated by other men and voiceless teen girls, and gosh, yes, it would take a lot of work to remove that helmet and recognize that the world is actually populated half by women (!), many of whom are not anorexic pretty teenagers but who are nonetheless doing interesting and valuable things.
Which gets to another beef I have with Disney princesses, besides the fact that they don't get to say quite enough (although interestingly, all except Aladdin pass the Bechdel test): why are they all teenagers? I have done some poking around the Internet and this doesn't seem to be something that has caused that much comment in the blogosphere, but it seems obvious to me that if you are making films for children, that they should be _about_ children. So, why are all the princesses physically developed adolescents rather than straight-up girls? Obvious answer: so that you can sexualize them. This is presumably more fun and titillating for any heterosexual males involved in the process of making Disney films (boobs are always more fun than no boobs, right?), plus you don't have to do any hard thinking about what to have as a happy ending ("I know! A handsome prince can fall in love with her! Our work here is done. Let's go for coffee.") Happy endings for bona fide kids, I suspect, would be much more interesting and varied; my daughter's goal for this kindergarten year, for instance, is to meet a unicorn; a classmate would like to be a panda wrapped in a taco - and I do see that finding a happy ending that all small children could unilaterally agree was awesome might be difficult. Surely, however, some compromise could be found - a taco party with pandas and unicorns? Disney, make that movie, and I will promise to take my kid to it.
Here's my totally predictable feminist-rant theory: the conspiracy to make girls feel ugly and incomplete without a male, and to be willing to submit to dominant male voices in their lives, has to start early in order to get it really stuck in their psyches, because if it's not really truly entrenched in their little brains before they hit sexual awakening, then you might not be able to make quite so many squillions of dollars down the line selling them eye-liner, push-up bras, botox, boob jobs, magazines advertising 10 best blow-job tips, wedding catering services, and diet pills. I'm open to other theories, but until I hear a more convincing one, or until Disney starts making movies that are better for girls, our house is going to stay a no-princess zone.
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