Light and Momentary

A version of normal

All through the early months of the pandemic I kept a running list of the things I missed at church. With the goal of reducing transmission risk, we stopped singing the Gloria and we switched to the Apostles' Creed, because it's shorter. There was that whole THING about how Catholics were going to receive communion, and I kept trying to put a brave face on it-- to recognize that my preferences are only preferences, and that protecting the vulnerable is always more important than an individual's preferences, and that people who were really emphatic about their preferences still deserved patience and a listening ear from me.

I don't think I ever put it all together in one post, though I wrote about some of it in this post from July 2020. In a world where a million Americans had died or were dying or were soon to die of COVID, it was a teeny little minor trivial thing to miss the Nicene Creed. But I did miss it. 

Today the five of us who are in town this weekend went to church together, and it felt pretty...normal. We sang the Gloria. We said the Nicene Creed: light from light, true God from true God. When I went up to receive communion I knelt down, bare-faced, before my bare-faced pastor, exactly the way I was longing to do it in that old post. Despite the COVID notices that keep plopping into my email inbox at work, the community rate is low and -- for the moment, at any rate -- we are living a cautious grateful approximation of normal.

I am noticing two things lately as we tiptoe back toward something like normal: one is that I remember the shutdown weeks differently in hindsight. I felt so much fear and uncertainty at the time, but in my memories those days are...cozy? almost, weirdly, nostalgia-inducing? Pete says he feels the same way but it still seems odd to me. I guess it's a little like being nostalgic when I see toddler pictures: the hard parts have mostly faded out of my memory, even though I know it was a hard season.

The second thing I am noticing is that my name-retrieval skills are rusty after more than two years of deliberately attending the least crowded Masses. It's great to see people again, and also a little awkward to fumble for names I haven't used in many months. It's interesting to see what my brain spits out as it's trying to get to an actual name-- little nuggets about how the name isn't spelled the way it sounds, or possible alternate names with phonological similarities to the name that has gone walkabout.

Are you noticing this too? Tell me it's not post-COVID brain damage, okay?

Wiped

I think COVID did a number on my fatigue resistance. If I don't get enough sleep, I am just flattened. In general I'm doing fine, but I have to pay attention to the amount of rest I am getting. I had a short night and a full day, and I am just...toast. It feels like being 30 weeks pregnant with undiagnosed anemia, which is my personal benchmark for The Tiredest I Have Ever Been.

I am 18 days out from my first day of symptoms, and I was a little sicker than I expected for a little longer than I expected, so I suppose this isn't especially surprising. Here's hoping an 8:30 bedtime will do the trick. 

And down

I tested positive for COVID this morning.

I feel okay, as if I have a mild cold. In the before times I would never have dreamed of missing work for something like this. I should have known something was up yesterday, when after a lot of staring and thinking I got tangled up in a Killer Sudoku that should have been straightforward. (I look forward to the Saturday Killer Sudoku starting on about Thursday. It is my favorite puzzle of all. Perhaps I will write a journal article: A Novel Method For Diagnosing COVID-19 Infection. It could be very useful for the -- oh, 12 or so people in the US who share my obsession.)

On Friday night just before bed I said to myself, "Hm, is that a sore throat?" But I have asked myself that question so many times over the past two years that I don't give it much weight these days. I woke up yesterday morning and thought, "Hm, that seems like it might be a sore throat; should I take a COVID test?" But I have taken so many negative COVID tests in the wake of hypochondriacal thoughts about possible symptoms that I didn't.

And lo, those possible symptoms were actual symptoms.

I am very curious about where I picked it up. There were a ton of people at the concert on Wednesday night, but it was all outdoors on a breezy night and neither one of my roommates is sick despite identical exposure. And the test turned positive double-quick, which makes me wonder if I was exposed earlier. Could have been at Mass last Sunday despite the KN-95 mask, but Stella was right next to me and she is not sick. Could have been in the adoration chapel last Sunday afternoon, courtesy of the person who spent some time in the opposite corner, but we were a fair distance apart in a high-ceilinged space. Nine days ago I ate at a restaurant with two other people; they don't seem to have COVID.

Elwood and Pete traveled for a board-game convention last weekend. Although they wore masks at the convention, it also seems possible that Elwood brought home an asymptomatic case which he shared with me while sleeping next to me.

No one else is sick so far. Stella has a drippy nose and a negative test. I breathed all over her yesterday, though, while thinking, "Isn't it strange how often I wonder whether I have a sore throat?"

Anyway, say a prayer or wish me luck, according to your preferences. Feel free to speculate about which route of transmission seems most likely and/or dispense advice about getting through it.

Saturday Report

Today, my friends, I finished the admissions portfolios. [heavens open, angels sing.] That was a JOB. I had a wee-hours admissions anxiety dream, in which I was sitting in the committee meeting noting how far my ratings diverged from everyone else's ratings. I suppose it was better, though, than the professor anxiety dreams in which I have forgotten to write the syllabus and also I am late for the first day of class which is in a building I have never been to. It was definitely better than the professor anxiety dreams where I have to lecture about the French Revolution for 75 minutes or the ones where I forgot to write the final exam.

Wait, I just had a happy thought! Maybe all the times that you dreamed you were going to take an exam for a course you had never attended, you were actually going to my classroom, where I was kicking myself because I hadn't written the exam yet and the students were showing up to take it! Maybe neither one of us needs to worry in those dreams, because we are each other's best-case scenarios.

Tonight I did a thing I haven't done since before the pandemic: I went to a play indoors. Elwood misses Life With Activities more keenly than I do, and he asked if I would go with him tonight. Their website said they required either a vaccination card or a negative test for admission, and (somewhat surprisingly) they were checking them at the door. They also required masks in the theater, regardless of vaccination status, and the actors were all vaccinated AND freshly tested AND masked. 

They wore a kind of mask I'd never seen before: made entirely of clear plastic, cupping the chin, open at the top. Like this, only a little snugger-fitting. It seems unlikely to make much of a dent in aerosol transmission, but it covered their lower faces without much interference at all in the sound of their voices and no barriers at all to seeing facial expressions.

It was an odd play, but I'm glad we went anyway.

I am thinking a little nostalgically about the concert we went to in February 2020. Elwood had given me the tickets for Christmas, and we crammed into a local venue to hear a bluegrass-flavored band. I've been to classical concerts since then on campus -- everybody masked and quiet -- but I haven't been to a raucous concert since then: a couple hundred strangers, coming together to enjoy a carefree evening, cheering and calling out requests.

Someday! Not this month, but someday.

Where we go from here

Today I asked a person interviewing for a job at Gladlyville U what kinds of changes she envisioned in higher ed as a result of the pandemic, and she pretty much brushed off the question. But I have been thinking a lot about this question, and I am going to muse in your direction about it for a bit here.

We have offered students a lot of flexibility over the past two years. We have wanted to treat them humanely, compassionately, as they go through something unprecedented. It was the right thing to do, and they appreciated that flexibility. And now...I'm ready to be a bit less flexible again. If I put a due date in the syllabus and I remind you about the due date in person and you write to me to say, "I did not know if the thing would be due because it was snowing," I am going to have a facepalm moment before I reply politely to say that the posted due date was in fact the date the thing was due. It used to be a big part of our department culture that dates and deadlines mattered, and I would like to move in that direction again.

It is not a massive colossal hassle to allow students to attend via Zoom, but it's definitely a hassle; there are a lot of things to think about if I'm going to make a class work in two formats at the same time. Students have seized enthusiastically upon the idea that there are alternatives to attending class in person. I am ready for fewer alternatives. I'm tired of having in-class work submitted in multiple formats (sometimes on multiple days). It's not totally unreasonable for a group of students to ask me if I would record class for them on a day that they're attending another university's grad school open house, but it is not a request they would have made two years ago. (Oh, and would you like to hear about the student who ANSWERED A FACETIME CALL DURING CLASS yesterday? Because that is a thing that happened, and I attribute it at least in part to shifting norms.)

Our enrollment is up, which is both a good thing and a problem. My undergrad classes are >50% larger than they are supposed to be. One of them is a writing class. This, my friends, creates some difficulties. I cannot give thoughtful feedback on student writing if they have packed the class with 75% more students than it is supposed to contain. Can't do it. I think we have to decide: are we going to chase the tuition dollars, or protect the original purpose of the class? It has to be one or the other.

We can't just dust off our hands and declare that we're done with pandemic flexibility RIGHT NOW, any more than we can dust off our hands and declare that we're done with the pandemic. I can imagine that well-intentioned people will come down on different sides of questions like "Where does higher ed go from here?" If one of the most important things about higher ed is making strong connections in a classroom, maybe we push back harder against adjunctification. If one of the most important things about higher ed is ensuring access for all kinds of learners, maybe we put more energy into making technology more available to more people.

I do not have a road map for the next phase of the pandemic, any more than I have had a road map for the past two years. But I am tired. And I have a lot of questions.

The way we live now

This morning I was having a happy and unexpected chat with a group of old friends. One of them added me to a conversation about our high school's upcoming production of Fiddler on the Roof -- he thought it would be fun for us to go back together, since we'd all done it together in 1987. I am not going to travel to West Virginia to sit in a crowded auditorium in a month when I am just barely keeping my head from popping off, but it was fun to reminisce a little and see who's still in touch with whom.

"Kevin!" I said. "We have to add Kevin!"

One of my friends DMed me right away: Kevin died last year.

Another friend followed up in the group chat: COVID hit his church and his family pretty hard.

I knew that Kevin's father had died of COVID, and that his mother had been terribly sick at the same time. But I had no idea he had been sick himself. 

He was a vivid person: bright red hair, full of personality, a trumpeter. In Fiddler on the Roof he played Motel, Tzeitel's husband, and I can still hear him singing Miracle of Miracles to her.

I have a silly story about him: when we were rehearsing Wizard of Oz, one night we went to the Garden Club meeting and performed the long scene where Dorothy meets the Scarecrow, the Cowardly Lion (played by Kevin), and the Tin Man. I was cast as Glinda the Good, but for some reason I was filling in for Dorothy that night. I was supposed to slap Kevin when he tried to scare Toto, and the first time we rehearsed it for the Garden Club ladies I gave him a light little play slap. 

"You've really got to hit him," they told me. "I've really got to hit him?" I thought. "I've really got to hit him," I told myself. "I've really got to hit him!" I said as I marched up to him the second time we ran through that bit.

You guys, I knocked him down. I was so horrified.

He picked himself back up, gingerly, and he said, "Not quite that hard, Jamie." 

***

One of the people in the group chat scanned and uploaded the program from our production of Fiddler on the Roof. It is a mix of names I remember well and names I do not remember at all, people I am in regular contact with and people I haven't heard from since 1987. I can know, objectively, that this is the way of things with playbills from long-ago performances: one by one, the people who filled those roles will fade away. It is too soon for Kevin to be gone, though. He was a pastor, a husband, a father, a grandfather. His grandchildren are so little that I doubt they will remember him. It is not right.

I am certain, though, that this will not be the last time I have this conversation about someone I used to know. It seems inevitable, as the pandemic death toll draws closer to the million mark. We're all going to be having this conversation, aren't we? "Oh, hey, how's so-and-so?" we will ask a mutual friend. "He died in the pandemic," the reply will come.

So much loss.

Things I miss, an incomplete list

1. Singing harmony with friends
2. The bar with friendly staff and fancy cocktails that does not seem to have survived the pandemic
3. Seeing students' entire faces
4. Popping over to a restaurant at lunchtime
5. The days in which the RNC did not appear to regard smearing feces on the walls of the Capitol as "legitimate political discourse"
6. My friend David, who died in March 2020, when it was still shocking for a healthy 51-year-old to die suddenly of respiratory illness
7. Playing flute at Mass
8. Carefree winter parties
9. Our local sing-along Messiah
10. The conviction that most Americans would want to pull together to protect the vulnerable

For more than 5 weeks our local case counts have spent every single day above the record set during the very worst part of November 2020 -- sometimes way, way above that record. It was bad, you guys. Today, for the first time since December, we're finally down below that line. In our hospitals, as of today, 11% of the beds are free -- after weeks in which it was usually 1-2%. Feels like progress.

I think I will feel more cheerful when we are a little less hunkered down. And I know I will feel better when the admissions committee work is over. It's like an exhausting part-time job on top of my full-time job.

The crowded kindnesses, COVID version

Yesterday afternoon we joined an extended family Zoom call, in which people were talking about what they've been up to, and afterward I was keenly aware of how many things we have not been doing. "I want to go to a restaurant," I said a little mournfully. "I want to look at a menu and share an appetizer and think about the specials and have someone wash my dishes without my having to ask."

"We can make that happen!" said Pete.

I thought he meant, "You can stop living such a narrow life and go to a dang restaurant," but what he actually meant was "We can bring a restaurant to you!"

He and Stella put their heads together and created a menu. I heard them in the kitchen: "What does Mom especially like to eat?"

Not long afterward they seated me at the dining room table. Stella was the waitress; Pete was the chef. The menu had an appetizer section, from which I requested the hummus with toasted pita. They brought me a pretty little plate: perfectly toasted triangles of pita, a dollop of hummus, a little glass dish of nice olives. To drink I had a glass of seltzer over ice with a splash of real lemonade.

The menu offered me a number of entrée options; I chose pizza bread with quartered artichoke hearts. Pete washed every dish afterward.

You guys, I felt so loved.

The COVID situation here has been so bad lately. Our official case count, which is surely only a fraction of the actual cases in town, just kept vaulting upwards over the top of the y axis. Our case record had stood since November of 2020, but earlier this month the official tally spiked up to almost four times that previous record. Cases, positivity, hospitalizations-- you name it, we were setting new records just about every day. The hospitals were overflowing.

So we've been living a pretty quiet life over here. We're back to online church with drive-through communion; we're wearing KN95 masks everywhere we go. I suppose it makes sense that if an extraordinarily contagious virus is unleashed in a county that's only moderately vaccinated, there's going to be a lot of viral replication happening. But watching it unfold was still astonishing.

We seem to have turned a corner; cases and positivity are down. Overall hospitalizations are still high, though our local public radio station reports that we have more available ICU beds in part because of a series of ICU deaths. It all feels pretty grim, and I think I will hold off on flipping through any menus in person for a while longer.

But at dinner tonight I told the kids again how much I appreciated their willingness to make my wish happen. And this is the best part of all: Pete sighed happily at the memory, and said, "That was so fun!"

I am still thinking a lot about COVID

One of the factors that determines how vigorously we respond to COVID is the seriousness of the disease. This has been a contentious point from the very beginning of the pandemic. First the COVID minimizers insisted that it was like the flu, which would only have been true if the flu were twice as transmissible and ten times as deadly. Now they're saying that the omicron strain is pretty much a cold.

If COVID were always a short-term respiratory illness, then it would be silly to make a big fuss about it. But I am still going to attempt to avoid COVID. I'm not especially worried that it's going to kill me at this point, but I am concerned about the degree and the duration of COVID-associated morbidity. Even if I were to develop a mild case myself, I hate the idea that I could spread a disease with the potential to cause significant disruption to someone else's life.

For a subset of patients -- most often but not always those with risk factors -- COVID is associated with significant morbidity. Let me tell you a story to show you what I mean. I know a woman whose case of COVID landed her in the hospital. Although she was my age, healthy and active prior to her COVID diagnosis, the virus attacked her heart and left her with atrial fibrillation.

Atrial fibrillation is one of the serious arrhythmias. It disrupts the steady, strong coordinated contraction of the heart and allows blood to pool in the atria. When blood isn't moving steadily, it clots. If you spin up a blood clot in your heart and push it out into your blood vessels, bad things will happen. Atrial fibrillation significantly increases your risk of a cardiac event and it quintuples your risk of a stroke. If you say "untreated atrial fibrillation" to a doctor, the doctor will grimace and wince.

So they impressed upon her the urgency of treating the arrhythmia. They tried to fix the problem with a cardioversion; the process of administering electrical shocks to her heart was unsuccessful as well as much more unpleasant than advertised. Next they did an ablation, running a catheter up from her groin to her heart and burning out the problematic wiring. I doubt that any of these healthcare expenses are tallied up anywhere as COVID-related costs, but they were the direct result of her COVID infection.

She was on blood thinners all through the attempt to get the arrhythmia under control, because nobody wanted this 51-year-old woman to throw a clot. When you get a prescription for blood thinners, the pharmacist warns you about the potential side effects, but the events that ensued still took her by surprise. At age 51, she thought her ovaries had closed up shop. It had been six months since they had last alerted her to their activities, but suddenly they were back in action with a torrential vengeance. We're talking go-build-yourself-an-ark levels of nonsense.

Because? Blood thinners. Because? Atrial fibrillation. Because? COVID. If you're telling your blood to clot less effectively, torrents may result.

She got home and tried to run upstairs to grab some Advil and start a load of torrent laundry. But the situation was bad enough that instead she blacked out on the stairs, and hit her face as she fell. 

Guess what happens if you fall and hit your face while on blood thinners? Massive facial bruising, that's what. Appalling facial bruising, of the sort that makes everyone who interacts with you for the next two weeks say, "Are you...safe...at home?" to which you reply, "Oh, I'm fine; I just fell down." ...Sure you did, they think to themselves, because no one bruises like that from a simple fall.

Unless they're on blood thinners, because atrial fibrillation, because COVID.

In the big picture she has had a good outcome. The doctors did eventually get the atrial fibrillation sorted out. The COVID fatigue did eventually abate. The bruises did eventually recede. But also...dang. That was a lot of hassle and expense and medication and time off work and worry and intrusive questions and avoidable suffering. 

That doesn't sound very much like a cold to me.

Some of the things I am not saying to the gym manager

I am really motivated to keep lifting weights, and also I do not love the news about the transmissibility of the omicron variant. I did not expect to find it so satisfying to move barbells around, but here we are. I'm not going to buy a powerlifting setup, so I keep going to gym, aiming for the times when it's likely to be empty.

There are usually a few other people there wearing masks, but not today: today I was the only one. Maybe all the other cautious people are staying home because they know omicron is coming? Maybe they're waiting for the data on how sick it seems to make people? Who can say? 

There's lots of talk in my Facebook feed about the left's overreaction to COVID, and I was thinking about it as I was driving home from my workout this afternoon. Have you seen this graph? In both September and October, COVID was the #2 cause of death in this country. Only heart disease killed more people. In three of the last 13 months (Nov '20 through Feb '21), COVID killed more people than heart disease. Do you know anybody who had a heart attack last month? or the month before that? I do not. I don't actually know a whole lot of people who've died of heart disease across the 51 years that I've been alive. But it would be a grave error for me to extrapolate too far from my personal experience. If I were to say, "Heart disease is no big deal! Hardly anyone dies of heart disease!" -- obviously, it would be a false statement.

My gym acknowledges the reality that sometimes people's hearts stop beating unexpectedly. They have paid to install defibrillation units; someone on staff gets paid to inspect them at intervals. They have paid their staff for the time required to get trained in AED use. They've invested time and money into protecting people at the gym from the adverse consequences of a cardiac event. They've done so not because people are keeling over every other week, but because cardiac events are (usually! maybe not this winter!) the thing most likely to kill American adults.

AEDs aren't magic bullets. More than half of people who experience cardiac arrest are going to die, even in communities where AEDs are widespread. We invest in them because they shift the odds; they have significant potential to reduce suffering and death, even though that potential isn't always realized.

So here's my question: in September the number of deaths caused by COVID (1899 of them) was just slightly under the number of deaths caused by heart disease (estimated at 2056). How is that not serious? In October the number of COVID deaths dropped to 1683, but that number is higher than any other cause of death recorded in this country -- even when you group every form of cancer together. More serious than cancer = pretty dang serious.

And yet-- the same folks whose membership fees pay for seldom-used AEDs are balking at the idea that they should wear masks in the building. It's true that masks, like AEDs, aren't magic bullets. It's also true that masks, like AEDs, have the potential to reduce suffering and death.

I don't understand the discrepancy.

Careful what you pray for

Okay, so this is weird. And, frankly, unwelcome, and entirely unsurprising.

This morning I was praying in my dark and quiet house and I asked God to help me grow in holiness. I was thinking about how I've been focused on just getting through things for a while now. I haven't really been thinking about growth; I've just been keeping my head above water. "I'm ready to start growing again," I said this morning."

Soooooo maybe I should have seen this coming.

In my orbit there is a person who pushes every single button I have. The odds are low but not zero that the person in question will view this post, so I will not share the button-pushing details. Instead I will just say that if I were the elevator in which Charlie Bucket and Willie Wonka took flight, which in my memory if not in reality was simply covered in buttons, every one of my buttons -- every last one -- would have been thoroughly pushed in my past interactions with this individual.

Who is expecting to participate in festivities at my house later this week.

Who, despite having attended a gathering earlier this year at which everyone was supposed to be vaccinated, did not get vaccinated.

I could tell you more reasons why I think this decision is especially egregious in this particular set of circumstances, but I would just get all riled up again. No one reading this post will be surprised to learn that I think frequent interaction with vulnerable people necessitates special attention to COVID prevention.

But, as I was reminded earlier this evening, not everyone agrees with me on that one.

This is something I've been thinking a lot about lately, more and more as my patience wears thinner. Glaring at the folks who defy a store's mask mandate is not going to change any hearts. My narrowed eyes are unlikely to broaden their perspectives. But this isn't just about a 10-second interaction with a stranger in the toothpaste aisle at CVS. This is someone who wants to come to our house and sit at our table and eat our food, while also making choices that I find appalling.

This is also someone who just recovered from COVID, so the infection control question does not seem pressing. But the love-thy-neighbor question -- that's a whole 'nother kettle of fish. I have known for a while now that my attitude about vaccine refusal was not great for my soul. And hey-- here is my same-day answered prayer, my very own opportunity to grow in holiness.

So tomorrow morning in my dark and quiet house I will say to God, "OK, I forgot about your knack for hilarious timing. That was pretty much a stroke of comic genius there! And also-- what the heck do you want me to do?"

Boosted, baby

I am entirely better, 100% better. My experience, for what it's worth: I had Moderna shot #1 in March (mild arm soreness, NBD) and shot #2 in April (massive whopping arm soreness, fatigue, achiness, under the weather for most of a day). I had Moderna shot #3 on Friday, and I felt like hell yesterday from about hour 20 to hour 28 after the shot. Fever, aches, significant arm soreness, fatigue, and ALSO I kept messing up my logic puzzles. Maybe I should report that last one to VAERS, because it was vexing as all get-out. I felt so crummy that I wondered if the nurse made a mistake and gave me a whole dose instead of a booster dose. But I went to bed early and woke up feeling perfectly normal.

I would still prefer to live in a country where 90% of people had had two mRNA shots, so that I would have less need of a third shot, but what are you going to do?

Dragging

I got my COVID booster shot yesterday and it has hit me pretty hard. After my second shot in April I felt genuinely grateful for feeling crummy: grateful for the existence of the vaccines, for the opportunity to be vaccinated, for a healthy functioning immune system. Today I am just crabby about all the folks in my county who have refused to get the shot, making our town less safe for everyone else.

Let's talk for a minute about the assertion that keeps popping up about COVID, the idea that we shouldn't make such a fuss about a disease with "only" a 1% mortality rate. The thing is, 1% (which is too low as a mortality estimate for unvaccinated people in the first place) is non-trivial. Take a look. We vaccinate entire populations against diseases with much lower mortality rates. You can't go to school if you're not vaccinated against some of those diseases, because we take them seriously.

So many people have died avoidable deaths. This post by Kieran Healy shows 2020 all-cause mortality (so not just COVID deaths, which have become yet another bone of contention for the folks who think COVID is overblown), broken down by state and compared with data from the previous 5 years. So much loss tucked into that graph -- so many deaths.

Kieran Healy also looked at COVID deaths as a function of a county's proportion of Trump voters. In 2020 the lines mostly run together, except for a scary blue line that illustrates the early explosion of COVID in New York City. Since vaccinations became widely available, the lines have diverged more and more: the counties at the 90th percentile for Trump votes have seen a COVID death rate >50% higher than the rate seen in the counties at the 10th percentile. 

The focus on purportedly low mortality rates disregards the impact of morbidity altogether, as if the only people with any serious complaints are the 1%. As if long COVID weren't a thing. As if all these hospitalizations and ICU admissions are only a big deal to liberal snowflakes who need to toughen up.

My brain is not firing on all cylinders today; it is befogged by the immune system I am trying to nudge into fighting off this virus more effectively. I keep making a hash of the logic puzzles that are usually a pleasing diversion. So if I seem to have made a hash of any of the logic in this post, please be kind.

Indoor Season

I've been pretty calm about Pete doing stuff with Scouts. On campouts he shares a tent with another vaccinated kid, and it's hard to get COVID outside. Even if another Scout showed up sick, it wouldn't be very likely to spread during outdoor activities.

But now things are different. I just sent him off on a campout that is going to be riskier than I realized. It will start with a 1.5-hour masks-optional bus ride, and they will be spending most of their time indoors once they arrive. It's not as if I want him to go sleep in a tent outside by himself in this weather, but it is true that his odds of COVID would decline if he did so (even as his odds of frostbite rose).

He especially wanted to go this weekend because they'll be planning their activities for the next year. I made the mistake of assuming they'd be planning outdoors.

I do not feel confident in my ability to assess the risks here. I am guessing that something like 40% of the kids on these campouts are vaccinated, but I am only guessing. We are having a little post-Halloween COVID spike here in Gladlyville, mostly concentrated among younger folks. Lots of messy questions, right?

I am frustrated by the voices saying prematurely "we're just going to have to learn to live with it!" when COVID caused more deaths in September than anything else except heart disease. No one would suggest that we should all just make our peace with cancer, I don't think, and COVID killed more people in September than all the varieties of cancer combined. No one would suggest nonchalance about strokes, one would hope, but the number of September stroke deaths was less than a quarter of the number of September COVID deaths. There's a lot more work to do before we can treat COVID like a garden-variety disease. Does some chunk of that work consist of me telling my 16-year-old that he should hunker back down until it's easier to do things outside again?

I do not know the answer to that question.

Doctor Knows Best

There's been a lot of talk about the difference in the public's response to 1950s polio vaccine campaigns and its response to the 2021 COVID vaccine push. There's been a lot of justifiable frustration about folks who say they've done their "research" when the research consists of dubious Facebook links shared by people inside their echo chamber. (I say this as a person with an echo chamber of her own, just so we're clear.) But there hasn't been, I don't think, much focus on the changes in the culture of medicine.

In my ten years as a La Leche League Leader, I often thought about the paternalistic approach to medicine that the founders of the organization were responding to when they started hosting meetings in 1956. "Your baby isn't getting enough food; that's why he's nursing so often," said doctors who didn't know anything about normal variations in maternal storage capacity. "Your milk isn't rich enough," said doctors who didn't know that the fat content of human milk is a moving target, changing across every feeding and over the course of every day. "Formula is scientifically designed to give babies what they need," said doctors who didn't know that the absence of LC-PUFAs in 1950s infant formula could influence both the structure and the function of infants' brains. 

Don't even get me started on the long-since-debunked obstetric nonsense that was the norm in 1950s maternity wards -- practices that were hard on mothers, hard on babies. When the founders planned their physician-attended births at home, they were reclaiming their autonomy in a way that inspired many thousands of women to figure out birth options that would work well for them and their babies.

At the time, the demise of the "doctor knows best!" approach seemed to me like an unambiguously good thing. I mean, sure, doctors know best about some things, but they may not know a lot about lactation. "Watch for your baby's cues," I said to the women who came to meetings and called me seeking help. "Your baby will tell you what he needs."

There's a lot of truth in that, I continue to think, but even then it was clear that a person could take it too far. There was some anti-vaccine sentiment among the moms who came to meetings, along with some reluctance to set limits with toddlers, and there were an awful lot of people trying to determine whether their babies were fussy because they'd eaten too many tomatoes or too much broccoli or whatever else. (NB: It is very unlikely that a tomato in mom's diet will cause a baby to cry.) Sometimes your baby's cues are not the most reliable source of information. Sometimes the things that seem true to you are not actually true.

I would still say it's a good thing that we've left the "doctor knows best!" days behind us. Informed choice is better than uninformed lack-of-choice. But an emphasis on informed choice is going to mean that some patients wind up more informed than others, and some patients make better choices than others.

I was hopeful that we would see 1950s levels of enthusiasm for the COVID vaccine. It really does seem to me like a gift from God that these vaccines became available so quickly and have worked so well to reduce disease transmission, severity, and mortality. I guess, as with any gift, you can't predict how people will receive it.

Antennae: Permanently Aflutter

In yesterday's post I didn't even tell you about the nascent friendship Thing that was most on my mind. It felt too weird and vulnerable so I wrote about a coffee meet-up from a month ago instead. But here it is: I had an odd lunch with a friend this week.

We were on the retreat team together last month, and after the retreat was over I sent her an email. It said something along the lines of, "Hey, I really enjoyed getting to know you better during the retreat preparations. Would you like to meet up for lunch sometime?" It took a little back-and-forth to set a date, and then we had a weather-related cancellation/reschedule, and then we finally got together this week.

The whole time, she seemed kind of irritated. This could have been a zillion things, I know. Maybe the maintenance light had just come on in her car and it felt like ONE MORE THING for her to deal with. Maybe she's having some kind of friction with a loved one, and she didn't want to talk about it but also couldn't quite set it aside. OR MAYBE-- she was irritated because she didn't really want to have lunch in the first place. Or because, even though she had warmly assured me that eating outside was fine, she actually didn't want to be outside. Or because I had ordered online and she had not, so she had to wait in line and it was a zoo in there.

In my life I have been in situations like this a kazillion times. Other people get annoyed at stuff. Sometimes it's my fault, mostly it's not; annoyance happens. It just felt unusually bothersome afterward, as if I could have prevented it with a little additional forethought or perhaps a little less personal quirkiness.

I think the pandemic has recalibrated my awareness of other people's unhappiness. Sometimes when I am lecturing it's like there's a little alarm going off: THAT STUDENT IS BORED!! SPEED UP!! BE FUNNY!! STOP BEING BORING!! It happens in office hours, too: THIS STUDENT IS UNHAPPY ABOUT THE THING YOU JUST SAID EVEN THOUGH YOU HAD TO SAY THE THING. I feel more aware of the way that a joke lands, or doesn't. 

This week in one of my classes I am talking about autism spectrum disorder-- about challenges with managing sensory input, and difficulties with making sense of other people's emotional states and responding appropriately. Just today I was talking to my students about how we refine our understanding of the workings of peer relationships by experiencing peer relationships. I'm pretty neurotypical, or at least I like to think so, but phew! No wonder people on the spectrum struggle with this stuff.

I suppose it's not surprising that I would need to recalibrate after so many months of connecting with other people asynchronously and through screens. It's as if I have relationship antennae, and right now they aren't really distinguishing between "light breeze you can ignore" and "gale that requires you to take shelter immediately." Here's hoping my antennae and I figure it out soon.

Well, it's a good thing I'm not superstitious

If I were a superstitious person I might think my happy blog post from last night had caused the email I got today, in which the Dean of Students office let me know that one of my students has COVID without saying "your student has COVID." 

If I were a grumpy person I might grouse about it because this particular person sat in class and coughed up a storm both days this week -- mostly masked, but only mostly.

If I were a crotchety person I might mutter a little about the whole water bottle thing. It hasn't been that long since students drank water between classes, not during them. We did not take water bottles to class with us when I was an undergrad, but these days they are ubiquitous, and they occasion a lot of mask breaks. This idea that human beings shouldn't go an hour in a climate-controlled building without a beverage is a recent one.

If I were an irritable person I might complain about my unwarranted optimism. I thought to myself, "Surely with a cough like that she has been tested for COVID already. Surely she would not take a cough like that out in public in the middle of a pandemic unless she knew she was not going to be spreading COVID to the people sitting near her."

But! instead! I am trying to be a grateful person.

A) Grateful, so grateful, for the vaccines and for a high proportion of vaccinated students and staff.

B) Grateful for a campus mask mandate that seems likely to result in the containment of most of those virus-laden respiratory particles.

C) Grateful for low numbers of new cases on campus this fall (this one is probably closely related to items A and B above).

D) Grateful for good health, good luck (so far, at any rate!), and a good job.

...and also-- still a bit crabby about the whole thing. I really hope the students sitting around her were all vaccinated.

The administration has told us that we are expected to ignore students coughing in class. This makes sense. We can't say "have you been tested for COVID?" because that would be invasive and students' medical decisions are not their professors' business. But the assumption that students will say to themselves "I should get this cough checked out" turns out to be a faulty one. I guess we'll see how it turns out.

In-person teaching in a pandemic

I am so much happier teaching in person.

We are all masked and the students are pretty good about it. It's a little weird to encounter a student outdoors without a mask, because I'm not very good at predicting what the lower half of someone's face will look like. Learning names is going really slowly, but I'll keep at it.

I have a little microphone. The speaker hooks into a pocket or a waistband, or hangs around my neck if I have neither pocket nor waistband, and the microphone curls around my head like a 1950s phone operator's headset. It is making my life a lot easier. In years past my most consistent request from students in the classroom has always been to speak up and slow down-- I have a small voice and I speed up when I get excited. The microphone doesn't give me a ton of amplification, but it seems to be enough to counteract the effects of the mask. My students always have an open invitation to throw up a hand and ask me to back up, rephrase, slow down -- but nobody is taking me up on the offer this semester.

I saw a professor complaining on social media about the difficulties of masked teaching, saying it had been terribly hard on her lungs and her voice. Little microphones FTW, man. My voice is holding up better than usual. When the microphone does the work, my lungs don't have to.

It seems like a lot of what we do in the classroom should transfer into online teaching, but that has not been my experience. When I lecture enthusiastically, I can feel the students' reciprocal enthusiasm. I mean, sure, some of them are always going to be yawning in the corner, but I love that sense of taking a class to a new and interesting place where they've never been before. Over the months that I was teaching remotely, it was so disheartening to pour my most enthusiastic efforts into the computer. In the classroom I toss a metaphorical ball to the students and they catch it and throw it back. Online I toss a ball to the students and it thuds to the ground.

Teaching in person makes me tired. When I go to class in person I am ON ON ON, and then afterwards I have a bit of a slump-slump-slump. I've always felt like I should be able to walk right out of class and into the next work task, and it has always bugged me that I need a little time to unwind instead. But this semester I am viewing it differently: on good days, something magical happens in the classroom. And magic is hard work.

Updates from Gladlyville

Hi, friends, how is it going? I am back in the classroom and it is mostly really good to be there. I have expended a lot of energy over the past 18 months attempting to make enthusiastic video recordings for my students, and now I can just settle into the real-time real enthusiasm mode. I'm a fan. I think the students are too.

Gladlyville U is handling COVID well, I think-- about 2/3 of students are fully vaccinated and still more have received at least one dose. About 5/6 of employees are fully vaccinated. Masks are required in indoor spaces on campus, and people on campus are much more cooperative about mask-wearing than people off campus. Our local COVID numbers are rising, but not in a way that suggests to me that returning students are causing a spike. 

My ferocious COVID anxiety has largely abated. This afternoon a student emailed to ask if she could attend class today via Zoom because her roommate had just been identified as a close contact for another COVID-positive student, and I called the dean of students to see if I could encourage her to come to class after all (answer: yes). This is a pretty marked shift from my attitude earlier in the pandemic, but it feels good to be less worried and I was genuinely glad to see her at her desk. This has been a bad stretch for people with OCD-ish tendencies, and I'm relieved that my hypervigilant brain seems to be standing down at last.

We are down to two kids at home again. It's quiet. Grocery bills are down. The youngest kids are adjusting to being in school 5 days a week. The college-aged kids are adjusting to living on their own again. So far so good on the adjustment front, I think. Three of us saw Alex in Chicago over the weekend. I miss that boy.

Not all the news is rosy here in our half-red/half-blue/half-vaccinated county. I have a friend from church who has been adamant about the evils of vaccine mandates; her sister is a committed anti-masker. Both of their parents have been in the hospital for a week now, felled by COVID pneumonia. Yesterday her mom coded: her kidneys stopped working and the resulting electrolyte imbalance stopped her heart. She did respond to the resuscitation efforts; now she's on dialysis and a ventilator. All over the country there are so many preventable tragedies unfurling. I do not understand.

Finally

Alex is HOME at last. We weren't sure he would make it, since Midwestern storms delayed his flight. But he caught his train by the skin of his teeth, and tonight for the first time since Christmas 2019 he sat at our table, catching up and cracking jokes.

I've missed that boy.