Yesterday was a good day

I actually got some work, albeit only two opinions and not enough to pay for a typical load of groceries, but still, it was nice to get something. I also managed to score the highly coveted toilet paper, paper towels, and a few other desirables from Sam’s Club. I resumed a few of the disciplines - drums, vocals, and guitar, which, after several days off, felt like a victory. We’re just slowly transitioning into our new normal. I plan to resume my regular DTD schedule, and I think mentally it's just a matter of sorting out what we could as well as managing to stock up on essentials for the next several months in most cases.

Ultimately, I think it’s the uncertainty that impacts motivation the most for me. Once I feel like I have a good idea of what’s in store, and I’ve done what I can to prepare for it, I can focus my attention back on the creative disciplines. That’s not to say we know the future, and it’s still impossible to predict exactly how everything is going to play out. We’ve seen a mixture of actions at the local, state, and national levels to “flatten the curve,” but it will still be weeks to months to determine the results.

So far, there have been requests, mostly at local levels for help from healthcare providers. There have been a few emails about volunteering at other VA sites that are facing shortages, but it’s been a mixed bag. I’m not sure if I’ve said it here or not, but I’m more inclined to answer a call to return to active duty than I am willing to put myself at the disposal of VA leadership. My experience, admittedly anecdotal based on my nearly nine years in the same clinic, is that I’ve seen leadership fail on some of the most basic and routine critical tasks. There’s a mixture of incompetence and ambivalence you’ll see across the VA and the federal government, and it doesn’t spare those in leadership positions. Arguably it’s the more professional and reliable people that ascend in responsibility, but this isn’t universal.

In times like these, most people do raise their game to meet the task at hand, so I would expect some improvements in all areas for those answering the call. That being said, most of the efforts are ad hoc and improvised since the scope of this pandemic caught most by surprise. I have no problem going into harm’s way to help out, but I have more faith in Army leadership to plan and assess risks, and only put personnel at risk when it’s mission essential. Not that the Army doesn’t get it wrong, it’s made of humans with human failings, but as an institution, it is much more proactive and rigorous in planning and learning from past mistakes.

It should also be noted that not only do I not have any critical care experience, I also haven’t worked in primary care with any regularity since 2007-2008. I don’t think I would be much of an asset on the literal front lines of COVID-19, but I might be able to help as backfill for the regular patients while so many resources are being dedicated to the pandemic. We did receive an email from Army HRC soliciting feedback on interest from retired medical personnel. As far as I know, it’s only been information gathering thus far and there haven’t been any recalls. They had a list of several medical jobs, but PAs weren’t on the list. It was mostly critical care and respiratory-related specialties.

I’m standing by to see if this changes and they start actually recalling retirees, specifically my specialty. At that time, I’ll give it serious consideration if it’s an option. If it’s an involuntary recall, then the decision is already made for me. The main drawback is that I’m the sole caretaker for Aeyong, and if I got called away for 1-2 years, she would have to fare on her own for the most part. We’d probably find a way, but it would be a big challenge now that she’s accustomed to me being here most of the time. I also worry about her chronic health issues and the ability to fight the virus if she becomes infected. As we’ve seen, even the most healthy-appearing individuals can get very sick, even die.

My philosophy towards this is the same as it was for combat on active duty. I had answered the call to duty by enlisting, and combat was just one of those possibilities you accept as part of the oath. I didn’t hunger for it, but I also didn’t resist or try to avoid the duty when it came time. I feel the same way about COVID-19. I’m not actively looking for opportunities to volunteer based on the multiple factors mentioned, but I’ll answer the call if it comes. This may seem a bit crass, but I’ve had experience in multiple large scale efforts where a whole bunch of people just show up wanting to help, and I while I commend the spirit, my experience has been that it’s much more effective when leaders and planning personnel can request and place those skill sets in the ideal situations.

As a nation, even though we ascended the incidence list several days ago, we haven’t seen the worst this pandemic has in store I don’t think. The number of cases and fatalities will continue to rise and it’s nearly impossible to predict how these scenarios will play out at local, regional, and national levels. We’re trying to mentally buckle down for the ride and do all we can to limit the spread of the virus and prepare to help out as needed. Right now the main message we get from any leadership is work remotely if you must and stay home if at all possible. We’ll see where this leads us.

We're still perched on the cliff...

…in the US at present, in my opinion. The cases have likely hit that level of exponential spread, but our testing is so limited (pitiful) that the numbers are probably severely underreporting the prevalence. Right now, the CDC is reporting 15K cases as of yesterday. Worldometer (not sure how reliable this is) is showing 19K cases in the US with 276 deaths. Johns Hopkins is showing a similar 19K. JH is showing 429 cases in Texas with 5 deaths. Mind, these are confirmed/tested. I’m sure the actual numbers are much higher.

We’re continuing to shelter in place and plan on several weeks if not months more of this to come. Many places, including California and New York, have essentially gone on full lockdown except for essential services, but Texas and several other states haven’t followed suit. At this point, I fail to see the downside of being conservative, but I think many leaders are driven more by economic considerations than disease prevention.

I still haven’t heard anything from work, but I’m assuming it’s only a matter of time before they shut us down as non-essential, at least for C&P exams. I know the VA will remain functional, and it’s possible their mission may shift to caring for civilians as well. As before, I’m preoccupied with this timeline to the extent that most of my typical pursuits/disciplines are not drawing me in as normal. I’m spending part of each day following the news, completing odd jobs/household tasks, and then after that, I’m only finding the motivation to read a bit and then play video games or watch television.

https://coronavirus.jhu.edu/map.html

Decent week, maybe the last for awhile

By week, I mean two days of work with decent sized cases. Enough for a month+ of groceries, probably more considering we’ve bought so many dry goods that will keep for a long time. I braved the wilds of Sam’s Club yesterday, starting with a drive-by recon and seeing that there were no lines snaking out the door, I decided to stop in. There were lines at the cash registers again, but only about halfway back in the store this time. TP was sold out and I noticed a lot of people were buying water, which is probably not necessary, assuming infrastructure won’t collapse, but I went ahead and bought another case as an emergency backup for any scenario, including tornadoes, etc. Other dry goods were depleted, but I managed to get another five-pound bag of flour, so that should keep us eating for a while. The biggest challenge is the short term perishable produce and the like, these typically need resupply at least weekly.

The situation at work isn’t much different since last week, there was some more specific guidance for triaging and patient flow of suspected COVID-19 cases, and they have restricted patient visits to appointment only. The VBA regional offices have also announced that they aren’t accepting walk-ins for Veterans now, but they will remain in operation at present. They’re trying to get us set up for remote access, but I wasn’t able to get it working yet. There are always several hoops to jump through for this stuff. I’m going ahead and ordering a CAC reader in case that will make it easier. It would be a huge change if I was able to check email and my schedule from home. I wouldn’t have to depend on others to send me emails at my personal address whenever something changed.

I think we’re still right at the edge of the cliff. We’re about to see that exponential rise in cases and the real test of the American people, healthcare system, and the government will commence at that time. There are still a bunch of people completely ignoring the recommendations, including a lot of young adults and teenagers. This won’t hit home until someone they know/love gets sick and/or dies. Then it will hit home hard. The willfully ignorant are in for a rude awakening, but I have a feeling many of them will just project the problem onto others. The “leader” of this country has taken to referring to COVID-19 as the “Chinese Virus” and this has just fueled increased incidents of racism against anyone with Asian features. I’ve told Aeyong she needs to stay home for infection control reasons, but I also don’t want her at risk for any racial attacks. I know we have plenty of racists in Texas, and it cuts across all demographics. Just yesterday, I was talking to a psychologist that’s been in our department for a long time and she was regurgitating this idea of a Chinese manufactured viral weapon. She has a history of this, and although I try to avoid these conversations with her, I’m fairly confident she fits squarely into the Fox News demographic. A Ph.D. Education and rationality don’t always go together.

There are already several reports showing that the data overwhelming supports a natural, not manufactured, origin. Still, racists are going to race. They’re just going to latch on to whatever flimsy excuse they have to call someone out for looking or thinking differently.

Gainfully employed, for the present...

I got an email back from my scheduler and I have a patient for tomorrow as well as the already scheduled patient for Wednesday. As far as she knows, there hasn’t been any scale-back of the clinic schedule, but the requests for exams remain down from the normal (this has been an issue for several months). At this point, as long as I’m not symptomatic (or anyone in our household), I’m going to continue working as long as they can get patients scheduled. I’m going to stick with the belt-tightening until such time as the risk has been deemed as behind us, and the VA resumes normal operations.

This is assuming we’re going to see some downturn in operations, although this hasn’t happened yet. I think it’s inevitable that work will be down from the previous normal for several months, if not for the rest of the year. We had already been down and the coronavirus only stands to impact that further. I think I mentioned in a previous post that this will be an early stress test for “no income” living, even if unplanned and early to boot. I’m not sure we can maintain our bank balances with a mortgage payment, although we are going to attempt just that. If we reduced the budget down to the bare essentials, it may be possible but I’m not sure. There are a lot of large deductions that we haven’t rigorously budgeted for (health insurance, pet medical plan, auto/flood, etc.). We’ve always had plenty of money to pay these off immediately when I’m working regularly, so not only do we have to find ways to meet the monthly needs, we need to find ways to actually put money aside for these bigger annual bills.

I’m hoping that work won’t fall off so much that we have to make some hard decisions, but I think it’s still too early to tell where things will go.

The Coronavirus Doldrums

Given the span of possible contexts, I suppose doldrums is preferable to crisis, disaster, pandemic. Oh, wait. From our vantage point, it’s really only through the lens of media and the internet that we’re even aware of the now labeled pandemic, per a World Health Organization announcement several days ago. The only visible example we’ve seen so far was when I went to our big-box retailer (Sam’s) on Friday, and the lines were as long as I imagine they’ve ever been. Most of the store was still stocked up, but they were out of everything from toilet paper to water to flour, sugar, salt and other dry goods with long storage potential.

From what I’ve seen online, many other places have been hit much harder. I’ve seen multiple posts from all over the US of completely emptied out supermarket shelves. To my knowledge, our logistical chain has never had to deal with a crisis of this magnitude. Regional markets in hurricane-prone areas have to go through this every year or so, but this is on an international level. The domino effect hasn’t struck just yet, and I’m wondering how much of an impact this may have on our economy in the future. It does warrant questioning the viability of our supply chain, which is so dependent on international manufacturers and shipping. That’s not a xenophobic comment in the least, it’s a practical reality that if we get so much from a country like China, and they shut down the entire country for weeks or months, the reverberations of that will persist for months and years to come.

Several retailers have taken additional precautions to keep shelves stocked and disinfected - Walmart and other 24 hour chains have started closing for 8 hours overnight so they can replenish stocks and clean more thoroughly. We’ve tried to stock up on all the dry goods and durables possible, but it’s unavoidable that we will need to restock short term perishables like fresh fruits and vegetables. I suppose we could find alternatives to even those if we had to. Something to consider for the next several weeks.

Another casualty of this forced isolation has been my motivation. I’m not depressed, it’s just my thoughts are focused on the impact of the virus and the prolonged loss of income I’m expecting. So far, I haven’t heard of any work stoppage, but I can only imagine that’s forthcoming. Our numbers had already been down for several months and I’ve needed my scheduler to perform acrobatic maneuvers just to keep me gainfully employed. This will only become more challenging as an increasing number of VA employees and patients are affected. As they keep repeating in the media, things will only get worse before they get better.

I’ve dialed back our mortgage payment to just barely above the minimum, ($2500, minimum $2487) instead of the $8000 we had been paying. We’re going to need that extra money for the essentials and even with that belt-tightening, I think it’s possible we’ll be headed to deficit spending. If push comes to shove, I’ll eliminate most if not all of the discretionary spending, especially subscriptions. I’ve already taken some steps in that direction, but have held off until I can get a better idea of what’s happening at the VA. The government is sadly often slow to react, and that’s especially typical at the VA. They did take some infection control measures fairly early on compared to the utter disregard you see in many places, but it’s hard to say from this vantage point what effect the virus is going to have on overall operations.

Most of my discretionary subscriptions can be paid for in a matter of minutes at work, so, for this reason, I’ve left them current, but basic necessities are the priority and after that would be paying off the mortgage earlier. My running mantra for several years has just been “pay off the house”, because after that we should be able to live on my pension income if necessary. It appears we’re going to get a stress test earlier than planned, and while we’re still paying off the mortgage. I’m fairly confident (because I haven’t rigorously reviewed the budget) that we have several months of cushion from where we sit. My pension income will at least pay for the mortgage, utilities, and there should be enough left over to at least make a dent in the basics like food.

We may slowly start to deplete our revolving checking balance if work at the VA is completely cut off. If I can at least pull the odd shift, even one day a week should be enough to cover all the necessities with even some discretionary spending for needful things that aren’t necessarily as critical as food, medicine, etc. I’m hoping all of this will blow over before we get to a financial crisis point, but even then we have options. I consider this a last resort, but we have enough in our TSP (401K) that if we took a withdrawal, we should be able to pay off the mortgage even with the fairly large tax hit we would take. I’m hoping it doesn’t get to that, but paying off the mortgage should put us where we could get by on pension income alone. All of this is predicated on the idea that I might not be able to work at all, and that’s certainly not my plan.

These sorts of large scale epidemics and pandemics are part of our future, I think. The United States needs to take a hard look (how many times has this been stated?) at our dependency on foreign goods and energy. There’s little reason that we can’t supply all of our needs from within our own borders, and even if we would still be subject to temporary shutdowns for epidemics, the residual effects would be briefer than what I expect will be coming in the months ahead. Corporations prove time and time again that profit is the only goal, and moving so much manufacturing overseas was completely driven by financial concerns.

The need for a social support structure (don’t say socialist, it scares people) that includes healthcare, jobs, education, housing, and the basic necessities has never been more apparent than now. Still, the Republican majority in all three branches of government is still proving their loyalty to big money, even now blocking the passage of emergency funding to allow Americans to get tested and to cover their short term financial shortfalls due to work stoppages and quarantine. It’s ridiculous that with the wealth of this country that we aren’t already prepared to test and treat as many citizens as is necessary. It’s been repeated often that we don’t live in a Democracy, and it’s true that the framers created more of a representational Republic than a true Democracy. But, we’re not even at that level. The old white men in power are serving their own needs and the needs of their wealthy benefactors. The rest of us are mostly on our own, and this has been evident in stark relief these past few weeks.

Shuffling towards Armageddon...

Okay, I hyped that title a bit, but it should trigger the memory if I review this post in the years ahead. We’re just on the edge of the cliff here in America, coronavirus wise. Each day seems to bring an incrementally more serious development and today I woke up to the news that Trump had suspended most European travel, the NBA had apparently canceled the season (which really seems crazy to me), and Tom Hanks and his wife, Rita Wilson had both announced they had tested positive for the virus.

At present, the CDC is reporting 938 cases in the US and 29 deaths. I think this number has to be way below the actual total, seeing that very few people can even get tested. Reading around the net, it seems private interests and individual citizens are taking the lead in getting information disseminated and trying to mitigate the rapidity of the spread. The earliest moves by the government (Trump) were trying to downplay the severity and prevalence of the disease, likely for financial and political reasons. This may prove to have grave consequences as things play out in the coming weeks and months. It’s vivid evidence (on top of the mountain that preceded it) of how incompetent and capable he is as any sort of leader, especially the country.

We’re fortunate in that we’re already sort of living the lifestyle that limits exposure since I typically only work 2-3 days per week and we only go out for groceries about once weekly. The only other recurring social interaction is concerts, and we’ve cut back on those quite a bit. Seeing the number of live events and tours that have been canceled, it feels inevitable that the upcoming shows in April and May (Who, Stones, Primus) are likely to get canceled or postponed. At work, there hasn’t been any forced stoppages or reductions in hours, but I feel it’s inevitable at some point. It will probably apply moreso to non-essential admin jobs since the healthcare workers will be needed to care for patients, but I’m curious how this will impact the FWOPC since they don’t have any inpatient capability.

I imagine my job as C&P examiner is going to take a further hit since we depend on exam requests from the regional office, which is all admin type jobs. We’re already planning to scale back our expenditures for the foreseeable future since we don’t know how long this might take to play out. As long as I can work and they get me patients, I will plan on going in and just following protocols. I assume we’re all likely to be exposed before this is over.

My hope is that this pandemic (per WHO as of two days ago) will serve as a wake-up call for disease and disaster preparedness as well as an example for the electorate of just how incapable Trump is at doing his job.

It's March and time for this year's credit card fraud

It appears our Visa (my number specifically, we have a joint acct with different numbers) has been compromised again. I can’t remember if it has been one or two years since last time. It seems like this is just part of the process now, at least if you use a c-card online with as many different merchants as we do. I’m not entirely sure, but there were a few charges for $25ish from a character called GOOGLE*Ivan on my account, and I didn’t recognize them so I asked USAA to cancel the number and issue a new one. The last time this happened there were a few smaller charges and then a charge for several hundred dollars appeared. I didn’t let it get that far this time. I will say that the process is pretty fast and you can immediately block the card if you’re worried about fraud. I’m not sure how many times we’ve had sketchy c-card activity now.

Our first experience was with BOA when someone tried to take all of our bonus points, which at that time were worth a couple grand. We got it fixed and then it happened again about a year later. I’m still thinking that had to be an inside job. We gave up on BOA after that and have been using USAA for everything since, although I do have a few other c-cards that I got purely for concert tickets. Those are coming in handy now while I have to wait for the new card. We’ve had a few other fraudulent transactions since then and we’ve always been able to cancel the cards and have the fraudulent charges refused. Luckily, there are so many c-card combinations that I don’t think we’re at the risk of running out of numbers anytime soon.

I’ve been feeling dissatisfied with my guitar playing recently (we call that Sunday), having been watching a few gear videos and just hearing other players’ ability to improvise chord changes and solos with such melodicism and fluidity. I allow myself to get into ruts, practicing riffs in support of wanting to eventually play a cover of something, but this isn’t really getting me anywhere as a player. Ironically, I was watching a Drumeo video that posed the question “Are you an intermediate drummer"?”, which I thought I must be at the beginning of the video, but by the end, I realized their metric for advanced is so high that I’m more aptly described as a beginner considering how many techniques they mentioned, many of which I’m not capable of performing. It’s much the same on the guitar. I have studied a lot of the fundamental vocabulary on guitar, including several courses at Berklee, but I’ve let those muscles atrophy and haven’t taken things any further.

I tend to get focused on simple techniques like speed (alternate picking, etc.) and I really should be focusing more on my ability to play in multiple keys, over chord changes, etc. I’ve decided to sort of reassess my practice regimen and I’m going to dip into the considerable volume of lesson material I already own. I’m starting with “The Path to Fretboard Mastery” which will help reinforce my knowledge and take it further. I can find all the notes on the fretboard, but I tend to use reference points and jump, as opposed to being able to quickly name a note in any position. This is just one of those fundamental skills you must have locked down. It ties into knowing some of the more common modular chord shapes, which I have somewhat retained from my Berklee class.

Knowing movable chord shapes, at least for triads and seventh chords can really open up the entire length of the fretboard and has definitely helped with compositions. I’ll go through this course and see where that leads me next. I know I have a few chord courses, including the Ted Green stuff that I’ve never fully studied.

Lastly, here in the US and around the world, the Coronavirus epidemic (pandemic forthcoming?) has been another reminder of the incompetence and negligence of this administration and many around the world. Trump is still trying to play for political points and his on air comments continue to baffle all within earshot. There’s the cruise ship that was quarantined and apparently he wanted to know if they kept it quarantined and didn’t allow the passengers to disembark if it would count against the disease totals. It’s a good question, we wouldn’t want to damage the re-election campaign for a few thousand lives. It’s not helping that the media is hyping everything as they always do, it’s all good for ad revenue, regardless if factual or helpful. We’re somewhat lucky in that we can handle sequestering ourselves at home for longer than most people since I don’t work full time and we have a bit of a reserve to tide us over if things shut down.

So far I haven’t heard anything at work about them closing or restricting the clinic hours/services, but I feel like it’s almost inevitable at this point. Luckily for me, I’m not ostensibly treating “sick” people. If my patients are ill, it’s a coincidence and not tied to the context of their visits most of the time. It’s also fortunate that I typically only see one patient per day so my relative exposure is probably not as bad as just running into Wal-Mart to grab a few things. I just hope all the dire projections are just that, projections that won’t play out as severe as some are suggesting. Some of these estimates would very quickly completely overwhelm our healthcare system.