Welcome to the New Abnormal- Kiwi Style

These are extraordinary times we find ourselves in globally trying to best deal with the COVID-19 pandemic. Uncertainty and fear rule the day and in a time where we want to reach out and hold closer to our family and whānau, we are warned that may be the worst thing we can do.
In light of this I have decided to temporarily re-purpose this blog as a more efficient platform to share our experience here with others, with the hope of making us feel less isolated.
Here is our situation as of Sunday, March 22, 2020.
The first case was diagnosed in New Zealand February 28, a sixty year-old man returning from Iran via Bali. In the last week the number has risen from 8 to 39 (actually rising from 39 to 52 while I am composing this), most so far acquired overseas with the origin of two cases unclear. The government is trying very hard to walk the fine and indefinable line between over and under reaction. As a result, just today they upgraded from Level 1 to Level 2 alert and will any day go to Level 3 when community transmission is documented. The Ministry of Health keeps its coronavirus information up to date and if you want the real time report here is the link.
Last week, foreign visitors from most countries could still come in but all overseas arrivals were asked to self-quarantine for 14 days. As of now, only New Zealand citizens and permanent residents (which we are) are allowed to enter the country. At the beginning of the week, gatherings of >500 were banned, and as of yesterday it went down to >100. Social distancing is urged, frequent hand-washing, and as of today everyone over 70 are advised to stay at home. Restaurants, schools, movie theaters are not yet closed, and no confirmed or suspected cases have been reported in our South Canterbury region of the South Island.
I appreciate the approach the Ministry of health is taking. The risk of community transmission right here, right now is still low, but will surely soon rise. When businesses close they can be expected to be closed for weeks to months. If you start strict restrictions earlier, you prolong the consequences of the closures: unemployment, isolation, deeper economic disruption. Also, human nature indicates that compliance will wane as the weeks drag on. You want the full participation of the population when it is likely to provide the most benefit. It is a very tough call.
Our lives have already been impacted personally and professionally even prior to the coronavirus appearing here. On the personal front, Fayne and I have enjoyed a familiar weekly routine.

• Tuesday is dinner out with my medical colleagues. It has been a great source of fellowship and bonding. That has been cancelled but there is some thought to alternatives, such as take-out fish and chips on the beach sitting six feet apart. 
• Wednesday is Pub Quiz and the Sail & Anchor, hosted by Barney and noted for the sticky floor and home to the 2019 NZ Pub Quiz Championship Trophy. The Wednesday quiz will be our last for a prolonged time.
• I had reservations to go to a large New Zealand/Australian medical conference in Melbourne early May and that has already been cancelled.
• We are booked to return to the USA mid-May and go to a conference in Boston early June. That is all uncertain at this time.
• I go to the gym almost every day. That will soon stop.
• The Timaru Film Society is suspending operations for the time being.

Professionally, I am preparing for my work life to be drastically changed. Already the virus which has not yet arrived here is causing disruption. I have been involved in hours of meetings planning for catastrophe. The healthcare workforce is affected by employees with challenges returning from overseas and the 14 day mandated self-isolation. When people start getting sick the problem it will be much worse.
All of us working in healthcare have extra risk of acquiring the virus, but also the worry/danger of being asymptomatic and infecting patients, family, and friends. Just as the public doesn't focus on the risk of driving, we don't actively worry about the health dangers we face from work. Prior generations of Western hospital workers routinely were exposed to TB, polio, even smallpox. As far as I know the only significant infectious disease I have contracted was a quite distressing case of scabies, from which I am happily 100% recovered. The professionals I know will be prepared and cautious but not overly fearful. The sense of duty and the opportunity to have a specific role, something to do, spurs us on.
However, the stories out of Italy are horrific. I guiltily confess that like many Westerners, the earlier deaths and suffering in China did not have the same impact as the images of deserted streets in Rome, Milan, and Venice. Things like this reveal bigotry we hide from ourselves. When things seem "remote" we can observe them more objectively, but if you have some personal connection to someone or someplace mortally afflicted by war, AIDS, or natural disaster, it is a natural human trait to feel it more deeply and emotionally. I do dread the possibility that the in the weeks to come we will be overwhelmed by suffering and dying patients and it will be my responsibility to carry on.
I am wishing for the best fortune and health to all of us to get through this. I also know that if any of my colleagues or myself become ill, we will receive absolute best care possible from our brothers and sisters.

Rome in happier times (10/18)-The Blums at the Spanish Steps

Piazza Santa Maria in Trastevere, Rome

Life in the Time of Coronavirus

A lot has happened globally since the end of my last blog posting: an impeachment "trial", the 49ers losing Super Bowl LIV,  Super Tuesday and Joe Biden rising from the dead, and the coronavirus pandemic. With 2020 soon to hit the quarter mark, it seems to be passing quickly, yet it will be a looooong time until the November US election. Here are a few highlights of my year so far; my reflections on the pandemic are at the end.

January was spent in the USA, split between a visit to Georgia (where Sofia and her family are now) and California. We arrived in the Peach State in time to help grandson Isaiah celebrate his 6th birthday with cake and lots of presents.

A central part of their life revolves around the synagogue Congregation Sha'arey Israel in Macon.
 
As with most places I've been on the planet, there is always something to explore and learn from. Just across the river from Macon is the Ocmulgee Mounds National Historic Park with its impressive display of 1,000 year-old mounds and artifacts from the prehistoric indigenous peoples. Sofia suggested we visit with the kids, and we all had a grand time wandering around appreciating the works of the ancient peoples.

The portal below leads into the earth lodge, a meeting place for the elders.

Earth lodge interior

I wish we had more time to visit the museum housing many artifacts and displays of the area.

View from atop the Great Temple Mound

They actually live in a newer development 25 miles south of Macon. On a walk just 100 yards from the house, I was somewhat concerned by a sign similar to this one.

Macon was founded in 1809 as a post for trading with the native population. In the 1830's, President Andrew Jackson forced the native Creek Nation out to be relocated eventually in Oklahoma. Present day Macon is a collection of antebellum buildings, late 19th century structures, and more modern additions.

Center: Macon City Hall (1837). Clockwise from the left upper corner: Georgia Sports Hall of Fame; Terminal Station (1916 train depot designed by the same man who did Grand Central Station); Thomas Jefferson Bldg. (1917); Macon City Auditorium (1925); Armory Building (1884); and the Tubman Museum

The Tubman Museum is dedicated to African American Art, Culture, and History. Although I don't think Ms. Tubman ever visited Macon, her story of bravely helping her people escape slavery is truly inspiring. Just as we must not forget other periods of injustice and suffering, reminders of our past and recent history are needed.

The museum also informed me of how many of the legendary musicians and performers of my generation came from the area, including Little Richard, James Brown, and Otis Redding.

Little Richard's piano

The Godfather of Soul (1957)

The signature piece of the museum is the 55 foot-long mural of black history in America, from the first slave ships to the current day.

Our last full day in Georgia was on my birthday, and Sofia went out of her way to make it special for me. First, she treated us to breakfast at H&H Soul Food, a legendary local joint founded by Inez Hill and Louise Hudson and steeped in history. It was a favorite to many musicians, including the Allman Brothers Band, who first hit it big while living in Macon.

H&H Restaurant founded in 1959

The walls are plastered with posters and photos of Macon soul and rock stars, and "Mama Louise" or "Mama Inez" at times went on the road to cook for the Allman Brothers Band.

"Mama Louise" Hudson (1972)

The menu is a classic, and you should drop by for the history and atmosphere (it is across the street from the synagogue).

...but honestly I've had better soul food in Oakland, CA.

The Ramblin Man: A biscuit with smoked brisket, egg, American cheese, and fried green tomato.

After the meal, she treated us with a visit to The Big House where the band lived communally in the early 70's, and has since been turned into a shrine for all things Allman. I cannot overstate how deeply touched I was by this gesture of my daughter: to graciously take her aging Boomer father to a museum dedicated to a 70's rock band was above and beyond.

The actual guitar Duane Allman played on Layla

I also got a t-shirt and CD out of the deal, not to mention later a home-made cake and spirited rendition of "Happy Birthday"!. Perfect. Thanks, Sofia!


After a full week in Georgia it was time to head back to California and, naturally, more celebrations of my birth with friends and family

Slightly belated BD dinner in Corte Madera, CA....

....followed by cake at Margaret's house.

A few days later we took the ferry to SF and as Fayne lunched with old friends I went to the San Francisco Museum of Modern Art (SFMOMA), always a good place to spend a few hours on a rainy day. Here are a few things that caught my eye.

Resonator Wind by Nevin Aladağ

Figures with Sunset, 1978 Roy Lichtenstein

Jackie Triptych, 1964, Andy Warhol

The Flower Carrier, 1935 Diego Rivera

Ich (I), 1980 A. R.Penck

The discovery of invisible nature, 2019 by Minerva Cuevas, a meditation on the environment and the devastating fires in CA

After two months away (SE Asia, California, Georgia) it was time to go back to New Zealand. Continuing the theme of 1970's musical legends, about a year ago Sir Elton John announced one of his stops on the multi-year Farewell Yellow Brick Road Tour would be in Dunedin February 4, 2020. I made sure to book tickets (not cheap) and looked forward to my fourth Elton John concert. My first was in 1973 at the heights Elton-mania. Some may consider him to be too "pop" or a caricature of himself now, but he is the best performer I have ever seen live. The last time I saw him was in Caesars Palace in Las Vegas 15 years ago, and I noted his vocal upper register had diminished significantly from his prime and so I was wary of what was left in the 72 year-old icon.

At the concert, very good seats

I need not have worried. He and the band put on an excellent show, playing continuously over 2 1/2 hours. They focused mostly on earlier hits up through Goodbye Yellow Brick Road,with many of the same musicians that have played with him since the 1970's. 

The Elton John Band taking a bow with Elton: Davey Johnstone (guitar); Nigel Olsson (drums, vocals); Ray Cooper (percussion); John Mahon (percussion); Kim Bullard (keyboards); and Matt Bissonette (bass, vocals).

Although the concert was outstanding, before and after was quite unpleasant. It was cold and pouring rain all night, transportation was a mess, although the stadium is covered the wind whipped through the open gates, and the line for coffee was over an hour and then they ran out. We arrived back in our room at midnight, drenched to the bone and quite chilled. Not fun. We'll think twice or thrice before committing to a stadium show again.
While in Timaru, I feel an obligation to support and attend every cultural opportunity available. That meant we were sure to see the Great Moscow Circus. The fanciful tent was alluring and they provided two hours worth of "you don't see that everyday" entertainment.

This circus is animal-free and was of higher quality than the Circus Vargas I remember from Fort Bragg 25 years ago, at least in the sense that there were no near-misses of either an electrical fire or a rampaging elephant. In fact, the performers demonstrated an impressive array of skills, from trapeze, tumbling, balancing on spinning barrels high above the crowd, and motorcycle stunts with multiple riders inside a steel mesh sphere (aka: the Globe of Death) and leaping from a ramp to fly high over the crowd.

Man perched on a spinning barrel

Motorcycles inside the Globe of Death

I looked forward towards the end of February to attending the Internal Medicine Society of Australia and New Zealand (IMSANZ) meeting this year in Christchurch. We had time to take in some of the redevelopment going on in the Central Business District, such as the much-anticipated Riverside Market which houses an variety of take-out and food markets including some favorites displaced from the 2011 quake.

The conference was a very high quality educational experience, and the highlight is always the gala dinner on Thursday night. It is an ideal opportunity to visit with colleagues and make new friends from around the country. This year it was held at The Tannery, a shopping and dining complex lovingly resurrected from the site of the 19thC Woolston Tanneries.

For the "leap weekend" we  drove to Twizel to checkout the annual Salmon and Wine Festival, an event that promised both but delivered significantly less. Twizel is nestled among the Southern Alps, just below Aoraki/Mt. Cook, and was established in 1968 to house construction workers on the Upper Waitaki Hydroelectric Scheme. In 1983 when the work was finished the plan was to revert the site back to farmland, but the residents had grown fond of life there and managed to keep their town.

Part of the Waitaki Hydroelectric Scheme

It is a lovely region but the festival itself, although nicely situated on the shores of man-made Lake Ruataniwha, was a disappointment. Since the $25 entry fee did not actually cover any salmon or wine, it would have been better spent towards a nice glass of wine and salmon dinner in a local restaurant.

The lake is the home to the South Island Rowing Centre and the clubhouse features this photos of noted Kiwi rowers who have competed here, some Olympic medal winners.

South Canterbury being smallish, it was not surprising we ran into our favorite constable Renee Chapman (former ace physical therapist at Timaru Hospital).

Sunday March first was a gorgeous day to drive home and afforded this view of Aoraki/Mt. Cook across Lake Pukaki.

The Novel Coronavirus Covid-19 Pandemic

There is no elegant way to transition from my personal travel blog to a global crisis, but it is weighing on all our minds. Like everyone, the enormous impact in the future weeks and months is very hard to process. The projected consequences have gone from possible to highly likely. Every day this week I have attended meetings trying to prepare my hospital and community for the looming disaster, as if a massive cyclone is directly approaching but one that may last a year or longer after it hits. It is likely that this will result in one of the most important external forces to impact my generation, akin to the Kennedy assassination, the Vietnam War, and 9/11. The next two weeks will reveal if the USA follows the pattern that has seen Italy literally shut down and at the moment result in over 18,000 cases and 1,300 deaths.

I share your fears for our loved ones, especially the elderly and infirm, like my 94 year old father currently in a rehab unit in San Diego, but the truth is all of my generation is in the higher risk group. Also, the fact that the young are generally less severely afflicted does not mean they are safe. If the mortality rate for the young is 0.1% but 1,000,000 children get the virus, then 1,000 of them will die tragically. The best hope in the short run is to "flatten the curve": i.e. to slow the spread so that even if the same number of people eventually get it, health care facilities may not be overwhelmed and paralyzed, allowing precious time for a specific treatment and in 12-18 months an effective vaccine.

The situation is changing daily, and just yesterday Jacinda Ardern the Prime Minister of New Zealand announce new restrictions on travel and gatherings. Here is a link to her remarks if you would like to see what competent leadership looks like.

Ronald Regan famously said in his first inaugural address "...government is not a solution to our problem, government is the problem". Too many people have made it their universal mantra. In context, he was talking specifically by the early 1980's recession, not in all arenas. Instead of vilifying and dismantling our institutions and government services, this crisis illustrates how vital they are.

Finally, I have one recurring random odd thought whenever I see an image of Covid-19: it really is quite elegant. Not unlike the Death Star in Star Wars, despite the destructiveness, the symmetrical yet subtly complex representation is "admirable", a reminder that life and science can reveal a cruel beauty.

I send my hopes and good wishes to all that read this and all your loved ones. Stay safe, live a healthy life, and cherish every moment. We need each other. 

This too shall pass.