May 29, 2020

Dear Interested Readers,

 

100,000 And Counting With A Very Stable Genius Leading The Way

 

This has been a very difficult week for all of us. 100,000 is a very large number of people. The Rose Bowl seats 92,542. I spent a long time yesterday morning reading the tribute that the Washington Post published as a painful acknowledgement of this horrendous loss of life. There is no way to pause and reflect on each one of the more than 100,000 victims of the pandemic. It’s not possible to have a remembrance like our annual reflections on 9/11 when more than 3,000 names are read. There are 58,320 names on the Vietnam War Memorial. It is a moving experience to meditate on the pain of that experience as you run your fingers over the names carved in the walls, and try to find the names of those you knew in high school who died so far from home. The Post used a dramatic graphic and words to capture the feel of this moment that no one expected when the year began:

 

Nearly three months into the brunt of the epidemic, 14 percent of Americans say they know someone who has succumbed to the virus.

These 100,000 are not nameless numbers, nor are they mostly famous people. They are, overwhelmingly, elderly — in some states, nearly two-thirds of the dead were 80 or older. They are disproportionately poor and black and Latino. Among the younger victims, many did work that allowed others to stay at home, out of the virus’s reach.

For the most part, they have died alone, leaving parents and siblings and lovers and friends with final memories not of hugs and whispered devotion, but of miniature images on a computer screen, tinny voices on the phone, hands pressed against a window.

 

What follows in the article is a photographic overview of what we have endured. It emphasizes the pain and suffering that has become a constant shadow over our lives as we have added new language “like social distancing,” “essential worker,” and “lock down” to our everyday vocabularies. Many of us spend as much time on Zoom as we once spent in office cubicles. If the material, the photos and associated verbiage, was presented as a glossy hard copy you might leave it on your coffee table like a momento from a trip to the Twin Towers 9/11 Tribute Museum in lower Manhattan at “ground zero,” the The United States Holocaust Memorial  in Washington, or the Museum of the Birmingham Civil Rights Institute.

 

It is a very dark and depressing moment in the history of our nation. No one alive has personal experience with such a combination of loss of life and economic peril which may make tens of thousand more collateral damage through the diseases of despair. 40 million of us are unemployed. 25% of people who were working in February are struggling without a job, and 50% of families say they have lost income. These economic side effects of the loss of 100,000 lives in a pandemic with no end in site are perhaps the factors that most guarantee that there will be many more tens of thousands of COVID related deaths. Our president, a self described “VERY STABLE GENIUS,” is more concerned about his reelection than he is about the heath of the nation. He appears to be betting that if he can pull off an economic miracle or just the elusion of some economically better “new normal” by November, he will be reelected no matter how many lives are lost in the process. 

 

There was a second Washington Post article that was more like a high school yearbook. It was entitled “Faces of the dead: This is how they lived — and what was lost when they died.” The pictures and vignettes are evidence that the virus can kill anyone. Many of the faces are elderly. Many of the names and stories are accompanied by the smiling faces of healthy people in midlife. Many of the faces belonged to people of color who were essential workers. Some of the 100,000 were nurses like Freda Ocran, and others, like Frank Gabrin, are doctors. Many worked in some part of healthcare and were at work when they were likely infected because their tasks were “essential.” Some, like Paul Carey, an EMT from Colorado, traveled to New York to volunteer for work that cost him his life.  As we pass 100,000 lives lost we are learning that probably more than 300 nurses, doctors, and other healthcare professionals have died. That number is thought not to be accurate. There are probably many more, and many of those deaths are the result of inadequate PPE. Our in adequate preparation is in part related to the Trump administration’s disregard for the previous work done by the Obama administration following the Ebola scare. Our “very stable genius” thought that devoting resources to preparation for a pandemic was a big waste of money.

 

In these pictures and brief histories of dozens of victims from around the country, we can surmise that the virus does not discriminate. We don’t know yet all the factors that determine its victims, but we do know it can take the famous as well as the downtrodden. Some of the pictures were of well known people like the singer/songwriter John Prine, or Elias Marsalis, the jazz pianist who was the father of Wynton Marsalis. One of the oldest victims was Annie Glenn, who used her fame as the wife of our first astronaut to become an advocate for people with speech disorders. I urge you to explore all of the stories and imagine whether adding to their number is justified by a strategy to win an election. Will not the economic costs continue to rise if the price of our collective impatience is more human life?

 

One of the youngest faces belonged to 28 year old Valentina Blackhorse who “was an administrative assistant for the Navajo Nation. She is reported to have dreamed of someday being a leader in her tribe. My guess is that she was included because the Navajo nation is enduring one of highest incidences of infection and death from the virus. Our government’s multi century history of corruption and abuse of native Americans persists into the pandemic. ProPublica has reported this week that “Zach Fuentes, President Donald Trump’s former deputy chief of staff, formed a company in early April and 11 days later won a $3 million contract with IHS [Indian Health Service] to provide specialized respirator masks to the agency for use in Navajo hospitals. The contract was granted with limited competitive bidding.” Those masks were mostly junk, and didn’t meet FDA standards. The water level in the swamp that the president promised to drain is higher now than ever. The combination of the virus and the swamp was perhaps too much for Ms. Blackhorse just as the relaxation of preparedness guidelines by the Trump administration for hospitals and nursing facilities was the equivalent of a gardener turning the soil and adding fertilizer to promote the growth of a crop–in this instance the new coronavirus. 

 

In another ProPublica article published on Wednesday entitled “100,000 Lives Lost to COVID-19. What Did They Teach Us?,” the author Carolyn Chen makes an observation and asks a question:

 

Each person who has died of COVID-19 was somebody’s everything. Even as we mourn for those we knew, cry for those we loved and consider those who have died uncounted, the full tragedy of the pandemic hinges on one question: How do we stop the next 100,000?

 

I have discovered that many people think that the worst is behind us. I hope that they are right, but for them to be right there are lessons to be learned and processed, and changes that still need to be made. The messages we get are very mixed. Even in Massachusetts, where some of the most significant losses have occurred, many colleges are planning for on campus classes in the fall. As an expression of the confusion and uncertainty that surrounds us, The Boston Marathon, which had been rescheduled for September, was canceled yesterday, and will now be a “virtual” event. How can leadership in the same location be following a coordinated pathway if it is opening college dorms while it cancels a famous race? I don’t get it.

 

Ms. Chen notes one of my major concerns:

 

COVID-19 has also laid bare many long-standing inequities and failings in America’s health care system. It is devastating, but not surprising, to learn that many of those who have been most harmed by the virus are also Americans who have long suffered from historical social injustices that left them particularly susceptible to the disease. 

 

We have been told that the most vulnerable people to this virus have “pre existing conditions.” That phrase usually brings to mind someone with diabetes, congestive heart failure, COPD, or perhaps morbid obesity. For some, the condition is cancer or an inflammatory condition, like ulcerative colitis, that require treatment with drugs that impact their immune response. The virus has shown us that being a member of a racial minority, or being poor, is also a “pre existing” condition that may double one’s risk of infection or death compared with an age matched individual. We are back to the fact that one of the most powerful predictors of your potential longevity is your ZIP code. 

 

Consider the natural experiment of New York. Johns Hopkins reports COVID-19 data by county. Queens, The Bronx, Brooklyn, and Staten Island are all in New York City. Each of those boroughs is also a separate county in the State of New York.Taken together, they average about 9 deaths as their combined case fatality rate. Richmond County (Staten Island) is the least dense borough, and has the lowest fatality rate at about 6. Westchester County is a contiguous to New York City. It is an area of affluent suburban towns, and its case fatality rate of 4.07 is less than half of New York City’s combined rate. To the east of Kings County (Brooklyn) on Long Island is Nassau County, where the case fatality rate is 5.34. Where you live does make a difference. What you have is a large determinant of where you can live.

 

Over the years in casual conversation with family and friends, when explaining why New York has never appealed to me, I have often referred to the large public housing projects in the Bronx, Queens, and Brooklyn as human file cabinets. I feel the same way about the towers of luxury condos and apartments in Manhattan. I don’t want to live where people are stacked on top of one another. That life appeals to many. Others have to accept those living arrangements as their only alternative. Looking at the data, whether it is from New York, a Navajo reservation, the South side of Chicago, or South Dakota, if you live or work in an environment that is crowded, and worse yet, where your activities of daily living or your work as an “essential worker” keep you in close contact with other residents or essential workers, your risk is higher.

 

My son and his wife live in a moderately large apartment building in Brooklyn. Shortly shortly after they “escaped” to an apartment over my garage in New Hampshire, the wife of their “building super,” a woman in her mid fifties who was a long time legal immigrant from Central America, died from the virus. Had they stayed would they have come in contact with her and caught the virus? Having family resources probably does improve your risk. My son has recently discovered that a friend his from his graduate school days at NYU, who could have escaped Brooklyn for a safer environment in “the Hamptons,” chose to stay in Brooklyn, and was lucky to survive several weeks in the hospital with the virus. Perhaps it is not our race that protects us or makes us vulnerable, but rather the social realities associated with our race and location determines our outcome, with this virus. Our overall medical vulnerability seems to be a issue of both “who and where.” You are very fortunate, and most likely not a member of a racial minority, if you can control the “where” of your life.   

 

Speaking of race, COVID-19 does prey on minorities, but then it appears that maybe the police do also. The South is frequently considered to be the epicenter of American racism, and with its history of Jim Crow and lynchings, there are facts to support that opinion.  Once again, like the senseless killing of Trayvon Martin in Florida,  the shooting of Ahmed Aubury in Georgia while he was jogging is a painful reminder that racism lives on. As an expatriate from South Carolina in 1967, I was surprised to discover almost as much racism in Boston as I had witnessed in my native South. This week the epicenter of racial tension is in Minneapolis after the strangulation of George Floyd under the knee of a policeman, Derek Chauvin.  It’s been one hundred and fifty five years since the end of the Civil War and the passage of the 13th and 14th Amendments to the Constitution. Dr. Martin Luther King, Jr. was assassinated 52 years ago, and we are still a racist country. 

 

My son from Brooklyn and I were discussing this latest flare of racial injustice while on a walk this week. He surprised me when he quoted Angela Davis. I looked up the quote and he had nailed it. She said:  

 

“In a racist society it is not enough to be non-racist, we must be anti-racist.”

― Angela Y. Davis

 

I know no one who would allow themselves to be called a racist. Even people whose actions seem to match the label will not allow it to be pinned on them. Maybe we should stop talking about not being racist and accept Ms. Davis’ challenge to be anti-racist. 

 

Few of us are legitimate anti-racists. I am ashamed to say that it would be a big stretch of the truth for me to try to say that I am a consistent, effective anti-racist. I might qualify as an occasional event driven anti-racist, but then the issues subside a little, and other things move of the agenda, and the convictions ease. We cringe at the idea of actively correcting the attitudes and circumstances that still make race a barrier for healthcare. We certainly get very bent out of shape if anyone suggests some sort of reparations or program of affirmation action. We contend that individual responsibility and education will fix things because we live in a meritocracy, but then we under fund public education. We scratch our heads rather than look in the mirror when we hear that African Americans who have access to healthcare still have poorer outcomes. How could that be? We wonder about the issue, but rarely dig into an analysis that points to the answer. It seems unAmerican to imagine that race, with any amount of income, might be a social determinant of health. 

 

When I fact checked my son, I also discovered that Ms. Davis had other things to say that we should consider. She had long ago written about race from a much broader perspective than pure economics or healthcare. Could it be that our society is racist even if none of us will admit to the label?

 

“I feel that if we don’t take seriously the ways in which racism is embedded in structures of institutions, if we assume that there must be an identifiable racist who is the perpetrator, then we won’t ever succeed in eradicating racism.”

― Angela Y. Davis, Freedom Is a Constant Struggle

 

COVID-19 leaves us no place to hide when it comes to health care inequities, and the racial and economic bases for healthcare disparities. In a world as complex and as frequently as “compact” as we find ourselves, we need to learn how to practice great social equity and social cohesion as we also practice social distancing. We are on pace for even greater collective misery than the loss of another 100,000 lives. There are lessons to be learned. 

 

Where The Hard Road Ends And Turns To Clay

 

I hit a rough patch on my life’s journey in the late seventies and early eighties. During that time an acquaintance with whom I had a complicated relationship introduced me to the music of the Red Clay Ramblers. My “friend” claimed to have been an early associate of some of the band members at the University of North Carolina, a fact which I was never able to corroborate. Our friendship did not end well, but I will be forever grateful for his gift of the “Red Clay Ramblers.”  There have been many days when I was feeling awfully low, and I would slip one of their cassette tapes into my “Walkman” and head for a long run. Whether it was the music or the run, I could always count on feeling better and ready for “more” after getting lost for an hour or so on the road with the Ramblers.

 

Every one of the Red Clay Ramblers’ songs paints a lush picture that either tells an interesting story or leaves you to imagine your own story that fits the picture. I had many “favorites,” but the tune that appealed most to me then and now was “Twisted Laurel” from their 1976 album, The Merchants Lunch. Please listen to it while you read the words.

    

Twisted Laurel

 

Just across the Blue Ridge

Where the high meadows lay

And the galax spreads through the new mown hay

There’s a rusty iron bridge

‘Cross a shady ravine

Where the hard road ends and turns to clay

With a suitcase in his hand

Well a lonesome boy stands

Gazing at the river sliding by beneath his feet

 

And the dark water springs

From the black rock and and flows

Out of sight where the twisted laurel grows

 

Past the coal-tipple towns

In the cold December rain

Into Charleston runs the New River train

Where the hillsides are brown

And the broad valley stained

By a hundred thousand lives of work and pain

In a tar paper shack

Down the road, across the track

Stands an old used up man trying to recall something back

But his old mem’ries fade

Like the city in the haze

And his days have flown together like the rain

 

And the dark water springs

From (cross?) the black rock and flows

Out of sight where the twisted laurel grows

 

The line that congers up the most significant image for me is:

 

“Where the hard road ends and turns to clay”

 

I think about that line a lot while driving around in New Hampshire.  When we deliver wood in the winter, I have come to expect that the destination is very likely to be a rusted out old “double wide” up a long dirt road, deep in the woods. The pavement frequently ends and the road goes on, often up a steep hill.  The further you go, the greater the feeling that you are traveling back in time as you are simultaneously traveling down the nation’s socioeconomic ladder. 

 

The non profit community action organization that my wife and I helped create with many other caring neighbors, Kearsarge Neighborhood Partners, has been pursuing several projects in collaboration with other local organizations. One of our recent collaborations was “Garden In A Tray.” I had nothing to do with the organization of the project, but my wife and I found being part of the “delivery system” to be a very rewarding experience. The notice on our website describes the project and names KNP’s partners. 

 

FREE: “Garden in a Tray” for Growing a Family Garden

Several neighborhood partners in the Kearsarge Region have created a Garden in a Tray Program to create long term food sustainability exclusively for Kearsarge Region Families in need and Essential Medical Workers.

The Garden in a Tray contains 42 edible plants (vegetables, herbs and flowers) grown by Spring Ledge Farm. These plants are ready for planting. We will provide you with tips on planting and season-long support to help your family grow a successful garden.

Register today for a free Tray by contacting the New London Hospital Wellness Office.

 

On Wednesday morning this week, about twenty volunteers met at Springledge Farm to pick up the trays, as well as free bags of mulch, a shovel that recipients could have if one was needed, a pair of work gloves, and printed information for delivery to over 100 families in our region. My wife and I delivered seven trays to families in four of the towns in the Kearsarge region. 

 

Our trip took us down several roads where the pavement met dirt. Getting to the house pictured in today’s header was quite a trip. Google maps took us to the end of one dirt road. We texted the recipient who gave us an alternative route. In the end we followed a circuitous route of over ten miles. On the way we did cross a “rusty iron bridge” over a swiftly flowing mountain river. Several miles later “the hard road turned to clay,” and our revised Google Maps entry informed us that our destination was still three miles away. We realized that we were exploring a beautiful rising road with old stone walls and at least one old homesite where nothing but a stone foundation still gave testimony to the fact that someone once lived there. We stopped for a moment, but then traveled on believing in Google, even though it had already failed us once. 

 

The cell phone service in the area was thin and our information told us that the recipient preferred to be contacted by text. By text she assured me that her house was at the end of the road.  We pressed on despite the fact that we had not passed another house in over two miles, and sure enough, when we got to the end of the road there was a house which you can see in today’s header. I was a little apprehensive as I walked up the walk between piles of nicely cut firewood. Two white geese which you can see under the lilac bush were the only sign of life. The side door under the porch roof on the right side of the house was wide open. I could see an open laptop on a cluttered kitchen table, but no one was visible. I knocked loudly on the door frame and said “Hello” several times. When “Hello” did not work I shouted, “Anybody home?” After waiting for several minutes it was clear that either no one was home, or if someone was home, they either could not come to the door, or didn’t want to come. I carefully placed the plants out of the way on the small porch, and left. Back in the car, I texted the directions that I would have given if someone had come to the door. 

 

Yesterday, I was delighted to have my text returned:

 

Thank you again. Incredible work you all are doing. I will pay it forward. (Heart emoji) 

 

I don’t know if her promise to pay it forward was a result of reading our literature. One of our five principles is:

 

We recognize the value of reciprocity in our relationships and seek opportunities for those we serve to join us in building community.

 

I love where the hard road meets the clay because that is where you find some very interesting experiences.  

 

Be well! Practice social distancing. Wash your hands frequently. Don’t touch your face. Cover your cough. Stay home unless you are an essential provider. Follow the advice of our experts. Assist your neighbor when there is a need you can meet. Demand leadership that is thoughtful, truthful, capable, and inclusive. Let me hear from you often, and don’t let anything keep you from doing the good that you can do every day,  

Gene