Governmental Dependency as a Toxic Relationship

When it comes to logistics and preparedness, the mode of thinking needs to be logic and reason — not emotion. Pretend you’re an interstellar alien, we’ll call him Spock (or her Spockette, if you want to be equal opportunity), evaluating our relationship with central Federal bureaucracy from outer space.

Two pertinent points: First, when an entity has failed, over and over and over, to accomplish goals timely and accurately, is it logical to keep depending upon it, or to demand from it what it has repeatedly foot-dragged and failed to deliver? Spock(ette) says: No. Highly illogical.

What is that entity? Distant, detached, massive, red-tape-ridden, impersonal, faceless Federal bureaucracy. I’m speaking of the whole entity, as a large, bloated mass, not individual right-minded people inside it who are trying to improve things, mostly in futility.

Epidemiologists have been warning of a pandemic like the one ongoing, for over a quarter of a century. Yet through multiple D and R presidencies, multiple D, R and split Congresses, this is the result. Blaming only the current people (while they deserve just the latest few years’ share of it) is purely partisan, shortsighted, ignorant of history, and emotional — not logical, not reasoned.

This scenario has been warned about for DECADES, with only token, window-dressing action. Such longstanding foot-dragging in preparation for what has been an inevitable pandemic is just one example of such lack of foresight and attention to low-probability (in any one year), high-impact events that will happen some year. This is such a year.

Those who expertly predicted it for the last few decades have every right to say, “I told you so, why didn’t you listen to me and prepare?” And they are entirely reasoned and logical in asking such a question. Spock(ette) would approve.

This is why foreseers and visionaries get disillusioned: government bureaucracy — too debt-ridden and bloated from generations of exceeding its literal Constitutional authority in many areas — is too focused on the here and now and the pork-barrel pandering that doesn’t lend itself to accommodating accurate expert farsightedness. This is objectively demonstrable in the lack of preparedness in numerous crises — not just this coronavirus. And when it comes to logic and reason, objective evaluation is what matters.

Is it logical to expect quick deployments and resolutions when, as only a mild exaggeration, it takes 37 layers of approvals and nine months to unlock a door latch? Spock(ette) says: no. Highly illogical. We see it over, and over, and over, from slow hurricane response, to days/weeks wait for Federal deployment on wildfires, to the CDC bungling of this virus disaster, to weekly politicization of nonpartisan issues.

Yet I see so many people demanding more involvement of the very same thing that keeps failing, over and over and over: Federal “help”! That’s not only illogical, but irrational, unhealthy, toxic! And also: Sisyphean.

Second: Disasters really are local. This is because individuals are affected.

States (especially for their resource/economically poor rural areas) and major cities need to learn to prepare as if they essentially will get zero help from above in a timely way. Quite often, after all, that’s the brutally honest truth. This way, if help does arrive, it’s a bonus, a relief.

Dependency on big, inefficient, untimely, unreliable Washington is really a form of unhealthy codependency — akin to a neglectful, often gaslighting, sometimes abusive personal relationship, but wrought on a broad scale.

Think about this, please. Relate to it. Would you tell your friend in such a relationship to stay the course, stick it out, trust the abuser/neglector will somehow, someday reform? If you have been in such a relationship personally, you will get what I’m saying. Why encourage such relationships of cities, counties and states with Washington, who has and will let them down, gaslight, neglect, attach strings, token-“help”, or even trample them as often as fully assist?

If you still don’t understand the concept of betrayal by centralized DC bureaucracy, and how systemically destructive that can be, ask our native American Indian tribes.

Exactly as we correctly advise friends in toxic relationships, states and cities need to learn to get out of that bad relationship with Washington and go it on their own, with years to decades of advanced planning for every sort of disaster that could befall them. Spock(ette) would see this through the lens of history and say, “That’s imminently logical.”

Top 40 Unique Country Songs

Long before Kenny Rogers died last night, I’ve been pondering the status of country music — how it’s hard to find a truly unique new song in this era of homogenized, corporately centralized radio airplay. By that, I mean a song that someone old enough to have heard the country music of the ’70s and ’80s newly played can, the first time you hear it, had this reaction: “Wow, I’ve never heard anything like this before, and it’s really good.” As for a younger listener, the analogous reaction would be hearing it for the first time recently and thinking, “Wow, I don’t hear anything like this today, and it’s really good.”

A few more of recent (<10 years) vintage are very nearly alone in their sound, and have come close to my “top 40” uniqueness list; don’t get me wrong. But it’s an exclusive, subjective, opinionated set for a reason. My reason is this: I listen to each attentively, for the countless Xth time, and still can’t think of another quite like it.

Some of the tunes below you’ve at least heard peripherally, if not a country fan. A couple will require some digging even for die-hards. All at least charted on the country hit lists (regardless of where else in crossover realms), and got good radio airplay at the time. Some were megahits. Most indeed are oldies, but not all.

But as someone who has listened to thousands of hours of country on a life-long basis, I’ll hold these up as a cross-section of unique country songs that either set a standard, or emerged so different from the rest that they stand alone in their sound, still today. Because I value uniqueness married with quality, these represent the creative edges of the country soundtrack of my life (even those that predate my birth, but later heard on the radio).

I’ve also left a ton of favorites off this list that are songs I love, in some cases even more than a few of these. For example, much as I like some songs by Patsy Cline, Toby Keith, Ronnie Milsap, Hank Williams (Sr. and Jr.), and the Oak Ridge Boys, they’re just not distinctive enough from their own other material to make the cut. By contrast, Johnny Cash is the only artist with some part in three of these, and it could be more, even as a few of his unlisted songs do sound similar to each other.

Omissions are songs similar to others from the same artist, different artists, or not quite as distinctive and genre-flexing as these.

Look ’em up and take a listen. These are in alphabetic title order, not order of preference:

Amarillo by Morning (George Strait)

Big Bad John (Jimmy Dean)

Big Iron (Marty Robbins)

Blown Away (Carrie Underwood)

Changes in Latitudes (Jimmy Buffet)

Class of ’57 (Statler Brothers)

Coal Miner’s Daughter (Loretta Lynn)

Convoy (C.W. McCall)

Country Bumpkin (Cal Smith)

Don’t It Make My Brown Eyes Blue (Crystal Gayle)

Ghost Riders (Johnny Cash)

Good Ol’ Boys Like Me (Don Williams)

Grandma’s Song (Gail Davies)

Highway 40 Blues (Ricky Skaggs)

Highway Patrol (Junior Brown)

The Highwayman (Nelson, Kristofferson, Jennings, Cash)

I Loved ‘Em Every One (T.G. Sheppard)

If We Make It through December (Merle Haggard)

I’ve Been Everywhere (Hank Snow)

Jolene (Dolly Parton)

Lady (Kenny Rogers)

Midnight in Montgomery (Alan Jackson)

Mona Lisa (David Allan Coe)

New San Antonio Rose (Bob Wills & the Texas Playboys)

Old Dogs, Children and Watermelon Wine (Tom T. Hall)

Po’ Folks (Bill Anderson)

Rhinestone Cowboy (Glen Campbell)

Rocky Mountain High (John Denver)

Roll on Mississippi (Charley Pride)

Seminole Wind (John Anderson)

Smoky Mountain Memories (Mel Street)

Song of the South (Alabama)

Snowbird (Anne Murray)

The Streak (Ray Stevens)

Sunday Morning Coming Down (Johnny Cash)

A Thousand Miles from Nowhere (Dwight Yoakam)

Time Marches On (Tracy Lawrence)

Wildfire (Michael Martin Murphey)

Wurlitzer Prize (Waylon Jennings)

You’re My Favorite Star (Bellamy Brothers)

Chinese Coronavirus, You, and Me

It has been a fairly busy year so far, with assorted projects at home and work, so I haven’t posted a lot to the BLOG. For some readers, that’s good news (so why are they bothering reading?).

However, the coronavirus that arose in Wuhan, China, and is igniting a worldwide and U.S. pandemic, has taken over the news, and the minds of everyone who isn’t utterly isolated from modern communications. This is the worse worldwide disease outbreak in 102 years, since the Spanish flu, because of its easy spread and higher-than-flu death rate of roughly 3-4% (so far).

Two days ago (as of this writing), my friend Dr. Jason Persoff, physician at a major Denver hospital and all-around great guy, sent out the following update from the front lines of medicine. I’m posting it unedited, exactly as he wrote it.

This is not some clickbait quack online, nor your buddy Bubba who heard something on the news, nor Aunt Bea with her worthless herbal remedies. Jason understands the science behind this disease. Pay close attention to his words. If you read anything about the coronavirus epidemic, start here. Serious stuff, but also, reasons for hope…


COVID Update 3/8–Long, but Important–yes you can share

Well, it’s been an interesting week. For those who don’t know me, I’m a hospital medicine physician and the Assistant Director of Emergency Preparedness for the University of Colorado Hospital. We are still very much in containment mode (isolating patients w/ COVID, quarantining persons of interest), but there are hallmarks that this will likely be in a different phase in the next week or two. For now, the increase numbers continue to be correlated in part with increased testing and in part due to real time increase in disease burden. I think the key message here is that containment will be unlikely and we’ll enter mitigation: treating the most sick with most people quarantining at home. I do think it is reasonable to assume that COVID will be a global pandemic. Now the question becomes: how do we deal with that?

That brings us to the term social distancing. This is a pretty serious issue that is a stage above mandatory quarantine. Social distancing means, essentially, no unnecessary public gathering. We’re seeing ideas of this begin to pop up with the NBA and Olympics. I think others are coming. We’re already seeing self-selection in this direction with canceled conferences, canceled airline flights, and self-imposed canceled vacations.

What makes me the saddest at this time is how truly financially and socially devastating this could become and is becoming. Some of this is driven by hype, but truly I believe all the extreme measures–be it canceling SxSW or closing University of Washington–may help in spreading out the disease. Why would that be a good thing? A trickle of cases over a longer period of time means a better opportunity for us in healthcare not to be overwhelmed.

As an insider in our hospital’s emergency response, I can tell you that this past week has proven to be really draining. Long days and lots of meetings with multiple successes and failures at dealing with this disease. We’re getting on top of it, but this disease is just beginning. We’re still ramping up.

The most startling information to come out of China from the WHO is the abysmal rate of oxygen needs for patients. Five percent of patients end up on ventilators whereas 15 percent require oxygen for the 3-6 weeks it takes to recover. That’s an unprecedented burden on the healthcare system. We are simply not able to take a head-on hit if these numbers remain accurate–but over time, we could handle a sustained surge better.

Think about being out of work for 3-6 weeks on oxygen and you get a better perspective why I have concerns about the wherewithal of the financial system. I feel very sad for people whose lives depend on working day-to-day–this is going to hurt for a while and so that brings us to not panicking.

Okay, so what if we are facing a pandemic. First off, and I beg you to heed this, if you fall ill with fevers and a cough DO NOT GO OUT until the fevers have been gone at least 24-48 hours. I don’t want you to get me sick and you don’t want to sicken anyone else. Sorry, no going to work or socializing–self-quarantine. Oh, not because you have COVID, but because I don’t want any of the other types of illnesses out there either. What has been staggering to me is how many cases are tied to people who were ill not being mindful of others and going to their events anyway.

Second, if you have persistent fevers and are worried about COVID, contact your local health department for guidance. Do NOT go to the hospital unless you are gravely ill or can’t breathe. We’re not going to test you just because you want reassurance you are COVID-free. The most common types of respiratory illnesses remain far more prevalent right now, so you probably have them rather than COVID: flu, RSV, human metapneumovirus, etc.

Third, STOP PANIC BUYING. Hand sanitizer is a good idea, but you don’t need a 36 month supply. Don’t be an asshole–stock up, but leave some for others. I can’t even imagine why people need 14 months worth of toilet paper, btw. Again, be reasonable. If you don’t panic buy, the manufacturers should be able to keep up.

Fourth, start contingency planning. It turns out most travel insurance policies don’t cover epidemics. Anticipate that most businesses may be running at 85% capacity at their worst, so be courteous and patient with everyone. Be flexible with your job–you may need to help keep operations running meaning changes in your schedule–and you may need that time yourself, so be generous. Hold off on purchasing trips for a month or so to see how we’re doing then.

Fifth, masks aren’t going to protect you. Your biggest enemy is your own face. We touch it on average >40 times an hour. Learn to be mindful of this. We believe, other than getting sneezed or coughed on, hand-to-face contact is a main mode of transmission. So, begin to learn when you do this. Do you know that most people unconsciously sniff their hands within two minutes of shaking hands with someone? Crazy but true: therefore, stop shaking hands and bump elbows or feet. Wearing a face mask will not prevent you from your own habits.

Sixth, don’t visit with ill friends. Hospitals, including ours, are severely restricting ALL visitors at this time, and even more stringently for patients who may have COVID. Facetime and video messaging is the way to go.

Seventh, keep reminding yourself that this is going to last a while. Don’t sprint, slow down. Make haste slowly. Don’t spread panic, deal with the numbers as they become available. The current numbers on the Johns Hopkins site show that China appears to be reaching a sustained plateau of cases, but it’s not dropping off yet. Were that to apply elsewhere, we have months to go.

Eighth–have hope. I do. And I’m in the thick of things. We’re all in this together and we’ll muddle through. Things may not look like we want them to look for a while, but this will pass. The virus will mutate, the vaccine will come out, a medicine may work, whatever happens this will change. This isn’t forever even if it feels like it. We’ve made it through 9/11–we made it through 2007. Be at peace that this is happening. Be practical but caring. Believe in the future…


Jason is well aware of what’s happening in prepared places like South Korea and Taiwan, which are holding their own, and Italy, which is overwhelmed despite a modern health-care system. They are short of both staffing and needed medical supplies, and having to let people die among those most seriously affected with the viral pneumonia that is destroying their lungs fast.

Most folks who get this (apparently about 80%) will experience only minor to moderate symptoms and move on with some immunity. Others, particularly the old, hypertensive, diabetic, cancerous, immuno-compromised, and those with heart or lung disease, have a much higher death rate. The brutally honest truth is that each of us — you, me, each of your friends and co-workers — ultimately will know someone who dies from this, and maybe multiple someones. Perhaps you or I will lose a parent grandparent, mentor, old friend, esteemed colleague, or role model. Even a few otherwise healthy and/or young people will be lost…who knows why?

We have to get obsessive as can be about prevention and hand cleanliness — to delay the onset of this crap in ourselves at least long enough for the medical system to not be overwhelmed everywhere. I’m trying to change habits quickly and use lots of soap and wipes. For the sake of the most vulnerable among us, I hope you are too.

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