Tuesday, February 25, 2020

Global Body Warning Interlude 2: Give me a Candy Koan. Assessing my germs


2/23/2020

Here we are with a very embodied Koan by the name of Covid-19. It is not in the book of Serenity, The Blue Cliff Record or the Book of equanimity, the Gateless Barrier etc. It is as big as the world and the suffering in it. The passions that exist are beyond comprehension. How can I even explain my compulsion to work with it?
Here we are stepping into the unknown and unknowable. I woke up with a head cold sinus combination. At any other time pre Covid-19 it wouldn’t matter much. For a long time taking off when feeling slightly unwell has been my practice. I guess two bouts with cancer taught me how to stay indoors to heal. There is nothing fancy or glamorous about that.  I would miss the class.  The right thing today as it is a long class and very engaging in many ways. Koans are very embodied and I really don’t know how to answer them.
What is it?
This virus is an improvisational work in progress, and it has moves. It is the entire opus. I wanted a Candy Koan and you gave me this vast emptiness here it is CATCH MY Breath! I dare you.

Friday, February 21, 2020

Subtle Light, Silver Bowl: Global Body Warning Covid-19 Koan Interlude with t...

Subtle Light, Silver Bowl: Global Body Warning Covid-19 Koan Interlude with t...: 2/21/2020 Cover Up While the learning curve for some health workers to consistently and correctly use protective personal equipment ...

Global Body Warning Covid-19 Koan Interlude with the truth of my personal relationship with risk management. Please join me for a cup of zazen.


2/21/2020
Cover Up
While the learning curve for some health workers to consistently and correctly use protective personal equipment (PPE) was high in one nursing home I worked in, it was not a high bar for Dr. Kentaro Iwata whose specialty is infectious diseases and control. In a YouTube video he spoke of his alarm at the breaches of infection controls or lack of them on the Diamond Princess Cruise Ship. I lump together cruise ships, airplanes, nursing homes, high rise apartment buildings, dormitories, prisons, military barracks and similar places as playgrounds for germs and viruses. I got up from my cushion where I sat as the thought of a cruise ship turned on its bow. There it was a high rise docked in the bay. Dr. Iwata said that appointed officials seemed to be in charge of quarantine on the ship instead of health care professionals. This did not surprise me as we have seen the global trend to place administrators and political appointees in positions above the actual practitioners. This is across the board in all professional fields. Health, Science, Economics, Environmental Action etc.
Expensive Teatime
For a long time, I questioned why it is necessary for anyone with a few hundred dollars in their pockets to plunk down the cash to fly, fly, fly, away to exotic places, to stomp through them and oh and ah. Well if that’s your cup of tea then have at it. According to PBS “In China, travel restrictions and quarantines have decreased carbon emissions by 100 metric tons over the past two weeks”.  I was once asked did I ever want to go to China. That time came and went with the Tiananmen Square Democracy movement and the clampdown on Americans traveling there for five years afterword. I said to my questioner, “China does not need my ass there, they have too many people already. Do they need me there too?” I prefer my ass to be sitting zazen. From that position I can travel anywhere. The point is to be here not there. But you know, the mind does wander. It needs to have safety valves like a faraway place, time, emotion, people, things and nothing but a breath. Teatime.
What about all the people on this planet? I attended a recent seminar taught by esteemed experts on the climate crisis. I realized afterword that the reality of overpopulation was not brought to the table. Is this reality not in vogue anymore? Don’t we need to talk about it? Is it not trending? Is it considered taboo to bring it up? Isn’t overpopulation still an issue?
Not One but Two
Overpopulation is back in the limelight. When cities have 20 million people, they need to eat. Why can’t China which produces field hospitals in ten days produce enough protein foods, so their people don’t need to cling to medieval eating habits holding on to magical meat from hillside warrens brought into town?  The issues of people, food, behavior and public health are always in my face. Public health is a global reality. I know that the restaurants in Chinatown are empty. Is that really a racist response or is it one that is more about resilience? Look deeper.  People are worried about their families and each other. Chinatown is mostly a tourist haven. It is also my home base. Not eating in Chinatown because one is afraid of getting sick either from the annual flu or COVID-19 which has a complicated trajectory and defaming Chinese people are not one but two things. On Tuesday my husband and I took the M9 bus which winds its way through Chinatown to get out of the apartment on a bright day. Our destination was Battery Park (formerly a land fill).  People on the streets were not tourists, they live in the community. Most of them do not work in the restaurants or own them. Every now and then there is brought forward the idea that perhaps tourism has been overdone. Trust me, it is. We can do with less tourists in my opinion. Notice I said less.
Risky Business
Mass migration of people for specific holidays is always a flashpoint for possible disease. Yet every time these viruses erupt in specific population the idea of some “ism” is brought up. We can be more nuanced than that. To disparage others is hateful in response to someone’s personhood. But a lot of Chinese people are staying out of restaurants too. Are they racist or do they care about public health? Did China close restaurants because they hate money and commerce? I think we know the answer to that.
In New York State, according to the American Hospital Directory there are approximately 60,000 beds. Because COVID-19 is endemic and evolving there is a subclinical infected aspect to the virus. It also spreads through just about every way possible. Through droplets, aerosol, oral fecal, and fecal aerosol, it lives on surfaces and is extraordinarily infectious. About 20% of cases require very expert and careful hospital care with breathing assistance, specialized medicine and staff. This resource demanding virus is a humanitarian crisis.
And who wants to get sick? The restaurants will eventually recover with financial assistance as a distressed area. There is no reason to risk lives.
As I write today, we are on the edge of pandemic COVID-19.

Monday, February 17, 2020

Subtle Light, Silver Bowl: Corona Virus Sars 2 COVID Koan Prelude:Consumer Se...

Subtle Light, Silver Bowl: Corona Virus Sars 2 COVID Koan Prelude:Consumer Se...: Corona Virus Sars 2 COVID Koan Prelude:   Consumer Service over Contagion Paradigm Global Body Warning 2/15/2020 I got the text “c...

Corona Virus Sars 2 COVID Koan Prelude:Consumer Service over Contagion Paradigm, Global Body Warning


Corona Virus Sars 2 COVID Koan Prelude:  Consumer Service over Contagion Paradigm
Global Body Warning
2/15/2020
I got the text “can you work tomorrow?” That hooked me into the reality of why I would say no. I love my work in health care. But the trade off is too risky. This year I have battled against the ignorance of our health care system which forces clinicians to be stupid about Public Health Policy and contagious diseases in relationship to what I call the “consumer service over contagion” paradigm. The patient comes first and what they and their families want takes precedent over what is safe for us and the general population.
Autumn 2019 I was at work in a nursing home. We were beginning to have a couple of C. Auris patients. I had treated one of the first in greater New York City a number of years ago. That was in Queens. At that time, I didn’t know what it was. A very kind and knowledgeable physical therapist saw the affected patient’s name on my treatment roster. She grabbed me by the arm and told me the name of this new disease and to be extremely careful. The patient was marked for contact isolation, which is nothing unusual in nursing homes. You gown, glove and mask up. But the physical therapist said keep your distance this is not safe for you or any of us. If it hadn’t been for her I would not know anything. She instructed me to look it up as soon as I got home. I did. Life on the front edge of new diseases is precarious for all clinicians, if they are not told what they are dealing with by administrators and other leaders. I often cite this example because we now know how dangerous C. Auris is for staff and how deadly it is for patients. It is highly resistant to antibiotics and is a fungus that sheds off from a person’s body into the air through air exchanges and lives fairly long on all surfaces.
By 2019 I knew what to and what not to do with C. Auris patients. The first is to wear all protective equipment and limit exposure time with the patient and keep them inside their room. Yet what happened is almost impossible to describe. All kinds of protocols were breached. I blew the whistle about it and other clinicians where actually going to bring this sick C. Auris patient to the public treatment gym. I said no, no, no she can’t come to Rehab. One therapist brought this deathly ill, highly contagious person down to the gym. Everyone just cleared a path filled with horror, amazement, incredulity and disgust among other revulsions. This supposed highly trained therapist was wearing a yellow gown, facemask and gloves. She clearly did not know public health, this disease, and did not want to listen to me. I also had the same patient but insisted on seeing her in her room. This therapist was pissed at me and wanted me to accompany her in her stupidity. That did not happen. I stood my ground and I was right to do so. In a short time, the New York Times had a front-page story on Nursing Homes and C. Auris infections. The administration and therapists quickly snapped out of their ignorance. The learning curve was high for some of them.