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.

Global Body Warning Assorted Writings on Public Health. My Personal Risk Management Journey

2/17/20

Global Body Warning Assorted Writings on Public Health Care, My personal Risk Management Journey.

I have been following the Novel Corona Virus since the first inklings of a pneumonia outbreak in China in the beginning of December 2019. In the last 15 years I have also noticed that many people in this country don’t know the importance of Public Health practice, how their bodies work and how diseases spread.  I put that responsibility on our education systems across the United States. But this is not the time to go down that rabbit hole.

Why was I interested in some artifact of health news seeping out of China? I love history, and Asian cultures because they offer so much to the world. I also love and respect science especially biology. Why? In Junior High School we learned about Public Health, and gasp, Sex ED or as it was safely called “Reproduction,” disease and how to prevent or heal when and if possible.  We dissected fetal piglets, looked through microscopes at slides, outlined phylogenetics in relationship to vertebrates and non- vertebrates. We had to graph, draw, listen, and read. I went to a public school. To be interested in how the world continues to work, I keep alert to the places that are known to produce new viruses. By now we all should know of those places. The convergence of history in general, disease in specific and my interest in Asian culture and people kind of all started in my early teens. 

Here in New York City we have the Department of Health which offered a unique two-day training in the nineties which was taught by Dr. Vincent Coello. The topic was Risk Management and the example to apply it to centered on Pandemic Influenza. As a result of that FREE two-day class I learned that it would not be If but When a pandemic would happen again.  This was the only instance in which I was ahead of Bill Gates!

I find it alarming that people in this country put Health on the back burner unless they are research scientists or clinicians who see the results of not caring about health. Then when they are very sick, expect practitioners to come up with miracle cures. When you are laid out with 2019-nCoV is NOT the time to correct your diet. You will be lucky if you will be able to eat. There is no vaccine yet, only supportive care.  Guess what the result of poor public health practice is? The structures that support the cost of care fail. The enormity collapses in on itself. It is chaos with cost far beyond Medicare for all, Universal Health Coverage, or Affordable coverage.

The triangulation of History, Science and Public Health puts me in my seat studying the Novel Coronavirus of 2019 about six to twelve hours a day. Except of course during a winter retreat for a week.

Because I am not a research scientist but a clinical health care worker with front line expertise, I am not as knowledgeable of what could be next. But we have the internet and social media which when put to good use and tethered with technology is an open door, a mirror, an unknown realm intertwining or as Buddhist and others describe it Indra’s net.

We look back to history of Pandemic Flu of 1917-18, Polio, Swine Flu, SARS, MERS, and Wuhan 2019 nCoV or whatever its new name will be. We have our regular Influenza every year which kills thousands and sickens many more. I just wish the numbers of those cases could be tabulated to see how many of them availed themselves of Influenza vaccines as imperfect as they are. Many health care workers shun the Flu vaccines. They can spread Flu to their patients. There is talk of the enormous cost and burden that is put on Public Health care by those who do not vaccinate against the “regular flu” but are now scared of the unknowns in the Novel Corona Virus of 2019. Would they get vaccinated if a vaccine for it existed? 

In China the clampdown on those sick or not with the virus is creating a screen for the Chinese Communist Party to “disappear” people. This reminds me of the brutalization that occurred during what we know of Mao’s time by Red Guards and others. I am not alone with those thoughts. It is part of the continuing saga of China. Let me say the Chinese army is always ready to go. It is huge, it is always training. It can do good, but it is still an army, that carries out orders. At this time, it appears the orders are a travesty. A devolution of a culture. Building a hospital quickly is a marvel. Taking care of the health of a country requires a lot more than technical ability.

Germ Theory and Koch’s Postulate on how to define disease were discovered and implemented to save humans and sentient beings. They work to help us cross all barriers with compassion. The use of evidence-based science and biology to educate people about Public Health. That is a true cultural revolution.

Note: as of 2/11/2020; this Novel Corona Virus is called COVID-19 short for COrona VIrus Disease as named by the WHO.

People are going missing who reported on this disease. There is a mounting international out-cry.

It is spreading and may be able to be inhaled because it aerosols into fine mists in the environment.

There is a chance of quick turnaround of reinfection after the initial one is cleared.

Diana JiFu Lakis

                                                          THE BRIDGE

I will go back to the seemingly esoteric.  There is that gut level or experiential quickness that I am so sure of. Oh it saved my life a few times. But then I remember and tally up and keep account. I feel confused and get caught in my experience and the memory of this narrative with two streams, movement, currents, bubbles and swirling waters. Underneath this surface it slows down. How do I separate the slow moving quiet waters from that chatty skittering, roaring and groaning surface that is exposed? I can't do it. And so it goes, in my body which is mostly water. I can make a bridge as in yoga, or a back bend. This recognition is slower, methodical and takes a different kind of energy. Not the sprint but the long distance plodding. The streams have cognitive ease built into them. There is no illusion of skill there. It just is.The breath and my watery body are two actual streams. Very absolute alone unto themselves with the relativity of one to the other. "When you mix them you know where they are" (from the the Song of the Jewel Mirror of Awareness.) That is if you do not deny their existence.

The Zen poem The Jewel Mirror of Awareness intrigued and captivated my imagination. It pointed to different ways of knowing. The subtlety of the thought process involved is a study of depth in a puzzling metaphorical cascade that is plunked into my hands to play with. When the book Thinking Fast and Slow was given to me, I chewed softly on it. Fast and Slow how simple. Chomp chomp. It is so much easier to go fast to attain and sanctify our belief in the fallacies we have created. The illusions of knowing why we chose to do what we do and pat ourselves on the backs for our success. Ah! but there are so many things we have no control over.

Robes and Reality

3/9/19

Think Neither Good Nor Evil plants us right in the middle way. What has that to do with a robe a bowl, a barely literate man running into the mountains and encountering a former military man who wants to take what you have? This sounds like a plot to some cheesy novel about truth and faith in the fields of a foreign country. But what if it was all perverted and the robber was not “an originally honest and good-hearted straightforward man?” Suppose he wasn’t any of that and just took the robe?  What version might we be reading?  What does “think neither good nor evil" have to do with this?’ The story would have moved from the truth to a lie. Continuity would be disrupted. That robe represented more than the physicality of truth and faith.

Trump stole the robe. Now he is sweating in a massive perversion of faith, truth or as we call it, dharma.

As I tried to write I remembered a book called The Robe.    It is in Christian context but here is the synopsis from Wiki.

The book explores the aftermath of the crucifixion of Jesus through the experiences of the Roman tribune, Marcellus Gallio and his Greek slave Demetrius. Prince Gaius, in an effort to rid Rome of Marcellus, banishes Marcellus to the command of the Roman garrison at Minoa, a port city in southern Palestine. In Jerusalem during Passover, Marcellus ends up carrying out the crucifixion of Jesus but is troubled since he believes Jesus is innocent of any crime.          

Marcellus and some other soldiers throw dice to see who will take Jesus' seamless robe. Marcellus wins and asks Demetrius to take care of the robe.

Following the crucifixion, Marcellus takes part in a banquet attended by Pontius Pilate. During the banquet, a drunken centurion insists that Marcellus wear Jesus' robe. Reluctantly wearing the garment, Marcellus apparently suffers a nervous breakdown and returns to Rome.

Sent to Athens to recuperate, Marcellus finally gives in to Demetrius' urging and touches the robe, and his mind is subsequently restored. Marcellus, now believing the robe has some sort of innate power, returns to Judea, follows the path Jesus took, and meets many people whose lives Jesus had affected. Based upon their experiences first Demetrius and then Marcellus becomes a follower of Jesus.

Marcellus then returns to Rome, where he must report his experiences to the emperor, Tiberius at Villa Jovis on Capri. Marcellus frees Demetrius, who escapes. However, later on, because of his uncompromising stance regarding his Christian faith, both Marcellus and his new wife Diana are executed by the new emperor, Caligula. Marcellus arranges that the robe be given to "The Big Fisherman" (Simon Peter).

Robes have physical presence, significance and represent the intangible, untouchable in our experience. We exist and the valence is neither good nor evil but what we do with and how we manifest our faith in self and other. Take the robe, do not take it, touch or not, steal or not, give freely or not. Consequences of conscious will pursue us and the choices we make. I would say that after reading some of Ryokan’s poetry he would attest to that.