Thursday, May 7, 2020

Small Pleasures

Blondies


Like all of you, we are staying mostly at home these days, and have found that simple, unexpected things sometimes brighten up the day.

Like receiving face masks in the mail.  We had other masks but this batch made us smile.  The masks were from a tailor who prior to the shutdown sold custom-made suits.  The masks are well-made, the material used is comfortable, and on the front is written: “We’re all in this together.”  And best of all, for every mask sold, a donation goes to the Coronavirus Relief Fund to support immediate and long-term relief and recovery in vulnerable communities during one of the most challenging times we have collectively faced.  Getting a big box of toilet paper delivered also made us smile, but the masks were cooler.

You can order through this site:  https://davidalanmasks.com

Like baking.  Judy has been on a tear—cookies, scones, cupcakes, brownies.  We take part of each batch over to our son, daughter-in-law and grandkids.  The last delivery was blondies.  Our grandkids had previously ignored blondies, but this time they became enthusiastic fans.  We smiled hearing that they liked the blondies, which have always been a special treat in the family.    

You can find Judy’s blondie recipe at:  https://jzcooks.blogspot.com/2012/08/blondies.html

Like contributing to the Pittsburgh Food Bank.  Like other places in this country, there are lots of people who do not have enough money for food, and the food banks have been overwhelmed.  We have been making regular donations to the food bank, but on May 5 we made an extra donation.  Bank of America had arranged to match all the donation for that day.  When we lived in California, Bank of America was neither community nor customer friendly.  It was a long time ago, but it gave us pleasure to help get the matching funds from Bank of America.

Like discovering Schitt’s Creek.  Have you seen it?  It’s a bit hard to get into, because the characters can be annoying, but the show becomes addictive.  I’m in the fifth season and Judy is at the end of the sixth and final season.  I watch at the end of the evening.  It makes me laugh and leaves me relaxed.  

Like having baseball to watch.  Baseball is back.  Not in the US, but in Korea.  ESPN has begun broadcasting games from the Korean Baseball Organization (KBO).  According to the articles I have read, the quality of the games fall somewhere between A and AAA minor leagues in the US.  I went to State College Spikes games for many years, which were an A league team. Games were quite entertaining.  The play in the Korean league is described as traditional, with lots of bunting and base stealing.  There are some different customs, too.  Bat flipping after a home run is fine, but spitting is not allowed.  When I read that, all I could think of is the hilarious spitting scene in the movie Naked Gun.  Games are broadcast live early in the morning, but rebroadcast in the afternoon.  Here’s more information about the KBO.


Like having time to read.  I have always been a reader, usually finding time at the end of the day or when on vacation, but now I can sit down with a book whenever I feel like it.  I have read a lot of light, entertaining books—spies and sleuths mainly, but I also like history.  

A few weeks ago I picked up a book that had been on the shelf for ages, An Army at Dawn by Rick Atkinson.  It is the first book of a trilogy of the history of US involvement in North Africa and Europe during World War II, and I am now nearly done with the second book, The Day of Battle.  Atkinson is a very good and engaging writer.  The biggest surprise for me has been how inept many of the US and British generals were.  They seemed to have learned nothing about tactics, but often just pushed ahead against heavily fortified positions.  Didn’t any of them study the Civil War and Robert E. Lee?  It’s always better to be on high ground than to try to attack from below.  

We won the war because of the great courage and sacrifice of our soldiers, and because we could overwhelm Germany and Japan with our resources.  For four years, the country built almost no new cars, but tens of thousands of jeeps, tanks, planes, ships, guns and so on.  There was rationing, shortages, and other privations, but President Roosevelt’s leadership brought the country together and helped everyone accept the need to put all our resources into the war effort.  It’s a big difference from today with people whining about not being able to do whatever they want, even if it means spreading the COVID-19 virus.

There is a quote I love in An Army at Dawn.  During the battle for Tunisia in 1943, the chief of staff for the commander of the German forces wrote about the irrational demands being made by Hitler: “Hitler wanted to be stronger than mere facts, to bend them to his will.  All attempts to make him see reason only sent him into a rage.”   Does that sound a bit familiar to you?  

Postscript.

I have now completed The Day of Battle.  There was at least one American, Major General Fred Walker, who had studied Robert E. Lee.  Walker was ordered to make one more frontal attack on a critical high point in the Anzio area of Italy held by the German army, Colli Laziali, after several frontal attacks had already failed.  Walker laid awake that night wondering what General Lee would have done.  He remembered that army patrols had reported there was an old cart path that led up the mountain that led up to unfortified areas between two German units.  He convinced his commanding officer to attack up this path.  The result was a breakthrough that led the German units to withdraw and contributed to the collapse of the whole German defense in that part of Italy.  

Interestingly, General Walker was the oldest division commander in the field.  Perhaps it was the perspective of age that led him to look to the past for a solution

Sunday, April 26, 2020

What Does a Starfleet Captain Do in Retirement?



Jean-Luc Picard, the former captain of the Enterprise, retired to his family vineyard in France.  It is a beautiful setting and a quiet life for someone who previously explored the far corners of the universe.  Like many people who are retired, however, Picard looked back at his work and was troubled by the things he regretted and had left undone.  So when he is approached by a young woman seeking his help, he jumps back in to find redemption for a terrible set of events that he felt responsible for.

That’s the starting point for the new series, “Picard.”  It’s built around a prototypical retirement story, except maybe for the space travel and phasers.  The young people in Starfleet don’t want Picard back, and view him as a relic.  He can’t climb stairs or run any distance without getting winded, and he’s not up-to-date on the latest technology.  But with the help of some old and new friends, he throws himself into the midst of events that threaten the known universe.  A fun task for retirement.

Picard was always the most thoughtful and reflective of the Star Trek captains.  Captain Kirk would talk about the “Prime Directive,” which prohibits Starfleet missions from interfering with the development of alien civilizations, but which in the end Kirk often ignored.  Ethical dilemmas, however, were at the heart of many of the conflicts that Picard and his crew faced on the Next Generation series and play a prominent role in the new Picard episodes.  Luke Skywalker had a contrasting retirement, sulking on a remote island seeking enlightenment that he didn’t seem to have found.  Where the Star Wars franchise has relied on special effects and cartoonish battles to make up for a lack of new ideas, Picard has gone forth boldly, though a bit more slowly than in the past.  He’s not an action hero.  Rather, he is a wise person who has an unfaltering understanding of the importance of doing the right thing.  It helps that Patrick Stewart, who plays Picard, is such a fine actor.  

The series has been great fun to watch, a nice diversion in our current dilemmas.  I’m now enjoying the other new Star Trek show, Discovery.  It’s entertaining, though you have to get past the first two episodes.

And if you are really serious about Star Trek, and who isn’t, I just read that Tribbles are available on e-Bay.




Friday, April 17, 2020

Covid-19 Deaths in Nursing Homes: Why It Is Important to Consider Causes and Solutions

Sunset over Lake Vattern in Sweden

This headline in yesterday’s Washington Post caught our eyes: “Covid-19 is ravaging nursing homes.  We’re getting what we paid for” (see link below).  There’s no question that clusters of infections and deaths have been common in nursing homes across the country, as well as other countries such as the UK where statistics on prevalence of Covid-19 has been reported.  Half of the deaths in Pennsylvania have been among nursing home residents and staff.

We should not be surprised.  Nursing home residents constitute the most vulnerable group in society.  But it’s not just that residents are old and frail.  Rather, the articles we have seen report that the nursing homes and assisted living facilities that had clusters of cases did not take the steps needed to protect residents and staff.  We want to be clear that there are excellent, well-run residential facilities for older people that have done a good job of protecting residents and staff.  The point raised in the Post article is that inadequate funding for nursing homes is a long-standing issue and so it should not be surprising that there are deficiencies in responding to a crisis like Covid-19. 

Nursing homes are not the only problem area.  The Covid-19 crisis has revealed many weaknesses in our health and public health infrastructure.  Federal and state governments have spent the last few decades cutting back public services and investments in health, education and most everything else.  With all the people who still have no health insurance or lost their insurance when they lost their jobs, it’s clear that we need universal health care.  We also need the state and federal government to have the infrastructure to respond in a crisis, for example, with more efficient ways of delivering unemployment benefits.  And then there is testing and tracking of the virus.

But once the crisis is past and there are discussion about building our infrastructure, let’s not forget long term care. The US alone among economically-advanced countries has no program of universal long term care.  Instead, we have a rickety system of funding.  People who can pay privately for care can often, but not always, receive good care.  But the typical nursing home that depends primarily on Medicaid will, despite good intentions, struggle to provide a high quality program.  

Here is a modest list of what we need, or at least where to start.

1.     Along with discussions of universal health care, we need to advocate for a national program of long term care insurance that will assure that people get good quality care when they need it.  We could follow the model instituted in Japan and South Korea, where the tax funding long term insurance goes into effect when people turn 40.  That way, the tax burden does not fall on young workers, who tend to have lower earnings.  And by 40, most of us have realized we may need to help aging parents, and indeed, that we may need help for ourselves.

2.     Long term care programs, and indeed, all of health care, should be run either by government or by non-profit organizations.  Simply put, when there is a choice between paying for improved care or maximizing profits, it is too easy for administrators and owners to cut corners that improve their bottom line.  We have seen that happen over and over.  Some of the worst clusters of Covid-19 have been in for-profit nursing homes.  They didn’t pay for adequate staffing or for taking the steps to protect residents and staff.  When owners of these programs have been identified by the press, they often hide or refuse to comment.  

The perversions caused by using a business model that prioritizes profits over care affects all of health care.  With nursing homes, however, the effects are particularly pernicious because residents are the least able to advocate for themselves and because we have such low expectations for quality of care.

3.     We need stronger programs for helping older people remain at home.  Almost no one wants to end their life in a nursing home.  But while we have given lip service to supporting people to remain at home, the system of community services remains fragmented and inefficient, and workers are typically poorly paid and trained.  All-too-often, community service agencies make excuses instead of delivering the type of help that people need that will keep a frail person at home.     

4.     The people who work in aging services need better training.  We have each been in this field for over 40 years, and it is frustrating to say that we have not made much progress in training the front-line people better.  Everyone from administrators to nurses to the aides that deliver the care needs specific training in aging and long-term care.  All too often, the training people receive involves how to meet various state and federal requirements and not how to provide optimal care.

In the US, a certified nursing assistant receives 75 hours of training.  By contrast, in Sweden where nursing home care as well as community services are generally quite good, care assistants (vardbitr√§de) receive one year of training, and nursing assistants (undersk√∂terska) complete three years training.  Pay is not great, but it is relatively better than in the US, and everyone—employees and their families—are covered by the Swedish national health care.  As a result, they can live on their salary.  Workers can also gain the training needed to move up, from care assistant to nursing assistant to nurse.  Tuition is free. We saw one recent article that proposed extending the GI bill education benefits to health care providers working with Covid-19 patients. That would be quite a nice step forward.

5.     The best facilities we have visited over the years in the US has someone in charge, either the administrator or director of nurses, or both, who has a vision of what good care means.  They pay attention to the details of everyday care, and make sure that all staff share the same values around good care.  We need to find more people like that, reward them, and make sure their voices are heard. 

There are likely to be shakeups in how we do things in this country, once the immediate crisis diminishes.  We need to make sure that long term care gets included in the discussion.  

Reference:  

Saturday, April 11, 2020

Missing Baseball



Sitting mostly at home these days, I found myself wishing that there was baseball.  Baseball is the perfect sport for when you have lots of time on your hands.  The slow pace doesn’t matter.  I remember a time when I was in graduate school and had a bad case of the flu that kept me in bed for more than a week.  I looked forward each day to the radio broadcasts of the White Sox games.  Win or lose, it brightened the day.

In the absence of real games, I decided to watch my favorite baseball movie, Bang the Drum Slowly.  It doesn’t make most lists of favorite baseball movies, but I find it captures more of the essence of the game than films like Field of Dreams that romanticize the game.  The movie was released in 1973, but it was based on a book written by Mark Harris in the 1950s and has the feel of an era before baseball became big business.  The movie stars a young Robert de Niro who gives a terrific performance as a back-up catcher who has a terminal disease.  The team’s star pitcher (Michael Moriarty) tries to help him hide the illness and stay on the team.  Despite the serious theme, the movie is often quite funny.  The pep talks given by the manager (Vincent Gardenia) are hilarious, as is much of the banter among the players.  

In the end, the movie quenched my thirst for baseball, at least temporarily.  It felt like baseball.  The players faced real dilemmas that teams encounter during a pennant race.  With, of course, one major difference, a teammate who was dying.  The players responded with an awkwardness you would expect from young men and but also with sensitivity.  Maybe it’s a movie for our times. Or at least to enjoy baseball for a couple of hours.

Saturday, April 4, 2020

HIGH RISK!

In Marrakech airport  

During our stay in Morocco, one of the emails we received from the US Embassy asked us to register with the embassy so they could contact us. They also asked us to indicate if we were at high risk for COVID-19. After looking at each other for a minute, we realized we are at high risk by our age. Although the embassy did little to help in the end, it did change how we think about ourselves.

Since coming home, our “high risk” designation has been reinforced. Every communication in the media emphasizes that we should take extra precautions. Food stores are creating “senior hours” where we can shop when there are fewer people in the store. One of our friends, however, warned us that lines form outside before the stores open, but we have not
encountered lines.

Being considered high risk comes as a shock. We are used to thinking of ourselves as healthy.  After all, we lead active lives. We exercise daily and travel to exotic places like Morocco. Yet there it is—high risk. The label conveys in a very tangible way the consequences of our age. But we are adapting. Gyms are closed so we take 3 walks a day around our community. Lots of our neighbors, young and old, are out, too, and we all say hello but keep the appropriate social distance. We restrict our trips to stores to a minimum. 

\We discovered an unexpected treasure the other day, discovering that we could buy tissues and 4 rolls of toilet paper at our local pharmacy. Who knew that buying toilet paper could be exciting?  We have decided it is important to help our neighborhood restaurants during the crisis by ordering take out on a regular basis. On Monday, it was soup dumplings and pot stickers from Everyday Noodles. Then, it was croissants and sandwiches from La Gourmandine Bakery. Next, some excellent Thai food from Silk Elephant. This really seems “win-win.”

The hardest thing about being high risk is not visiting our two grandchildren who live here. Our daughter-in-law is a pediatrician who works in a hospital and could be exposed to the virus. As “high risk” people, we need to avoid any place we might pick up the virus. So far, we are doing Face Time, and hoping for a quick resolution, though we suspect COVID-19 will be around for a while.

We would feel better about the situation if the government had an organized approach to the
crisis. Our governor has taken positive steps but the federal government has dropped the ball on marshalling resources needed for medical care and protecting people from the virus.
There are people who see the whole picture and know what we need to do, such as Anthony Fauci and Ezekial Emanual, who wrote a terrific column the other day (see the link below).
We received a terrific video from our friend, Elia. The video was made by Dr. David Price, a
pulmonary specialist at Weill Cornell Medical Center in New York City. Dr. Weill, who has been providing care to the COVID-19 patients in his hospital, discusses how the virus is transmitted and how the steps he proposes will reduce risk. He also discusses what to do if you begin developing symptoms. We highly recommend the video and have provided a link. It made us feel that maybe we are not at such high risk after all.  Of course, in light of new information in the past week, some of what Dr. Price says has to be modified (the part about aerosols). And now we are wearing face masks whenever we go out. 

There was also an excellent editorial in the NY Times by James Baker that lays out the steps that need to be taken to lead us out of this.  




Link to Dr. Price’s video: 
https://www.youtube.com/watch?v=WxyH1rkuLaw

Link to the column by Ezekial Emanuel:
https://www.nytimes.com/2020/03/23/opinion/contributors/us-coronavirus-
response.html?action=click&module=Opinion&pgtype=Homepage

Link to the James Baker editorial:  
https://www.nytimes.com/2020/04/03/opinion/defense-protection-act-covid.html?smid=nytcore-ios-share

Wednesday, March 25, 2020

Morocco!




We are home from a culinary and cultural tour in Morocco.  The food was wonderful and the Moroccan people were friendly and welcoming.  But we had some unexpected excitement at the end.  To prevent transmission of COVID-19 to the country, Morocco cut off flights to most international locations, including our flight out.  For a few days, we felt a bit like Ilsa Lund and Victor Laszlo from the movie Casablanca searching for a way out.

Let’s begin with the many good things that happened.  We have found that culinary tours are an excellent way to find out a lot about its culture and history.  We found this to be especially true on the two tours we previously had taken with Peggy Markel, to Tuscany and India, and on this trip as well in Morocco.

Peggy operates a company that offers small group culinary and cultural tours in several countries and leads the tours herself.  These tours are not like any other we have been on.  It’s not like checking off tourist sites from a guidebook.  We are instead meeting Peggy’s friends.  These are people she has developed friendships with over the years who are doing interesting things as chefs or in growing and producing food, or as artisans working on local crafts.  When we meet them, we feel welcomed into their homes and communities and we learn about their cuisine, culture and way of life. 

On this trip, we were based at a small Riyadh outside of Marrakesh called Jnane Tamsna. Peggy has known the couple who own the Riyadh, Gary and Mary Ann Martin, for over 20 years. In addition to running the Riyadh, they are involved in organic and sustainable agriculture.   We used produce and herbs from their garden and nearby farm in our cooking classes.  We also learned about the couple’s work in helping build local cooperatives that are developing new products to help improve the local economy. 

The cooking lessons at Jnane Tamsna were given by their long-time chef, Bahija. We learned how to do Moroccan cooking in tajines and about the different herbs and spices that give the food its special flavor.  We also made breads, couscous and kefta. Although Morocco borders on the Sahara desert, the produce grown there is varied, delicious, and fresh.  Through Gary and another organic farmer we visited, Domain Sauvage, we learned how they were able to grow crops in that setting, for example, protecting plants from the heat by siting them in the rows between olive trees, and judicious use of scarce water.  

We traveled from Marrakesh for a few days to see a bit of the country.  Our first stop was an an inn, the Kasbah du Toubkal, which is located in the Atlas Mountains near the 13,000 foot peak of Mount Toubkal.  The inn was developed for trekkers and has been recognized for its sustainable design.  It was also accessible only by foot or by mule.  We opted for the mules, who were more sure-footed than we would likely be.  During our stay, we walked higher up the mountain through walnut groves and terraces used for agriculture to a village perched on the edge of the mountain.  There we were invited into a home—Peggy’s friends—for tea and conversation about living in the mountains.  And we had a cooking lesson from the Inn’s chef.

From there we went to the Atlantic coast near the town of Essaouira.  We visited the shops in town, including a Berber rug store where we succumbed to the charms of the owner and the beauty of the rugs.  Steve also got to emulate Lawrence of Arabia with a camel ride on the beach.

We came away from the trip with an understanding of the possibilities for organic, small-scale and sustainable agriculture.  We also saw how people in Morocco were able to work in cooperatives that helped them develop new products and markets.  Like the other trips we took with Peggy, this was no ordinary tour, but a genuine look into the culture and daily life of a country, accompanied by delicious meals made with fresh, local ingredients.

At the end of the trip we were back at Jnane Tamsna but with no way home.  The US Embassy was of little help.  Not only had most flights out of Morocco been canceled, the government was saying it would close down all international flights in a few days.  

Two heroes, however, rode to our rescue.  Stephanie and Alice, who are service representatives with United Airlines, managed to get us out via British Air, which was still flying.  They were great.  We got home one day late filled with memories of the wonderful experiences we had and armed with new recipes to try out at home.  

Friday, February 21, 2020

The Integration of Creativity and Experience



I recently received a remarkable book, These Are Not Your Grandfather’s Medals, by James MaloneBeach.  Some of you have probably met or know about Beach.  He is married to my long-time friend, Leeny MaloneBeach.  Beach is an accomplished metal-smithing artist who has worked for many years on medals.  Medals have a long history as objects that are markers of allegiance to a higher authority or, as we know them, as symbols of high achievement.  Beach’s medals have been exhibited world-wide, and several pieces can be found in leading museums, including several in the British Museum.  The book contains photos and commentary by Beach of medals he has created across his career.  The medals draw on classical and contemporary designs and are often humorous and joyous.  Some medals also provide ironic commentary on contemporary people and events.

I mention the book for two reasons.  It is delightful to read and to see the wonderful range of images Beach has created.  And the book covers the whole of Beach’s artistic career, including the most recent years since his retirement from teaching.  The book reminded me of an issue we raised in a previous blog, that retirement can involve a continuation of activities that we did earlier in life.  And as Beach’s work shows, creative work can be done at a high level.

There is a belief that great artists, musicians, and writers do their best work when they are young.  After all, how many great symphonies did Mozart compose after age 35?  If you said none, you are right.  Mozart died when he was 35.  That is part of the reason that we believe that younger artists are most likely to be creative.  In the past, many creative people died young, like the rest of the population.

Given a long life, however, many creative people remain creative into their old age.  Dean Keith Simonton, who is Distinguished Professor Emeritus at UC Davis, cites examples of people who made major contributions in old age, including J. S. Bach, Verdi, DaVinci, Gailieo, Goethe, Kant, Einstein, and Georgia O’Keefe.  Dr. Simonton also suggests that the type of creative work differs by age.  Works of creative people when they are young tend to take new and different perspectives, to be paradigm-breaking or as Simonton writes “hot from the fire.”  By contrast, creative works by older people tend to emphasize integration of perspectives, complexity, and insight into interrelationships of ideas and people.  They draw on knowledge and experience.

I am in no way an artist, but I find something similar in the work I continue to l do with younger colleagues, I find I can draw upon things that I learned in the past that provide a broader perspective or at the least help them avoid some wrong turns in their research.  And although I don’t consider myself a creative photographer, I can call upon knowledge from the past to capture images that I enjoy and, importantly, that my grandchildren enjoy.  We don’t lose the knowledge acquired over the course of our lives, and that knowledge does not necessarily become obsolete.  Having activities that we enjoy and can carry over into retirement or even expand seems like a good way to go.

For more information, here is the complete reference for Beach’s book:
James MaloneBeach (2020). These are not your grandfather’s medals.  PolyMarket Press.  http://polymarketpress.net
Here is a reference to Simonton’s work:  Simonton, D. K. (1990b). Creativity in the later years: Optimistic prospects for achievement. Gerontologist, 30, 626-631.