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The Long Haul Covid Glass is very half empty.

Published by Anonymous (not verified) on Fri, 12/11/2021 - 1:13am in

It's time for another long haul covid update at ca 11 months. (For my "covid diaries," see here;  hereherehere; hereherehereherehere; hereherehere; here;  herehere; hereherehere; herehere; here; and here). It's pretty clear now that my situation has deteriorated since the late Summer, but before I get to that first some of the decent news:
1. The ENT (ear nose throat) specialist came up with a plausible plan to tackle the after-after-effects of a swimmer's ear (which was interfering with my sleep patterns), which in combination with chronic sinusitis and a malfunctioning Eustachian tube was causing irritation when I am horizontal. I think the new meds are working. But it's not gone yet.
2. Since the break, I have now taught two sessions of my course without collapsing half way and feeling almost normal in doing so. (We'll see what the students say on the evals later.) It's really joyous to be in the class-room.
3. At the suggestion of my better half, after a week of no painkillers at all, I now (largely) only take pain-killers when the headaches prevent me from sleeping. Otherwise I rest in bed. The good news is that the permanent headache and nausea have ended. (Her hypothesis was that I was suffering side effects from the painkillers.) The bad news is I do spend a lot of time in bed feeling crappy.
4. On the not too crappy days, I walk about 8km/day. (Some of you may have noticed my new hobby: pictures that make me peaceful.)
Okay, that exhaust the glass is half full part. Here's a lot of the mediocre news:
A. The morning after the seminar, I start having a headache in my sleep. I woke up with throbbing headache and nauseau. And that headache can last up to 36-48 hrs. (That is now!)
B. All multiperson social interactions trigger what I call head fatigue and headaches. (One on one, especially casual conversation is not so bad.) Zoom is even worse.
C. I avoid cycling because it too gives me a weird head fatigue and headache. (Most of my walks I do with noise canceling headphones on--but wouldn't dare to bike like that.)
D. My occupational physician has decided that I am in no position to increase my workload next semester. So, I will remain half-time. Even though I agree, this depresses me greatly because the undergrad teaching brings the best out in me. (We're now deciding whether I should teach the large tried and tested lecture course on history of political theory or a new course on feminist theory.)
E. I have been referred to an ergo-therapist/occupational therapist. Unfortunately, they have long wait lists, but it looks like I can start in a few weeks with someone near my home.
F. I had such an unpleasant interaction with my (Dutch) neurologist, that I wrote a pointed email the next day which led to a new appointment later in the month. Short version: intake was done by a medical student. By the time the neurologist showed up, I has such a headache and fatigue that all i wanted was the meeting to end. He thought all my symptoms were due to post-viral effects (so no stroke or tumor--good news!) But what I found astonishing was that the physician claimed (a) I was clearly improving, and (b) that I would make full recovery. The next morning I wrote the email from my work address (and signed 'prof') and name-dropped my better half and a comment that most patient complaints are due to miscommunication. I got a response within 30 seconds, and a new appointment in a few weeks.:)
G. As a comparison, I am supposed to see a neurologist in February in London in the NHS. For various reasons that's bad timing. Trying to change that meeting earlier in the week involved four phone calls--several transfers, and a voice message that may or may not get a response! 
H. Meanwhile thanks to sleuthing of my better half, I am now exploring experimental medical trajectories, especially low dose naltrexone in a private clinic in London. My Dutch and UK GPs will give me their view on this treatment this week. The Long Haul clinic in London have promised me feedback next week--I am especially interested in what they have to to say. My occupational physician thinks it worth a try.
I. Because of the class prep/grading, my serious headaches and the effort to obtain more specialized medical care are so exhausting, I am not doing much of any academic writing or even refereeing. (I try to do a few blogs each week, so as not to get too down.) But the headaches make it hard to find space/time for it. 
J. Starting in January my work status will change subtly because there will be an effort to start preparing a possible social security file. (After two years of illness I would get kicked into social security system.) This means that the university has to make a good faith effort to create 'fitting' work for me. That will be interesting, but more about that next year.
K. On Sunday, my sister took me to the unveiling of the stone of (recall) Arthur Wijnschenk. I was sick after. But it felt important to show support for his sister and her family. More selfishly, I wanted a moment to mark my own loss. I was sad I could barely interact with a lot of old friends, but I made some small talk in the edges of the event.  My sister found a bench under a tree near the grave, so I could stay for the whole ceremony.
That wraps it up. It's fascinating to see physicians avoid giving you care because they know they can't help you (leaving aside the subtle pressures of rationing operating in the background). Because covid started with lung problems, a lot of the chronic care is oriented toward lungs/breathing, and this generates odd passive aggressiveness among rehab facilities--the emails to me and my occupational physician are really quite striking. (My heart and lungs seem fine.) 
I get a lot out of the mutual support of others who are struggling with long haul. That's basically a few chat messages per week checking in. Because of these posts of mine I have also become a resource for new, long haulers. I hate to tell them I don't have any magic cures.

A few years ago I did a series of posts on Elizabeth Barnes' The Minority Body (recall here; here; here); and here). For me, the take home message was that all living is living within one's constraints. The adjustment process to my new constraints is frustrating, and generates lots of fantasies of sabbatical-like research escapism (especially because I can read and write pretty much normally again). And I don't especially like it (recall) when philosophizing is a source of escapism. But it could be worse.


Seneca's Last Gasps; meditating joyful and brave thoughts (Letter 54)

Published by Anonymous (not verified) on Tue, 02/11/2021 - 2:02am in

1. My ill-health had allowed me a long furlough, when suddenly it resumed the attack. "What kind of ill-health?" you say. And you surely have a right to ask; for it is true that no kind is unknown to me. But I have been consigned, so to speak, to one special ailment. I do not know why I should call it by its Greek name; for it is well enough described as "shortness of breath." Its attack is of very brief duration, like that of a squall at sea; it usually ends within an hour. Who indeed could breathe his last for long? 2. I have passed through all the ills and dangers of the flesh; but nothing seems to me more troublesome than this. And naturally so; for anything else may be called illness; but this is a sort of continued "last gasp." Hence physicians call it "practising how to die." For some day the breath will succeed in doing what it has so often essayed. 3. Do you think I am writing this letter in a merry spirit, just because I have escaped? It would be absurd to take delight in such supposed restoration to health, as it would be for a defendant to imagine that he had won his case when he had succeeded in postponing his trial. Yet in the midst of my difficult breathing I never ceased to rest secure in cheerful and brave thoughts.

4. "What?" I say to myself; "does death so often test me? Let it do so; I myself have for a long time tested death." "When?" you ask. Before I was born. Death is non-existence, and I know already what that means. What was before me will happen again after me. If there is any suffering in this state, there must have been such suffering also in the past, before we entered the light of day. As a matter of fact, however, we felt no discomfort then. 5. And I ask you, would you not say that one was the greatest of fools who believed that a lamp was worse off when it was extinguished than before it was lighted? We mortals also are lighted and extinguished; the period of suffering comes in between, but on either side there is a deep peace. For, unless I am very much mistaken, my dear Lucilius, we go astray in thinking that death only follows, when in reality it has both preceded us and will in turn follow us. Whatever condition existed before our birth, is death. For what does it matter whether you do not begin at all, or whether you leave off, inasmuch as the result of both these states is non-existence?

6. I have never ceased to exhort myself with counsels of this kind, silently, of course, since I had not the power to speak; then little by little this shortness of breath, already reduced to a sort of panting, came on at greater intervals, and then slowed down and finally stopped. Even by this time, although the gasping has ceased, the breath does not come and go normally; I still feel a sort of hesitation and delay in breathing. Let it be as it pleases, provided there be no sigh from the soul.7. Accept this assurance from me: I shall never be frightened when the last hour comes; I am already prepared and do not plan a whole day ahead. But do you praise and imitate the man whom it does not irk to die, though he takes pleasure in living. For what virtue is there in going away when you are thrust out? And yet there is virtue even in this: I am indeed thrust out, but it is as if I were going away willingly. For that reason the wise man can never be thrust out, because that would mean removal from a place which he was unwilling to leave; and the wise man does nothing unwillingly. He escapes necessity, because he wills to do what necessity is about to force upon him. Farewell.--Seneca Letter 54 Translated by Richard M. Gummere (with minor changes)

After many long letters, Seneca returns to brevity with a letter that becomes poignant in light of his own end. For a few years after Seneca wrote this, Nero sentenced him to suicide. And it is not clear that by obeying the sentence, Seneca really wills it himself and so escapes necessity. Compare the contrast with a case in which Nero had sentenced him to die, and that in order to escape the mad emperor's henchmen, Seneca had committed suicide. In the latter case, Seneca can be said to escape necessity in virtue of his own actions. Perhaps there is no real distinction here.

Seneca has set the stage for being remembered for his fearless (and dramatic) death.  If you deny that he could anticipate the future, it is worth noting that in this letter the plane of necessity and death are treated in temporal symmetric fashion. Either way, it is not clear to me why Seneca returns to this theme which he had discussed more fully in (recall) letter 24 (among other places).

When I was a teenager, I was diagnosed with exercise asthma. But once diagnosed, it's been mostly under control except once: in the aftermath of my TIA (recall) in the Summer of 2013, my lung capacity collapsed mysteriously. My asthma medicine was changed, and since then it seems to have no impact on my life and not preventing a fairly active life-style. This last fact seems to disappoint the medical types which have attended to me in the aftermath of covid. (For my "covid diaries," see herehere; here; herehereherehereherehere; hereherehere; here; herehereherehere, here; here; here; and here.) For, somehow they are all way more confident they can treat lungs than the spooky, cognitive problems I am dealing with.

I had classmates with debilitating asthma, and once (recall) nearly drowned as a kid, so I can imagine without great effort that an asthma attack could be a kind of practice in the what it's like of a last gasp. Seneca is explicit that physicians call the experience "meditating on how to die" [medici hanc 'meditationem mortis' vocant]. It's hard here not to think of those who claimed that philosophy is a meditation on death "Philosophiam esse meditationem Mortis"), which is often (but not always) associated with Socrates (Phaedo 64A). For a brief moment it looks like we have landed in the competition in the authoritative art of living between medicine and philosophy familiar from, say, the Symposium (including its comedy.)

But Seneca refuses the comic note, and he makes clear there is no competition but rather parallelism between art and philosophy. For, during his asthma attacks he practices another kind of meditation with silent exhortations [exhortationibus - tacitis scilicet] which seem to slow down the actual asthma attacks. The exhortations involve a kind of reminder to self that life is surrounded by death. 

The one time I have been in the presence of death -- my father's (recall) -- his last breath sounded like a deep snort of exhaustion not a gasping at all. But then again, he really was ready to die. Because his whole childhood had been surrounded by mysterious disappearances (recall), which turned out to be deaths, I wonder if he saw his whole life as a kind of lucky surplus and so made it easier to let go. I regret not asking him.  

Be that as it may, and as it happens, a lot of people familiar with my cognitive challenges since long haul covid has set on are encouraging me to take on meditation. (These are not just new age types, but also physicians and fellow long haulers.) Last week I went to my first public lecture. After twenty minutes I felt the onset of great fatigue. But I decided to stick it out by closing my eyes and pretending as if I was listening to the lecture from afar. I even asked a (modest) question, but half-way through the Q&A I realized I was not going to make it home without collapsing if I would stay longer. So I left. 

And if the medical specialists can't find anything -- this week I have lined up a number of appointments --, I have, in fact, toyed with trying out some of Seneca's exhortations filled with joyful and brave thoughts [cogitationibus laetis ac fortibus]. And if these work, I'll share my secret here, for free and joyfully.

Building an Athletics-to-Med-School Pipeline for Black Men

Published by Anonymous (not verified) on Tue, 28/09/2021 - 6:00pm in

Aaron Bolds didn’t consider becoming a physician until he tore a ligament in his knee while playing in a basketball tournament when he was 15. His orthopedic surgeon was Black, and they hit it off. “He was asking me how my grades were, and I told him, ‘I’m a straight-A student,’ and he was, like, ‘Man, this is a great fallback plan if basketball doesn’t work out,’” recalls Bolds, who is African American.

“He looked like me,” Bolds says, “and that was even more encouraging.”

If not for that chance encounter, Bolds, 34, a doctor at Mount Sinai Health System in New York, might never have gone into medicine, he says. When he was growing up, there were no physicians in his family or extended social network to model that career path. And at the schools he attended, he says, his aptitude for science didn’t trigger the kind of guidance young people often receive in more privileged contexts.

What Bolds did get attention for was his athletic ability. He got a full basketball scholarship to Lenoir-Rhyne University in North Carolina, where his team won a conference championship. But when he transferred to Bowie State University in Maryland, where he also played basketball, an academic adviser discouraged his pre-med ambitions, Bolds recalls, saying his grades were low and he lacked research experience.

Bolds is not alone in finding in athletics a fraught lever of educational opportunity. Whereas Black players comprise more than half the football and basketball teams at the 65 universities in the top five athletic conferences, and bring in millions of dollars for their schools year after year, the graduation rates for Black male college athletes are significantly lower — 55 percent as compared to 69 percent for college athletes overall — according to a 2018 report from the USC Race and Equity Center. Many Black college athletes end up without either a professional sports contract or a clear career path.

Now some educators and advocates are looking to reverse this trend by connecting sports, an area in which African American men are overrepresented, and medicine, where the opposite is true. As of 2018, 13 percent of the U.S. population, but just five percent of doctors — according to the Association of American Medical Colleges — identified as Black or African American. (The AAMC data notes that an additional one percent of doctors identified as multiracial.) Decades of efforts to increase diversity at medical schools have made progress with other demographics, including Black women — but barely any with Black men. “No other demographic group is broken down with such a large split between men and women,” says Jo Wiederhorn, president and CEO of the Associated Medical Schools of New York. “And none of them have stayed stagnant, like that group has.”

According to data the AAMC provided to Undark, the proportion of Black men enrolling in medical school hasn’t changed much since 1978 — with only some headway being made in the past few years.

The absence of Black male medical professionals ripples across the health system, experts say, contributing to widespread health disparities. African Americans tend to be diagnosed later than white people with everything from cancer to kidney disease, leading to more advanced disease and earlier deaths. Meanwhile, a recent study suggests that Black men who see Black male doctors may be more likely to follow medical advice. Other research also suggests that racially concordant care, in which patients and doctors have a shared identity, is associated with better communication and a greater likelihood to use health services.

“We are in a crisis point, nationally,” says Reginald Miller, the dean for research operations and infrastructure at Icahn School of Medicine at Mount Sinai. “I don’t think it’s a stretch to suggest that the health of communities of color are directly proportional to the number of practitioners available to see,” he says. “It’s just that straightforward.”

Last year, the National Medical Association, a professional organization representing African American physicians, embarked with the AAMC on a joint effort to address the structural barriers to advancement for Black men. “We need to look at this with a unique lens,” says Norma Poll-Hunter, senior director of workforce diversity at the AAMC.

Bolds began to apply an athletic mindset to his pre-med classes, and his grades improved. “I would get to the library before anybody.” Credit: Jeenah Moon for Undark

There is no single solution to such an entrenched and multifaceted problem, Poll-Hunter says. According to her, some medical schools have adopted a holistic admissions process that evaluates many personal factors rather than relying on standardized test scores, which can exclude promising Black candidates. In addition, she says, students of color need better access to high-quality K-12 science education, particularly in under-resourced public schools. “There are a lot of barriers that exist early on,” she notes, “and that then creates this narrowing of the pathway to medicine.”

But the novel strategy of wooing athletes is slowly gaining traction. Advocates point out that high-performing athletes possess many of the skills and attributes that doctors, psychologists, physical therapists, and other medical professionals need — things like focus, a commitment to excellence, time management, and problem-solving skills, as well as the ability to take constructive criticism and perform under pressure.

“When you say, ‘What’s your ideal medical student?’ it’s not just a kid who’s academically gifted. It’s a kid who’s got resilience, attention to detail, knows how to work on the team,” Miller says. “Because science and medicine are team sports.” And by virtue of being athletes, these young men are already attuned to nutrition, fitness, and other aspects of human biology.

Two former NFL players, Nate Hughes and Myron Rolle, recently became physicians. And there is evidence that competitive sports experience contributes to medical success. A 2012 study of doctors training to become ear, nose, and throat specialists at Washington University, for example, found that having excelled in a team sport was more predictive of how faculty rated their quality as a clinician than strong letters of recommendation or having attended a highly-ranked medical school. Likewise, a 2011 study found that having an elite skill, such as high-achieving athletics, was more predictive of completing a general surgery residency than medical school grades.

Advocates of the athletics-to-medicine pipeline point out its practicality. Thousands of Black men are already in college, or headed there, on athletic scholarships. It would only take a small percentage of them choosing medical careers to boost the percentage of Black male doctors to better reflect the proportion of African American men in the general population, they say.

No one thinks it will be easy. One obstacle, advocates say, is a lack of role models. Black sports celebrities are household names, but some young athletes may never encounter a Black medical professional. “People don’t believe they can become what they don’t see,” says Mark R. Brown, the athletic director at Pace University.

And for the best chance of success, many say, these young men need to form and pursue medical aspirations as young as possible, along with their athletic training. “Those kids who are able to do both, the rewards at the end are enormous,” Miller says. But the adults in their lives may not believe the dual path is possible. “The second that a kid says to a science teacher or someone else that he’s an athlete,” Miller says, “they go into a different category. ‘They’re not really serious about science and medicine, they’re just here, and so I don’t expect this kid to really achieve.’”

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Rigid course and practice schedules also make it challenging for busy athletes to undertake demanding and time-intensive science majors, observers say. What’s needed is “a cultural change, and not just a cultural change with the athletes. It’s a cultural change with the whole structure,” Miller says. “Everybody’s excited about the idea” of the physician athlete, he adds, “because it makes sense. But when the rubber hits the road, it is challenging.”

Donovan Roy, the assistant dean for diversity and inclusiveness at the Western Michigan University Homer Stryker M.D. School of Medicine, was one of the first people to envision the potential of directing Black athletes toward medical careers.

Roy, 48, who is Black and a former college football player, grew up in the working class, primarily Black and Latino community of Inglewood, California. Attending an elite private high school on a football scholarship was eye-opening. He vividly remembers the first time he ever saw a walk-in pantry, at a friend’s home. “It was stocked like a convenience store,” he recalls. “Five different types of Hostess, Ding-Dongs, sodas, every type of snack that you ever wanted.” Equally startling was speaking with another friend’s mother, who was a lawyer. “I’d never seen a road map to success in my community,” he says.

Roy’s athletic talent continued to open doors — at 18 he got a scholarship to the University of Southern California — but poorly prepared by the under-resourced public schools he had attended through ninth grade, he struggled academically, and left both USC and later another university that he also attended on an athletic scholarship.

Eventually Roy found his footing, and when he did, he became a learning specialist. After working through his own academic struggles, he wanted to help others with theirs. Roy took a job as a learning skills counselor at UCLA’s medical school. There he helped the students who were struggling with classes like anatomy and genetics. In early 2015, he returned to USC as the director of academic support services at Keck School of Medicine.

Something Roy noticed at both these medical schools stuck with him, though it would take a few years for the observation to crystallize. A certain kind of student sought help despite, by ordinary standards, not needing it. These were the athletes, and many of them were Black or Latino. “They always talked about, ‘How can I excel? How can I get better?’” he recalls. They “were getting 90s and they wanted to be 100.”

Roy began a doctoral program in education in 2015, the same year the AAMC published a damning report about the lack of Black men entering medical school. This was a crisis Roy understood both personally and professionally. For his dissertation, he decided to interview 16 Black male students at Keck School of Medicine. What was it about them, he wanted to understand, that had gotten them there against all odds?

The answer, he discovered, was what academics call social capital. For medical students from privileged backgrounds, social capital might take the form of a family friend who arranges a summer internship at a biotechnology lab, or a well-funded high school that offers advanced placement science classes. The young men Roy interviewed did not, for the most part, have access to those sorts of resources.

In his residency, Bolds is focusing on rehabilitation medicine, and is pictured here working at Mount Sinai’s sports medicine clinic. Credit: Jeenah Moon for Undark

“Growing up, I didn’t see a Black male with a college degree until I got to college,” medical student Jai Kemp said in a separate interview Roy conducted for a documentary he’s making on the topic. The social capital these young men leveraged to get to medical school took the form of parental support, science enrichment programs and clubs, peer social networks, faculty mentors — and the perks that come with athletics. “For me it was just sports that got me through,” Kemp said.

The pieces started to fit together. Roy knew from his own experience all the benefits athletes get, not just entrée to educational institutions, but travel, enrichment, and academic advantages like tutoring and early class registration. Athletes also tend to possess social cachet on campus and, with more exposure to different types of people, may feel comfortable in environments that seem foreign and forbidding to other young people from disadvantaged backgrounds. Roy also recalled the drive for academic excellence he had observed in the athletes who came to his tutoring programs. “I got this epiphany,” he says. “Why don’t we look at student athletes in order to increase Black males’ representation in medicine, because they have the most social capital and the most network on predominantly white campuses.”

But when Roy began talking to his medical school colleagues about recruiting athletes, who according to a report from the Center for American Progress — a liberal think tank — make up 16 percent of Black male college students receiving athletic aid in the Big 12 athletic conference, he says most weren’t receptive to the idea. The same thing happened when he got up the nerve to make the suggestion publicly at a 2018 conference in Orlando, Florida. The idea ran against type. “I think people tend to lump athletes into this box,” he says. “They just think that athletes are big meatheads.”

Roy knew this truth viscerally, because with his offensive lineman’s build of 6-feet-6-inches and 300-plus pounds, he sticks out in academic settings. “People stare,” he says. “They do not expect me to be in the role that I am in.”

What Roy didn’t know was that the idea was percolating elsewhere, including at the National Collegiate Athletic Association. Brian Hainline, the NCAA’s chief medical officer, says he and Poll-Hunter of the AAMC are in talks with several universities about launching a pilot program to support African American athletes interested in medical careers.

Meanwhile, in 2018 Miller founded the organization Scholar-Athletes with Academic Goals (a.k.a. SWAG, a name he hopes will resonate with young people). The initiative connects promising athletes with a range of available programs to help them pursue and succeed in science and medicine. Recently, Miller worked closely with leadership at Pace University to create a program, expected to launch next year, to support Black college athletes interested in attending medical school. Pace officials want the initiative to become a magnet for out-of-state athletes and a model for other schools. “My hope is that two years from now, colleges and universities will call” and ask, “Wow, how did you do this?” says athletic director Brown. “Once we have some success, and proof of concept, then I think it can really grow.”

Bolds graduated medical school in 2018 and is now doing his residency at Mount Sinai. His focus is rehabilitation medicine, and he plans to tend to injured athletes and serve as a team physician. He got a business degree while in medical school, and his long-term goal is to open his own interventional spine and sports medicine practice specializing in preventing and rehabilitating injuries in both athletes and non-athletes, as well as helping serious players enhance their performance.

Donovan Roy at the Western Michigan University Homer Stryker M.D. School of Medicine, where he is now the assistant dean for diversity and inclusiveness. Credit: Mark Bugnaski for Undark

But there were tough moments along the way, such as the encounter with that academic adviser, which Bolds says only served to motivate him. At the time, he thought, “Wow, this person doesn’t believe in me. So let me make them a believer,” he recalls. “That was, moving forward, really a turning point for me, honestly. Because I knew that people aren’t going to believe in you unless you give them a reason to.”

Bolds began to apply an athletic mindset to his pre-med classes. “That same grind of having to get up, 5 a.m., get to the gym, get shots up before anybody gets there, to put in that extra time — I was doing that with my studies,” he says. “I would get to the library before anybody.” Once Bolds turned his grades around, professors began to notice and help him, he says. Still, he says, his score on the MCAT, an entrance exam required by nearly all U.S. medical schools, was borderline. Instead of giving up, he attended multiple events at Howard University’s medical school, where he met people who advocated for him. It was the only medical school he got into.

Whereas Bolds had to bushwhack, he saw other Black students fall off the medical path — and his fellow Black teammates avoided it entirely. Many athletes find themselves enmeshed in a profit-making system that may not prioritize their education. The NCAA has been criticized in recent years for its long-standing policy which prohibits profit-sharing with college athletes — a policy that was only recently reversed under interim guidelines. Others have said that Black labor has been especially exploited.

As of 2014 reports, fewer than two percent of athletes in the NCAA will go on to play professionally. But for self-serving reasons, critics say, (Clemson University’s football team, for example, made $77 million in average annual revenue from 2015 through 2017) universities often direct athletes to “academic paths of least resistance.” Many schools practice “major clustering,” in which players are steered to the same relatively undemanding major, such as communications, so they can devote themselves almost entirely to their sport. Major clustering is more pronounced among athletes of color, according to a 2009 study of football teams at 11 universities. At six of those schools, the study found, over three-quarters of the non-White football players were enrolled in just two academic majors, although dozens of majors were offered.

Sheron Mark, an associate professor of science education at the University of Louisville, co-authored a 2019 case study of two young Black men who arrived at college on basketball scholarships, with the intent to pursue respective careers in computer science and engineering. But both found it difficult to balance academics with athletics because of pressure and blandishments from coaches and faculty advisers.

“For so long, they’ve been sold this message that you don’t have many choices, that banking on a professional sports career is one of very few options for you if you want to advance your station in life,” says Mark of many Black athletes. It’s important to have a plan B, she says, since “the odds just aren’t in their favor.” But coaches can discourage academically demanding majors because they may cut into practice time, and college athletes are not always capable of pushing back, she says, because their financial packages are tied to fulfillment of their team responsibilities.

Many Black college athletes are already strong candidates for medical school, advocates say, but others may need extra academic support to compensate for deficits acquired at under-resourced K-12 schools. They may also need post-graduation training to take science classes they did not have time for while working long hours as athletes — with some working 20-plus hours a week. “How are they being mentored and guided and protected in planning for their futures?” Mark asks. “They are high achieving in sports, they want to be high achieving in academics. Why don’t we support them?” When people wonder whether student-athletes can cut it in science and medicine, Mark’s response is: “It’s on us. It’s on us to help them do so. That’s how we can grow their representation.”

When Bolds was 15, his surgeon suggested that he consider becoming a physician as a fallback plan to basketball. Without that encounter, Bolds says he may never have gone into medicine. Credit: Jeenah Moon for Undark

That’s what Pace University intends to do. The school already nurtures academic success in its athletes, who collectively had a B+ average last school year, but premedical studies have never been a great fit, in part because afternoon practices can conflict with long lab classes, says athletic director Brown. As part of the school’s new initiative, Pace science departments have pledged to offer flexibility in course section offerings in order to accommodate football commitments. Athletes of color from any sport will be welcome, but football was prioritized because it is the largest and one of the most diverse teams and has the most complicated schedule, Brown says.

The school also plans to adjust its advising, tutoring, and library services to ensure that pre-med athletes won’t falter when they struggle with personal issues or tough classes like organic chemistry. “Rather than saying, ‘Oh, chemistry, nobody likes chemistry, you’re right, you should just drop that,’ instead now it’s going to be, ‘Yeah, you’ve got to buckle down. And here’s how we’re going to do it,’” says Hillary Knepper, the university’s associate provost for student success.

Meanwhile, Brown will be directing his coaches to actively recruit Black and Latino high school athletes who are interested in medicine. In the past, Brown says, his coaches were less likely to select such students because of anticipated scheduling challenges. But now Pace is trying to establish a partnership through which a nearby medical school would give preferred consideration to pre-med athletes who have completed the Pace curriculum. “With our new approach, you’re not only going to have the ability to do it,” he says, “but you’re going to have a support system, to make sure that you follow the path.”

Some advocates for the athlete-to-doctor paradigm see this work as part of the larger movement for social justice. “Look what Jackie Robinson did, right? Look at Muhammad Ali, look at Colin Kaepernick,” Roy says. “Athletics has always been the vehicle for social change.”

Medical professionals can influence public policy, accumulate wealth, and help empower others in their orbit. “The impacts ramp up really quickly, from just that individual benefiting,” Mark says, to “your family, your neighborhood, your social network, and society — people you won’t even meet, and across generations.”

Studies suggest that African American doctors are more likely to choose to work in underserved communities. They also may be more attuned to, and motivated to combat, the disparities in health care. A study published last year, for example, suggests that Black newborns are half as likely to die when they are cared for by a Black physician.

Bolds is keenly aware of the health disparities for Black communities, and he jumps at opportunities to mentor other young Black men, to show them that they, too, can become doctors. “It seems like there’s so many steps that just are never-ending,” he says. But, he adds, to see someone “that you can connect with that’s at that finish line or has already passed that finish line — I think that’s very key to their success.”

One of the people Bolds has connected with is Darius Ervin, a talented Black basketball player from Crown Heights, Brooklyn, who is now a sophomore at Cornell University. The two met when Ervin attended a virtual event late last year, sponsored by SWAG, at which Bolds spoke. Afterwards, the two chatted, and Bolds now checks in periodically with Ervin, who says he appreciates the encouragement. “Those are people that have once laced up shoes and got on the court and played just like how I did, and now they’re in the hospital helping people,” he says. “Being able to speak to those people gives me the visual, allows me to see that it’s an opportunity and it’s definitely possible for me to do.”

This story originally appeared in Undark. It is part of the SoJo Exchange from the Solutions Journalism Network, a nonprofit organization dedicated to rigorous reporting about responses to social problems.

The post Building an Athletics-to-Med-School Pipeline for Black Men appeared first on Reasons to be Cheerful.

Seneca (Letter 53), Long Haul Covid, and Impiety

Published by Anonymous (not verified) on Fri, 10/09/2021 - 8:55pm in

I was suffering too grievously to think of the danger, since a sluggish seasickness which brought no relief was racking me, the sort that upsets the liver without clearing it. Therefore I laid down the law to my pilot, forcing him to make for the shore, willy-nilly. When we drew near, I did not wait for things to be done in accordance with Vergil's orders, until

Prow faced seawards


Anchor plunged from bow;

I remembered my craftsmanship [artificii] as an elderly [vetus] devotee of frozen water, and, clad as I was in my cloak, let myself down into the sea, just as a cold-water bather should. Whaat do you think I suffered [Quae putas me passum], scrambling over the rocks, searching out the path, or making one for myself? I understood that sailors have no  reason to fear the land [Intellexi non immerito nautis terram timeri]. It is hard to believe what I endured when I could not endure myself; you may be sure that the reason why Ulysses was shipwrecked on every possible occasion was not so much because the sea-god was angry with him from his birth; he was seasick [nausiator erat].--Seneca, Letter 53, Translated by Richard M. Gummere (with modest modifications) 

It seems likely that this letter was written during the last two or three years of Seneca's life, around AD 63, so, to be on the conservative side, when he was nearly sixty. I am just close enough in age to feel some himpathy for his scrambling over rocks in his cloak, while not obtuse to the comic nature of the scene. One can imagine the local villagers telling each other stories down the generations -- too bad there were no spyglasses or iphones to capture it -- about the fabulously wealthy, once powerful courtier and philosopher, famous for preaching "the incredible force of philosophy is to counter all the forces of chance" [Incredibilis philosophiae vis est ad omnem fortuitam vim retundendam], going onshore in panic and unsteadily.

Not unlike Aristophanes' hiccup, Seneca, who chooses to share the story so he is clearly not obtuse to the comedy of it all, realizes that our physical infirmity can undermine our dignity. Not to mention that Seneca may have originated the tradition of taking a new year's day dip in the sea. 

I do not mean to suggest here we're just in the realm of comedy. Seneca's impious naturalization of Odysseus's journey is not an isolated feature in the letter. For in context, the force of philosophy, especially in the hands of the wise [sapiens], is compared favorably to that of God (singular). The beneficial effects of wisdom are our own achievements, whereas God is, we might say, beneficiary of natural luck.

Before I get to the main point of the letter, I have to admit that the unsteadiness he describes at sea, hit a bit home this week. On Wednesday I taught my first in-person class -- fittingly on Book 1 of the Republic -- in over 17 months. I had divided the three hour seminar into three, giving myself and the students a break every 45-50 minutes. In line of the advise of the occupational physician, my department had lowered my work-load by cutting the student numbers in half. They also tasked the teacher of the other half to be my back-up, in case I could not make it to class. (For my covid diaries, see hereherehereherehereherehereherehere; hereherehere; here; hereherehere; here, and here). 

The seminar starts at 5pm, and after lunch I developed an awful headache just as I was finishing up my hand-out. I usually just improvise my seminars, letting the conversation take us where chance directs (with a few sights I tend to wish to visit along the way.) But I had decided on the hand-out to take some of the cognitive load off my brain during the seminar. So, as I lay in bed, I contemplated initiating the back-up plan. Luckily, the painkillers worked and by three, I decided to bike the work. There I scouted the room, and even looked for a place outside in the heat. It was an evening for Plato under a tree, but sadly I could not find a quiet enough spot.

The students all arrived masked, and they turned out to be excellent. I was reminded again that even with inexperienced students in an introductory course, a seminar-style discussion is a site for mutual learning. A student's question led me to see that Polemarchus' attitude toward inviting Socrates anticipates Thrasymachus' understanding of justice. 

Unfortunately, in the second hour, just after I had gone through the course requirements, I felt my head go light (as if my sugar had dropped), and my legs went unsteady. In a moment of self-aggrandizing pity, I thought of the magicians that died on stage. Then I remembered Seneca's unsteady legs, and was comforted. Luckily, in my course plan, this was just the moment I had settled on a group assignment without my participation. So after quickly instructing and dividing them, I left the class room to get some fresh air and (against all my principles which forbid coffee after 5pm) an espresso. By the time I eased back into the class-room, I noticed I had not been missed and my head had settled.

My occupational physician has kind of settled on trying to convince me not to accept succor from medical science. But not to get too dispirited because while I am clearly not recovered, I am improved relative to some date months ago. More subtly, she tries to remind me that while my symptoms keep recurring -- weird memory loss, random headaches, what I call head-fatigue, lapses in concentration --, my recoveries of each seem fairly rapid.

And indeed, I managed to lead discussion in which we collected and analyzed the findings of the group assignment.  Because my students are so splendid, it was easy. But near the end I realized my brain was working at half speed. Good enough for the day. And not for the first time, I am reminded how lucky I am that, despite all the evils of the modern academy, I have landed in such a joy-producing occupation. (Of course, we'll see how many students show up for second class!)

There is a lot of interesting philosophy in letter 53. For example, Seneca insists that sometimes we know when we sleep that we sleep. And that there is an asymmetry in how we experience physical and mental/psychic pains.

But here I want to focus on the main point of the 53rd letter, which is Seneca's insistence that philosophy should be in some sense all-consuming (in context really, all conquering). "philosophy says to all things: "I am not going to receive at this time what was left over to you, but you will have that which I have rejected."" ['Idem philosophia rebus omnibus: non sum hoc tempus acceptura quod vobis superfuerit, sed id vos habebitis quod ipsa reiecero'.] This claim is out of fashion for three reasons.

First, it goes against the popular idea that philosophy is the mother of the sciences, who become mature (or at least adolescents) when they break off from philosophy. Now, we tend to think of philosophy as the diminished remainder, of what is left over, from the more successful, more progressive, and better funded sciences. This is familiar enough from the recurring crises of identity within philosophy which claims for itself (not entirely convincingly) expertise in conceptual analysis in one decade, in inferential practices in another decade, in analyzing arguments in another decade (or two), in modal thinking in another decade, and so on (yes, I plead guilty for having peddled synthetic philosophy). 

Second, it goes against the increasingly powerful idea that there should be a work-life balance, or a proper integration of work-life. And this reflects the idea that somehow doing philosophy professionally is in need of containment. And those of us who recognize the mad, publication arms race in the context of limited jobs, may well come to agree that someone should impose limits or we will be all consumed by trying to publish and refereeing the attempts to publish. 

Third, the very idea that philosophy is a way of life that can benefit us is taken to be archaic. And in so far as someone should be busy with how to live, and how to ground intellectually our experiments in living, it is thought this is best left to religion (we hasten to add, Eastern or Western) or to popularizing psychologists, who can draw on the best scientific insights. (I would mention our historical rivals, the poets, but our culture has let them wither.)

It is worth noticing that in so far as one accepts the modern intellectual division of labor, in the complex world of our open society (with heavy government involvement), this only makes more urgent that there should be a site of disciplined reflection on how to live collectively and individually. Rather than being embarrassed by wisdom, or relegating it to footnotes, or ceding it completely to mystics, philosophy should be inviting to those that seek paths to wisdom. Luckily the roads to wisdom cannot be patented or be turned into a trade-mark or turned into private property. As Seneca implies throughout the Letters, philosophy is our commons.

The activities that give us joy, community, and energy should not be limited. If we need to be protected against overworking in philosophy, perhaps we should re-organize how we construe the content of our work? Yes, Seneca's unsteady stomach and legs and my headaches are a reminder that there are physical preconditions to joyful activity that may be fragile along multiple dimensions. If you want to preach revolution, you may add the many unnamed slaves in Seneca's entourage, and the precariat at my own university to those material preconditions.

Let me wrap up. As regular readers know, I am myself not convinced that Seneca is right that philosophy can conquer uncertainty. And, Seneca's idea that philosophy should "rule" our lives is easily mocked. Yet, during the months I spent in my sickbed this year, I realized that such mockery is itself a sign that not all is well. That behind the mockery there is no insight, that nothing grows in its meaningless void. Our lives are relatively short, do not delay, "let us, therefore, rouse ourselves, that we may be able to correct our mistakes" and each take our baby-steps in our perhaps occasionally intersecting paths toward wisdom and let these shape our lives.



Chronic Covid

Published by Anonymous (not verified) on Thu, 01/07/2021 - 10:45pm in

One of the most psychologically annoying features of long haul covid is that any new somewhat mysterious ailment generates the bewildering question whether it is part of the post-viral syndrome belonging to the aftermath of the disease or a sign of a new (potentially serious) problem. (For earlier installments in the series, see here; here; herehereherehere; here; herehere; here; here; here; here; herehere; here; and here).

For example, since last week Thursday I suffer from a new kind of head fatigue. The fatigue disappears after a good night's sleep but recurs throughout the day. At first I thought it was an effect of too much intellectual ambition with me working on my Foucault manuscript. But the head fatigue also occurs when I am not on the laptop at all. I call it a 'new' fatigue because unlike the first five months of covid, this fatigue does not impact my ability to read intellectual stuff. It's not what other people call 'brain fog.' Rather, it is a feeling of tiredness combined with hunger (and irritability). 

As it happens, last week I picked up new fancy, varifocal glasses. I had gotten them because, as I remarked before, during my long bed-ridden period of convalescence I was reading books without my eye-glasses on, but with one eye closed. My cognitive-scientist, vitreoretinal-surgeon better half had nudged me to the optometrists suggesting that better eye vision might facilitate cognitive renewal. I never had varifocal glasses before, and I had been warned that a transition period might be tricky. 

In particular, I was warned not to use the varifocals at first while driving. After wearing them for about twenty minutes I could see why. As you move your head to look at new objects, different parts of the visual field go blurry. The haze disappears quickly as your eyes look through the right part of the glasses and the world returns to focus. Over time you notice the blurry moments less and your eyes adjust more quickly to where they should look relative to your glasses. While I do have a driver's license, I don't drive in the UK. This decision was unrelated to Covid (or Brexit). I simply decided that I do not drive enough anywhere to trust my judgment driving on 'the wrong side of the road' in the UK.

But last week as the fatigue first hit me, I wondered, is this covid or the fancy glasses? A week later, I can't be sure but I have to assume it's covid. Because by now I barely notice the blurry moments. And I do, in fact, enjoy reading books and my mobile phone without taking off my glasses. 

Either way, after three excellent weeks in which I was feeling close to recovered with only minor, lingering issues, now I am back at the stage where I am grateful for the good periods during the day. I was warned against such relapses by others in my long haul covid fellowship. But since I had read plenty of narratives about folk who had suddenly recovered fully, I had come to hope during the third good week I might be one of the lucky ones.

If you are like me, you might wonder what the physicians think of all of this? First the good news: I have had a battery of blood tests this past month. (For a while this showed in astounding black and blue marks thanks to a nurse's inability to find my veins.) The blood results all report that I am in fine health. The second bit of good news is that I am finally assigned an appointment with a long haul covid clinic. Sadly, that also contains the bad news, which is that the appointment is still seven weeks away. 

It's not that I expect much help from the long haul covid clinic. My GPs have tempered any expectation about breakthrough cures. Most of the folk who do benefit from medical intervention are showing symptoms much different than mine. But it would be nice to have some attentive, skilled medical attention beyond 'be patient, and don't push yourself too much.'

Anyway, it's now been six months. June was the best month of the year for me. It was the first month where I spent most of my time out of bed and active in various ways; I was very happy to be improved. I had been looking forward to my discussion with the occupational physician next week. While I am still hopeful I can return to normal teaching, say, in September at the start of the academic year, I now am considering the possibility that June was a harbinger of the possibility that my condition might be chronic; that I might be like the folks that have CFS/ME, and that I should expect good and bad periods to alternate.

When I started blogging about my long haul symptoms, a distinguished academic with CFS/ME told me she 'learned to become a fast writer.' (I have not asked her how she teaches.) Since I am a parent I write much faster, so I can relate. Even so, there is more to life than writing. As I contemplate this, I am wondering how I can be me with new constraints.  But now I must take my son to a physio appointment, for him.


Covid's Incomplete Recovery

Published by Anonymous (not verified) on Mon, 21/06/2021 - 9:08pm in

It's about three weeks ago that I view as a turning point in my not quite completed recovery from covid. (For earlier installments in the series, see hereherehereherehere; here; here; here; here; here; here; here; here; herehere; and here).  Since then I lead a more active and social life. I walk about five miles a day. I try to write three days a week for about five to six hours a day on my quixotic Foucault and the liberal art of government project. At the end of each week, I am pleasantly surprised how much progress I have made. But I don't trust my own judgment yet whether this is professionally interesting or just a weird form of delusional auto-cognitive-therapy.

I am more pro-active in reaching out to family by phone. I am less noise sensitive than I had been most of the year. We do family dinners again, and I find that when other people put on music I don't run away anymore. Last week I went to my son's school play, and enjoyed most of it. While my reading is still light, I did referee two papers this past month.

A propos of nothing. I read Ursula Le Guin's early novels: Rocannon's World and Planet of Exile in reverse order. They are both part of the Hainish universe. Planet of Exile was a bit disappointing, although in a weird way reassuring that her genius and wisdom was not fully formed at once. In re-reading Rocannon's World, I could see when in my first reading I had quit. I am glad that I gave it a second chance: it's a beautiful homage to Tolkien, and simultaneously a powerful meditation on the what it's like to be in the service of empire in the name of science and humanity. Since I had recently read Mill's (1859) "Few Words on Nonintervention," (as part of my liberal art of government project), Le Guin's wisdom really shined for me.

So, at first sight I seem recovered. And I am enjoying the mental space that for the first time in several decades I am free from deadlines and other commitments. I especially enjoy the privilege to ignore emails. My university does not have sabbaticals, so I imagine this is the headspace I have always imagined sabbaticals to be like. Of course, in a sabbatical I would try to write and read much more and more intensely.

Most of the obvious symptoms of Covid have disappeared: I sleep much better. Even so, while I feel much improved and optimistic again, there are some signs that not all is well yet. First, thirty to forty-five minutes is my limit of multi-person zoom. (I can lengthen that a bit if I close my eyes and treat it like a radio-show.) At that point I start to fatigue and irritability creeps into my demeanor. Yesterday, I went to a delightful and small dinner-party (of five adults and two kids). After about an hour I started to fade.  This fatigue can slide into modest temporary headaches (although nothing like what I experienced earlier in the year).

Second, I still have weird memory issues where I seem to have missed parts of conversations. I mangle words, and I can't recall names of people and events. Because my life is so simple at the moment, and I am so visibly improving, it's not especially disconcerting. 

Meanwhile I am still waiting for my appointment at the long haul clinic. Given my ongoing symptoms the perspective if a neurologist might be useful, although the neurologists I know all caution me not to expect much.  Every week I check on cancelations, so far to no avail.




Recovered Covid Patients Send Their Leftover Meds to Those in Need

Published by Anonymous (not verified) on Tue, 08/06/2021 - 6:00pm in

Early in May, Marcus and Raina Ranney, a doctor and a physiotherapist, heard from one of their domestic staff that his son was ill with Covid-19. The boy’s medical expenditures were piling up. So, the Ranneys reached out to neighbors in their Mumbai apartment complex through a residents’ WhatsApp group. Had anyone recently recovered from Covid, and did they have any unused leftover medicines? Several of their neighbors responded, and, thanks in part to the medicines they sent, the boy made a full recovery. 

“That’s when the penny dropped,” recalls Marcus Ranney. “I thought: if one apartment [complex] can come together to save a life, then imagine what a locality or city or country can do.” 

That was the start of India’s Meds For More initiative (MFM), a simple idea that has grown quickly — in just one month, the effort has developed a presence in a dozen cities. As part of the effort, hundreds of volunteers collect unused, leftover medicines from recovered Covid-19 patients in their apartment buildings, offices, student clubs, schools and elsewhere. They send them to MFM’s collection centers, and from there, NGOs licensed and equipped to work in the health sector transport the medicines to underprivileged or marginalized communities in urban and rural areas. Health care professionals working with these NGOs sort and pack the medicines, and hand them over to hospitals and health care centers to alleviate the supply deficit caused by the second wave of the pandemic raging in India since late February. 

Cases have shot up in India over the last three months — in May the country recorded the highest number of infections and deaths worldwide. India’s overconfident government — whose health minister declared in March that the country was “in the endgame” of the crisis — was caught unprepared for the surge. In recent weeks, patients have died while waiting for medical oxygen, and citizens have flooded social media pleading for oxygen cylinders, ICU and ventilator beds, and antiviral medications. 

Meanwhile, the demand for drugs commonly prescribed for Covid-19 patients has given rise to a black market on which patients often pay seven to ten times typical prices. (Even in the best of times, 65 percent of Indian patients’ out-of-pocket health care expenses are spent on drugs, versus the global average of about 20 percent.)

India’s surge has hit rural areas particularly hard, as workers who had migrated to cities for jobs make their way home, bringing the virus back to their villages, where public health infrastructure is already often quite poor

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Dr. Nandkishor Pethsangvikar, an ayurvedic doctor in rural Maharashtra, is the medical lead for an 80-bed Covid Care Center (CCC), one of the many opened in India to care for mildly ill patients. Maharashtra’s CCC supplements the paltry 100 beds in the public district hospital. 

Pethsangvikar says that the district hospital that feeds the CCC has been sending only four drugs. Other medications are provided by individual donors and organizations, MFM being one of them. “Most of our patients work as agricultural or industrial laborers, so the medicines are not affordable for them,” Pethsangvikar says.

In the remote tribal areas of the western state of Gujarat, the situation is similar. Himat Chauhan, whose Pochabhai Foundation works to uplift tribal people in this area, says that the medicines are inaccessible to the community as the nearest pharmacy is about 20 kilometers away. No one wants to hop on a bus and spend money and a day looking for medicines in understocked pharmacies in nearby towns. So, whenever a health care center hands them a prescription instead of medicines, they go without treatment. “Their attitude is, whatever will be will be,” Chauhan says. 

Chauhan will deliver a package of medicines from MFM this week, which will help hundreds who depend on the primary health center, the first and only point of contact with a physician in those villages. Some of the more general medicines — like antacids and broad-spectrum antibiotics — included in the package can be prescribed for illnesses other than Covid-19, as well. 

Mumbai-based volunteer Khushboo Rastogi is part of the MFM initiative’s eight-member core team. Pharmacies in cities like Mumbai often only sell full strips or boxes of medicines, even if the patient doesn’t need that much, which means that a lot of people, like Rastogi, end up with overflowing pill boxes at home.  

“Since I’m not a medico, I can’t give away my unused medicines to anyone, so this initiative really resonated with me,” Rastogi says. Being a part of it, she says, gives her a “sense of fulfillment,” a sentiment that MFM taps into to make this initiative successful. 

The effort has created a ripple effect. “In the past week, similar initiatives have sprung up in at least four other cities,” Ranney says. 

To make his citizen-led movement a legacy, he’s working to connect with the government in the coming weeks. “There’s no reason why the leftover resources of every illness or surgery cannot be channelized properly through the right law and policy control.”  

Ranney knows that as this initiative scales up, corruption and misuse are likely, and a percentage of the medicines might not reach their assigned destination. “But I’m an optimist and will not let that sentiment hold me back from what I’m trying to do.”

The post Recovered Covid Patients Send Their Leftover Meds to Those in Need appeared first on Reasons to be Cheerful.

Feeling Covid Optimism

Published by Anonymous (not verified) on Fri, 04/06/2021 - 9:21pm in

This is, I think, my sixteenth covid update (see here; here; here; here; herehereherehere; here; hereherehere; here; here; here). It's the first one I am writing with a sense of optimism about the possibility of full recovery. This past week, I have been more mobile, more energetic, more social, and more intellectual than at any time since the middle of December. And while each day I hit a moment in which I simply have to rest, that moment tends to be late in the day and passes. I still find that viplin music I used to enjoy sounds like scratching on blackboard, but I can now tolerate simple beats much better than a few months ago.

I realized that I was improving in the middle of a rather lengthy eye exam last Friday. After noticing that I was reading books without my eye-glasses on, but with one eye closed, my cognitive-scientist, vitreoretinal-surgeon better half had nudged me to the optometrists. The hypothesis that persuaded me to go was that better eye vision might facilitate my convalescence and aid my cognitive renewal, as I like to call it. She might it sound as if the theory has a solid foundation in the literature. Rather than doing my own review, I decided, mindful of my Nietzsche, that hope was better than no hope.

During the exam I reflected on the fact that that week I had spent quite some time on the phone with lawyers, accountants, and immigration specialists trying to sort out how to approach the impending final Brexit deadline (end of June). The experience itself was frustrating because it's clear that if one's territorial and life-style circumstances are even remotely hybrid and one's aspirations is to keep it that way, most of the credentialed folk actually have no idea how the rules should be applied to you (and, admittedly, may come to the conclusion the rules themselves are not yet sorted). But that I could spend so much time politely on the phone over several days without collapsing was good sign. 

At the optometrist I had the deal with a number of (very kind) people for up to three hours. By the end of it I was tired, and considerably poorer, but I realized that my fatigue was not that much worse than it would have been anyway. Then, that holiday week-end our son went away with a classmate's family. My wife and I had our first days of privacy in more than a year. Sleep and sun did their magic job! And while there were still moments of fatigue and irritability on my part, especially because at times the noise and bustle Camden's crowds overwhelmed me, we walked for miles, went to markets, and enjoyed a date in a sit-down restaurant.

One rather unfortunate side effect of my long haul covid, which I have been perhaps too oblique about in these digressions, was a disinterest in physical intimacy. I think this disinterest was partially a loss of libido, but also a fear of my own irritability and hypersensitivity around others. To be attentive to and vulnerable with another requires a minimum of receptivity and self-trust that I simply lacked for most of the time during my long haul.

Meanwhile, I have gotten a bit more serious about using this period to write a somewhat crazy book, The Liberal Art of Government: a Commentary on Foucault's Birth of Biopolitics, which I am developing from my series of digressions. My underlying intuition was (and still is) that I am not quite capable yet of developing philosophical work from scratch. I am, however, improving at editing what I have. (My initial drafts read like a stream of consciousness on prednisone (recall).) Initially I did this in 20 minute intervals, but these are being extended to ninety minutes.

I wouldn't claim I am capable of days-long writing weeks on end; I have to vary my activity throughout the day to avoid headaches. Even so, I am getting increasingly more critical with my existing drafts and that tells me some of my professional instincts are recovering. I am now circulating an introduction and two chapters, although these are still plenty disorganized and not quite at the level one would wish. (Part of the problem is intrinsic to the book I am conceiving because it does not fit any pre-existing disciplinary molds.)

The previous paragraph hints at the fact that recently I have had too much time to reflect on my past and future. Perhaps because my convalescence coincided with my fiftieth birthday I have come to reflect on my limitations and bad choices. Somewhat disappointingly, the only major conclusion I arrived at, whose importance I already realized for quite some time, and have successfully managed to implement thus far, is not to answer work emails at once. It's not a major step in self-improvement, but it pleases me greatly right now.


The Pandemic Timeline

Published by Anonymous (not verified) on Fri, 02/04/2021 - 7:00am in

Trump’s lies are like zombies. Fact-checkers keep killing them, but he keeps bringing them back to life — and repeating them over and over again. The only antidote is the truth — repeated over and over again. Steven Harper is following the pandemic for Moyers on Democracy. Continue reading

The post The Pandemic Timeline appeared first on

Book at Lunchtime: The Political Life of an Epidemic – Cholera, Crisis and Citizenship in Zimbabwe

Published by Anonymous (not verified) on Thu, 04/02/2021 - 8:23pm in

TORCH Book at Lunchtime webinar on The Political Life of an Epidemic – Cholera, Crisis and Citizenship in Zimbabwe written by Professor Simukai Chigudu. About the book:
Zimbabwe's catastrophic cholera outbreak of 2008–9 saw an unprecedented number of people affected, with 100,000 cases and nearly 5,000 deaths. Cholera, however, was much more than a public health crisis: it represented the nadir of the country's deepening political and economic crisis of 2008. This study focuses on the political life of the cholera epidemic, tracing the historical origins of the outbreak, examining the social pattern of its unfolding and impact, analysing the institutional and communal responses to the disease, and marking the effects of its aftermath.
Across different social and institutional settings, competing interpretations and experiences of the cholera epidemic created charged social and political debates. In his examination of these debates which surrounded the breakdown of Zimbabwe's public health infrastructure and failing bureaucratic order, the scope and limitations of disaster relief, and the country's profound levels of livelihood poverty and social inequality, Simukai Chigudu reveals how this epidemic of a preventable disease had profound implications for political institutions and citizenship in Zimbabwe.
Panel includes:
Professor Simukai Chigudu is an Associate Professor of African Politics at Oxford and a Fellow of St Antony's College. Prior to academia, he was a medical doctor in the National Health Service where he worked for three years. He is principally interested in the social politics of inequality in Africa, which he examines using disease, public health, violence, and social suffering as organising frameworks. He has conducted research in Zimbabwe, Uganda, The Gambia, Tanzania and South Africa.
Professor Sloan Mahone is an Associate Professor of the History of Medicine at Oxford University. She specialises in the history of psychiatry and neurology in Africa as well as the history of medicine and psychiatry globally. Her current research projects, funded by the National Institute of Health Research (NIHR) and Oxford's James Martin School, involve the implementation of oral history programmes on epilepsy in Africa and in resource poor settings globally. She is a member of Oxford's Epilepsy Research Group. Professor Mahone has also worked extensively in historical research and community development in Zaire (Democratic Republic of the Congo), South Africa, Botswana, Zimbabwe, Uganda, Tanzania, and Zanzibar.

Doctor Jon Schubert is a Leverhulme Trust Early Career Fellow at Brunel University. He is a political and economic anthropologist working on state institutions, infrastructures, and transnational trade in Angola and Mozambique. He is the author of Working the System: A Political Ethnography of the New Angola and has previously held postdoctoral research positions at the universities of Leipzig and Geneva.