Fortunate

In the scope of things we've been incredibly lucky:

  • We can do the core of our work remotely via telephone or video
  • The nature of our work as an internal medicine clinic means we haven't seen as much customer drop off as many other businesses
  • Because of our aggressive move to digital workflows over the past decade our employees have all been able to work almost exclusively from home with little issue or extra effort
  • We automatically received a small support check from Medicare because of our on going relationship with them
  • We've been able to keep all our employees on full time with their healthcare to this point
  • None of us or our loved ones have so far gotten sick

We have seen our weekly visit load drop by just more than a third, which means we are approaching a potential crisis point in terms of keeping everything/one fully funded. We applied for the PPP program as soon as our bank, Chase, accepted applications, but like so many other businesses, we ran into a host of errors during the application process and the initial funds for the program ran out well before they got to our application.

The program has received another round of funding, and our application is actively being reviewed, but that doesn't mean we'll be accepted or that they won't run out of funds again before we get to the end of the process. We can only wait and see, and investigate other solutions in the meantime.

Our patients mostly continue to work with us with a negligible amount of push back, mostly from patients who don't seem to be taking the risk seriously.

I don't really have a problem with informed people deciding they're comfortable risking their own lives, but I've always taken issue with people who think it's OK to risk other peoples lives for their own convenience/profit, and I'm deeply disturbed by the volume of disinformation being distributed by the likes of Fox News, Breitbart, and, of course, our Yam in Chief, and the way their faithful adherents reject reason for propaganda.

I do have to start planning for when and how we're going to open the office back up. Even if we can finally get the PPE we need, much of which our supplier still won't even let us order, I'm struggling with how to secure the office from becoming a vector of transmission from one potentially infected patient to an uninfected other.

I found the idea of taking temperatures at the door to be absurd from the get go as the threat continues to be more from asymptomatic infectees. Add to that the fact that the virus can stay airborne for hours means it wouldn't take much for the waiting or patient rooms to become potential death traps, and I don't have a good solution for that yet.

Maybe if we just inject everyone with Clorox and have 'em swallow a UV light?

Looking For Balance

UPDATE - 6/20/20
It 's recently been reported how Warren Ellis has for some time been [using his status to predate on vulnerable women] (http://www.multiversitycomics.com/news/warren-ellis-allegations/). This is an upsetting revelation and my heart breaks for his victims. As such, I'm removing most of the external links in this particular post and explicitly remove any encouragement to engage with his works. Dealing with the public works of artists separate from aspects of their personal lives is a complicated endeavor, but this is how I feel most comfortable dealing with this particular artist at this current moment.

"I don't give up. But I don't give up myself, either. So I won't be number one. But I'll still be me. You have to be okay with that trade. And you have to be okay with looking in the mirror and still seeing a recognisable version of yourself. And if you smile, then the smile has to be real, whether it's rueful or not -- not brave, desperate or terrified.

Still winging it. Still fine with the ride." - Warren Ellis

News letter: Orbital Operations

Curated playlists: Spektrmodule

The tone, velocity, and emotion of Ellis' writing often reminds me of Harlan Ellison and Hunter Thompson: kinetic, aggressive, imperative. Thankfully he doesn't have their misogyny.

Ellis seems to do a lot more research than the latter two, and is able to incorporate more real world bits into his work, whether that's the alt-culture in Crooked Little Vein, the history in Gun Machine or the speculative science which shows up in much of his work, Global Frequency being a great example.

The research creates a more grounded feel than Ellison's rawly speculative fiction, and a wider range than Thompson's largely psychoactive/political subject matter, making for a more enjoyable oeuvre.

"Even Angels Fall For Demons"

So, a fourth week working from the office-disguised-as-ghost-town.

My anxiety levels have continued to drop as all our prep work continues to play out better than expected, and patients show an unexpected willingness to work with pandemic induced constraints. Well, most of them.

My daily work regimen has been a little strange, but I'm hoping and planning for it to enter into a warm, dark mode sea of coding this week, where I can drown for days on end.

Today's soundtrack is 5 songs on repeat:

I really enjoy [Ryan McMullan]'s voice, and his new EP is a joy:

A dance invoking tune by [X Ambassadors]:

Just Us Chickens

Computer desktop's littered with files: protocols, sign templates, phone scripts, meeting notes, financial spreadsheets, COVID-19 web clippings, desperate digital brainstorming sessions. Three weeks worth of figuring out how to keep patients and staff safe and the business from going under.

Everything I'd intended with my Year of Consolidation is out the window. We're now a world of mice, our schemes gang darkly agley. Even so, I have been consolidating at a record pace, just not the way I'd hoped.

Today's the first day at the office with just my wife and I. We set up two of the office staff to work from home last week and finished setting up the third yesterday. Doc's set up in a patient room doing remote telemedicine visits and working through digital messages and refills, and I'm here in my office taking a breather before cleaning up the great mess I've made before I figure out the next step to keeping the spice flowing. (You know, I do feel a bit like a Guild Navigator wannabe, trying vainly to bend space and time to my mutated will.)

We started taking our visits remote three weeks ago and locked up the office completely last Monday. Our patient population is largely older and immunocompromised, and the idea of us becoming a vector leading to any of there deaths was unthinkable. Quickly running out of protective gear and being unable to restock sealed the decision.

We are making concessions for patients whose treatment requires injections which can't be missed or delayed, and are trying to figure out lab draws for patients whose health requires close monitoring, but we've done our best to make sure those circumstances are both rare and as safe as possible for the patients and staff. I know I'm not ultimately responsible for the safety and wellbeing of patients and employees, but because I do have a slight measure of influence and responsibility for an area of intersection, it can be hard to keep my anxiety from spinning up to something far out-sizing the truth of my control.

Shreveport Opera cancelled their production of "The Marriage of Figaro" a few weeks ago, and earlier this week Texas Shakespeare Festival announced they were cancelling their summer productions. I'm strikingly disappointed, but doing anything else at this point would be irresponsible, in my opinion. That these things are my biggest losses so far in this thing is an incredible blessing.

Need Some Room To Breath

Most of my days have become consumed by trying to manage the various levels of our prep and response to COVID-19. Creating and adjusting policies for protecting the patients and staff as best I can, figuring out how to effectivley provide telehealth services, and also how to keep us afloat as a business until this all plays out.

Between that and the little urgencies which regularly crop up I'm struggling to handle a constant state of anxiety.