Category Archives: General Interest

General life interest

A forgotten CODEs gig at an SCCM meeting resurrected

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Hello again, the 50th Anniversary of the Society for Critical Care Medicine (SCCM) is coming up and they were wondering if the CODES were available to play for the meeting again as we did several years ago. Not likely as we haven’t played together for a couple of years but it was a good run as our first gig was in 2006.

So I suggested maybe I edit a song from our last SCCM gig, which was several years ago. I rummaged through the high-resolution videos of that gig, selected a song that featured all of us playing and cut it back to a minute and a half. Don’t know if they’ll play this in their repertoire of ZOOM selections but I gave it to them. Maybe they’ll play it. Maybe not, but here it is for whatever interest anyone has.

The song is “Twilight Zone” originally done by a Dutch group Golden Earring (1982). It’s a great song and part of our set list for years. I chopped it after the meat & potatoes just before the extended lead break for brevity. You’ll get the idea. Listen for Gary’s scrape of the low E string from top to bottom. EEEEEOOOOOWWWWW. Not very loud. You have to listen for it.

Enjoy if you have an interest. As always, turn up the volume.

Percussion: Mike DeGeorgia, MD, FCNS
Professor
Chair, Neurology and Neurocritical care
Case-Western University, Cleveland

Rhythm guitar and backup vocals: David Crippen, MD, FCCM
Professor Emeritus (ret)
Department of Critical Care, Neurovascular ICU
UPMC, Pittsburgh

Lead Singer and base guitar: Stephan Mayer, MD, FCNS
Professor
Director of Neurocritical Care and Emergency Neurology Services, Westchester Medical Center, Valhalla, New York

Lead guitar and vocals: Gary Bernardini, MD, PhD, FCNS
Professor
Chair, Neurology and Neurocritical care
Cornell Medical Center, New York City

Protests v. Violence: Forward to the past

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Last night, 5/30/2020, my daughter the cop was called out emergently with a bunch more cops, to join the National Guard in protecting the city (Pittsburgh) from roving bands of vicious destructors. Cars overturned and set on fire. Store window glass destroyed and stores looted. Four cops hospitalized, dozens of others treated at various sites. Traffic backed up for miles. All seemingly to raise the public’s consciousness about what amounts to 100 years of racial inequality and abuse. The first Amendment allows for peaceful demonstrations to complain about various kinds of abuse and one rarely hears much complaint about it. City dignitaries and various professional sports figures (here) frequently join such demonstrations.

Some history:  Back in the 60s Dr. King’s strategy was strictly non-violent demonstration to point out inequities in how the races were treated. There were good reasons for this. If protesters fought back in kind when physically abused by police, it might be construed that the protesters were assaulting the police, giving them a legal reason to beat them to a pulp in self-defense. These were the days before pocket size video that everyone now carries. In the 60s, creative photography made it difficult to prove one way or the other who was assaulting who.

This strategy lasted from the 50s into the late 60s when it was finally figured out that non-violent demonstrations were ineffective, if for no other reason than few cared and they were not carried to large audiences via what was then rudimentary TV. About the time Dr. King was assassinated, it was becoming clear to would-be protesters that getting routinely beat up wasn’t very effective in proffering their points. About this time, younger black leaders, Rap Brown, Malcolm X, Eldridge Cleaver, JoAnne Byron, the, The Black Liberation Army, (BLA), Black Panthers and many others began various “push-back” strategies of getting their agenda more noticed by becoming more noticed. BLA goons assassinated white police officers walking beats.

So, somewhere in this time period, protesters figured out they get a lot more attention if they started inconveniencing those who really don’t care much about their activities, aided by the visual media (CNN) whose advertisers love anything that draws viewers to their plethora of commercials. So drawing viewer’s attention to social inequities moved from visual to violent.

It should also be noted that none of this is anything new. The white population in virtually any city traditionally had a heap of contempt for former slaves who had been legally liberated but remained their previous underdog social status. White lawmakers, administrators and politicians greatly feared that if blacks gained any amount of political power (voting), this would diminish the dominion of those ensconced in power. Various very creative schemes were created to insure “minorities” stayed minor.

For want of a better term, “Whites” as a group have never liked the black population very much and that dates all the way back to Reconstruction. They are legally mandated to legally treat them as equals but that changes nothing about their emotional feelings about them. It must also be remembered that blacks are no longer “minorities” anywhere. They’re majorities or near majority in virtually any major city except in the deepest Western States. In many cities with ingrained racial problems, the local TV stations gleefully portray them on-screen after they’re picked up for various law-breaking, subjectively suggesting that most of the ills of the city are caused by roving bands of grimacing black criminals festooned with facial metal, tattoos and bulky hair braids. Aliens. Aliens caught doing damage.

So here we are.  One would think that police officers would have enough sense to do whatever it takes to stop killing those black guys, especially the ones obviously unarmed. They’ve been doing it now pretty reliably since Fred Hampton in 1968. Killing them over and over, sometimes for the thinnest excuse, nowadays each episode filmed from multiple vantages by ubiquitous cell phone video cameras. Whenever a cop appears almost anywhere, fifty cameras appear starting with Rodney King in 1991. You would think they’d learn that every time it happens it gets videoed in high resolution, followed by multi-city riots.

Why does this keep happening?

I think it keeps happening because the experience of many police officers with black citizens is pathologic and not much is being done to rectify it. A relatively few bad interactions goes a long way. After a cop gets shot at a few times, and forced to follow would-be armed criminals up dark, dangerous alleys, they start considering them not much more than vermin and stomping them out isn’t much different than eliminating cornered rats. Videos of many of these murders don’t show much emotion on the faces of cops killing other humans.

Similarly, anyone that’s viewed the killing of Mr. Floyd will not be reminded by protests. They’re quite aware of the atrocity and it’s as unclear how to solve it as it was in 1968. Mass peaceful protests usually fall on bored motorists that avoid the traffic jams shown up on WAZE. However, once protesters start burning cars and businesses, beating up cops and doing as much damage as possible, everything changes. CNN, MSNBC, Fox News and all the local stations stop everything and photograph as much as the violence as they can- close up from helicopters. Already Beleaguered downtown business owners (from COVID shutdown) pleading with looters carrying out flat screen TVs. Protesters throwing Molotov Cocktails through broken glass windows to start damaging fires in their own community.

At this point, no one remembers the original point of the “protest”. Now it’s become a Netflix special action series, cops against the bad guys. If TV viewers glued to the tube didn’t care much about the root cause of the protest anyway, they now loathe them and the entire thrust of the protest vanishes as the police and National Guard prevail because they’re more of them and they’re better armed.

So, in essence, the events of the 60s that evolved to the violent 70s is coming around again.

Editorial comment by me 5/14/2020

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What I’m seeing here in Pittsburgh is similar to what’s happening elsewhere in the mid-west, lots of people believing that rituals will save them from doom and gloom. That wiping down things with alcohol, wearing essentially ineffective surgical masks and bandanas that demonstrate they’re “doing something” and playing out the opera as dictated by experts who have never seen anything like this before and are all guessing.

Sunday, on Fareed Zakaria’s show, expressed the idea that the virus most probably did start from a wet market in China where a large number of previously “wild” animals were herded together (as food stuffs) in proximity to lots of humans, some probably sick or with immune deficiency for whatever reason. It’s easy for any virus to follow these pathways from sick animals to sick humans. And as more and more of the natural habitat of these animals is destroyed to build Hiltons and parking lots or simply to slash and burn, the pathway from animal to human becomes smoother. I think that’s a very viable theory and what it means as a practical matter is that this virus made a very smooth transition to the globe and for all those reasons we can expect more of the same.

In Pittsburgh, we are now in the “Yellow Zone” of social activity, which means “some” businesses are now open in a limited sense, with nods to social distancing and crowd control, lots of wiping things down and some kind of mask for all. But Americans always find creative ways around anything that inconveniences them. Two businesses that are STILL shut down in the Yellow Zone are gyms and hair salons. I have no idea why, but I have an appointment at a local Gym tomorrow to start building my functional ability back again. I also have an appointment next week for a haircut after two months. If I look around, I can find a place to go out to eat. So, I would hazard a guess that all over the country, most of these admonitions for the viral infestation are simply ignored or things like surgical masks are being touted as “real” prevention. What that means is that the virus will persist for a LONG time and lots of things will become the “new normal”.

What will be the new Normal? Last night on the news, they explored the probability that we will become a “Virtual” nation. That means computer visualization of meetings, education and everything else formerly requiring face-to-face discourse. It’s already happening. Schools and universities have already served notice that they are most assuredly transitioning to computer classes, students participating by laptops from home. Harvard School of Medicine has served notice that they are rapidly gearing up for visualized classes from home. The dehumanizing effect of this kind of faux social interaction is truly scary.

Everyone accesses their daily items and desires from Amazon, Craig’s List and eBay, with more added every month.  It’s simply more convenient and those on-line businesses have EVERYTHING for sale, cheaper than the increased cost of the necessary middle-man in structural stores. Brick & Mortar businesses are closing right and left. The last one yesterday was GNC food supplements, a huge office building and shops all over the country. They’re going to go the way of Radio Shack, with thousands of jobs going with them.

The concerts that normally fill stadiums have all been cancelled with no hint of when, if ever, they will return. That means the Kenny Chesney concert scheduled for next week is out and all the football games that normally number over 50,000+ rabid fans that come from all over the country to see the Steelers in Heinz Field are cancelled till further notice. Similar actions for hockey and baseball. What they didn’t mention is what’s happening right now. All those 50,000 rabid fans eat food, drink beer and park their cars in Pittsburgh, bringing in a ton of money and literally supporting industries. All gone, and with it those industries and jobs.

The major grocery in Pittsburgh is the Giant Eagle and going for food is a very interesting trip. The entrance to the store is about 30 or so yards along the side of the store from the entrance and the only way out is the designated exit. No entry without a mask of some variety. 6 feet spacing on the sidewalk and store personnel walking around to enforce social distancing. Large chunks of foodstuffs missing off the shelves due to panic buying, including water bottles. Prices of everything are up at least 30% so far. As there is more and more unemployment and providers of meat slow down production, this will continue and get worse. As demand from kids school meals vanishes, Farmers are dumping milk into their fields as the cows need milking whether the product is sold or not. The income from milk is now less than the cost of producing it. This has the potential to destroy farming.

The CEO of Boeing Aircraft was interviewed yesterday and he opined that at least one, possibly two airlines were poised to enter Chapter 11 due to decreased number of passengers and increasing cost of fuel and airport costs. Delta is burning through fifty million dollars a day. There are several photos of passenger planes lined up, filling the entire runway at Pittsburgh International. The planes that are still flying are doing so with only a few passengers. They won’t do that for long at the current cost of fuel. So, not only are people not traveling anymore, the potential for carriers is progressively crashing. I was thinking I might want to go one more interesting place before I died. Delta told me to forget it unless I was prepared to pay an astronomical price for a seat 6 feet from the next guy.

The Washington Post detailed American workers filing 3 million new unemployment claims last week, bringing the eight-week total of coronavirus-induced layoffs to 36.5 million. This number will progressively increase as more and more businesses go under. The money men in government are sending out trillions of dollars here and there. No one knows where it’s coming from or exactly where it goes. The effective long range planning by central government officials can best be described as loose cannons rolling around the deck firing the odd shot here and there. The unemployed will start protesting their plight in larger and larger numbers resulting in ????  This is said to return when “things get better”.  I think there is some evidence that once many of these industries die, the cost of resurrecting them would be prohibitive and they’ll stay dead. Society will then learn to live without them and that will be a very interesting life, indeed.

I’ve made it to nearly 77 years of age and I now count myself as exceptionally lucky to have lived in an era where I could do pretty much anything I wanted, go where I wanted and work in a career that worked very well for helping sick persons. I’m very glad I won’t have to live in the world being created right now as I sit here. I feel very sorry for those much younger than me that will have to figure out how to survive in it.

 

“The Edge… There is no honest way to explain it because

the only people who really know where it is are the ones

who have gone over it.”

 

―Hunter S. Thompson, “Hell’s Angels: A Strange and Terrible Saga”

 

Some history that might affect us in 2020

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Some history that might affect us in 2020

David Crippen

The great famine in Ireland, 1845 -1849.  During the worst of it, 1847, one million Irish died and another one million were put on ships bound for America. A microorganism, the “potato blight” was actually found first in Philadelphia and New York City. Winds spread the spores to the rest of America and it crossed the Atlantic into most of Europe but settled most in Ireland because of its dependency of a single susceptible variety of potato, the “Irish Lumper” The blight also affected Germany, leading to the deaths of 700,000.

In 1846, three-quarters of the Irish harvest was lost to blight. By December, a third of a million destitute people were forced on the dole or straining meager public works. Since over three million Irish people were totally dependent on potatoes for food, hunger and famine were inevitable. By February 1847, there were huge snowdrifts and the poor had no warm clothes to work outdoors in cold and wet weather. When the father of a family became sick or died after working on the public works, the women or children in the family tried to take over the work but it was very hard and involved carrying heavy loads or digging. This type of work was not useful in helping the people who were starving.

English landowners quickly figured out it was cheaper to purchase tickets to the new world for their Irish tenants than support them through a blight no one knew the potential length of. New York, three times the size of Boston, was better able to absorb its incoming Irish. Throughout the Famine years, 75 percent of the Irish coming to America landed in New York. In 1847, about 52,000 Irish arrived in the city with a total population of 372,000. The Irish were not the only big group of immigrants arriving. A substantial German population totaling over 53,000 also arrived in 1847.

Unlike many other nationalities arriving in America, the Irish chose to huddle in the cities partly because they were the poorest of all the immigrants arriving and partly out of a desire to recreate the close-knit communities they had back in Ireland. The Irish loved each other’s company, but the daily pressures of living in America at the bottom rung of society also brought out the worst in them. Back home, the Irish were known for their honesty, law-abiding manners, and chastity. In America, old social norms disintegrated and many of the Irish, both men and women, behaved wildly. In the hopeless slums of New York, prostitution flourished and drunkenness occurred even among children.

So many Irish drifted into the five points of New York City, a repository of the poorest, most disadvantaged and exploited of all the immigrants, including the Irish and the Blacks. Since virtually all Irish were Catholic, the burgeoning supply of them fostered fear of the Papacy, which became fear and hatred of the Irish.

The original Five Point in New York City are no longer there as they were in the mid-1800s. They existed off Centre Street to the west, Bowery to the east, Canal to the north, and Park Row to the south. The Civic Center and Chinatown also bound this area now. The Martin Scorsese film“Gangs of New York (2002) , accurately depicted a long running catholic/protestant feud erupted into violence fueled by Irish immigrants rebelling against low wages and social repression and an influx of freed slaves with similar repression. This mix of low wages, lack of jobs, racism and social repression generated frustration and anger finally brought to a head by the onset of conscription into the Union Army (in New York) in at the time of “Draft Week”(Mid July, 1863).

The actual riot boiled over July 13-16, 1963.  Working class discontent and smoldering anger were a function of white working-class men, mostly of Irish descent, who feared free black people competing for work and resented that wealthier men, who could afford to pay a $300 fee to hire a substitute, sparing them from the draft. Initially focused on frustration and anger at the draft, the protests evolved into a race riot. The death toll was thought to be around 120 individuals. Herbert Asbury, the author of the 1928 book “Gangs of New York” upon which the 2002 filmwas based, puts the figure much higher, at 2,000 killed and 8,000 wounded.

The military swinging up from the residual of Gettysburg did not reach the city to create martial law until late in the second day of rioting, by which time the mobs had ransacked or destroyed numerous public buildings, two Protestant churches, the homes of various abolitionists or sympathizers, many black homes.  The “Colored Orphan Asylum”  at 44th Street and Fifth Avenue was burned to the ground. Eleven black men were hanged over five days.  The area’s demographics changed as a result of the riot. Many black residents left Manhattan permanently with many moving to Brooklyn. By 1865, the black population had fallen below 11,000 for the first time since 1820.

Reading through the narrative of the New York City situation in the mid-1800s, reveals several things that stand out. A populous stranded by low or nonexistent wages into squalor and miserable living areas full of crime and death. A populace unable to get reasonable paying jobs. Rampant disease and no real protection from it. Psychologists suggest that these conditions have the facility to alter the normal adaptive human brain to a “Mob Mentality”. Humans tend to imitate each other’s behavior in certain situations.  Crowds can easily become uncontrolled and frenzied once a critical mass of numbers is reached, exerting a hypnotic impact resulting in otherwise unreasonable and emotionally charged behavior the individuals would ordinarily indulge in. When angry and frustrated individuals congeal into a large group, they “deindividualize”, absorbing the power and authority of the anonymous mob, then they become capable of striking out violently at issues not original to their complaint. The violence becomes the remedy for their complaint, which usually broadens quickly.

A study of riots in the 60s and 70s show that original complaints of poor, crowded living conditions, few jobs, police hassle of a poor black population and no viable hope of any improvement eventually boiled over into massive riots that did millions of dollars of property damage, and death, most of it doing more damage to the original complaints of the rioting population. Seemingly minor issues sparked many of these riots. The Watts riot started when a Los Angeles police officer tried to arrest a Watts resident for drunk driving. The Watts riot lasted for six days, resulting in 34 deaths, 1,032 injuries and 4,000 arrests, involving 34,000 people and ending in the destruction of 1,000 buildings, totaling $40 million in damages. Rioting to make a social point vanishes when rioters destroy and loot business establishments they would ordinarily protect.

But all that was then. This is now but we have some of the same pressures building and we should be aware of them because we’ve been there before. What we have now for the first time in 100 years is a massive social and physical disaster that threatens to bring back some of the factors that created mob violence in the past.

  1. Coronavirus has the capability to relentlessly incapacitate virtually human on the planet. It’s like the “Terminator” (1984) “Listen, and understand! That Terminatoris out there! It can’t be bargained with. It can’t be reasoned with. It doesn’t feel pity, or remorse, or fear. And it absolutely will not stop…”. We canmore or less “flatten the curve” of its longevity and potential to kill humans, but not obliterate it. It moves and shakes in its own schedule.

 

2.  In “flattening the curve”, we perpetrate on ourselves a style of living that doesn’t work well for our longstanding social order. “Social Distancing”, voluntary or involuntary quarantining, involuntary closing of all but (seemingly) necessary businesses, creating virtual ghost towns.

 

  1. Large masses of citizens forced to be out of work with no consistent end in sight, none of their usual funds to pay for rent, transportation, food. Promises of Federal money to offset this, none seen as of yet. Panic within the population that their homes, cars and especially their jobs are at risk.

 

  1. Previously healthy persons not predicted to succumb to this strain of flue, unexpectedly dying, sometimes very quickly. The realization that first line defenders of the population, doctors, nurses and other medical providers seen to be wrapped up like modern day mummies, many lined up to (legitimately complain bitterly about their lot on Cable News Network (CNN).

 

  1. Federal Administrators promising to insure all the needed materials to buttress the viral Pandemic, face masks, gowns, gloves, goggles/face shields, ICU equipment, mechanical ventilators. These promises are inconsistent and the identified individuals in charge, mostly politicians have not come through as yet, leaving the population with the impression there is no protection from the virus.

 

The point of this long diatribe is to point out how some of the above factors have led to violent riots in the past.

 

  1. A seemingly inalterable scourge will continue seemingly unabated, picking out innocents to infect everywhere and anywhere. Open-ended fear and anxiety that death looms unpredictably.

 

  1. Loss of normal social interaction (distancing and quarantining) creating lonliness, antisocial ideation, open ended anger at a threat that cannot be seen or felt. Looking for something to rage at.

 

  1. Loss of the extremely important social interactions inherent in meaningful performance of work that generates a paycheck that an individual can maintain social visibility by paying his bills. No convincing evidence this situation will resolve before the job is lost.

 

My point is that if all this comes to a substantial head, a critical mass of angry, frustrated citizens ready to find something to rail at, riots are possible. History shows that some of the factors that created riots like the Draft Day riot of 1863 can be superimposed over some of the factors involved in the Pandemic of 2020. A hated but otherwise indistinct metaphysical object (the Draft), uncomfortable living conditions, loss of jobs, social breakdown, inconsistent political assistance (Boss Tweed) and fear of unpredictable death from the environment. That we haven’t seen any yet, only means the requisite critical mass has not been reached, but it could happen if some of these factors don’t start resolving fairly quickly.

A critical mass can be a very dangerous thing. Camp of the Saints (Jean Raspall- 1975)  a dystopian fiction novel depiction the destruction of western civilization by the mass migration of the “third world” (the poor and disadvantaged) to France and the West, like locusts in the western United States. The critical mass of humanity was reached to enable them to move as one force, absorbing everything in their way.

Copyright DWC, 2020

 

 

 

Film Review “1917” (2020)

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“1917” is an unusual film, somewhat like “Dunkirk” (2017), a vision of war through the eyes of individuals. Two men have to trek across a dangerous terrain in order to save the lives of 1,600 others, and time is a factor. It’s said to be the opposite of “Saving Private Ryan (1998), one soldier on a mission to save 1600 rather that a group trying to save one. There are two really interesting sides to this film.

1. The filming. The cinematography by Roger Deakins (nominated for an Academy Award) is simply phenomenal. This is the same guy that thrilled audiences with “Sicario”, “Skyfall”, “No Country for Old Men” and “Blade Runner 2049”. Seemingly filmed with one camera in real time with no apparent cutting, making the film apparently seamless. One long shot. The color and set is magnificent, I would imagine as accurate as how it actually appeared in 1917. Director Sam Mendes takes the audience along for the ride through the carnage rather than just as observers, and it’s a sad, deadly journey that seems to go on with no end.

2. The film depicts the death and brutality of the First World War (WW I) in very graphic terms, sparing little. The enormity of WW I is not fully appreciated today if for no other reason than the participants who would remember it are all dead and the incredible senselessness of the whole affair (which was thought by Great Britain would be over in a few weeks). In the previous 40 years before 1914, Great Britain had been involved in the minor leagues of conflict. In 40 war skirmishes Britain lost less than 40,000 men. However, in the Somme Offensive in France (1916), 58,000 Allied soldiers were dead in one day’s fighting, the bloodiest single day of face-to-face (non-atomic) ground warfare in the history of the English speaking world. For perspective, in the Franco-Prussian War of 1870-71, France suffered an estimated 270,000 battlefield casualties. France surpassed that number in the first three weeks of WW I. In a two-year span, the life expectancy of a French male dropped to 27 years of age.

Roughly ten million soldiers and 6 million civilians died in WW I, mostly as a result of incredibly absurd battle tactics designed to kill huge masses but resulting in extended stalemates. All this for what amounted to an extended royal family feud acting out old grievances. The sheer incompetence of strategy and tactics was exceeded only by their callousness toward those dying for them. The two survivors, Britain and France would be so shattered as to never fully recover.

Warning- not for children, very vivid slaughter and devastation scenes.

Some interesting asides- Over 5,200 feet of trenches were dug for the film (just under one mile). The verse that Schofield recites to the French baby is part of the poem “The Jumblies” by Edward Lear. In the scene where a soldier bleeds to death, his face gets paler and paler until it’s paper-white. This is a medical reality that many films overlook when someone bleeds out.

I give this film 4 of 5 Lee-Enfield .303 bolt-action rifles. Recommended by me. (Best Picture nomination for 2020)

David Crippen, MD, FCCM
Critical Care Medicine (ret)

A treatise on aging and dementia

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I read with great interest Mike Darwin’s essay on aging and potential dementia. I decided to add some to that, including a perspective of my own experience- how it applies to me as I age. (76 years of age this month).

The issue of dementia has become more prevalent for a very interesting reason. In my research for my 60s music appreciation class at Pitt I ran across a very interesting statistic. Because of the huge birth rate during and following WW II, all those kids landed in the same place at the same time.  Do the math.  Born 1945, in 1965 half the population of the USA was under 21 years old. This formed the platform for the 60s cultural and musical era that never would have happened otherwise. Then all the 21 year-olds continued along the line until now ~2015, add 50 years and they’re all in their early 70s.  50% of the 2015 population is over 65 years of age.

That age group is responsible for at least two discrete population dynamics: a much larger population getting sick and a much larger population living longer and suffering from various degrees of dementia.  In the early 1960s, the average life expectancy in the United States was 70.2 years. In 2013, the average life expectancy was 78.8 years. However, the quality of life of aging Americans has not increased commensurately. In the 1960s, the incidence of dementia among people approaching death was less than 1%. Currently, the incidence of dementia in Americans is between 5% and 7% for adults’ age 60 or older. Starting at age 65, the risk of developing some form of dementia doubles every 5 years. By age 85 years, between 25% and 50% of people will exhibit signs of Alzheimer’s disease or some degree of nonspecific dementia.

The issue of subtle, age-related deterioration of brain function is difficult to sort out. The “heart too good to die” concept as espoused by Peter Safar does not apply to the brain. The heart is usually amenable to restart by traditional resuscitation. The brain has proven to be dramatically less so. The brain is a rather frail organ, rapidly damaged during hemodynamic or metabolic disasters and difficult to resuscitate.

Cerebral atrophy occurs naturally in aging and is accelerated between the ages of 70 and 90. But the process actually begins sub-clinically in gray matter of the cerebral cortex at a much earlier age. It’s unclear whether “normal” cerebral atrophy during aging affects each brain the same way or how each cognitive area is affected. Cognitive abilities such as verbal fluency increase until the mid-50s but start to deteriorate in the sixth decade, after which most of the neo-cortex continues to degenerate until death. Many people in their fifth and sixth decades experience “word searching” and a transient inability to recall previously known names. This variety of cognitive deterioration is associated with hippocampal inadequacy.

Interestingly, aging people have a propensity to trade cognitive decline for enhanced judgment. As processing speed slows in late life, logic, reasoning, and spatial abilities remain generally well preserved. Older individuals’ life experience, their long accumulation of knowledge, and their maturity and wisdom offset some of the losses during processing decline. For instance, an adult tells a child to play in their safe yard and not in traffic. The child has the knowledge and enhanced ability to play with great vigor but lacks the wisdom to refrain from dangerous behavior.  This, of course, proceeds into the teen years.

Now, I’m 76 years of age and much like Linda Ronstadt, I can feel the onset of something wrong before it actually happens. Poor Linda. In her time, one of the most beautiful voices in the universe. In the movie of her life she said one day she instantly knew something was wrong because she could feel the prodrome no one else could hear. She went on to get Parkinson’s so severe she was too frail to travel to Cleveland to get her award at the Rock & Roll Museum.

If I could name one deficit that started about age 65 and continues to encroach on my life much like Darwin’s slope of deterioration, it would be the extremely irritating and debilitating issue of “word-searching”. It’s reached the point where holding a conversation with friends is punctuated by instant inability to remember the formal name of persons, places or things. “Yeah, I went to the ……….(blank) concert and it was great! I knew what I wanted to say. It was safely ensconced in my memory bank, but I couldn’t recall it in the time available. I meant to say “I went to the Electric Light Orchestra with Jeff Lynn concert…..”, but when asked to recall it instantly, I just look blank and offered “I’m blocking”. I watch “Jeopardy” on TV and I actually know the names of many of the questions but I can’t produce them in time to hit the button before any of the contestants.

My general physical condition began to deteriorate at about age 70 and unrelentingly progresses yearly, as does my word-searching. When writing something, I frequently use Google to pull up the name I’m trying to remember. I’m a victim of a phenomenon of the 1940s (baby boom) that silently followed me for two generations until we’re all the majority of the population now, collectively consuming huge amounts of medical care to keep us alive longer, but our quality of life has not necessarily followed increased with our viability. Not what we anticipated in the 60s.

So I’ll leave you with the masterful philosophy-of-life according to Pete Townshend of “The Who” (currently age 75):

“People try to put us d-down

Just because we get around

Things they do look awful c-c-cold

I hope I die before I get old”

                 

                          The Who, “My Generation,” 1965

 

 

 

 

 

 

 

Some interesting 1960s stuff

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While researching some things for the Pitt class I teach on 60s music appreciation, I picked out a bunch of dead vintage musicians over the past ten years or so. Never mind those that expired in the 1970s. I split them into suicides for those that couldn’t make the transition into the new millennium and, of course the inevitable drug deaths, some accidental using the spectacularly dangerous drug (in amateur hands) Fentanyl.

Then comes a very interesting category, those 60s and 70s rockers that died of “old man diseases”. Now, recall that statistics show that something like 38% of the American population was less than 21 years of age in 1965. This, of course, greatly contributed to how the culture evolved through the 60s, including the psychedelic years. Now, assuming most of these guys were around 21 years old in 1965, do the math. Add (rounded off) 55 years to these guys to the present and most of them exceed the 70 years old range. The range where many of the “old man” diseases start occurring, heart disease, cancers, obesity, diabetes, hypertension and trauma.

To me, if you were a world class rocker in or around 1965, as most of these guys were, 70 is an independent marker of “natural” death once drugs and suicide is ruled out.

Suicide

Butch Trucks (Allman Bros)

Keith Emerson (ELP)

Kurt Cobain (Nirvana)

Brad Delp (Boston)

Richard Manuel (The Band

 

Drugs

Prince

Chris Cornell (Soundgarden)

Tom Petty Heartbreakers)

Bobby Hatfield (Righteous Bros)

Ike Turner (Ike & Tina)

John Entwistle (The Who)

Dee Dee Ramone (Ramones)

Owsley

 

Old age/Old man disease (and their age at death)

Alvin Lee (68)

Ritchie Havens (72)

Lou Reed (72)

Jimi Jamison (72)

Jack Bruce (71)

Dallas Taylor (66)

Percy Sledge (73)

BB King (89)

Cory Wells (74)

David Bowie (69)

Glen Frye (67)

Paul Kantner (74)

Scott McKenzie (73)

Ray Thomas (67)

Danny Kirwan (68)

Marty Balin (76)

Otis Rush (84)

Gregg Allman (69)

Daryl Dragon (76)

Peter Tork (77)

Eddie Money (70)

Rik Ocasek (75)

I have excluded all the 60s rockers that expired in the 70s. On Oct. 4 in 1970, singer Janis Joplin was found dead of a heroin overdose on the floor of a motel room at the age of 27. Janis was the second of a triumvirate of exceptionally talented people that pushed the envelope of a “no rules” life and paid the price of admission they didn’t anticipate.  Jimi Hendrix, age 28 (Sept 1970) and Jim Morrison, age 28 (July 1971). A large number of very talented people found out those consequences the hard way in the late 60s.  Perhaps prior lessons learned from the existential philosophers, most of whom went mad or suffered violent deaths, should have been heeded. Forty years later, Jim remains an example of the fate that awaits those who reach too far for answers unobtainable.

Dave Grohl believes that all music can eventually be traced to a central origin that nurtures and modulates it and he’s working very hard to explore that path. The best way to explain the concept is to postulate the repository of music as an unstable star in the universe of existence, undulating and straining but not ready to explode just yet, waiting for the right stimulus. Back in the 40s, big band music was simple and staid, feeding upon itself. In the 50s, a fundamental instability began with skiffle in England that created the Beatles In the USA, be-bop and rhythm & blues, Gene Vincent and the Blue Caps, Little Richard, Jerry Lee Lewis and of course, Elvis. All of this boiled to the surface to bring the star to an explosive point in the early 60s, setting the stage for the cataclysm that occurred in the second half of the 60s when it all literally and metaphorically went electric. A musical revolution never before dreamed of and will probably never be seen again.

The star erupted sending chunks of musical expression out into the abyss. Lets make a quick & dirty list of just a few the blinding chunks flying forth to change the fundamental nature of music. Hendrix, The Animals, the Zombies, The Kinks, Cream, the Doors, Pink Floyd, The Velvet Underground, The Rolling Stones, Frank Zappa, Otis Redding, Creedence Clearwater, The Byrds, Simon & Garfunkle, Janis Joplin, James Brown, Miles Davis, The Who, Sly & the Family Stone, Paul Butterfield Blues Band, Buffalo Springfield, Procol Harum, Paul Revere & Raiders, Hollies, Dave Clark Five, Neil Young, Steve Miller Band, The Guess Who, Roy Orbison, Them, Beach Boys, Steppenwolf, the Temptations, Blood, Sweat & Tears, Jackie Wilson, Sam Cooke, Marvin Kaye, Jefferson Airplane all at once.

Each of these chunks shone brightly and independently, eclipsing other nuggets in similar situations. But in the end, like real stars, gravity rules and all the chunks were slowly drawn back into the mass of the star by gravitational pull, stabilizing it into a huge mass of encyclopedic, heterogeneous, eclectic sound and tone. There is no more critical mass. The star allows a solar wind to emit from its surface, a temporary swell of unfiltered music that waxes & wanes in time.  Disco, Britney Spears, Justin Bieber, “American Idol”,‘The Voice. They’re all out there wafting around at the whims of the desultory solar mini-eruptions. That’s maybe the new music of the new millennium. Unknown if or when the next big eruption will occur.

Peter Fonda (1949 – 2019). Last of his kind

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Peter Fonda, maybe the last living icon of the 60s idealism he never let go of, is dead at 79. Lung cancer. The 60s officially died with the Manson murders in August, 1969 but the ideal of free spirits taking the cathartic road to find and immerse in the unknown remained in the background with Peter. He is best known for his paean to “On the road” (Jack Kerouac, 1957) riding custom motorcycles instead of cars. It’s said that vision from motorcycle riding is the closest thing to flying.

“Easy Rider (1969).  Two hippies riding custom bikes accumulate a cash stash from a drug deal (Phil Spector) in Southern California, then ride cross-country searching for spiritual truth. On their journey, they experience unexpected bigotry from small-town America and also meet with other travelers, all seeking alternative lifestyles. After a “bad trip” in New Orleans, the two counterculture bikers discover there is no peace and love anywhere in America.

The custom bike Peter rode was a highly modified 1942 Harley-Davidson Police Special. There were actually two made. One for the progress of the film and another to be trashed at the end. The trashed bike was restored and is now on display somewhere in California. The street version disappeared, presumed stolen and now resides in someone’s living room somewhere. It has never been found and probably never will be.

Watching “Easy Rider” is not much of a fun experience anymore. It’s so horribly dated. Virtually all of it ceased to exist many years ago, the film remaining as a hallmark in vintage memorabilia museums somewhere. I have a full size poster, signed by Peter Fonda, Dennis Hopper and Jack Nicholson hanging on my den wall. I also have an original “Captain America” leather bike jacket with the full size American flag on the back. You can get the jacket still but not the one with the flag. I wear it out on the road now and then. It always generates remarks. (I have included stock photos of both, as I don’t have actual photos of mine at the moment).

“Easy Rider” was not Fonda’s first reach into filmdom (Generated by the family name). He had somewhat limited success starring in other similar films, most notably “The Wild Angels” (1966) directed by Roger Corman. Wild Angels began the biker forum that persisted into the 70s and introduced the “Hell’s Angels” to film. Wild Angels was a pretty crummy second or third-rate film full of gratuitous sex, violence and notably Harley-Davidson motorcycles (ridden by real Hell’s Angels). The Angels were pointed out as authentically “free spirits”, ignoring convention; riding around all day enjoying whatever came. In fact, dealing with the Angels was a risky proposition as they impossible to control, had virtually no respect for anything or anyone and would start fights for virtually no reason.

There have been books written and documentary films produced about the Angels and they are an interesting culture. Perhaps the best was written by Hunter S. Thompson in 1967:  Hell’s Angels: The Strange and Terrible Saga of the Outlaw Motorcycle Gangs. Here is a representative clip from that volume:

“They were a bunch of overgrown adolescents,

stuck in their religious mind-set as a way of life. 

They defined themselves by their opposition to

any and everything.  The strength of their

antagonism was the source of their faith, and

like all holy wars, their greatest enemies and

their greatest source of bloodshed was from

within, battles against rival competing for

bottom of the barrel status.”

 The Angels are still around, still wearing their “colors” but not much noticed any more than any other drug dealing gang in Southern California.  Peter Fonda never lost his interest in immersing into what remained of the counterculture, even far after it passed into obsolescence. Peter is maybe the last of the true 60s riders into the unknown, never finding more than appearing for a few minutes on a Harley as a guest star in “Wild Hogs” (2007):

“Why do you think I don’t wear the colors, Jack?

Why do you think I ride alone? ‘Cause you don’t

know about it anymore. I think you all oughta get

back on your bikes and go out and ride the highway

until you remember what riding’s all about”.

 I suppose his indomitable spirit is out there somewhere doing exactly that.

Peter Henry Fonda (1940 – 2019)

 

 

 

Electric Light Orchestra (ELO) with Jeff Lynn and Dahni Harrison (August 1, Pittsburgh)

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elo_660x360-b7cf1f0f60Electric Light Orchestra (ELO) In Pittsburgh, Thursday evening, Aug 1 with Jeff Lynn and surprise (to me) Dahni Harrison Band opener (yes, George’s son).  ELO started in England in 1970 by songwriter, multi-instrumentalist and producer Jeff Lynn. Their music has from the beginning been Beatlesque rock interfused with classical arrangements and a monster light show. Through its recording and touring career, ELO sold over 50 million records worldwide and collected 19 CRIA, 21 RIAA, and 38 BPI awards. ELO was inducted into the Rock and Roll Hall of Fame in 2017.  They are an authentic supergroup.

They played Thursday night, August 1 here in Pittsburgh and I went out of my way to get good seats through StubHub. A fact of life. If you want regular ticket price, you get regular seats a half mile from the stage. You get what you pay for and I did. I did notice that there were a few seats open in the front rows for US$1600. A little rich for my blood.

Normally, I pay little attention to “opening acts” as most are local and not very good. However, this time I didn’t want to get stuck in a parking dilemma so I arrived pretty early. Hordes of people were descending on the PPG Paints arena, home of the Pittsburgh Penguins- 20,000 seats. At some point in the concert they turned the house lights on for the musicians and every single seat was filled. The acoustics in the arena were world class.

As we were seated, I started picking up on the opening band. I didn’t know who they were but I was increasingly impressed with every number. They played different instruments, electronic keyboards and they were really, really good. World class musicians. The lead singer came up focused on huge TV screens we could see easily and I didn’t recognize him. I checked my phone to see if I could find the band and it turns out it was the “Dhani Harrison” Band. Yes, that Harrison. Jeff had chosen him to open for the entire twenty city tour, of which Pittsburgh was the last. It was an excellent start.

I first saw ELO in the opening year of MTV which would have been 1981. The MTV concert began with a huge flying saucer on stage, pulled up slowly by cables revealing the band that started their set with the saucer hanging over them. This time, there was no saucer, the show started with a huge light show complete with multiple modalities and lasers. It was just about the right number of decibels. Loud enough to push out anything else in your soul but not to do serious hearing damage. Loudness is important to Rock.

That said, there’s something really existential about a real “live” concert as opposed to listening to a record or something off a portable device. I’ve had the dumb luck to play rock music with a great band in front of hundreds of people in venues like “The House of Blues” around the country. I could see what was happening in the crowd from my vantage on the stage and this was the microscopic minor leagues. If you are the proper connection, the vibration of the music from a  20,000-seat auditorium simply fills your soul to the brim. The music grabs you so tightly there is no competition from anything else.

ELO blew the audience away when they hit:

“In this life I’ve seen everything I can see, woman
I’ve seen lovers flying through the air hand in hand
I’ve seen babies dancing in the midnight sun…….”

BUT I…I….I….I NEVER SEEN NOTHING LIKE YOU!”

at full volume with blinding multicolored lights. The aisles were full of dancing people, many my age. The old guy to my right was in tears. Everything  from our youths in the 70s came back in a flood. Unclear how that connection was made but it was absolutely there.

“Twilight” blew me away:

“Twilight, I only meant to stay awhile
Twilight, I gave you time to steal my mind
Away from me”.

At this point, old memories previously forgotten rushed back into me.

Then Jeff introduced his acolyte Dhani Harrison to do a duet of the first song the Travelling Wilburys sang as a group. “Handle With Care”, written in 1988 by George Harrison with specific intent for Roy Orbison to sing a specific section. As the song was being fleshed out in the acoustics of Bob Dylan’s garage, it had no title. Harrison looked around and noticed a label “Handle With Care” on a shelf box and that’s what he named it. The song “Handle With Care” is beautiful and meaningful music.

“I’m so tired of being lonely
I still have some love to give
Won’t you show me that you really care?”

 “I’ve been uptight and made a mess
But I’ll clean it up myself, I guess
Oh, the sweet smell of success
Handle me with care”

This music has intense meaning to a lot of people. A lot of people. When Dhani came out and ELO began this song, I was immediately in tears. Again, no one has explained the emotional connection but it is intense. I think I can die now. I’ve heard ELO and Dhani Harrison speak to me.

And so it goes, the entire concert was an intense emotional experience, and accordingly, I have provided for you some of the intensity in the form of YouTube clips that will show you some of it.  First is the original Wilburys singing “Handle With Care” back in 1990-I think. Since then Tom Petty, George Harrison and Roy Orbison have passed, leaving Jeff Lynn and Bob Dylan. I think one of the most musically beautiful songs that can be sung by humans. After than, I found a clip of Jeff Lynn and Dhani Harrison reprising the song from this year’s concert. It spoke to me.

After that, I have given you some classic ELO songs that you should all hear and I hope you will as a favor to me.  First is “Roll over Beethoven” from the Rock & Roll Hall of Fame induction in 2017, tribute to Chuck Berry, featuring ELOs magnificent string section. Then “Twilight” and “Do Ya” (The song that made the Pittsburgh crowd absolutely delirious, including my wife who cares nothing about any of this-slapping her knee), both masterpieces of performance art. Please give them a look. You can’t possibly be disappointed.

 

“Handle With Care” (Travelling Wilburys)

 

“Handle With Care” (ELO with Dhani Harrison)

 

“Roll over Beethoven” (ELO)

 

“Do Ya” (ELO)

 

“Twilight” (ELO)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Some notes on Cuban trip December 3-7, 2018

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Only 90 miles or so from Miami but much more a foreign flavor. Only recently opened for foreign visitors by Obama who reversed the Bush embargo in 2009. Embassies appeared in 2015. Any US citizen can attend any professional meeting in Cuba but a visa must be obtained. Unclear what hoops must be jumped through to just be a tourist.

On December 3 – 7, the International symposium on altered consciousness and brain death was held. The very gracious Dr. Calixto Machado hosted us.  We stayed at the Habana Librae, the enormous hotel where the meeting was held. The hotel advertised Internet access but it never became available.

The meeting was interesting. It was mostly about the Jahi McMath situation and brain death. I’ll pass on comments regarding that as Michael Kuiper has summarized the daily activities for CCM-L.

My interest really lay in the awesome collection of vintage automobiles that filled the streets of Havana. Mostly 50s and 60s cars, many converted as taxis to show tourists the city. We did an hour and a half tour in a 1955 Chevy convertible.  It was fascinating (see photos later).

Our aim was to see “old Havana” and we did. Old Havana was named a notable historic city centers by UNESCO in 1982. Restored areas of Old Havana features styles from Baroque and neoclassical to art deco. It reminded me of parts of New Orleans a bit was very scary in some respects. Not terribly safe to walk about. Over 28,000 people currently live in unstable dwellings that could collapse without warning. USA Today recently reported almost 4000 building collapses from 2000 to 2013.  In 2016, Havana has a shortage of over 200,000 dwellings. Havana officials are using mostly tourist revenue to solve these problems.

The people of Havana are exceedingly friendly and helpful to foreigners, including Americans. The food in restaurants is always excellent and there is virtually no violent crime. It’s safe to walk anywhere. There are no guns. Interestingly there are also no McDonalds, Burger King, Wendys or any other fast food place.

However, Americans are discriminated against within the economic system, No one in Cuba accepts any credit or debit card from any American bank. It’s cash and carry. American dollars are subject to a 10% tax when converted to Cuban Pesos, plus a 3% service fee. So converting an American dollar will get you 87 cents. However, one Euro will get you 1.14 Cuban Convertible Pesos, but when you go to convert dollars to Euros, the exchange rate at the airport is awful. I changed 700 dollars and got 550 Euros. So you get stiffed coming and going, exchanging anything.

You know me; I’m always on the lookout for interesting knick-knacks.  One of my wife’s friends begged her to bring back some Cuban cigars for her husband. I could have cared less. All cigars smell like dead cats, but I tagged along to the cigar shop just to see them. On arrival, I noticed a decorative (empty) humidor box with Che Guevara’s likeness (smoking a cigar of course) on it in high-resolution porcelain (see photo below). I looked at it for a long time while my wife purchased a box of ten cigars for what amounted to US$100.  Yes, ten bucks per cigar, and there were much more expensive ones available.

By the time I got back to our room, I was obsessed with it and had to have it. I went back and paid a bundle for it. It now graces my mantle. Note in the video also some female (very female) stick figure single cigar holders. I would have bought the entire collection but I ran out of money and had no way to get any more.

Che’s likeness is everywhere in Cuba, many next to Fidel. Che isn’t really a very high-end role model, but I kept my mouth shut about both him and Fidel.

Now for some interesting history about both Fidel and Che. After it became apparent that Castro was a bull blown “Communist” and was quickly aligning his new society after that of Soviet Russia. After the disastrous “Bay of Pigs invasion in April of 1961, Castro’s paranoia became exponential and he became convinced the Kennedy would follow this attack up with much heavier weapons, including nuclear arms. Castro begged Khrushchev to send arms for the protection of Cuba. Khrushchev saw this as an opportunity to place nuclear weapons in the Western hemisphere, under the nose of Kennedy who he considered a weak sister following the poorly planned and executed Bay of Pigs and the building of the Berlin Wall in 1961. Khrushchev didn’t think Kennedy was decisive enough to do anything about it. So off they went, as the Cubans worked to build bases where these weapons could be housed, all quickly spotted by U2 planes. The rest of this is history.

But what isn’t so clear is the nature of Castro’s fervor to revolutionize the world by violent means. Following the Cuban Revolution of 26 July 1959, Che became Castro’s right hand man for the spreading of the gospel of revolution to other Latin countries. Che was actually a physician but never did anything medical after becoming radicalized by witnessing the sorry plight of Latin America at the time. Che trained the Cuban military forces that repelled the Bay of Pigs attack and was central to the negotiations that would have brought nuclear weapons to Cuba. He wrote a seminal manual of guerrilla warfare. Che became convinced that most of the woes of the world were a direct result of Imperialism and capitalism (Americanism) that required a violent world revolution to counter it.

Che left Cuba in 1965 to foment revolution initially (and unsuccessfully) in the Congo but ending up in Bolivia where American CIA quickly captured him assisted Bolivian troops and summarily shot without fanfare.  Following his death, Che rose to the position of a revered and reviled historical world figure and his likeness with the star beret was cited by the Maryland Institute of Art and “the most famous photograph in the world” (pretty doubtful But it’s up there in the top 20 maybe). Time Magazine named him as one of the top 100 most influential people of the 20th century.

However, Che was also an advocate of brutal violence to create a utopian world that would quash any dissent, an anti-imperialist Marxist and outspoken anti-capitalist whose image has been made an idealistic commodity not unlike that of Robin Hood and Don Quixote. Che was involved in hundreds, maybe thousands of executions of those opposing the Revolution in several South American countries. Che openly despised the United States and everything about capitalism and a Republic governing system. He was very interested in starting a nuclear war with the Imperialists (us) and probably would have worked it out had the missiles from the USSR had actually been delivered to Cuba (diverted by Kennedy). The whole point of those missiles were to be used against “enemies”. He was a brutal Communist agitator and all of his history is filled with death.

So for what it’s worth, I have a really interesting portrait of him that continues to fascinate me. I also acquired a pastel painting I’ll frame this week. You’ll see it in the film.

Interesting trip that will become clearer as you watch the video below. A collection of some of the photos I took.

 

Enjoy if you have an interest.

D. Crippen, MD