Out of a Cannon

Image from Shutterstock

I have never been terribly enthusiastic about New Year’s Eve resolutions. This is not because I lack resolve, but because the start of a new year has usually struck me as a rather arbitrary time to gain such resolve or to turn over a new leaf. If one is committed to certain goals and principles in life, then almost any day will do for fashioning new objectives in serving those goals, depending on circumstances. Why January 1? I suspect that it is mostly a reminder for many people that they have not spent enough time thinking about or pursuing their goals. They may need to develop the habit on an ongoing basis rather than pretending that the start of a new year will make things different. Will power and commitment matter. Do you really want to make things different? If so, then why not make the decision on February 4, or your birthday, or even the Fourth of July? Any day of the year will do, as long as the commitment is real. That commitment may arise out of a life-changing event, but it does not have to. New Year’s resolutions often fade into the ether of our dreams because those making them have not developed an adequate habit of connecting their dreams with a determination to make them happen.

All that said, on this particular trip around the sun, New Year’s Day seems for me a perfect day to launch some resolutions, even if many are focused on unfinished business. But I don’t just want to pick up the pace in 2024. I want to be metaphorically shot out of a cannon on New Year’s Eve. I want to start the new year with a passion.

I say this not because I changed how I feel generally about new-year resolutions. It’s because, for me personally, January 1 is a remarkably convenient opportunity for reclaiming lost energy. What happens a year from now may be different.

For one thing, although I don’t want to overemphasize this, as early as April, there were signs that I was facing a reckoning with regard to a medical problem that had been dogging me in one form or another for about a dozen years. Somewhere back then, my physician referred me to a urologist because of high PSA scores. PSA refers to prostate-specific antigens, antibodies that fight cancer or infections in the prostate gland. That led to a long series of periodic biopsies to monitor the possibility of cancer serious enough to merit surgical attention or radiation treatment, but doctors found only the slightest trace of an indolent cancer and never acted on it. Over time, it became harder to take it seriously, but such monitoring at least produced reassurance nothing disastrous was happening.

But that is not the whole story. In 2012, during a flight from Chicago to Los Angeles for the annual APA National Planning Conference, I became very ill. It felt like influenza, but by the time I left the plane, my only priority was to find a taxi for a quick trip to the hotel, where I promptly became seriously ill after checking in. Only a long-distance consultation with my primary physician, followed by a visit to a nearby urgent care center, confirmed that what I thought was the flu was actually prostatitis and required a major regimen of antibiotics for the next two weeks. I spent much of the conference in bed, sweating through a fever and visiting the bathroom frequently, occasionally struggling to attend events, only to succumb again. Fortunately, the antibiotics salvaged a post-conference road trip with my wife, Jean, to visit relatives in northern California and return to LAX along the gorgeous Pacific Coast Highway.

As for my urologist back in Chicago, when I later recounted these events, his eyes widened, and he said emphatically, “People have died from infections like that.” I did not, and I think I was otherwise far too healthy for that outcome, but it was unquestionably one of the worst experiences I have had with any sort of illness. Prostatitis is simply not fun. It is a bacterial infection, not cancer, but it can drive up PSA scores to drastic levels.

Prostate cancer drives them up much more slowly. It is a grinding menace, and because I have known people who died from it, I took it seriously all along. In the meantime, however, a less potent but serious problem developed called benign prostatic hyperplasia (BPH). Basically, it involves the enlargement of the prostate gland, a process that is typical as men grow older, but the big question is how big and how rapid the growth. By April, one of those periodic biopsies produced very uncomfortable impacts just as I was about to undertake a full week of online teaching for the Emergency Management Institute, for which I am a certified instructor for courses related to post-disaster recovery. The biopsy occurred on Friday. I was in miserable shape on Saturday, and I was already exhausted when I logged on with the class, another instructor, and our course supervisor at 7 a.m. on Monday. Although the course supervisor said he did not notice much difference in my delivery, it was a case of only making it look easy. When the day was over, Jean could see that I was thoroughly exhausted. It got a little better later in the week, but it was still a struggle.

My new urologist, Dr. William Lin, who had performed the biopsy (the original one retired in March), chose in a follow-up visit to refer me to a specialist who was highly trained in a new surgery called HoLEP (holmium laser enucleation of the prostate), for an evaluation of my suitability for this treatment of a prostate gland that was now about three times normal size. Other than aging, I have not found any indication that the medical profession knows precisely why this happens. It was just my bad luck, I suppose. Dr. Amy Krambeck did not have an opening until August 10, but at that appointment, she and her team made clear that I was well above the threshold for the surgery, and we scheduled it for September 29 at Northwestern Memorial Hospital. I also learned that she was regarded as quite possibly the best in the nation at this relatively new procedure, which basically uses laser treatment to hollow out the prostate gland, leaving the shell, thus drastically reducing bladder pressure, the main problem connected to BPH. I’ll let those interested follow the links to learn more. My focus here is still on New Year’s resolutions.

Why? Because the first thing I learned was that for at least a month afterwards, I was expected to adhere to some strict dietary limitations (mostly avoiding acidic foods and beverages) aimed at avoiding bladder irritation and allowing my internal organs to heal as well as possible. I was instructed to avoid most physical activity and not lift anything above ten pounds. The key was an intense focus on compliance, a self-discipline aimed at ensuring the best outcome.

Those who have been following the many blog video postings here in recent months will know that I spent much of my summer on trips designed to develop content for a documentary film about planning for community resilience in the face of natural disasters and climate change. By September, such travel became challenging, underscoring the real need for treatment. I had previously scheduled one more trip for early November in Texas—those blog videos are still coming—and deliberately asked Dr. Krambeck about the wisdom of its timing, which was tied to a Texas APA conference in Corpus Christi. She said I should be fine. I did get through it, but setbacks in the first week of November made me wonder as I worked with one of her assistants to determine their likely cause. They were ultimately blamed on inflammation, which could be addressed with Motrin or Ibuprofen. The trip took place, but not without its own challenges.

The reality is that recovery is often a bumpy road. Dr. Allison Shafron, who will see me on January 2 to assess my progress, texted a patient-portal welcome to “the roller coaster of recovery.” That struck me as curious because we use that same phrase in helping communities and local planners prepare for the long road to recovery after disasters. We even have a graphic slide in the EMI courses to illustrate the idea. By December, some other troubling personal matters were also seizing much of my attention, and I was feeling significant fatigue, sometimes as a result of a bit of sleep deprivation. I was also trying to rebuild strength and stamina by resuming a workout routine that I had suspended for nearly three months. I had to temper them initially to avoid overdoing it, but have gradually ramped up much of the exercise to pre-surgical levels. Some people might wonder if that might wear me out, and the answer is yes, but only temporarily. I have pursued fitness goals, on a noncompetitive basis mostly related to personal health, for years and know that the long-term benefits completely outweigh any short-term fatigue. That includes recovering from medical setbacks and injuries.

The reason for describing this at all is that it relates to my stated desire to be “shot out of a cannon” on New Year’s Eve. During much of 2023, I was decidedly passive about pursuing the sort of consulting work I have done in recent years because I was not confident about meeting the challenges involved while awaiting or recovering from the expected surgery. It did slow me down in ways that I am not used to. But I have also grown impatient to get on with normal life, to tackle new professional and volunteer challenges, and to achieve personal goals. These include raising money for and producing the HMDR documentary film, Planning to Turn the Tide; completing redesign of the disaster planning course I teach for the University of Iowa School of Planning and Public Affairs; possible additional course instruction for EMI; and finally, outlining and moving forward on some long-planned book projects. That is to say nothing of reinvigorating this blog with new content, as well as planning at least one personal trip to relax and see the world.

On December 20, I became only 74 years old. I expect to be around for a while, and I don’t plan to occupy a couch. For the first time in years, January 1 seems like a perfect time to fashion some resolutions that I will pursue with joyful vigor. Happy New Year, everyone!

Jim Schwab

Going Viral

Now I know what it feels like, or may have felt like. Kind of. Sort of.

I will never experience, in all likelihood, the very worst the COVID-19 virus can inflict on human beings. I was lucky in many ways. First, the virus just never found me as a target until early October of this year. Second, I am very physically fit for my age, and I don’t suffer from any chronic conditions that often expose people to more severe reactions to the virus. Third, by the time COVID-19 found me, I had the two initial shots of the Pfizer vaccine, and later a Moderna booster. My only failing was not having obtained the more recently released Omicron booster, but there is no question that vaccines made my path far easier than was the case for those who suffered earlier in the pandemic.

I spent most of my COVID time not knowing I had it, though there were indications that aroused my suspicions—just a bit. Late Sunday, October 9, I experienced some mild cold symptoms, but I sometimes have sinus problems that become more persistent as Midwest weather changes in the fall. On Monday, I began to experience more of a cold and struggled through online meetings, two about a video project, one preparing for an upcoming online training workshop. In the evening, I was supposed to volunteer with

It’s a lot easier to get a test now than at the height of the pandemic, when tests were as scarce as the places that provided them. Now you just pull up for an appointment, take the kit through the window, tickle your nostrils with a swab, and hand it all back to the pharmacist.

signature collection to help place our incumbent Chicago alderman, Daniel La Spata, on the municipal ballot next spring, but I called it off because I was not feeling well. By the next morning, I took a nasal swab COVID test at Walgreen’s, but the test came back negative the following day. As a result, I assumed I simply had what I called “the ordinary crud” of a normal cold. Just deal with it for a few days, I thought, and get over it.

I made no real changes to my plans and tried to maintain my normal pace. The previous week, curiously, had included my participation as a consulting expert in two online symposiums, both lasting two and three-quarter hours, on Tuesday and Thursday for a project at Johns Hopkins University addressing pandemic community recovery. I moderated the final panel on Thursday, dealing with the use of metrics, which are essentially statistical targets, for tracking the many variables concerning social equity and public health factors that would guide such recovery. In other words, COVID-19 already had my intellectual attention. I had no reason to suspect It would seize my medical attention as well.

But I was wrong on that count. By that Tuesday, some of the infamous COVID-19 fatigue was settling in, and the cold was tightening its grip. I had planned to attend a program of the Society of Midland Authors at Cliff Dwellers in downtown Chicago that evening. As on Monday night, I never made it. It seemed wiser to stay home. It was becoming a pattern.

Nonetheless, I spent Wednesday morning at a dealership service department. While in the waiting room, I met online with two planned guest speakers for my online University of Iowa class, which meets in the fall semester on Thursday evenings. I was very much looking forward to letting Linda Langston and Kehla West take over the class a week later because, in my opinion, both are impressive members of the natural hazards professional community and could share valuable insights. “Planning for Disaster Mitigation and Recovery” offers graduate planning and public affairs students serious comprehension of the natural-hazard threats facing our communities. Linda is a former county supervisor of Linn County, Iowa, who had helped lead her community through the 2008 floods that overwhelmed Cedar Rapids and into the recovery that followed. She later worked nationally on resilience issues with the National Association of Counties before returning to Cedar Rapids as a consultant. Kehla works with Region 5 of the Federal Emergency Management Agency in Chicago. Although she was doing me a favor by sharing her federal government experience, she regarded it as a great honor to be asked to speak to a class in which she was once a student. I was enthusiastic about sharing my virtual stage with them for two hours. The meeting was a breeze.

All right, this is a simulation of what I may have looked like, but it’s probably close. I found myself waking up in a seated position on the couch more than two hours after falling asleep early in the afternoon.

But most days that week, with increasing frequency, the afternoon was not. I no longer even remember which day was which, but I know that on several occasions, I would hit a wall of fatigue by late morning or early afternoon, and work would grind to a halt. One day, this happened around 1 p.m., and to regain some energy, I went downstairs from my home office to sit on the living room couch. I simply disappeared into deep slumber, with no recollection of anything. Sometime well after 3 p.m., I woke up, looked at the clock, and wondered where my day had gone. For someone very conscious of pending deadlines and obligations, it was deeply frustrating. At the end of the day, I like to know what I have accomplished. I did not want to find that I had lost a major chunk of my day to exhaustion. It became hard to believe that a mere cold had done this, but I kept thinking about that negative test. It was not COVID. I was just worn out fighting a cold. But day after day, I watched in growing alarm as the number of tasks falling behind schedule kept growing. The will power and drive that sufficed in normal circumstances to overcome such deficits never materialized, and the gap widened instead. The spirit was willing, but the flesh fell asleep, day after day.

That Thursday evening, I taught my class as usual. But it was not so usual. It became patently obvious that I was struggling with my voice, with sinus difficulties, with watery eyes, with fatigue, but I plugged away for two hours. By Saturday, in a phone conversation with someone about a potential film grant proposal, I struggled again in the conversation because my voice was weak, but I pushed ahead because the call was important, and the proposal deadline was at the end of the month, just two weeks away.

And so it went. If a meeting was on the telephone or online, I could make it work even if I was exhausted after it was over. If it was in person, I would cancel. Fortunately, most meetings, including a debrief with Johns Hopkins about the symposium two weeks earlier, a HUD guidebook review panel, and a Midland Authors board meeting, were online, usually via Zoom. I had contacted my doctor over the weekend of October 15-16 through a patient portal, and he asked me to come in, which I did by Wednesday, October 19. He made some suggestions but accepted the negative COVID test result. Following his advice, I began using a Neti pot to control the sinus congestion—and it works, by the way. In combination with Flonase (after the Neti pot), it has been effective. The fatigue, however, took its own good time to fade away.

The next day, Thursday, I had class in the evening, the one at which Linda and Kehla would speak in tag-team fashion about local and federal perspectives on planning for disaster recovery. That afternoon, Jean tested positive, much to her surprise. In our pre-class banter on Zoom, I mentioned that to Linda, who repeated it to Kehla when she logged on: “Jim’s wife tested positive for COVID.” Kehla immediately expressed her regrets. They taught the class, I offered occasional commentary, and for the most part, I got to rest my voice and conserve my energy.

But I had also decided at that point that getting another test the next morning was imperative. By mid-day Saturday, a Walgreen’s e-mail informed me that I had tested positive. I discussed it with an emergency room doctor, and later my primary physician, who said the symptoms we discussed just a few days before sounded a lot like COVID to him at the time. The ER doctor stated that, based on our discussion of what led me to get tested again, I had probably had COVID all along and may unwittingly have infected Jean. The verdict of these two men made sense to me, but of course, it was now after the fact. I was actually near the end of my COVID experience before I ever knew for certain that I had it.

Alex, to right of candle, after baptism service, with me at far right, Pastor Nancy Goede, Pastor Matt Stuhlmuller, Alex, sponsor Kornelius, and members of my family, including Jean, far left. I later wondered about any unintended exposure I may have cause through unawareness that I even had COVID at that point.

If there was one situation that brought some regret–it seems not to have produced any adverse consequences that I am aware of–it was that, not believing I had COVID, I joined others at our church for our grandson Alex’s baptism on October 16. Mass spreader events were at one time rather scary propositions. But there I was, unaware, part of a ritual and celebration that was a happy event but could have infected others. The following Sunday, I stayed home because by then, I knew I had contracted COVID.

Although I am certain that skeptics of the vaccines (and I know some) would say this was just one man’s opinion, the ER doctor stated that the vaccines had surely helped make my case milder (and Jean’s was milder still), and that the vast majority of those now being hospitalized or dying from the virus are unvaccinated. The statistics I have seen on the subject seem strongly to suggest as much. But people love to argue from anecdotes, which are easier to understand than statistical data, and the resistance will surely continue. The COVID-19 pandemic seems closer to having run its course after nearly three years. All pandemics eventually lose steam.

COVID is no longer half as scary as the ghost lady and her companion on Halloween. Okay, just kidding. But that guy is freaky.

By the following week, with minor help from a cough suppressant the ER doctor prescribed, I was able to regain energy and focus on the tasks that I had neglected for almost two weeks. They were too important to me to do otherwise. One was completing a grant proposal for a film project I am leading under the auspices of the Hazard Mitigation and Disaster Recovery Planning Division of the American Planning Association. The deadline was October 31, and with significant money at stake, I was not about to blow it. We had been laying the groundwork for weeks, but I needed to write some powerful explanations of our project and submit all the necessary documentation, which I did by that morning. I was able to walk our grandson through the neighborhood for Halloween and pass out candy afterwards, while triggering the spooky voice of our alabaster “ghost lady” without being noticed. She impressed only the very young, drawing only amused yawns from tweens and teenagers.

But that was just the beginning of a list of tasks and projects needing my urgent attention. I had promised to create a case study of Hurricane Michael recovery to present to my students on November 10. I finally completed it just an hour before class. On Saturday, November 12, I hosted with Amanda Torres, formerly the city planner for Rockport, Texas, an all-day training workshop on hazard mitigation and disaster recovery, offered as part of my teaching commitment with the University of Iowa School of Planning and Public Affairs. I had two documents I had promised to review, for which I sought and received additional time.

During the illness, I stopped my exercise routine. I currently visit the gym twice weekly with a rotating routine of exercises. After the illness had run its course, I still missed the workouts in favor of catching up on work. Before Christmas, I will turn 73. I find the exercise vital to good health at this stage of life, and I became anxious about the six-week gap that developed before I finally resumed the workouts on November 16. I have taken to them with relish. I simply feel better because of it, and I can finally spare the time again. Two days after Thanksgiving, I ran into a former trainer I worked with at X Sport, Michael Caldwell, who told me about his new work with companies on employee fitness and ergonomics, noting the serious toll on many people of failing to pay attention to such issues. I wished him well in his new enterprise. He seemed pleased that I was returning to form, just as he had always respected my resilience in the past after some injuries and surgeries.

But I also know that I am very fortunate. I find absolutely no evidence that I have developed any long-term COVID symptoms. I never fell victim to COVID-19 in the early days of the pandemic despite a short-term hospital stay in May 2020 on the only floor with non-COVID patients. I have even discovered the accidental grace of hundreds of presumed strangers who, in successive waves in October and November, registered as new subscribers to this blog at a time when I was seldom posting anything. I wanted to change that but just could not get it done. Their attention to my blog despite several weeks with no new posts encourages me to get back into the ring. I must have offered something in earlier posts that still attracts readers, and I hope to keep it that way for a long time. I hope this humble story adds to the blog’s overall value. I shall certainly try my best.

Jim Schwab

My Ode to Negativity

I am proud to announce that I started the New Year on a negative note. Having had a very mild fever Thursday evening and a very mild nagging cough, I thought the better part of wisdom these days was a COVID test, even though I would have bet serious money that it was something else, like a mere cold. But it did make me slightly uncomfortable. The fever was gone yesterday. So, at just after 8 a.m. today, I walked to a nearby National COVID Center, which offers free tests without appointment and was open today from 8 a.m. to 5 p.m. I strongly suspected there would be no line, that few other people had roused themselves out of bed, let alone showered and dressed and gone outside, so early this holiday morning.

I was right. I got there, a storefront on Milwaukee Avenue in Chicago, and the lone public health nurse staffing the place greeted me, the only person who had arrived, the only person the whole time I was there, had me fill out the forms, gave me both the rapid antigen and PCR test, and we chatted a bit while I waited 10 minutes for the antigen result. We discussed our dismay at the apparent lack of critical thinking among anti-vaxxers, and when I said I was trained to think analytically, she asked what I did, and we discussed the relationship between urban planning and public health, which goes back more than a century to Jane Addams days, when health officials and civil engineers and planners made common cause to clean up the city, build sanitary sewers, and pay attention to what makes cities healthy places to live. We discussed college as a gateway to learning how to learn for a lifetime. It was a great conversation. Then the ten minutes were up, and the antigen result (75% accurate, she said) was available: Negative. We must wait three days for the lab to e-mail the result of the 99% accurate PCR test, but I would stick with my original hunch.

But out of an abundance of caution, and a concern for those around me, I am still glad I took the time to find out for sure. You just never know, which is one thing I have also learned in spades as a planner specializing in disaster issues. This pandemic has been nothing if not a public health disaster, which always brings us back to this question of critical thinking. Give me one wish for 2022, and that would be it. The gift of critical thinking for the entire population of the U.S. and the world. I can dream, can’t I?

Jim Schwab

What Makes Us Grateful

Marybella at Lurie Children’s Hospital

People often lean toward traditional expectations of traditional holidays.  We expect them to unfold in predictable ways. It’s not just, for instance, that we know we should be thankful on Thanksgiving, but also that we have family traditions of a feast with certain preparations and foods and activities that are all part of what we anticipate. We relax with pleasure when we are able to follow the script.

Last year, seven months into a pandemic the likes of which our society had not experienced in an entire century, our expectations were tempered by the need for limited crowds and our awareness of those who had succumbed to COVID-19 who could no longer share a meal with us. This year, many of us reverted to accepting somewhat larger crowds, tempered by issues of who was vaccinated, but sought nonetheless to recover as much of that traditional script as situations allowed.

No one likes to have the holiday disrupted by sudden illness. I recall a Thanksgiving in 1990, when my wife and I were still relatively new residents of Chicago, because I suffered sudden illness. I don’t recall how I felt the night before, but I woke up that morning with a fever that reached 103°F., accompanied by some other miserable symptoms. I was in no condition to go anywhere or meet anyone. Jean simply ushered me to the car and took me to a hospital emergency room. Following x-rays, the doctor informed me I had pneumonia. He sent me home with antibiotics, and the next few days, as I recall, were less than inspiring. I was listless and tired, and I learned that pneumonia is an exhausting disease. I got it twice more in the next ten years or so, but never again.

On Wednesday of this past week, our daughter Jessica and her new husband Greg and their four kids arrived, but the youngest, Marybella, 7, was not faring well, coughing up mucus. Her behavior wavered between fatigue and her usual effervescent enthusiasm. Jean suspected something was wrong. On Thanksgiving morning, Jean convinced Jessica to let her take Marybella to a nearby emergency room, where she spent all most of the day. She updated us by phone. The doctors tested for COVID and ruled it out, as they did subsequently for respiratory syncytial virus (RSV). They ultimately concluded it was pneumonia and arranged for her transfer to Lurie Children’s Hospital. Jean joined her in the ambulance. Jessica took me to the first hospital, where I retrieved our car as well as the purse Jean left behind when she rushed into the ambulance.

The other nine of us, including Jessica, proceeded with a mid-afternoon dinner at Jean’s insistence, but afterwards I drove to Lurie to pick up Jean, and Jessica and Greg followed. They stayed overnight with Marybella, who occasionally got the chance to talk to her siblings by phone, and then stayed most of Friday. Jean ate a pick-up dinner of the ample leftovers once she was back home for the night.

That could have put a damper on Thanksgiving, and to some extent it did. We were all quite naturally worried about Marybella. Jean reported that she was in a critical care unit, with a doctor and nurse stationed outside her room. A playful kid, Marybella sometimes rang the bell that signaled a need for help just to try it out until the nurse made clear to her that it was not a toy and she should not use it as one. Despite a heart rate reaching 170, possibly a result of panic during episodes of difficult breathing, her lively attitude was still apparent.

Jessica reported that Marybella also expressed gratitude toward her brothers and sisters, grandparents, and everyone around her. Being hospitalized, with all the attendant tests and medicines, has a way of focusing a young mind on the people who are helping her endure a crisis.

Not that she and her siblings have lacked reason for grief and anxiety this year. Their father died in ambiguous circumstances in late February. Like other students across the nation, they were attending school remotely at the time. They moved and changed schools in the fall. Life has been rather unstable, but they are seeking to regain their bearings.

Marybella’s challenge made me think hard about my own perspective in recent days. I have been busy, which is one explanation for a lack of recent blog posts. I was approached in early November with a new short-term consulting assignment that needed to be completed by the end of the month. That pressure was lifted slightly this past week with the extension of a federal agency deadline, but I have other work that will easily occupy my time until mid-December and perhaps beyond. I had looked at Thanksgiving as a chance to relax for just a day or two, but that was not going to happen.

As if one illness were not challenging enough, the parents took another daughter, Shanaila, to the Lurie emergency room on Friday evening, bringing her home at 5 a.m. Saturday after doctors determined she has strep throat and prescribed antibiotics. She slept well into the afternoon. What a weekend.

Meanwhile, we had five teens and tweens in the house needing attention while Jessica and Greg spent time with Marybella. On Friday morning, I found an intriguing idea in the Chicago Tribune, which included, in its Arts & Entertainment section, a glowing review of King Richard, a new movie about Richard Williams (played by Will Smith), the outlandishly ambitious father of international tennis stars Venus and Serena, who defeated the odds associated with raising five daughters in impoverished Compton, California. The movie has been billed as a tribute by the daughters to their persistent but deeply principled father. I consulted with Jean, and we decided it was a good bet for entertaining the kids in the late afternoon.

When I announced that we would attend a movie after they helped us clean the house, the first reaction was a question: What movie? This is a gang still hooked on Marvel Comics and superhero films, so there was puzzlement when I mentioned King Richard, a movie they had not even heard of. But Lashauna, a high school freshman, mentioned she had done some sort of school project about Serena Williams, although she still thought the idea behind the movie sounded “lame.” A movie about the father of two tennis players promised none of the high-powered action and special effects of the Batman and Superman films that dominate the box office.

“Just try it,” I said. “It might be better than you think.” Even a “lame” movie, however, provided adequate motivation to help clean a room or two in exchange for a trip to the local theater.

King Richard, in fact, has dramatic action. Williams defends his daughters by confronting gang members in the ghetto, gets beaten up more than once, but steadfastly pursues his audacious plan to turn his daughters into world champions with the help of coaches persuaded by his determination and, more importantly, the dynamic talents of Venus and Serena. The movie ends after Venus, at 14, nearly defeats the reigning top seed in her first major tournament, attracting enormous media attention and rich corporate sponsorships. Despite family squabbles, the gratitude of the two daughters for their father’s overarching vision for their futures becomes the dominant outcome of the story.

Once we were back home, with Marybella still in the hospital fighting to regain health—she suffered some lung damage at birth that complicates matters—and with the parents staying with her for a second night, I asked what they all thought of the movie and why they liked it. Lashauna admitted it was a good movie and that her assessment that it was “lame” was premature. Her sister Shanaila liked the fact that Venus became the first female African American world tennis champion. Jean, a retired teacher, liked the fact that Richard Williams insisted that his daughters get A’s in school as a condition of playing tennis. I simply liked the positive reactions to my choice of movie. Young adults do not alter their perceptions of life in snap decisions. It occurs one movie, one story, one mind-shaping event at a time. As a mere grandfather, I keep trying.

As I write this, I am plugging away at professional and personal tasks in a very different way than I had planned just a few days ago, and my expectations for the coming week remain positive, but tempered by a new experience. I too keep learning something: When God throws you a curve ball, learn how to change your swing. You may adjust enough to hit one out of the park, but you may also learn to be thankful just for reaching first base. You may also learn that gratitude sometimes resembles the smile on the face of a young girl in a hospital bed, fighting pneumonia but happy to be alive.

Jim Schwab

Our Collective COVID Cabin Fever

I am not a doubter when it comes to the COVID-19 vaccines. All I want to do is sign up and let them put a sharp needle in my arm and inoculate me. Do it twice if the vaccine demands it. Even my experience in early February with the shingles vaccine cannot deter me. On a Tuesday afternoon, a pharmacist at the local Walgreen’s provided a shot that I requested at my doctor’s suggestion. It has been two decades since I experienced my second episode of shingles, but I vividly recollected the piercing pains in my shoulders and arms that made it nearly impossible to exercise my fingers on a keyboard, one of the most basic things I have long done to earn a living. I told the pharmacist that I “noticed it but did not feel it.” He put a bandage over the location on my upper left arm, and I left, thanking him.

It was that evening that I noticed my reaction as muscle aches spread from that left arm across my upper chest. Then the chills set in, and I pulled the covers over me in bed. I repeatedly felt my forehead, testing for a fever. Nothing happening. The next day, the muscle aches diminished, but the chills persisted, and I sat in a leather chair with a blanket pulled over me, doing little but reading a newspaper and then falling asleep. I had slept all night, but it mattered not; the fatigue overpowered me. Late that afternoon, I struggled through two online meetings, and my energy again failed me. I spent the next day feeling slightly more energetic until about 3 p.m., when I fell into a deep sleep, again with blankets covering me as I accomplished nothing. My wife says I turned white, but I wouldn’t know. I lacked the energy to look into the mirror.

By Friday, I at least posed a question to my primary physician on the patient portal: Is this normal? He wrote back to say that about 20 to 25 percent of people getting the shingles virus experience such a reaction, which mostly proved that the vaccine was beneficial. My immune system was relearning how to fight the shingles virus. That was vaguely reassuring, and I knew he knew whereof he spoke, but it took one last development to convince me.

Late that Friday afternoon, with the better part of a week lost to malaise, I suddenly felt the fog lift and the fever break, though it was not really a fever. All within an hour. It just stopped. My immune system had learned what it needed to know, and it ceased fighting what was not there. And I was fine. That’s part of how vaccines work, but I could not recall ever experiencing such a reaction to any previous vaccine.

 

Our backyard after the Presidents Day blizzard.

Amid this experience, however, the snow piled up in Chicago. First came a snowstorm that covered our yards and streets in blinding whiteness. Often, in Chicago winters, these snows come, sit around for a few days until the sun comes out, and they melt away as the temperatures rise.

But not this time. Until February in this season, we had seen little more than timid flurries of pixie dust that barely covered the ground, with green shoots of grass still poking out from below. Now it came to stay, as temperatures soon plunged to zero and slightly below, solidifying the growing accumulation of snow even as we struggled daily to clear a path down our gangway and along the sidewalk in front of our home. I shoveled in front of a neighbor’s home as well, knowing he had recently had hernia surgery. And the very next day, we had to do it again.

Jean wanted her turn at shoveling as a way to get some exercise. She got her wish.

The three weeks of persistent snow culminated in a 17-inch overnight debauchery on Presidents Day that left us staggering and feeling quarantined by virtue of a simple inability to move a car down the alley, or the challenge of climbing over hip-high snow piles at intersections. During those three weeks, our cumulative snowfall mounted to 40 inches.

Our somewhat metaphorical confinement by way of extensive pandemic restrictions now took on major physical dimensions, leaving us feeling imprisoned. Not only was there nowhere to go because the restaurants were closed, but there was no way to get out, either. In place of my brief fatigue in reaction to a shingles virus, I now felt a very real spiritual and emotional fatigue at the mere thought of needing boots and a heavy coat just to step outside. Staying at home felt more like incarceration than refuge. Even the mail, which provides some tangible connection to the outside world, was no longer arriving. The carrier on our route, and probably on many others, was not braving the snow piles and frigid weather, and the mail piled up at the post office until, one day, I simply walked the mile to get it, standing in line for more than half an hour for a pile of paper surrounded by a rubber band, partly containing bills to pay. The process took long enough that, by the time it was over, I needed to use a bathroom and home was too far away. I opted for the nearby Cozy Corner diner, and showed my gratitude by staying for lunch. It’s a very decent eatery, actually, and I enjoyed my California melt with fries. And then I walked home again, through the very snow piles that had impeded its delivery. Watch where you walk when you cross the street.

After weeks of erratic service, the mail came all at once, and not again so far.

By the following Sunday, temperatures rose and stayed above freezing. The snow began to melt, removing the impediments to delivery. Nonetheless, in the past week, delivery occurred only on Tuesday, when the mailbox was suddenly full, but it was an aberration rather than real change. No mail arrived for the rest of the week. This has been an ongoing problem across Chicago, for systemic rather than purely weather-driven reasons, and even more so in some South Side ZIP codes than ours, which is itself bad enough. The Chicago Tribune ran an article about the Trumpian mess in which U.S. Rep. Bobby Rush expressed his impatience on behalf of his constituents about the staffing excuses, saying there were plenty of unemployed people in the city, so “if you have a job, do it.”

The as yet uncollected recyclables in a bin filled to the brim.

That comment formed an interesting backdrop to the other event the same day all mail arrived. The city recycling pickup occurs on our block on alternate Tuesdays, and our bins were full, if somewhat piled around with snow. The trucks seemed to be very selective, leaving our stuff uncollected, so that we are now storing recyclables in paper bags in the garage. I complained to the city Streets and Sanitation Department in an online forum that left little room for comment, then forwarded the complaint and further explanation to our 1st Ward alderman, Daniel La Spata. I noted that the previous week, the regular garbage pickup occurred without a problem under worse circumstances. He informed me that a private company had been hired for the recycling, similar problems had emerged elsewhere, and added, “Honestly, that’s the difference between public employees and privatized ones, and why we’re pushing back on the latter.” Some might question that comparison in light of the post office problems, but I would suggest that the U.S. Postal Service, to a significant degree, has been the target of efforts to undermine it as a means of justifying privatization and subverting the integrity of mail ballots. In any case, I still want them to empty those blue recycling bins.

During all this, I nonetheless wanted to access the COVID vaccine so that I could move beyond the sense of limitation that nearly a year of closed stores and restaurants, and mask wearing and social distancing, has instilled in all of us. For compulsive extroverts like me, the compounded effect of long-term pandemic restrictions followed by a month of being buried in frozen precipitation is producing a profound restlessness. Put simply, I want out.

I have not yet mentioned that five grandchildren have been studying remotely in our home since September. We are guardians for one, and the others are here as their mother engineers a major change in her life, and besides, my wife is a retired public schools teacher who can mentor them. Throughout February, the Chicago Teachers Union engaged in a vociferous public debate with the Chicago Public Schools and Mayor Lori Lightfoot about reopening schools, arguing over the adequacy of the preparations for protecting teachers and staff from coronavirus exposure. This took place against the backdrop of the larger national debate over online versus in-person education, but I know what I see. The kids are noticeably glazing over and tuning out, and listening to a teacher on a screen is getting old. Students, particularly students of color (most of our grandchildren) and those with working parents, are falling behind, and the schools will have a major challenge in coming years of reversing the impacts of online education. Students in the early grades need human contact to remain fully engaged. None of this is to deny the necessity that drove the schools to close, but the national failure to manage the pandemic has greatly exacerbated the consequences.

We need to get our national act together, and moving millions of doses of vaccines to sites where people can get some sense of relief is the most important step right now. Instead, I’ve found myself checking online daily, sometimes multiple times daily, only to find no availability for vaccine appointments. But my wife finally got her call for March 2, so I remain hopeful. I have no other choice.

That expression of patience is at the heart of our dilemma. I could live with the snow, however impatiently and with some humor, because I knew that warmer days lay ahead, and snow cannot outlast St. Patrick’s Day in Chicago. Unlike Texas, our infrastructure is designed to handle winter. A slow, steady rise in temperature would allow snow to turn to water at a steady pace without triggering floods. We will be fine.

What has been less certain has been the ability of our national public health infrastructure, as disheveled as political neglect has allowed it to become, to respond to the pandemic. But I can also feel a steady warming trend since January 20, however halting it has seemed at times. The big snowstorm, which jostled its way through Kentucky and Tennessee and Arkansas all the way down to Texas and Louisiana, slowed distribution of vaccines, but maybe for a week. My wife learned that she got her appointment because PrimeCare, a local health care provider, had just received a big shipment.

Snow recedes to a manageable level as the weather has warmed.

My turn will come, and so will yours if you’re smart enough to get vaccinated. My outlook will change with the warm breezes of spring, and I will start to think about where I can go and what I can do. We will end this year-long cabin fever that has been induced by a tiny virus with protein spikes that latch onto receptor target cells in a microbiological process most of us do not understand.

But it may be a long time before we stop talking about it. Our collective COVID cabin fever does that. Let’s all talk about what we as a nation can do better next time. Do it over beer or coffee or tea, but make it a productive, meaningful conversation. I’m tired of gripes. I prefer solutions.

Jim Schwab

Plotting Post-Pandemic Recovery

Photo by Carolyn Torma

In recent years, the development of local or regional recovery plans following major natural disasters has become increasingly common. The Federal Emergency Management Agency has long encouraged such planning, and I led the production of two major FEMA-funded reports from the American Planning Association on the topic—Planning for Post-Disaster Recovery and Reconstruction (PAS 483/484, 1998) and Planning for Post-Disaster Recovery: Next Generation (PAS 576, 2014). I’ve spoken repeatedly on the topic, trained planners, and valued the collective knowledge of the two teams we assembled to make those projects happen. The underlying idea is to help a community assess its losses, reassess its goals, and find the silver lining in the dark cloud of the disaster that will allow it to rebuild better and stronger than before. This is the central concept of community resilience: the capacity to learn from such events, adapt to the changes they require, and move forward.

The idea of natural disasters has generally encompassed those caused primarily by meteorological and geological disturbances, such as storms and earthquakes, though it includes impacts exacerbated by human mistakes in building and planning. Disasters necessarily involve the collision of natural forces with the human and built environment, which has caused some people to question the very use of the word “natural” in connection with disasters. Personally, I am comfortable with the term “natural disaster” so long as we understand that no disaster exists without this interaction.

But there are those disasters where damage to the built environment is a secondary consideration, and the loss of lives is primary. Drought is somewhere in the middle. Damage to structures can occur, but only as the result of the slow, nagging loss of moisture in the air and soil. Heat waves can take hundreds of lives without affecting a single structure, though they can put enormous stress on energy and transportation infrastructure.

Pandemics, however, fall into another category entirely as biological disasters. They occur when bacteria or viruses emerge in the environment and attack humans before we have developed any effective immunity or vaccines. The current COVID-19 crisis fits this mold precisely. It can be far more devastating than a natural disaster simply because it can roam far more freely across the planet, as did the 1918 influenza pandemic, striking down hundreds of thousands if not millions of people. Before the era of modern medicine, pandemics like the bubonic plague in the Middle Ages could kill half of the affected population. Even without vaccines, we at least have the huge advantage of understanding how such microbial threats spread. Our disadvantage in the U.S. has been national leadership, starting with the President, that has been psychologically allergic to scientific advice. The result has been needless loss of life on a colossal scale.

It was a matter of time before some community, even without such federal leadership, applied many of the principles of recovery planning to the coronavirus pandemic. One critical question related to recovery is identifying the point at which the crisis is over, or at least waning. In natural disasters, drought being again the exception, this point becomes clear within a matter of days, or even hours in the case of tornadoes, as the storm passes. However, weather systems such as that which produced the 1993 Midwest floods, can last for weeks or even an entire summer. But at some point, it becomes clear that the emergency is over, and planning for long-term recovery can begin. In the absence of a vaccine, however, it is less clear when we can use the “all clear” signal for a pandemic. Right now, in the U.S., it is painfully clear that the rush to reopen is producing unconscionable and shocking consequences across the South and Southwest, and in a few other locations as well. It is incredibly hard, perhaps even impossible, to plan meaningfully for recovery when you are still stoking the fire by facilitating the spread of the virus.

Nonetheless, some states, notably including New York, much of New England, and Illinois, have fought hard against the odds to bring down infection rates, which are now a fraction of what they were in April or May. Their victory remains tenuous, considering the larger national crisis that remains a growing threat to public health, but Chicago under Mayor Lori Lightfoot has announced a list of states whose residents must quarantine for 14 days upon arrival, notably including Florida, Arizona, and Texas. Later, Iowa was added. By July 17, the Cook County Department of Public Health expanded that quarantine area to include all of suburban Cook County except a handful of suburbs that maintain their own health departments, and 17 states are on the list with new case rates exceeding 15 per 100,000 people per day. While it is nearly impossible to monitor all arrivals, the message is clear: We don’t want to re-create the problems we so recently overcame.

That is the context in which a large Recovery Task Force the city assembled released a recent report, Forward Together: Building a Stronger Chicago, which examines how Chicago could build a vibrant recovery from the coronavirus experience. Because such reports, especially those involving dozens of contributors and participants, are never crafted overnight, it is worth noting that the effort was launched on April 23, at a time when the outcome was far from clear. Neither the city nor the state could be certain then how long the problem would last or whether the stay-at-home orders and other measures would succeed at all in the near term. As of July 18, Illinois had dramatically increased its testing rate and brought its positivity rate for coronavirus tests down to 2.9 percent, well below most rates elsewhere, although it remains higher in Chicago at 5.4 percent.

So far, the strict measures announced in March have produced measured success, and the task force used that time to look farther down the road to the kind of city that might emerge from this ordeal. Forward Together is, to be clear, not a true recovery plan; it is billed as an “advisory report.” But it is the closest thing to a recovery plan that I have seen so far, and merits scrutiny and consideration for what it offers. (New York Mayor Bill de Blasio promised his own “road map to recovery” on April 26.)

The task force itself was broadly based. Lightfoot co-chaired it with Samuel Skinner, a businessman, lawyer, and political operative who served as both Secretary of Transportation and White House Chief of Staff under President George H.W. Bush. He has a long track record in public affairs. Committee chairs and members included elected officials, among them Cook County Board President Toni Preckwinkle, who was Lightfoot’s run-off opponent in the 2019 mayor election, labor and community representatives, business leaders, academicians, and civic leaders, including some prominent activists. The task force was broadly inclusive, which bodes well for public buy-in on the resulting recommendations. Moreover, the report shows significant evidence of wide community outreach, including a youth forum that tapped the ideas of teens and young adults.

Like all big cities, Chicago has witnessed significant disparities in impacts of the pandemic on specific disadvantaged groups, including the elderly, but also Blacks and Latinx residents. While these two groups each comprise 28 percent of Chicago’s population, they respectively comprise 30 and 48 percent of the cases of coronavirus and 44 and 32 percent of the resulting deaths. This is an important backdrop to the discussion of goals in the report.

The report discusses four specific initiatives to move the city forward and address many of the inequities and vulnerabilities exposed by the coronavirus. Invest South/West aims to bring public and private investment to those neighborhoods in the city that have suffered historic disinvestment, and where COVID-19 rates have generally been highest. Racial and ethnic inequities in coronavirus impact have been notably more severe among both Blacks and Latinx residents, in large part because of lower levels of insurance coverage but also because of differences in job exposures, poverty levels, and living conditions. Solutions Toward Ending Poverty (STEP) is a new program, announced in February by Lightfoot, that is attempting to identify evidence-based metrics that can plot a road map toward reducing urban poverty in Chicago. We Will Chicago—Citywide Plan aims over three years to develop what amounts to a comprehensive plan, something lacking in Chicago until now. The report says We Will Chicago “will encompass all elements of citywide planning.” Finally, Chicago Connected will aim to shrink the digital gap between more affluent and poorer neighborhoods by making broadband more readily available, a need whose urgency has clearly been exposed by the closing of schools and the challenges of assisting children from poorer households with remote learning.

A significant part of the report focuses on the economic development opportunities that Chicago can pursue to restore prosperity as the pandemic recedes. It is clear that certain categories of jobs—food service, retail, administrative, and manufacturing, but also arts and entertainment and personal services—have suffered the brunt of economic displacement from the pandemic. The report notes the opportunity for Chicago, as a result of some economic changes wrought by the pandemic, including shifts to online retail, to focus on transportation, distribution, and logistics (TDL) segments of the economy. These would take advantage of a longstanding Chicago advantage as a transportation hub.

TDL, however, faces its own challenges of inequitable opportunity. Food insecurity represents a serious challenge in “food desert” neighborhoods. Resolving those inequities is the intended purpose of the four initiatives, but it is hardly a challenge that will be resolved overnight. It has taken years of unequal opportunity, to say nothing of deliberate discrimination, to create the current dilemma. Failure to address these problems will slow down or even stagnate Chicago’s recovery from the current crisis.

The report makes what strikes me as an honest effort to address social services gaps that, if anything, grew under the previous administration of Mayor Rahm Emanuel, who closed some mental health centers in a bid to reduce budget deficits. The problem is that such reduced access to services only exacerbates problems among those needing such help and may increase other costs as a result. For example, a significant proportion of the inmates at the Cook County Jail (and many others around the nation) suffers from mental illness.

There is an urgent need to restore those services, but more importantly, the report shows that mental health services are far more prevalent on a per-person basis in more affluent, whiter neighborhoods than in poorer areas. For instance, 48 percent of whites with mental illness were receiving services in 2015, but just 31 percent of both Blacks and Latinx with mental illness were doing so. A map toward the end of the report shows differences shows a variation in presence of mental health providers ranging from zero or well below 0.25 per thousand residents in certain poorer areas of the city to well over 2 in predominantly white, middle-class areas and hundreds per thousand in downtown Chicago, a district well-nigh inaccessible to many South Side residents.

This may reflect, among other things, a disproportionate presence of white professionals in mental health and a need to bring more minority psychiatrists and psychologists to those neighborhoods. Reopening clinics in the neediest areas of the city would be a major step forward. As for the connection to coronavirus, the stress induced by greatly increased unemployment, to say nothing of job pressures within health care, can contribute to mental health challenges. Perhaps the most noteworthy proposal in this section of the plan is the recommendation to create a dedicated 211 line whereby residents can access a wide range of social services. It strikes me as essential, also, to reduce pressure on police to respond to personal mental health crises by instead responding to such incidents, to the extent possible, with mental health professionals and social workers.

As I noted, this is framed as an “advisory report.” I strongly suspect, however, given the tenor of the moment, that its recommendations will find widespread support among Chicagoans. What remains to be seen is how well voters and aldermen hold the administration’s feet to the fire to make it all happen. It is not enough to have confidence in a mayor who seems determined to make it happen. Implementation will require broad-based commitment to achieving the goals the report lays out. That includes embedding those goals in the comprehensive planning process that We Will Chicago envisions, and enacting measures to move them forward.

What is important about this effort for the rest of the country is the very idea of mounting such a broad-based effort to produce a forward-looking analysis of how our cities can recover from the coronavirus pandemic. Many may first have to learn how mayors and governors can exert the leadership, and evince the humility to consider the science, necessary to get the virus under control, as many other countries in Europe and Asia have done. These leaders must also be open to hearing from a widely representative cross-section of their citizens in preparing similar reports. Pandemic recovery planning is for all of us an experiment that can build on the foundations of other kinds of recovery plans while recognizing and thoroughly exploring the unique features of this monumental public health challenge. It is no small matter, and should not be treated as such, politics notwithstanding.

Jim Schwab

 

Community Planning and Pandemics Podcast

Periodically, I have linked blog readers directly to a new podcast in the Resilience Roundtable series, produced by the American Planning Association and hosted by the APA Hazard Mitigation and Disaster Recovery Planning Division. Last fall, I became the moderator of this series, and the last, pre-pandemic podcast interviewed Florida planning consultant Julie Dennis about her experiences in recovery planning for Hurricanes Irma and Michael.

Earlier this month, however, we shifted gears, and I interviewed Dr. Monica Schoch-Spana, a medical anthropologist and research fellow at the Johns Hopkins University Center for Health Security. Our topic was community planning and pandemics, and she shared numerous insights into the public health and community planning aspects of dealing with a pandemic like COVID-19. Most readers already know that I have written repeatedly about some aspects of the pandemic since March, but Monica in this interview sheds light on several other features of our current situation that I had not yet illuminated, in part because I lack her specific technical background.

Therefore, I am happy to provide this link to the new 40-minute podcast.

Jim Schwab

Inside the Hospital in the Time of Coronavirus

It started last Thursday evening after dinner. By 8 p.m., suffering shivers and chills and fatigue, I retreated to bed, unsure what was affecting me but hoping a solid night of sleep might provide some respite. I was near the end of two busy weeks. The previous week, I had been deeply involved in a huge experiment by the American Planning Association, which it called NPC20 @Home, a three-day online professional conference that would replace its canceled National Planning Conference, which would have taken place in Houston April 25-28. Instead, on opening day, April 29, I was moderating a session with three speakers[i] on “Demanding Equity: Planning for Post-Disaster Recovery.” We had rehearsed our approach, and it came off seamlessly before more than 1,600 participants, which made all of us very happy.

The following Monday, as chair of APA’s Hazard Mitigation and Disaster Recovery Planning Division (HMDR), I led our annual business meeting, which also had gone online after the NPC was canceled. With the support of our executive committee, particularly Christine Caggiano, our secretary-treasurer, who played the Wizard of Oz for our Zoom controls, it too had been a remarkable success with attendance spread across four time zones. So it went through Thursday, when two other speakers[ii] and I presented a webinar for APA’s Michigan chapter on the 2020 update of APA’s Hazard Mitigation Policy Guide. That was over by mid-afternoon; we patted ourselves on the back, and I went on to other business, such as a blog post that remains unfinished. I will get to it, I hope.

It was only as the evening progressed that I sensed something was wrong.

My wife, Jean, began to share fears that I was the latest victim of coronavirus. She, of course, was simply reacting to visible symptoms and venting her worst fears. But as the night wore on, my intuition led me in other directions, and I was unwilling to succumb to simple answers. Only I could experience and report all of my symptoms, which included a few trips to the bathroom, and it reminded me too much of previous experiences with prostatitis. In April 2012, on a flight to Los Angeles, I experienced chills and fever somewhere over the Rockies. Chicago to Los Angeles is about a four-hour flight, so I had to endure two hours of personal deterioration before landing at LAX, where I struggled to hold myself together as I grabbed my luggage and found a taxi to the hotel, where I could check in for that year’s National Planning Conference at the nearby convention center. At the hotel, I was already sweating as I checked in and found my room, where I remained for the evening, under bed covers, skipping nearly every event at which I was expected.

I was basically a physical wreck throughout the five-day conference, but, on the advice of my primary physician, found my way to a nearby urgent care center, where I was diagnosed with prostatitis, an infection of the prostate gland that can, under the worst conditions, kill the patient, as my urologist in Chicago later explained. I will say it was one of the worst experiences of illness in my entire life, and people who saw me when I made an occasional appearance outside my room uniformly commented on how awful I looked, and asked what was wrong.

Thursday night was nowhere near that bad, but still, it reminded me symptomatically of that experience.

Yet, by Friday morning, I thought I had perhaps gotten past it all. I felt reasonably okay, ate breakfast, dressed, and joined an online faculty meeting for the School of Urban and Regional Planning (SURP) at the University of Iowa, where I teach a course on disaster planning. Our discussion with the dean of the Graduate College, John Keller, focused on what might happen with on-campus instruction this coming fall, a question for which the answer was indeterminate.

Somewhere in the middle of that discussion, the malaise began to reassert itself, and I felt weak and tired. I sent a chat note to Charles Connerly, the director of SURP, saying that if I disappeared from the Zoom screen, it was because I was not well. Less than an hour into the meeting, I did exactly that, and went upstairs to our bedroom to rest. My wife noticed that my fever was not abating and worried that I needed medical attention. By noon, she insisted on taking me to the emergency room at nearby St. Mary’s Presence Hospital, and I gave in, not because I had resisted the idea but because I needed to muster the energy to get up and do it.

At the hospital door, a small group of security and admitting staff sought to ensure that I was arriving as a patient as I exited the passenger door of our car. I explained the situation. My wife and grandson could not join me because, amidst the coronavirus pandemic, and with most of the hospital devoted to such patients, no visitors are permitted. They had to wait in the car or go home, which they eventually did after picking up take-out lunch at a nearby Wendy’s. Once inside and admitted, I was on my own.

The first step by the nursing staff was to administer a COVID-19 test, putting swabs deep into my nasal cavity; it later proved negative. However, my temperature was 100.6° F. They did a battery of other tests based on my symptoms and concluded over the next few hours, as I sat in an ER unit, that I was suffering from a urinary tract infection (UTI). How I acquired it, I will probably never know, just as I never learned how I acquired prostatitis. All that matters is the treatment. I learned, to my deep disappointment, that I would be kept overnight for monitoring because of my history of prostate issues, which has included an almost fruitless search for evidence of cancer. I say “almost” because elevated PSA scores triggered the search nearly a decade ago, before the incident in Los Angeles, and on one occasion a fusion biopsy discovered a tiny sliver of affected tissue. But that finding has never occurred in all the years since. As a result, no treatment has been necessary. But still, caution was apparently in order when a UTI materialized.

The one reservation, of course, is that most of the hospital by May 8 was occupied by COVID-19 patients. One floor was reserved for non-COVID patients requiring hospitalization, and by 9:30 p.m., that is where I was sent. In the meantime, as evening approached, the attending nurse, Jesse, offered the use of his cell phone so that I could call my wife and ask her to bring my cell phone, my Nook e-reader, reading glasses, and power cords to help me escape boredom. He could see that, with nothing to do during long spells when nothing needed to be done (I already had an IV in my arm for a broad-spectrum antibiotic), I was becoming slightly stir crazy. Jean obliged by delivering the goods to the ER door, where Jesse retrieved them. My Nook contains dozens of books. They would relieve my anxiety and let me feel connected to friends and family, so that we could discuss what was happening.

One situation that disturbed me early in the evening was that I had promised to be part of two online events from 5 to 6 p.m. The first was to host the Zoom “room” for HMDR as part of a much larger invitation for members of any APA divisions to participate in a virtual Divisions Happy Hour. Given that HMDR has more than 1,500 members, and APA now has 22 divisions and eight “interest groups,” the number of registrants may have been rather large, but I never had time to check. It was surely in the hundreds, though once they were dispersed to their own groups, each division may have had a few dozen attendees, at most. At the same time, SURP was hosting an online happy hour event for John Fuller, a 41-year veteran professor of the planning school who is retiring at the end of the spring semester. I had arranged to migrate between the two events by having two other executive officers of HMDR, Caggiano and Stacy Wright, our chair-elect, take over when I moved from the APA event to the University of Iowa event. John, in his early days, had hired me as a graduate research assistant when I entered the program, supported my career for its entirety, and played a role in my being hired as an adjunct professor at Iowa in 2008. Before Jean brought my iPhone, I felt guilty about my inability to let anyone know why I was not attending, even though I could do nothing about it. Once armed with the phone, I called Connerly to explain my absence at the university event, and he promised to inform John and Kathy Fuller. I also emailed Caggiano and Wright to let them know why I had not shown up. They assured me the event had gone well. My evening would have felt much worse if I had not been able to make those contacts.

I later learned that my two daughters had unwisely come to the hospital seeking information on my condition, which they could have attempted more safely by calling. One was put off by the cold response she got from the staff at the door, but I told her the staff had bigger concerns than her hurt feelings. It could instead be a lesson in using better judgment. She had also questioned Jean about why she took me to the hospital at all because she had come to understand that no one these days comes out alive. That is clearly not true, but probably not uncommon mythology among the public.

At one point while still in ER, I heard a PA announcement barking “Code Joy!” three times, followed by the opening bars of the theme song from Rocky. I wondered what that was about but could only make lame guesses. Later, from a nurse in my room, I learned it was a celebration of a patient who was being released from the COVID wards—someone who had fought the virus and won. Before I left the hospital, this happened five times. It became a reassuring indication that people do, indeed, fight the virus and win—every day. And not just every day somewhere, but every day in the same hospital. Five times in three days while I was there. I will surely never know who they were, but good luck to all, and God bless every one of them. The Great Virus is not invincible.

As noted, late that evening, I was wheeled out of ER, through the halls and onto an elevator, and up to the eighth floor, the only remaining non-COVID section of the hospital. After being tested for vitals, I quickly fell asleep. The next morning, I awoke early, around 5:30 a.m., and began a routine that would last for nearly two days. I would alternate between using my cell phone for a small number of e-mail and text messages, and occasional calls with relatives, watching one news channel or another, reading, and taking naps. With an IV in my arm and heart monitors on my chest, I could hardly be more adventurous.

The biggest commitment was to finish reading The Great Influenza, by John Barry, a 2004 book about the 1918 flu pandemic that killed tens of millions around the world at the end of World War I. That may seem a gruesome topic for someone in the hospital, but I had read three-fourths of the book before becoming ill, and I wanted to finish. Also, I approach such information more clinically, trying to understand what mistakes were made, what changes resulted, and how people were affected, and I enjoyed the opportunity to learn so much so quickly. By noon Sunday, I finished, even perusing the photo sections and some of the author’s acknowledgments. Certainly, I could not have been reading history more relevant to our current dilemma.

My selfie in a hospital bed. Nobody said such photos would be beautiful.

Then I was faced with the question of what to read next. I had no assurance that I was going home that day, although it was possible. The hospital had received the lab results by late Saturday evening, and they indicated nothing unusual or troubling that would make mine a difficult case. But there was some question of how soon an infectious disease specialist and the doctor would sign off on my release. At that point, it felt that the real issue was more bureaucratic logjam than substantive, and I began to voice some urgency both to the overnight nurse, Klaudia, and the day nurse who followed, Katorina, that I did not wish to waste space if my staying no longer served a legitimate purpose. They could only reassure me that it would happen sooner or later, but I must say that both were extremely attentive and remarkably pleasant, even when it was obvious how restive I had become about the need to be released. Given the pressures surrounding them, they seemed like angels.

It was Mother’s Day, after all, and I was also feeling regret about not only missing the Friday happy hour events, one to honor a long-time friend and colleague, but now draining the pleasure out of a day that should have been spent honoring Jean. It did not seem fair that my unexpected illness should rob her of this honor. I had planned to grill steaks and baked potatoes to accompany a lush salad for her dinner, but could do none of that. I could only wait.

I made an unusual choice of my next book—a 1950s theological essay, Your God Is Too Small, by J.B. Phillips. Despite its dated gender language in the introduction, it is remarkably lucid and straightforward in explaining how we “box” God into small roles in our lives because we cannot bring ourselves to understand God’s vastness and yet God’s importance to the minute details of our lives at the same time. There was something vaguely soothing about the message, given the situation. I did not finish the book in the hospital. That task still awaits. But I put a large dent in it.

Suddenly, around 6 p.m., Katorina came to the room to provide some medicine and the news that the doctor was authorizing my release, with the understanding that I should call to set up a follow-up telemedicine appointment with him a week later. Within the space of a half-hour, the nurse removed all the equipment hanging from my arm and chest; I changed clothes, packed up my limited belongings, signed the release papers, and she was walking me to the elevator, down to the lobby, and to the front door, where Jean had been alerted to find me. She arrived within minutes. Yes, non-COVID patients are also leaving hospitals these days, though far fewer than used to be the case. Non-essential surgeries, in many places including Chicago, have been pushed aside because those ill from coronavirus need the beds. But, clearly, they too often leave and return home, just as I was doing.

I took it easy on Monday. I was still a little light on energy, so I spent much of the day reading a few newspapers that had accumulated in my absence, but I had no special ambitions and no appointments. I did cook that steak dinner as a reward for Jean’s patience and a delayed Mother’s Day. But in the evening, I had difficulty sleeping because tension in my neck and shoulders, probably the result of stiffness induced by a lack of motion with all the equipment attached to my body in the hospital, was causing a mild headache. At Jean’s urging, I took two pain pills and a sleeping pill, but then she applied some massage to bring the congested energy around my neck down my spine to my legs and feet, and I felt some relief. In the end, I managed to sleep until 6:30, which is late for me, but very good in this instance. It was refreshing.

On the trail in Humboldt Park, a day and a half after release.

I have spent part of Tuesday composing this story, but part of it further releasing that pent-up energy by hopping on my bicycle and riding it to Humboldt Park, a 700-acre expanse of municipal open space just half a mile from our home. I wandered down one path after another, past lakes and lagoons and trees in the open air of a Chicago spring morning. I had written part of this before I left. I felt more energized to complete it when I came back, once I had eaten lunch. I learned you can enjoy nature much more when you have missed it for a few days. I can only imagine the restless agony of missing it for much, much longer.

Jim Schwab

 

[i] Shannon van Zandt, Texas A&M; Marccus Hendricks, Univ. of Maryland; and Chrishelle Palay, HOME Coalition, Houston.

[ii] Pete Parkinson and Kara Drane, who were also co-authors of the updated guide along with George Homewood, David Gattis, and myself.

Unequal Exposure

On April 29, I will be moderating “Demanding Equity: Planning for Post-Disaster Recovery,” a 45-minute session in a special three-day virtual conference of the American Planning Association, NPC20 @HOME. The online conference is an attempt to replace the experience of the canceled National Planning Conference, which would have taken place in Houston, April 25-28. For the first time in APA history, the annual event will not go forward as planned. Like numerous other conferences, it was untenable to assemble thousands of participants in the middle of the coronavirus pandemic. But it is possible to provide a decent educational opportunity in its place by broadcasting and recording distance learning and letting participants ask questions remotely.

But why do I mention this one session, when APA is offering two dozen? Because it touches on some issues so central to the social and economic impacts of coronavirus, and speaks so directly to what planners and planning can do as we recover from this experience, that I wanted to highlight the subject in this post. It has been said often that the coronavirus does not discriminate. That may be true, but our society has done so and still does, often in ways people are reluctant to consider or admit. The result is that, as happens with most disasters, minorities and low-income people, those with fewer opportunities in life or greater exposure to danger, are disproportionately affected. And so it will be when the histories of this pandemic are written. The evidence is already stark enough for passionate discussion.

To give credit where it is due, the session was the brainchild of Adrian Freund, a veteran, semi-retired planner in Oregon. Before the NPC was canceled, however, Adrian was hospitalized (not because of coronavirus) and realized he would be unable to go to Houston. He reached out through a former president of APA, David Siegel, also of Oregon, to ask me to take over, and I agreed. We are on the same page on this issue. When APA decided to replace NPC with NPC20 @HOME, this was one of the sessions they felt must be included, and I reassembled the speakers to modify our plans for the new format.

All of them have a ton of wisdom to contribute on the subject. Shannon van Zandt is a professor of urban planning and department head at Texas A&M, and has authored numerous articles and led many projects on subjects related to equity in disaster recovery, particularly in the Texas context in which she works. Marccus Hendricks, an assistant professor of planning at the University of Maryland, is a Texas A&M graduate who has focused on infrastructure issues and environmental justice, writing his doctoral thesis on stormwater management in Houston. Chrishelle Palay is director at the HOME Coalition in Houston. Obviously, the panel has strong Texas roots, but there are few states where one can get better insights into the impacts of environmental inequities.

But it is the screaming headlines of the past week that have brought renewed attention to the issue in the context of coronavirus. In Chicago, we have learned that African Americans are dying from the virus at six times the rate of whites. Gary, a predominantly African American city, is the new coronavirus hot spot in Indiana. It is also where it gets personal for me. A 12-year-old granddaughter lives there and, as of yesterday (April 10), appears to have COVID-19 symptoms. Her mother called and was asked not to bring her to a hospital, but to isolate her at home. She will not be tested because, as everywhere else, this nation has not gotten its act together on testing. Will she even be included in the statistics, then, as a known case? Good question. I have no idea how Indiana is tallying such numbers. But she is in for a rough ride in the immediate future, and Gary and surrounding Lake County are certainly not fully prepared.

But what is happening in Chicago, as numerous commentators and public health officials have noted in the past week, is not only not unique, but to be expected. Detroit is emerging as a hotspot with major disparities in racial impact. State health data reveal that, while blacks make up 14 percent of Michigan’s population, they account for one-third of the cases and 40 percent of the deaths so far. In Louisiana, with one-third of the population, blacks account for 70 percent of the deaths. New Orleans has clearly emerged as a southern hot spot for coronavirus infections. Across the nation, one can find similar racial disparities.

Beneath those figures, however, are other disparities that weave in and out of racial and ethnic numbers. Age is perhaps the best-known factor, but so are many others. People in low-income service jobs, for instance, to the extent that they are still working, are more dependent on public transit and much less likely to be able to work from home like white-collar professionals. Public transit contributes greatly to mobility in urban centers, but does little for social distancing. It is still unclear just how transit will be affected for the long term, although it remains a vital link to jobs for many of the working poor. But coronavirus is clearly challenging the economic viability of many transit systems, one reason they were the target of assistance in the CARES Act.

It goes without saying that health care workers are significantly more exposed, but they are not just doctors. Their ranks include nurses, nursing assistants, and many others, some with much lower incomes, who nonetheless are risking their lives every day. Some of them work in nursing homes, which have not been the focus of any noticeable attention at the federal level. There are many ways to slice and dice the data to identify patterns of exposure, including those for access to health care, quite possibly the single most important factor driving disparities in this particular disaster. Lack of insurance coverage and inability to afford adequate health care leave many people untouched by the system and untested until it is too late. Poor or nonexistent health insurance coverage, especially for undocumented immigrants, accompanied by food deserts in many inner-city neighborhoods, endemic poverty in many rural areas and small towns, and exposure to job-related ailments, can produce numerous chronic conditions that make exposure to a new virus fatal or disastrous instead of merely survivable.

It remains remarkable, in view of these factors, that the Trump administration can maintain its drumbeat of opposition to the Affordable Care Act, including the recent refusal to allow newly jobless Americans to sign up for coverage. But this is one of many ways in which this nation, through both federal and state policy, continues to resist expanded, let alone universal, health care coverage to shore up health care deficiencies for the most vulnerable among us. There is both a meanness and short-sightedness that underlies much of this resistance. As I noted just two weeks ago, these health care vulnerabilities, with all the racial and socioeconomic inequities they embody, form the weak links in the chain of overall vulnerability for our communities when pandemic strikes.

And that brings me back to the point of the session I will moderate. One essential element of the planner’s skill set should be demographic analysis. The coronavirus pandemic highlights the critical value of addressing public health in comprehensive plans and other efforts to chart the future of cities, counties, and regions. Issues of national health care policy may be well beyond the reach of planners and their communities, but exposing the glaring disparities that have been made evident as the data on coronavirus cases grows is critical to knowing how resilient our communities are or how resilient we can make them. Access to health care is not merely a matter of insurance, as important as that is. It is also affected by the practices of local hospitals, the access to open spaces for densely populated areas, environmental regulations controlling industrial pollutants, public education around personal health, access to healthy food, the quality of our food distribution systems, and a myriad of other considerations that can be addressed to one degree or another through local or regional planning and through policy commitments to social equity.

That is precisely why, as the White House dithers, and federal management of the coronavirus crisis continues to fall short, dozens if not hundreds of mayors and governors and other local and state officials have stepped up to fill the gap. It is sad that there is not better national leadership in this crisis, but we are learning who our real leaders are. Enabling planners and other policy makers to support those officials with essential and meaningful data is an ongoing task, but if we are going to emerge from this disaster in a better place, identifying the inequities that weaken our communities and finding ways to build resilience across those weak links is going to be essential. There is no good alternative.

Jim Schwab

Test of Moral Imagination

Okay, now I’m angry. I had not intended to produce another blog article quite so soon, but false prophets are rampaging through the vineyards of the Lord. Fortunately, there are only a few of them reported so far, two of whom have been cited for certain misdemeanor offenses. But with the coronavirus, it takes only two megachurch pastors calling hundreds of people to live church services to let loose the plague on not only their own followers but everyone around them. They need to get some common sense and knock it off.

In addition, Rev. Jerry Falwell, Jr., son of the founder of the fundamentalist Liberty University in Virginia, has called students back to the campus after spring break, ignoring the actions of almost every other college in the nation to forsake such close contact and take lessons online for the duration of the semester. With several documented cases on campus already, the question is how many more students and staff will be infected.

In Central, Louisiana, Pastor Tony Spell of Life Tabernacle Church was arrested after holding services on Sunday in violation of the emergency order by Gov. John Bel Edwards for Louisiana residents to stay at home for the coming month. Released after his booking, he proceeded to defy the order again by holding services on Tuesday evening. As on Sunday, curious onlookers wondered what he was doing. On Sunday, according to the Chicago Tribune, people in the neighborhood were questioning what made the people of the church think they were so special as to disregard Gov. John Bel Edwards’s stay-at-home order. No one is discriminating against anyone’s religious rights because the order does not prohibit online gatherings and similar modes of worship. It aims to limit large crowds to inhibit the spread of a deadly virus for which there is, as yet, no known vaccine or effective cure. That is a matter of public safety. Thousands upon thousands of other congregations nationwide are live-streaming church services as a substitute for assembling masses of people in a Sunday morning petri dish for coronavirus.

I write from personal experience. My own congregation, Augustana Lutheran Church of Hyde Park, in Chicago, suspended services more than two weeks ago, but provides recordings, readings, and other online and private opportunities for worship and meditation as we can. I serve as the coordinator for the Adult Forum, the Sunday school session for adults, which predictably draws its fair share of devoted seniors, who are at greatest danger of exposure, and about whom we are most concerned. We are not meeting until further notice. We may miss the interaction and the discussions, but we do not wish to put anyone’s life in danger. Our priority is safety. We want everyone to emerge from this in good health.

In Tampa, meanwhile, Pastor Rodney Howard-Browne of the River at Tampa Bay Church violated a stay-at-home order by holding services this past Sunday. He later turned himself in to authorities, but the law firm representing him maintains that the church practiced social distancing. Given the human interactions inevitably occurring in large crowds, that may be beside the point. However, USA Today reports that, in a Facebook post, Howard-Browne described coronavirus as “blown totally way out of proportion.” It is worth noting that Florida is nearing 7,000 confirmed cases with 87 deaths so far, and the trend is moving rapidly upward. One wonders if the families of victims share his perspective.

Mark my words: In the face of the pervasive concerns of neighbors and fellow citizens and fellow Christians, such defiance soon turns to arrogance. And arrogance demonstrates egotism, not faith.

New U.S. coronavirus cases per day, as of April 1, 2020, courtesy of Wikipedia: https://en.wikipedia.org/wiki/2020_coronavirus_pandemic_in_the_United_States
(same for both graphs)
New U.S. deaths from coronavirus per day, as of April 1, 2020, courtesy of Wikipedia

Given several thousand deaths to date in the U.S., out of hundreds of thousands of confirmed cases, with untold suffering likely still to come, I have a simple question for these three ignorant gentlemen:

Who the hell do you think you are?

Pastor Tony Spell insists he will do it again because “God told us to.”

I’m sorry, but I don’t believe that. All those other pastors and rabbis and imams and nuns and priests, including Pope Francis, who is not asking anyone to come to the Vatican for Easter because he cares about the lives of fellow human beings, seem to be getting a very different message, which I suggest might sound something more like this:

Take care of my people. Save lives, especially those of my elderly servants, by taking precautions. This is your chance to show how you love each other, protect each other, and lead each other through the valley of the Shadow of Death. Use this opportunity to make your communities stronger. And, for my sake, think about the lives and health of my thousands of servants on the front lines–the doctors, the nurses, the EMTs, the social workers, the police—they are parts of your flock to whom I have assigned great responsibilities. Please do not think me so vain nor so cruel as to insist on the continuation of live worship services during this crisis. This is your opportunity to show that I have gifted you with moral imagination. Use it.

Jim Schwab