A dark cloud has descended, cloaking everything in gray.

It isn’t just me.

One of my colleagues, Tony Alvarado (@TexasKidneyDoc), is one of the most upbeat and outgoing people I know.

Now he’s quiet.

His trademark smile is faint, and the light has faded in his eyes. 1/

Tony texted me the other day.

The most I’ve heard from him in weeks.

“My dad died last night.
COVID.
Pretty fast.
2020. Hell. On. Earth.”

I responded as best I could. Told him I was there for him.

His father was a kind man.

He didn’t have to die.

Not like this. 2/
It’s Fall 2008, and I’m a resident in Internal Medicine.

I’m attending a forum where I’ve been invited to read from the journal I’ve kept since medical school.

These are my thoughts that have been slowly consuming me.

The documenting of a downward spiral. 3/
I’m growing increasingly aware of a numbness within me. Moments that would move me before, now they evoke nothing.

The crucible of residency is forging me into a cold and unfeeling alloy I never wanted to be.

I write about it, and read my words to others who also know. 4/
I’m a guitarist, and I compare the sensation to the gradual numbing of fingertips against sharp steel strings, as the skin thickens and calluses form.

I want to tear off the calluses so the pain remains fresh, and real.

I would rather bleed on the strings than forget them. 5/
After I finish sharing, the audience is free to speak.

One of the comments I still remember to this day is from Dr. Klemens Meyer, an attending nephrologist.

He rubs his chin pensively.

“Medicine is an art, like music.”

As he speaks, he seems to weigh each word carefully. 6/
“Perhaps it’s only when your fingertips grow callused that you can make the most beautiful music.”

I nod, understanding what he means.

We deaden some sensations only to protect ourselves.

To know something truly, to get to its core, you need both vulnerability and armor. 7/
It’s early 2021.

I received my COVID vaccine.

What felt like a turning point has already receded into memory.

Like a gasp of air before the plunge back under icy waters.

Psychologically I’m back to where I was as an intern.

Completely numb. 8/
When you tell people that care is being rationed, their eyebrows shoot up.

People still have no idea. How bad it is. How bad it’s getting. How bad it’s going to get.

No idea.

Care has been rationed for a long time now. It’s just going to get worse. 9/
We are often making decisions we rarely had to make before, regarding prioritizing limited resources.

Who gets what, and when.

It’s a crushing weight.

A constant burden.

The only thing that breaks through the numbness now and then is the anger. 10/
The quiet simmering fury that occasionally blazes into a full-blown rage.

I’m angry. All. The. Time.

For Tony. For his father. For all of us.

Blood on steel strings.

I can’t hear the music. 11/
Tony texted me again the other day.

“I’ve been struggling recently a lot with anger. This will make it worse. Here’s to hoping I can heal.”

Tony is a good man, like his father.

I hope he heals.

Calluses form.

So do scars.

Sometimes there’s no music.

Just the dying hours.

More from Economy

What do a Tory Peer, Selwyn Gummer (Lord Chadlington), David Sumner ( Sumner Group Holdings) and the Sanchez Perez family (drugs money, laundered through Gold mines) have in common?

It’s another company-saving a £50 million PPE contract shaggy dog story

Connections, connections


What a start to the story

“A bulletproof truck trundled down the road in downtown Lima, guarded by 18 policeman
They were wearing body armour & wielding high velocity rifles

No-one was taking any chances
This was a Special delivery for Peruvian Prosecutor for an anti drug trial


That was in 2011, the same year that Lord Chadlington’s daughter got married in Chadlington to Henry Allsopp.

Who was there?
Yes Kirstie Allsopp of Location, location, location and all this Covid nonsense fame) is his sister

Camilla, his Godmother

Jeremy Hunt

Cameron


Well. Come on. Lord Chadlington had been chair of the local Witney Conservative Association. It’s only fair.

Hang on. Julian Wheatland, Director of SCL Group/ Cambridge Analytica had also been chair of Witney Conservative Association...and campaigned for his mate Cameron

Are we sure Julian Wheatland and his side kick Alexander Nix were not there too @JolyonMaugham ?

I mean. They move in the same North Oxford circles.

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“We don’t negotiate salaries” is a negotiation tactic.

Always. No, your company is not an exception.

A tactic I don’t appreciate at all because of how unfairly it penalizes low-leverage, junior employees, and those loyal enough not to question it, but that’s negotiation for you after all. Weaponized information asymmetry.

Listen to Aditya


And by the way, you should never be worried that an offer would be withdrawn if you politely negotiate.

I have seen this happen *extremely* rarely, mostly to women, and anyway is a giant red flag. It suggests you probably didn’t want to work there.

You wish there was no negotiating so it would all be more fair? I feel you, but it’s not happening.

Instead, negotiate hard, use your privilege, and then go and share numbers with your underrepresented and underpaid colleagues. […]