Blessed by the Potato

I had been off, away from the blog, working on a third edition of the Value of Simple (mostly struggling with how much I could excoriate certain robo-advisors for not listening to me before it became libel), and it’s been going very slowly. Instead, I accidentally wrote an entirely different book on, of all things, Curling.

How do you accidentally write a book??

Well, I ran a development league at the curling club. The idea was that we’d have a mix of experienced curlers and lot of new curlers, and it would be a home for those fresh out of our learn-to-curl programs. As part of that, I wrote a weekly email with a development tip to send around. And you know me, that wasn’t a short tip like “line up to the target before you get into the hack”, no, it was pages and pages with diagrams.

So by the end of the year I joked that if it felt like they had read a book from me, they weren’t too far off, all together those emails were almost book length. So of course a few people chip in with “you should make it an actual book!”

And, well, here we are.

What’s it called?

Curling for Beginners and Improvers. In a bold, highly unusual step for me, the branding and title are actually very descriptive of the book’s scope and target audience.

What is it about?

Curling! It’s a how-to guide (I seem to be building a specialty in that field) with a big focus on helping relatively new players. It was written in the first place as a supplement and extension to our 4-week learn to curl program, so includes the basics like how you deliver a stone, along with some discussion of common errors and why we do things the way we do. It includes a discussion of the theories behind directional sweeping, and a very light touch on strategy.

I know that the directional sweeping stuff in particular is something that is missing from the market — there are no books covering it yet, and even on YouTube there are precious few resources to help get newbies up to speed on the topic.

When is it coming out?

The release date is set for Oct 16th, to line up with the start of the curling season. With all of the tragedies of the last year, I had to squeeze all of the slack out of the publication timeline so there is a small chance the print edition may get pushed back if there’s a hiccup in the process (I’m expecting the ARCs to arrive any day now, and if there are mis-prints and I have to start over with the printer that will add delays). But e-books are finalized and available for pre-order, and I expect pre-orders for print editions to open up around Oct 1.

How does it compare to other books/resources out there?

I know I’m a bit of a weirdo when it comes to writing/publishing in that I do an environmental scan to make sure I’m actually filling a need and not just piling one more book out into the world (which if I ever decide to write fiction I will have to get all the way over), but I was surprised at how few curling books are out there. I know it’s a niche sport and all, but given how many dividend investing books are out there, I was surprised…

Anyway, What’s Your Call? only came out two years ago, and is entirely devoted to strategy. So I kept the strategy section fairly light and focused on the club-level, first-time skip.

Curling: Steps to Success would be the most similar competitor — that one and mine are both basically books on how to curl. It came out just before the directional sweeping effect was discovered, so doesn’t have anything about that in there. It’s a bit of a different voice — I’m more focused on the casual player/newbie, while Sean Turriff has more of a focus on turning you into a competitive player (so more on teambuilding and drills to do, mental performance issues, less time on the basics). Mine has more Star Trek references, which really is what people come to a curling book for is it not? His has more drills to use in practice sessions. Overall I think if you finished mine and wanted even more with a different voice (hearing/reading the same information different ways does help it sink in more) I would say that’s a good one to get next.

Curling for Dummies has the recognizable “for Dummies” branding, but is ancient (don’t be fooled by the 2020 release date that Amazon shows, it’s just a reprinting of the 2001 edition). It has a lot of non-how-to content that still holds up that I don’t bother getting into (like how the ice is maintained and where granite comes from), but the descriptions of the equipment and methods are (a lot, a little, respectively) out of date now. They do cover the no-lift delivery at least, but the idea of how to line up hadn’t quite matured to where we are today (it was still close enough to the transition from the old backswing delivery). The sweeping section teaches sweeping on a slider, which is how I learned but generally discouraged for beginners now.

Curl to Win is also out of date (it says it was published in 2009 but feels even older than Curling for Dummies, with Russ Howard’s anachronistic-even-for-the-time promotion of the backswing delivery, and anyway looks like it’s out of print now). I didn’t manage to finish Coleman’s books, which were more autobiography than guide (at least as far as I made it).

And that’s about it. It’s a pretty small field for books, which I was surprised by when people told me there was a need for such a book after I made the joke about the weekly emails. Even if my Curling for Beginners and Improvers and the other books on the market had perfectly overlapping scopes, there would probably still be room for it just to hear the info in different voices and approaches.

Of course the scopes aren’t perfectly overlapping: most of the other books also seem to split their focus on helping someone totally new to the sport while also including “become a champion!” type aspirational sections (and right in the title of some). I don’t know if that helps sell books, and maybe I’m missing out by limiting my focus. The simple fact is that I’ve taught hundreds of people in various learn to curl sessions, clinics, and special events, but coached/played zero national champions, so it’s simply not in my wheelhouse to talk about anything other than getting started in the sport and then getting a little better at the recreational level.

There are a bunch of non-book resources, too. Jamie Sinclair’s YouTube channel is terrific (if not quite structured for a start-from-scratch viewer — an advantage books still have). Matt Bean has a well-structured online course available. Both of those offer videos which can really complement written descriptions well, so be sure to check them out, too. For strategy, there’s resources like Chess on Ice.

Interesting, I’ve never heard of this “Curling” that you speak of.

The book is also for you. Curling is a sport that I love, and I try to share my joy in it with the reader, and help bring you along. It’s so inclusive because you can have multiple generations playing together in a single game, which also means it’s a sport that can keep you active for life. It meets you where your abilities and passions are: you can have people putting their all into it with incredible physical effort that spikes even an elite athlete’s heart rate to the top of their range, alongside people who are just trying to focus on the strategy aspect and keep their exercise to nothing more intense than a light walk.

Most importantly, the Canadian winters fly by when you’re curling every week.

I’m sold, where can I preorder it?

I will update this post when more options become available. For now, the e-book is available for pre-order at ~all of the major e-book retailers. And many of them are offering a pre-order discount! You can also pre-order a print copy through my Value of Simple store (yes, set up for a totally different book) — note that those can only be shipped within Canada, but if you want it signed I can do that (though honestly, defacing the book like that will probably only decrease its value).

Pre-order the e-book from Amazon Canada or Amazon US (rest of the world should get taken to their country from the US link) if you have a Kindle reader.

Pre-order the e-book from Rakuten Kobo, Google Play, or Smashwords, Apple, or many other retailers if you have a Kobo, android tablet, or other device that you don’t want to go to Amazon for.

Should I sign up for curling now?

Yes! Most clubs are accepting registrations for new members right now (September, if you’re reading this later), go ahead and sign up if you’re interested in curling, take their learn-to-curl clinic, and the book will come out in time to help supplement those on-ice lessons. Or just sign up and hope with the book and some YouTube videos you’ll figure it out in time. It’s fun.

I see you have a “blog” section on the site for the book. Are you transitioning into a curling blogger?

No, that’s to put up a few posts talking about the book and the writing process, and to act as an “errata” section for any errors or changes that may be needed (e.g., if an academic study in the future debunks one of the competing theories on directional sweeping, that’s where the update will go). I’ve got a few little teaser posts scheduled leading up to the book’s release, including one talking about the behind-the-scenes editorial decisions and the scope I decided the book should have.

So for example, Curling for Dummies is roughly twice as long as Curling for Beginners and Improvers. It’s not because CfD has that much more information on how to curl — I haven’t done a quantitative word count comparison but I’d estimate it’s actually got a little less on delivery and a lot less on sweeping. It’s because CfD’s scope includes so much extra stuff that I thought was unnecessary: a history of the sport (yawn), a description of how curling ice is made and maintained (cool, but not something the average player needs or likely wants to know — the equivalent of including a chapter on Zambonis in a book on hockey or a chapter on lawnmowers in a book on golf), a bunch of “top 10” lists, most of which aged like milk, a section on becoming a coach yourself… you quickly get a lot of pages that, IMHO, weren’t relevant to the core purpose of the book. Anyway, discussing those decisions is that post.

I plan to put up some bonus content (e.g., a chapter that I cut that I was really on the fence about keeping in there), a bit more behind-the-scenes info, and then the page will be mostly a static sales page for the book.

Seriously now, how do you accidentally write a book? Like, how exactly did this go from a bunch of emails to a coherent book?

That is the topic of another blog post on the new site.

In brief, I made the joke about my emails being so long that I had basically forced everyone to read something close to a book by the end of the year. And some people encouraged me to make it an actual book.

Even with a lot of words written, it was a bunch of tip-of-the-week things — I had a few that chained together more coherently for a broader topic, but before it could become a book nearly all of it needed to be restructured and anchored to some coherent order. Plus some of it was stuff specific to our curling club (like how to find a spare, information about our other leagues, etc.), which didn’t make sense to keep. I had to create a detailed outline of everything I’d want a book for new and developing curlers to learn.

Oh, and I had to do it fast — that joke was in my end of season message, so if I wanted to shoot any photos on ice, I had to get to it ASAP before the ice was all gone. The original emails had a bunch of good-enough-for-an-email pictures and illustrations, including pictures I may not have had copyright to, a bunch of figures mocked up by freehanding in MS Paint (one of which I kept in the book because it was cute and to be able to show where this all started). So I worked feverishly, got an outline hammered out, then listed all the photos and poses I might possibly need for every chapter, then got to shooting with Alexis, the book’s official photographer (and it’s partly her fault — I asked her if trying to turn all the tips into a book was a dumb idea and she was actually supportive so she got dragged into the project).

In the end, we had a bunch of new photos and I created many new figures (or re-made them but cleaner). The tips had to be extensively re-written, and a bunch of new ones added — just under half of the word count is new stuff that was missing from the original set of tips. Once the ice was out I spent the early summer writing and re-writing (and thankfully finished before the serial tragedies started hitting).

It’s rare disease day, so let’s look back on TTP, the rare disease that Wayfare had/has.

Thrombotic Thrombocytopenia Purpura

The tense is hard with TTP. It’s a sudden, short-term, life-threatening blood disorder. But even once the antibodies retreat as mysteriously as they appeared and the platelet count goes back to normal, it’s never really gone. There’s a good chance a survivor received organ damage from the clots or bleeding during a TTP attack, which may manifest as brain, kidney, liver, or heart damage — or just about anything else.

But beyond that, there’s the fear that it will come back. Roughly half of patients will at some point have another TTP attack, each of which carries with it a risk of dying during the episode, and accumulating more permanent organ damage and disabilities.

Wayfare essentially has PTSD from her rare disease. It took over a week and several visits to urgent care and the hospital before her TTP was finally diagnosed correctly and treatment started. By that point, she had so few platelets remaining that they had to call a vascular surgeon in to the ICU to do a cut-down on her leg to access a vein. They couldn’t run a central line because if it happened to bleed, she’d bleed out before they could stop it. In the leg at least they had the option of sacrificing the leg and tourniquetting it if the line went poorly.

We can’t afford to wait that long if she has a relapse, but the first signs of a potential relapse are fairly every-day occurrences. So any headache, any mysterious bruise (or one with a known cause that doesn’t look to be healing fast enough), any splotching on the skin, any time she feels maybe more tired than normal… these are all potential medical emergencies and we have to get her blood taken. Every few months we are off to the blood lab on short notice, or sometimes straight to the hospital to check.

Fortunately, there’s a new drug available that can help. She was part of the clinical trial, and was out of the hospital weeks sooner than they had predicted when she went in. Who knows how bad the strokes may have been if she hadn’t got it?

In Which Potato Learns How Drugs are Approved

Being in medical research, but not drug development itself, I thought I had an above-average idea of how drugs get to patients: Someone has an idea, it goes through pre-clinical testing, then clinical trials (Phases 1, 2, and 3) then reviewed by Health Canada, then ta-da, new drug on the market!

Caplacizumab went through all that. It’s safe and effective. Health Canada approved it. But TTP patients in Canada still can’t get it.

We can’t even choose to pay out of pocket for it.

There’s one more critical step: the drug has to make it onto a provincial formulary, the listing of drugs available for purchase somewhere in the province.

A big influence there is CADTH, which makes a cost-benefit analysis. In our case, they decided to recommend against caplacizumab, which as someone with expertise in a related field, who’s done a lot of reading into TTP for obvious reasons, I cannot understand why. Nearly every other nation that’s completed their equivalent review has approved it — if Wayfare gets sick again, we may be best served by putting her on a flight to the US or UK, ’cause their patients can get caplacizumab.

Reading their report, they seem to have mis-understood the feedback patients sent in, saying that we were concerned about the risk of a relapse but the clinical trial didn’t address that question. The subtext is that the company is welcome to fund another clinical trial to answer that question, after which CADTH may re-visit the decision. But that’s insane, no company is going to do that for a rare disease, especially for a tiny country like Canada if the big countries have already approved it!

And that isn’t the point we were making! The point is that caplacizumab works. It works to stop the early disease process where the platelets are forming tiny clots just fucking everywhere and ruining your very best brain tissue and nephrons. It gives you time for the conventional therapy (plasma exchange) to do its job and clear the bad antibodies that kicked the whole cascade off. It gets people out of hospital sooner and with fewer long-term disabilities.

And not just the first time. Half of TTP patients will have a relapse. Some of them have multiple relapses per year. Every time they relapse, they run that permanent organ damage and disability gauntlet: will it be a stroke this time? Will they lose a kidney? Will it affect their energy levels a little, or will everything get all scrambled so much they put the sugar in the coffee maker and the coffee in the cup in the mornings and just cry about how awful their coffee is, unable to make the connection about how to fix the problem?

We wanted them to consider that these risks don’t hit TTP patients just once, they’re a risk every relapse. Cutting those risks down by some significant percentage (the exact number would need more trials but the anecdotal evidence suggests it’s somewhere in the 50+% range) is huge if you have to face that risk over and over again — it compounds. A 10% risk of disability with each attack becomes a 40% chance after 5 relapses. Cutting just 5 percentage points off that risk doesn’t sound like a big deal when you only consider the initial attack in the cost-benefit analysis, but after a few years that’s half as many TTP survivors with a disability.

And more than the hard economics of the cost-benefit analysis: nobody out there knows if they might get TTP. It’s super-rare, you may not have heard about it before now. But once you’ve had your first attack, you live with that constant fear that you might be one of the unlucky ~50% who will have a relapse. You live with PTSD, the constant triggers that any little every day thing might be the first sign of a relapse. Knowing caplacizumab is there to improve your odds if you do relapse would be a huge mental benefit even if you never actually need the drug yourself.

The other side of the cost-benefit was also hard to understand: it’s a niche, antibody-based drug, so it’s somewhat expensive, yes. But it’s not like a take every day forever kind of drug, more like an epi-pen: an emergency rescue medication taken during an acute episode to help buy time for other treatments to work, saving lives and tissue in the process.

Political Action

Right now, the patient group Answering TTP is sending a letter to some of the provincial leaders. It’s still possible for these leaders to choose to make caplacizumab available in their province — CADTH’s report is a recommendation only, it is ultimately a province-by-province decision.

Rare disease day doesn’t just have to be about awareness, we can also help improve treatment with a small step of getting a Health Canada-approved drug for a rare disease into the hands of the Canadian patients who need it.

So please, fire off an email to your province’s health minister, and CC your MPP. Or tweet at them and tell them CADTH made a whoopsie, it happens, but maybe they can go ahead and add caplacizumab to their formulary this rare disease day.

Thanks in advance from me.

Nitpicking

Screw it, I’m clearly never getting a job at CADTH, let’s burn some bridges and nitpick that CADTH report to show you why I just don’t get why this wasn’t instantly approved and lauded as a modern medical marvel!

“During the overall study period, a statistically significantly (P = 0.0004) lower percentage of patients in the caplacizumab group (nine patients; 12.7%) compared to the placebo group (28 patients; 38.4%) experienced recurrence of aTTP…”

Holy fucking shit, how is this not approved on that alone?!?! Yes, above I focused so much on the part they missed, about reducing the risk associated with each relapse, but it also pretty convincingly reduced the risk of relapses themselves in a statistically significant way!

“The submitted price of caplacizumab is $6,200 per 11 mg dose. Assuming 37.2 days of therapy (i.e., the mean exposure to caplacizumab for patients in the active treatment group of the HERCULES trial; the reported maximum was 65 days), the cost of caplacizumab for an aTTP episode is $236,840 per patient…”

That’s the worst-case cost. And like in many clinical trials, they didn’t really know what dosing regimen to use. I would place a sizeable bet that caplacizumab would give almost all of the benefits in a 10-day course costing just $62,000. The mechanism of action strongly suggests to me that it works best early on, and the anecdotes from other patients we’ve heard of include many dramatic turn-arounds in the first week or so. But if you’re running a clinical trial you’re not going to take a chance on that, you’re going to flood the study participants with the medication and be sure it works, and do some real-world evidence gathering to fine-tune the dosage later. More to the point, if Wayfare had a recurrence, she would instantly pay $62,000 out of pocket to get a 10-day course of caplacizumab… if it were available to Canadian patients to purchase in the first place. But CADTH only considered the all-or-nothing case of using the same dosing regimen as the clinical trial.

Indeed, the real-world experience in the UK is that they are tapering down the dosing regimen, stopping when levels are normalized, rather than continuing all the way through plasma exchange. A few years ago their average days of use was already down to ~30, and is likely lower now (as a non-expert pointing to the outfield, I tell ya, 10 days).

There are still a few days of the summer left, and it hasn’t been all bad, but 2022 has been right up there with 2020 as a summer that was not good for me.

Head Injury

It was after getting a head injury that I coined the term “Summer of Suck” in my mind.

It’s not even a very good story to tell: my indoor cat ran outside when my neighbour came to the door. So I tore out after the cat, with my hands making contact, just about to snatch him back up… when I ran head-first at full speed into the overhanging bay window. What they say about scalp wounds is true: they bleed a lot. Within a breath or two I had a big puddle of blood at my feet. My neighbour grabbed some paper towels for me, collected the cat from under the bush, took her dog back home, and kindly drove me to the hospital for some stitches and glue. No cracking under pressure with that one!

I had a ~3″ long slice across the top of my head, deep enough to bleed ridiculously but not showing bone. Thankfully I was seen fairly quickly, and was in and out of emerg in just over 2 hours.

In a bit of comedy, my mask’s straps ended up inside the bandages the doctor put on, so I had to wear it the whole way home until I could cut it off.

The wound healed up fairly well — I’ve got a small pink scar (with a palpable dent) where the stitches were, and the other ~1.5″ of the cut that was glued together seems to have healed without a trace.

Amazingly, I didn’t seem to get a concussion, even though it seems like I exploded my head from the force of the impact — I was wearing a hat which didn’t get cut, which casts doubt on my theory that I got sliced open by a sharp part on the siding.

Grant Conjunction

It was also an insanely busy period at work, another one of those projects where you’re thankful for work-from-home because there simply weren’t enough hours in the week to fit in commuting too (assuming, as we do, that running on 3-4 hours of sleep/night was already on the wrong side of the insane line and that there was nothing left to cut for train time).

It is not done to bite the hand that feeds you and criticize the agencies that provide research funding. But I have to note how crazy this summer was, and it was not because of so many researchers demanding my services. This year an agency launched a call on top of another agency’s major call (they often attempt to coordinate their deadlines better than that), and even just the one competition was so over the top on the work required and the lack of time provided that it was essentially a denial of service attack on the administrative hearts of the research institutions involved.

But the response was their hands were tied because their funding agreement with the federal government required such insane timelines on our end to make it work. And perhaps they have the same don’t-bite-the-hand-just-suck-it-up attitude we have (esp. as we’re the ones dealing with the fallout), but, like, funding agreements can be amended if you realize there isn’t enough time to complete the project on time. Just sayin’.

And that’s all I’ll say about that SNAFU for now.

Site Attack

Oh and speaking of attacks, I also had someone decide to attack the Value of Simple shop with hundreds of fraudulent orders, which soaked up what little blog/writing/side business time I set aside this summer.

Thankfully, Stripe, my main credit card processor, flagged the fraudulent transactions and stopped them after a handful had gone through.

You may not know this about running a small business, but when you issue refunds, you’re still on the hook for the credit card processing fees for that transaction. So if you buy my $7 e-book and then demand a refund (say for the very legitimate reason that someone stole your credit card), and I refund your $7, I still have to pay the credit card processor roughly $0.50 for handling that non-transaction. So I was out about four bucks, which is not a big deal in the grand scheme of things.

But here is where things get ironic: you cannot pay your bill to the credit card processor with a credit card. They want a wire transfer. I haven’t actually ever done a wire transfer, so I went to Tangerine to see what I should do (and how much they’d charge me to do one). While I was afraid it was going to be like a $20 bank service charge to pay my $4 debt, it turned out to be even more of a Catch-22: they don’t offer wire transfers, period.

Eventually my (concussed?) brain caught up with the obvious work-around: I bought a copy of my own book to get money into my Stripe account to cover the deficit.

At the moment, direct sales are suspended until I can figure out a way to help prevent a future attack — Stripe suggests adding a captcha, and I honestly can’t believe that’s not included as an out-of-the-box option in WooCommerce. There’s a third-party plug-in that will do it for $38/yr, which is right in that valley of being much more than the economic loss I’ve suffered while also being less than the brain damage and time I’d have to commit to re-learn a minimal amount of PHP to functionally drop in the code snippet myself.

The book is still available from Kobo, Amazon, Indigo, Google Play, etc., so I’m not in a hurry to make my direct-from-the-author webstore work again, so that may be a while.

I Was Once an Adventurer Like You

I picked up another fun injury this summer: apparently from sitting too long at my desk in suboptimal positions (hundred-hour workweeks will do that), I have blown out my ankle. It certainly wasn’t from physical activity or sports! Too busy to see anyone about it, of course, it seems to be healing slowly (very slowly). Nice big lump in my Achilles’ tendon, and it kind of gives out and won’t hold my weight if I lean to the right. I just hope it’s fully healed by curling season!

Road Trip

Once the grants were in, I was off to PEI on a road trip with Blueberry! This was actually a really nice part of the summer, I’m sure she’ll remember her daddy-daughter road trip for a long time. I was really nervous about it — I used to drive 2 hours at a time every week before she was born, and did the trip out East almost yearly. But in the last 10 years the longest road trip I’ve taken has been 3 hours, and I felt worn out after that. So on the way out I decided to space the ~19 hours of actual driving (plus meal breaks and pit stops makes it even more in the car) over three days, which also gave us a bit of time to hit some tourist attractions.

The driving itself was fine, and she was a great little passenger. So on the way home I decided to do the drive in two days.

And we’ve been home for 8 days as I write this and I still have motion sickness — like when you’re on a boat all day then feel as if you’re swaying when you get back on land, I feel as if I’m rumbling along the highway and get dizzy if I look anywhere but straight ahead. I keep hoping one good night of sleep will fix that… and am just waiting for that one good night of sleep to happen!

The Cat

Not too long after our return, the cat got sick. He threw up in every room of the house (more than once in a few), and stopped eating. I took him to the vet, and he had all the signs of a blockage in his digestive tract. A quick surgery found a section of diseased intestine, like bowel ischemia… but no foreign object causing it! Quite the medical mystery.

He’s forbidden from any climbing or jumping activity, not even going up or down stairs for 14 days while he recovers. Yeah, try telling a cat that. The first few days he was so sick and tired and low energy after not eating for a day and then surgery that it was easy to comply, but we still have the better part of a week to go and he is done with recovery.

More Injuries

And then I fell down the stairs randomly. I’ve tried to replay what happened but while I remember the landing, I don’t recall exactly what caused me to fall in the first place. I don’t think I was dizzy from my weird road trip motion sickness, but it could have played a part. I don’t think my weirdly injured ankle gave out, but it was the one that I fell on.

I managed to land pretty much on my kidney, catching a riser across that lower back area. On the plus side, I didn’t hit my hip or a rib so no broken bones. On the down side, everything hurts. And honestly, who lands on their kidney?

The Next Quadrennial

The past few years I’ve gotten more serious about curling (by which I mean, I play more often. I’m still plenty silly on the ice). I even have a team in the team-entry league! We have matching jackets!

Or, had. After the Olympics, many of the pro teams broke up and re-formed for new configurations to try to win their medals in the next 4-year cycle. And I guess that happened to us, too? So now I’m sad because I have to find a new curling team.

My Mom

And of course the worst for last: in case you weren’t aware, my mom has MS, and has been living through the gradual loss of function for years, but up until recently was still walking with assistance (i.e. a walker), could stand up, etc. Early in the summer she very suddenly and unexpectedly lost a lot of lower-body function and requires significantly more help in the daily activities of life. She apparently didn’t want to tell any of her relatives out on the east coast, and had just mysteriously cancelled her planned trip out there on them. So I got to be the herald of bad news while I was out there.

I had originally written that we were waiting on PSW support from the Province, but before hitting publish (and after two months) we finally got coverage for two visits, five days a week, which should help with some of the burden (which is falling mostly on my sister).

The Summer of Suck Comes to a Close

So, as August comes to a close, hopefully that is it for injuries and stress and bad news and health problems.

I haven’t had a chance to work on any of the site/side business goals I had for this year yet. No fun blog posts. And the health goals are way out the window, there’s no getting those back.

It’s been a hard slog for mental health this last year. Tough on physical health, too.

Err… year and a half. Damn.

Anyway, it just never seems to end.

There are some things we can do to help cope better, of course. They’re not panaceas, but they can help at least a little. The thing is, I have never managed to internalize those lessons.

Some pretty basic things can help with mood and energy levels: if I do some exercise, if I eat some fresh fruit, and I do it consistently, I’ll start to feel a little better in about 2 weeks. I’ve done enough tests with getting into a depressive funk where I don’t do those things and then forcing myself to do them again and it helps (not a full cure, but helpful).

So I try, every day, to at least go for a walk and it’s such an easy sounding thing to do and yet so hard. The eating is even harder — pandemic baking and potato chips have done a real number on my diet, but I consciously work in at least one piece of fresh fruit.

Then someone posted this meme of a determined/upset-looking bald eagle and that has become my new slogan. “I’m going on a stupid walk for my stupid mental and physical health. See you in an hour.” and I repeat it each night.

It’s still not a habit, and it’s still not an internalized lesson — I very much consciously get up and go for that walk (and repeat my refrain about my stupid mental and physical health). Maybe one day I’ll be one of those people who jumps out of bed and then exercises before staring the day, though that has always sounded just terrible to me. I also have to try to remember the gremlin rule: no snacking after midnight (I mean, no snacking ever would be even more effective but it’s not as cute and super-hard).

Am I feeling better now that it’s been a few months of semi-consistent bare minimum self-care? I don’t know, I guess, a little.

I think there was also something about sleep? Crap, forgot about that one.

Anyway, I think because the effects are so delayed I never learn that lesson. I don’t often feel energized after exercising, I feel tired and sweaty — but after a few weeks of doing it every day, I do feel more energized. But such a long stimulus-response delay keeps me from internalizing that message, and without that constant conscious effort, I quickly slip back into slothful inaction.

I can of course relate that back to investing: there are lots of lessons that aren’t easily internalized and we have to keep reminding ourselves of. Market timing and adding complexity are two that immediately spring to mind, especially in the current age of meme stonks and bubble warnings.

Ontario provided its updated figures and modelling for covid today. The slides are available here if you want to look at the data without squinting at the video.

It’s not all that unexpected — I was sketching vaguely similar curves and worried about what an even more contagious version might do. But hearing it made real was just crushing. Covid’s on track to challenge heart disease and cancer for the top cause of death in Ontario this year (and will make the top 10 easy). And the strain on the hospital system is delaying treatments (esp. surgeries) which will make those other conditions worse.

But the big, not entirely surprising bad news is the hospital system and ICU beds: we’re just about out of empty ones, and the curve is still rapidly going up and to the right. Surgeries are being cancelled (again), and we’re not far off from very painful decisions about what happens if there’s a car accident.

One thing that’s crushing is that we were so close to getting to zero in the summer, and just opened back up a few weeks too early, without the testing and tracing capabilities ready. Still, the cases were low, everyone had stocked up on masks, and I genuinely thought we could get back to normal-ish with masks, handwashing, and social distancing*. I signed up for curling, expecting we would get a season, esp. with the modified rules of play (everyone wears masks, and things like using one sweeper to maintain 2 m between players at all times) — I had my mask rotation all planned out, and even got contact lenses so my glasses wouldn’t fog up. Schools reopened, and we kind of talked about how important that was for parents to be able to go back to work.

Then the cases started rising in the fall, and we did nothing about it until we’re now finding the hospital capacity getting crushed again. More people are going to lose their dads and other loved ones to cancer because surgeries had to get postponed, again.

I’m depressed and angry and just crushed at the whole thing.

I’m also a touch confused. They showed some data about how many people were moving around — people going to work has stayed steady since the summer, even as Toronto, Peel, and York went into lockdown (code red or grey or whatever). How there was a big spike in people visiting other residences at Christmas (to the surprise of no one). But I haven’t heard much on contact tracing and explaining what’s behind all the transmission. Are masks and handwashing and social distancing working, but some people aren’t compliant, and it’s that movement that’s the problem? Is it schools or workplaces or superspreader weddings? A little bit of everything adding up?

For most of those questions there isn’t much I can do on a personal level. I’ve tried to cut out contact with the outside world as much as possible, stretching out the time between grocery trips to two weeks or so, and our social circle is a completely closed bubble of 5 people. Wayfare has been making homemade masks since the beginning, and she did a lot of research on the best patterns and designs. They’re 3 layers, with two layers of regular (cotton?) fabric sandwiched around a layer of non-woven interface material. They have metal strips to conform to the nose (important to minimize glasses fogging and get the air moving through the material for filtering and not around the material), and straps to tie tightly around the head, which keeps it pretty well sealed all the way around the face. Though she made a few models with noses or cone shapes or whatever, I wear the basic pleated rectangle ones, so there’s no tiny holes from stitching a seam right in front of your nose. I’m sure they’re a step up from disposable surgical masks, even after a few washes. And I’m very good about wearing it whenever I’m indoors (or with another person outside — though I don’t wear one on solo walks).

However, are cloth masks enough, especially with the new B117 variant? Should we all (but especially should I) be wearing a N95-equivalent to go grocery shopping?

* – Circling back around to add: I thought the masks, distancing, etc. precautions would be good enough to get r < 1 so life could return to more-or-less normal. It doesn’t look like those were sufficient in practice (whether it’s non-compliance or whatever is a bit of a moot point as we will have non-compliance, esp. as covid fatigue sets in). We are a long, long way from Covid-zero (and we were really close in the summer!), but that may be the only strategy that lets us avoid the hammer and the dance through the fall based on the current vaccine roll-out projections.