Richmond, Virginia
​November 26, 2020

Here are some photos from our Thanksgiving. Alison and I headed out to my mom's house in the style and comfort of my dad's convertible. We walked around the lake in her neighborhood, enjoying the glorious weather. Ian and two of his best friends spent the day hiking in Zion National Park, while my sister Rachel and her family celebrated at home. We had two feasts, one in the late afternoon at my mom's house and another in the early evening at Cam and Nancy's house, the first in their new home. We were joined by Nancy's parents and brother, and spent all of our time (save for the meal itself) in the garage, with plenty of air circulation. Alison's dad, pictured last here, spent the day with his son Tony and his family.

First, we have Nancy, dressed up for Halloween as the mayor from the TV show Schitt's Creek. You can't  see it here, but she was also sporting an impressive beer belly. Next, we have Ian Johnson, our neighbor in Lexington. He's been coming to our home each morning to have Alison oversee his schoolwork. He's an adorable, funny kid. Next, we have my mom, dressed in her Notre Dame finest, to cheer on the Fighting Irish at a recent football game. Lastly, we have our very good friend Beth. She joined us in Lexington for the day recently, at which time Alison presented her with a quilt she had made for her.

Here are three of my favorites of late. First, When the Saints Go Marching In, performed by The Preservation Hall Jazz Band and special guests including Paul McCartney, Elvis Costello and Dave Matthews, among others. McCartney plays an absolutely lousy trumpet, but that's part of the charm of this performance. Second, we have That Girl Is You, performed by Dave Matthews and Preservation Hall. Matthews performs a terrific tune, and is a hoot to boot. Lastly, we have This Train Is Bound For Glory, an infectious rendition of this classic tune by Mumford and Sons and The Old Crow Medicine Show. Check them all out. You won't be disappointed!

October 23, 2020
​Richmond, Virginia

The back yard in Lexington had been suffering for at least five years, overgrown with weeds and a space that we just did not use. This summer, we had a 16' x 16' concrete slab poured, bought some outdoor furniture, rocks and mulch, a fire pit and some decorative lights, and we've now got a very inviting outdoor space to use when the weather allows. Come join us there sometime!

The COVID-19 pandemic has turned me into a hermit. I can easily go for a couple of weeks without leaving the property. Alison ventures out to buy food and walk with her friends, but I've remained holed up at home. This has given me the opportunity to read more than usual. Here is a summary of the last few books that I've read and enjoyed.

The topic intrigued me, and a sufficient number of years have passed since that tragedy that I felt comfortable reading it. 2,749 people died inside the Twin Towers that day, and the authors give you a chilling, inside look at the people that made it out and those that didn't. There were many stories of bravery that day, most of them about civilians, not the rescue crews. The book also gives you a detailed look at the dysfunction at the Port Authority (the owners of the towers) and the fire and police departments of New York, who couldn't communicate with themselves, let alone others during the catastrophe.

As for the Steinbeck novel, the title of that novel is taken from the poem.

June 2nd, 2019
​Lexington, Virginia

With Eli moving out of our home and off to Tucson, the kids are now officially scattered around the country.

Nathan continues to live in Indianapolis and is looking forward to a 3-month volunteer stint in Madagascar at the end of this year. He will be working on two projects: lemur population monitoring and reforestation. He hopes that this experience will "put him over the top" and help him get into graduate school, his longer-term goal.

Ian continues to live life to the fullest as a San Diegan. During the day, he works at NavAIR and is currently assigned to the F-18 cockpit pressurization team. When he's not working, he's climbing mountains, skiing, playing beach volleyball and soccer, and pretty much any other physical activity you can think of.

​Lastly, Cam and his wife Nancy — thankfully — do live close to us. They've got one more year in Charlottesville until Nancy graduates from her Nurse Practitioner program. At that point, they've talked about moving to Richmond and producing our first grandchild, but we're trying to play things down so that they don't realize that we're super-excited about that prospect.

I never met Rachel Duncan. 

I did see her on stage and heard her perform many times, as Principal Trumpet of the Charlottesville Symphony at the University of Virginia. At the age of 33, having already performed with prestigious orchestras around the world, Rachel was a rising star in the classical music community.

​Rachel left our world (suddenly, unexpectedly, sadly) in August of last year. In September, the University of Virginia held a memorial service for her at Old Cabell Hall, home of the Charlottesville Symphony. Eli and I attended the service, which was structured as a series of musical performances from Rachel's closest friends and co-workers.

Rachel's husband spoke eloquently of her, after which he performed (also on the trumpet) an original jazz work with the UVA Jazz Ensemble. Lastly, the jazz department's John D'earth led the mourners out of the auditorium to a slow and haunting rendition of Patsy Cline's Just A Closer Walk With Thee. The service ended with Rachel's husband on stage, alone, playing the closing notes of the song to an empty auditorium.

The entire service was incredibly moving. It was, really, beyond anything that words could express. So, I won't even try.

In my last blog post, made almost a year ago, I said:

​All of that explains why I need the procedure (installation of a TIPS, or transjugular intrahepatic portosystemic shunt). As for when and where, the procedure will be done this Wednesday (March 14th) by the Interventional Radiology staff at Johns Hopkins. I will be monitored for a day or two and then sent home, barring any complications from the procedure.

I'm happy to report that there were no complications from the procedure that prevented me from going home after a couple of days in the hospital. I was unlucky enough, however, to exhibit one of the known complications from the TIPS procedure: hepatic encephalopathy. To quote Wikipedia:

​The first stage of hepatic encephalopathy is characterized by an inverted sleep-wake pattern (sleeping by day, being awake at night). The second stage is marked by lethargy and personality changes. The third stage is marked by worsened confusion. The fourth stage is marked by a progression to coma.

I quickly advanced to the third stage, rendering me (in my own words) a "happy dimwit." It was a very odd feeling, listening to someone speak, hearing the individual words, but having no ability at all to string those words together into something imbued with meaning.

Luckily, however, "there's a drug for that." In this case, it's a drug called Rifaximin. Although it was developed and approved for the treatment of  irritable bowel syndrome,  it turns out to be an excellent treatment for hepatic encephalopathy. Go figure!

With the encephalopathy under control, I was able to steer clear of doctors and hospitals for a good, solid six months. In early fall, however, my hemoglobin started to drop. To combat this, my oncologist started me on a course of steroids. That did the trick to remedy my hemoglobin, but the steroids also made me susceptible to other "opportunistic" infections (since steroids work by "shutting off" one's immune system). In my case, I came down with a case of cryptococcal meningitis. That's a fungal infection in and around the brain. The diagnosis and initial treatment for it cemented my inpatient status at Johns Hopkins for a couple of weeks in November. The complete treatment for this type of meningitis takes a full year, but it is as simple as taking a daily pill.

All in all, I continue my tour of modern medicine and the seemingly miraculous solutions that it can provide. What will the rest of 2019 bring? Who knows, but I bet it will be something interesting.

I've discovered a few new bands lately. Here is one of my favorites: Jenny and the Mexicats. Although many of their lyrics are in Spanish, a language that I do not know, I find their music and melodies to be infectious. Your mileage might vary.

Here are some photo collections from some of the highlights of the last year. Click any of them for more pictures.

​Here are some photos that we've either taken or collected recently.

Sunday, October 1st, 2017
Richmond, Virginia

Here is the capsule summary of where we stand right now:

1. The disease in my bone marrow is gone
2. The disease in my spleen and elsewhere has been substantially eliminated
3. A stem cell transplant is needed to knock out the last vestiges of disease
4. A stem cell transplant will fail (i.e. death) with an unhealthy liver
5. Circumstantial evidence (i.e. portal hypertension) indicates an unhealthy liver
6. A liver biopsy is needed to confirm or deny that indication
7. I am not healthy enough for a liver biopsy (my platelet count is too low)
8. In light of (7) and (8), we must assume that the liver is unhealthy
9. A stem cell transplant is therefore not an option
10. The last vestiges of the disease remain unchecked

That last point is the real kicker, of course. The liver specialists outlined two general approaches to #10:

• Do nothing (i.e. palliative care)
• Do something (e.g. a clinical trial or experimental therapy)

Assuming that we're not prepared to proceed quite yet with the first approach, we will be meeting with my oncologist at Johns Hopkins soon to discuss what the latter options might be. We'll keep you informed about what is discussed.

On the positive side, I haven't felt better all year! Go figure.

All four of our kids are currently professionally displaced for one reason or another:

• Cameron was evacuated from St. Croix in advance of Hurricane Maria
• Nathan is in San Antonio, Texas at a Petco conference for senior dog trainers
• Ian continues his adventures in San Diego, now extended through Thanksgiving
• Eli is in Jacksonville, Florida to observe an occultation of Triton, one of Neptune's moons

Alison and I continue to live vicariously through their various adventures.

I've knocked off a few books in the intervening month. They were:

This past month has also been a busy one for crossword puzzles. In the past, I've always enjoyed doing them (for example, if I saw a half-finished puzzle lying on a coffee table) but it is only recently that I've switched into daily mode. Each day I do the puzzle from either The Wall Street Journal or The New York Times. On more ambitious days, I do both!

When doing these puzzles, you can't help but pick up new words, but not necessarily words that you will ever have the opportunity to use in everyday speech or even writing. Case in point: a recent clue was simply Stage direction and the answer was...

 Exeunt is borrowed from Latin, the third-person plural present indicative (yikes) of the verb exire, which translates as "to go out" or "to leave." When I run across words and explanations like these, my response is always the same: