51. Year in Review 2020 — Personal and Macroeconomic

Below is a transcript for my Demographic Doom podcast episode #51 recorded on 28 December 2020 (released on 31 December 2020). It may differ slightly from the final broadcast. This episode is available on major podcast platforms, including Podbean, Apple Podcasts and a video version on YouTube. See the description on the YouTube version for extensive annotations, links and corrections. You can also comment on this episode there. The main website for this project is DemographicDoom.com

This transcript we derived from the automatically generated YouTube transcript, with only minor editing for clarity.

I'm Glenn Campbell. I call myself a demographic philosopher. I'm looking at life and trying to predict the future through the lens of demography or the study of human populations. I'm trying to view humanity from a distance like aliens would see us from space.

In this episode, I will review the year 2020 just as it is ending, and as years go this one was a biggie. The world experienced its first major pandemic of the electronic era. And it ain't over yet, so I'm not going to talk too much about the pandemic itself because you know more than I do especially if you're a listener from the future. In this episode, I'm going to talk more about my own personal year, which was momentous in itself, because I dodged another appointment with death, and I'm going to talk about the bigger macroeconomic picture that all of us are facing.

As of the end of 2020, the end seems to be in sight for the pandemic itself. Some vaccines have been developed and they're just beginning to distribute them, but the economic fallout is far from over. Rather than calling 2020 a very bad year, I would call it the first bad year of many. I suspect that 2020 will be the 1939 of bad years—bad in itself but even worse for what it foreshadows.

But i'll get into the worldwide story later. First, I want to give you a little review of my own personal year, which had some drama but ended pretty well. In the first half of the year, I had a relapse of my lymphoma cancer, which was previously treated in 2018. 

Starting in March 2020, I went through a series of chemotherapy cycles culminating in one of the most intensive treatments that oncology can offer, which is an autologous stem cell transplant. That's where I was isolated in a hospital room for 24 days and my whole immune system was essentially rebooted. It was wiped out with some industrial strength chemo, then they reconstructed my immune system from my own stem cells which had been harvested previously. So for three weeks I was a boy in the bubble, occupying a big room in Feldberg 7, which is the hematology oncology ward at Beth Israel hospital in Boston. Since I had no immune system, any little microbe could have done me in. I couldn't even step into the hall, but the staff could come into my room.

So how did I respond to this assault on my body? Well, I had a blast! I might be one of the few people you know who really, really enjoyed cancer treatment, especially the second time around. This time, I was very well prepared. I already knew the drill. I already knew all the folks at Feldberg 7, and I was thrilled to see all my friends again and—uh—give them a little entertainment when I could. It was just a wonderful experience. It was very meaningful to me, and once it's clear that I'm not going to die, I really enjoyed the whole cancer experience, both in 2020 and 2018. I don't want to minimize it. Cancer is a big thing it really concerns a lot of people. It kills a lot of people, but personally, my personal experience, because I take control of things, I really enjoyed the Feldberg 7 experience.

I was in the hospital for about 50 days from March to June and, sadly, I'm now out in the real world [now]. I'm back to my virtual life where I travel continuously for work, and I don't have a human contact anymore, and that's what I loved about Feldberg 7. I had actual friends there who I saw every day. Now in this time around 2020 everyone was wearing masks, so I didn't see their faces, but I knew everybody anyway, and it was nice to reconnect with them. I'm almost hoping for another bout with cancer so I can go back to my my home.

My cancer was hardly ever painful. At worst, it was very draining—meaning that I could hardly get out of bed—but intellectually, it was like a vacation, because I really had nothing to do all day but work on my computer, which is exactly what I love to be doing. So part of what made my cancer experience wonderful to me is that I totally took charge of it. I was the master of my domain, and I had plenty of time this time around to prepare for the autologous transplant. 

My greatest accomplishment—a very very important accomplishment—is that I built a swimming pool in my hospital room. I'm probably the only patient at Beth Israel who's ever done this, and it took me months to prepare. I knew I was going to go in for this month-long sequestering, this month-long isolation, and I prepared my swimming pool well in advance. 

What I did is I purchased a child's inflatable wading pool and smuggled it into the hospital. The security was intense, in that I'm not allowed to have any outside stuff in my room because I'm this boy in the bubble, so I had to do some conniving to manage to pull this all together, but I did. When the worst of my my situation had passed, when my blood levels, my platelet levels, were coming back and I was allowed out into the hall again, that's when I pulled my pool stunt.

I had this really big bathroom. It was a huge room, a room all to myself with a big bathroom, which was a room in itself. I blew up my pool, which is about, oh, a foot high and filled it with warm water and got into my pool. I was decently attired, and I just waited for my nurse to come in and discover me. This is a male nurse, when he when he discovered me, I was filming the whole thing, so if you want to see this, you can go to my Instagram account. The hashtag involved is “GPC”—Glenn Paul Campbell—GPC underscore cancer, and you'll see all my wonderful posts from my cancer experience both in 2018 and 2020. 

So I'm sitting in my pool my warm pool in my bathroom, and the nurse discovers me and says “Oh My God!” And I told him, you know, you better report this to the authorities, that the patient in this room has a has a swimming pool in his bathroom. You've got to report it [and] take it up the chain of command and find out what they want to do about this patient who has a swimming pool in his room. 

So eventually my real cancer doctor came in, Dr. Matt, and he was, “Oh my god!” It was time for his rounds anyway, where they come into your room and they listen to your heart and they check you out and they talk to you about your plan. And so he did his rounds while I was sitting in my pool. You know, he held the stethoscope against my chest, and we did all the usual stuff, and then he told me I couldn't have a swimming pool in my room—which is kind of what I expected. That's the outcome I expected, but my question is why. Why can't I have a pool in my room? Is there some sort of anti-pool policy at Beth Israel hospital? And the doctor simply said, “Infection risk,” which I think is bullshit. I don't think there was any infection risk. They just didn't want me to have fun in my pool.

So my pool lasted all of about two hours, but people came into my room and saw my pool, and I got the effect I wanted. I got the attention I wanted. I made the impression, and I then I took my pool down and that episode was over.

But that's the sort of thing I made out of the experience. Every day, I tried to… I couldn't leave the room, but I did have a window out into the hallway. So I had [these] two little tiny windows into the world. I had a big wall of windows looking out on the street, and I also had a smaller window looking out in the hallway, so at least in this this time when I couldn't leave my room, at least I could look out, and I could also post signs on the windows of my room, so before I ever went in for my transplant, I collected a bunch of signs, like “Beware of Dog” and things like that, and I posted them in creative ways in the window of my room, 

So I totally take control of the situation. That's my way. It was a bit of a shock in 2018 when I first learned I had cancer. I wasn't prepared. I wasn't prepared financially. [and] I didn't have a clue I was getting cancer. I thought I had something else, and [I was] disoriented for a couple of days, but I got oriented real quick, and I managed to, you know, channel myself into making the most of this and channeling myself into solving the various problems that I had—getting all my ducks in the row and totally exploiting this for all it's worth.

In 2018 I went through this very intensive program: 5 months of really knock-down chemotherapy. Many times I was released into the world when I could barely walk, but 2020 was way easier. 2020 was very intense but also very brief. I had a sort of “Lite” version of chemotherapy [in] March, April and May, and then I went in for the really heavy duty stuff in June, when they wiped out my immune system. But the disability, the part where I really couldn't function was only about a week. It was a week at my lowest point when they'd killed everything in my body and were giving me my stem cells back. It was about a week when I couldn't do much but sleep, but the whole rest of the time, I was very productive, typing away at my computer and doing stuff which is exactly what I would have wanted to do anyway.

So if you were to ask me how I spent the first few months of the coronavirus lockdown, it was there. I went into the hospital about March 23rd, which was just about the time when all the states in the U.S. were locking things down, so I did not experience very much of the outside world during that initial lockdown phase. I could look out in my out of my hospital window, and I could see that there was almost no traffic out there on the street, but other than that, it was very much like my previous stay in 2018. 

There were only a few little changes: All of the staff was wearing masks in 2020. I never saw their faces, and no visitors were allowed. Also, every patient got their own room. So during the light phase of my chemotherapy, I never had to share a room with another patient, which was an added bonus, and that's the only real difference. The same people. No one is particularly stressed in the cancer ward because they're not affected directly by Covid. It's not like everything's tense in a hospital during Covid. Only certain parts of the hospital are tense.

In all, I consider 2020 to be a pretty good year for me, but I know that's not the universal experience. It's a pretty horrible year for most people, and it's hard to get a handle on it because most of the misery is invisible. You only know about it from the statistics. 

Now, i've been there. I've known that growing sense of dread when you're trying to support a family and the money coming in, just isn't matching the money going out. You know you're on a ship that's sinking, and there's nothing you can do about it but worry. 

This happened to me back in 2003 to 2005. I was married to a woman with four children, and so I had an instant family. All of a sudden, I had children to care for who I had not raised and I had not trained and it was way more difficult than I ever imagined. When the marriage started collapsing in 2003, it was just the most dreadful experience one can imagine because not only was our marriage collapsing, but our finances were collapsing as well. I'm trying to keep this whole ship afloat, trying to protect people who seem to hate me. I couldn't live in the household anymore from 2003 until the divorce in 2005, and it was just a horrible ongoing stress. And maybe that experience is why I took cancer so well because cancer was a piece of cake compared to seeing my world collapse.

Another statistic that makes an impression on me is that back in 2018 and 2019, the Federal Reserve did a survey and found that 40% of Americans would have difficulty finding $400 for an emergency, and the pandemic has inflicted far more damage than that. And I know that vulnerable 40% are really suffering right now. You don't see any families living on the street yet, but maybe you will. People started losing their jobs back in March, and many have been running on fumes since then. They're protected from eviction or foreclosure by various moratoriums, but eventually those moratoriums have to run out, and that's when things really start breaking. That's going to happen in 2021: People who can't pay their rent or mortgage are going to be out in the street. So that's a delayed effect of the pandemic. There was this initial shock, and then there's the follow-on shocks that are going to happen one after another throughout the coming year. 

The U.S. economy is a sick puppy right now, and the pandemic is only part of it. There are huge dysfunctions in markets and monetary systems that predate the pandemic. In fact, I put out a podcast in December of last year called “The 2020s: The Horrible Decade”, which is Episode #22. Back then, before I knew anything about the pandemic, I predicted a vast economic collapse based on the macroeconomic dysfunction of massive worldwide debt and an aging population. I predicted that a “Black Swan” would come along to bring down the whole house of cards, and lo and behold, about a month later, that Black Swan materialized in China as this pandemic.

I put out another podcast very early on, around February 3rd, wondering if this was the Black Swan that would bring everything down—and it was, and yet it wasn't. The pandemic certainly crashed the economy, crashed the world-wide economy, but strangely it did NOT crash the U.S. stock market, which is flying higher than ever, which is one of the insanities of our moment in history. It's like what we need now is another Black Swan, another unexpected event, to make everybody take the first Black Swan seriously.

During one of the worst pandemics of history, stock markets have gone up, and that's not sustainable. That has to crash sometime, and that crash could easily happen in 2021. Or not. I've learned in macroeconomics, you don't make specific predictions. You can only make long-term predictions. You can always say this thing, this anti-gravity can't go on forever. It has to stop sooner or later. It's just unwise to predict exactly when, how and where it will stop and where when this process will begin. 

I put out my first podcast about the pandemic on February 3rd, which was only about two or three weeks after the pandemic was first reported in China, so on February 3rd, this was still a Chinese problem. There were no confirmed cases in the U.S. There were no deaths in the U.S., but I and many others said, “Okay, this is it. This is the Big One.” Even if it never gets out of China, this is the Big One that's going to trigger these events that that I and my Twitter friends all predicted. 

So that was the 3rd of February. The first death in the U.S. didn't happen until the 29th of February, and in the beginning of March, the United States markets really started noticing, and the stock markets did the rational thing: They crashed in March. They went down as one would expect when there's a going to be a huge hit to the economy. That was totally expected, and frankly, I didn't notice it much personally because the time of the stock market crash, about March 20th or 23rd, was also the time that I learned that my cancer was back. So I was preoccupied with that, and I saw in the news that the market was crashing, and I said, “Yeah, that's what I predicted. It's going to happen.” So over these next few months, I was inward looking. I wasn't looking out very much.

So maybe you want to know how I learned that I had cancer again. That's an interesting story. It was just about when this crash was beginning. March 19th and 20th was when I realized that I was feeling a little weak, and I could see on my fitbit that my heart rate had risen. Just doing the normal things like walking from the vehicle to into a store was very exhausting for me. I saw my heart rate go way up, and I had various theories about this. 

Of course, my first theory was that I had Covid, and so for about 24 hours I thought, “Okay, well this must be the Covid.” I'm feeling very weak, but I didn't have any of the other symptoms. I had no obstruction of my lungs, no congestion in my lungs, not even a drippy nose, so I discarded that theory. And my second theory was I was feeling winded because I was at a high elevation. I was in Albuquerque and vicinity at an elevation of five to six thousand feet. Maybe that was causing me to be winded, and that lasted for 24 hours. 

Eventually I realized what this is is some kind of anemia suggesting that my cancer is back. I had evidence, I had hard evidence. The evidence was my Fitbit. I had this certain baseline level, baseline heart rate, and I could see historically, my heart had gone way up since the 19th of March. And I knew, okay, one way or another my cancer is back. 

I got to get back to my hospital in Boston because that's the only place I could realistically be treated. It would be senseless to check into an emergency room in Arizona or wherever I was. I would have to get back to Boston, so it took me three days from the 20th to the 23rd to deliver my vehicle pick up another vehicle drive it to Boston and skid into the emergency room. As those three days are going by, my condition is getting worse and worse. Not only am I winded walking across the parking lot, but I'm actually physically fainting, physically collapsing, just walking from the car to a rest area restroom. 

On one occasion I fainted twice just walking 100 yards. It's not too dangerous. I could feel myself going down. It's not like a seizure where you have no warning. I knew I was fainting, and I could protect myself, and once I get back into the car and not exerting myself, I can still drive just fine. I'm still alert, but obviously bad things are happening. 

So I on the 23rd of March, I get into the emergency room in my hospital in Boston. I'm expecting a big crush of patients at the emergency room because of Covid, [but there were] no patients. There's no lines, no waiting at the emergency room. I went through a little screening process where they asked me some questions. I didn't have any of the symptoms of Covid, so they let me straight into the regular emergency room. 

Within about a half an hour, they had diagnosed my problem, and my problem was a build-up of fluid in the sac around my heart. So the heart sits in a little bag, a little sac, lubricated with a little bit of liquid, and there was a huge amount of liquid in this sac. They could see it in the echocardiogram. They knew what to do. 24 hours later, they stuck a catheter in my heart. I was awake for it, because I enjoy these things, and they drained out all the fluid, drained out about a liter of what looked to me like blood, a big pouch of blood, but they analyzed it and found out what that blood consisted of mainly was cancer cells, so the cancer had returned inside this sac around the heart, so I knew what I was in for. They transferred me over to Feldberg 7.

Once they drew the liquid out of my heart I was fine. I felt perfect. I was in perfect outward health because by relieving that pressure on my heart, my heart could beat freely again, and I was right back to normal, but of course we had to solve this problem of the cancer cells around my heart. 

And so for 14 days I was in the hospital with what I call “malingering”, because I had no serious symptoms whatsoever. I was a chipper. I was in top form. I could literally walk ten thousand steps every day while they decided what to do with me. So after those ten days, we decided on this this treatment plan, and I went on with it.

So only then did I begin to take a look at the markets again, and, yes, the markets did the rational thing. Between about March 20th and the beginning of April, markets crashed just as they're supposed to do, and then in the second half of [April] markets started rising again, and rising, and rising, until not only did they regain what they had lost, but stock markets in the U.S. reached all-time highs. And if that's not insanity, I don't know what is. 

As I'm speaking to you at the end of 2020, these all-time highs persist, and this makes no sense in terms of any fundamentals. It only makes sense in terms in terms of the artificial environment that the Federal Reserve has created, which is the subject of other podcasts, but that insanity is still with us in 2021. Even if the pandemic is solved, we have to do something, something has to happen to the astronomical asset prices, and that's just one aspect of the insanity. 

There are a bunch of things that just don't make sense right now. For example, to pay for Covid relief, the governments went even more deeply into debt than they were in 2019; yet, they're still able to sell bonds at a trivial interest rate. You can still loan money to the government and get virtually no interest for it, in spite of the fact that the government can't possibly make good on this debt. It can't pay it off. It can only keep borrowing, because it's so deeply into deficit. The only way it can fund itself is money printing. The Federal Reserve prints the money that the government is spending, and that can't go on forever. 

What's weird about this now is that there is no inflation. Normally when a government just prints money without restriction, there is inflation or hyperinflation. That's what happened in Zimbabwe or Weimar Germany, and that's just not happening in the U.S. right now, at least on the consumer level. You can get a dollar McChicken at Mcdonalds for a dollar still. Prices haven't really gone up very much, and that's one of the inexplicable things.

The another strange thing I'm encountering—because I see a lot of the country—is that there are Help Wanted signs everywhere. At every fast food restaurant everywhere in the country, there are Help Wanted signs. They are desperate. They're offering relatively high wages sometimes, and that's also crazy because we're in the middle of a an unemployment crisis where people have lost their jobs right and left, yet there's no one to man the Mcdonalds and other service jobs, so that's another bit of craziness.

One explanation for this is that people who have been laid off, they're still collecting unemployment and the unemployment payments would end if they went and got a job, so they don't want these jobs at Mcdonalds. Now, if unemployment ever runs out, then there's going to be rush for these jobs, and then we'll have fewer of these Help Wanted signs and more people unable to find work. Right now, anyone who wants work in the U.S. can have it. It's just very low-paying work, and if you're used to a high salary in some other industry, it might not even seem worth going to work, if you're only going to make ten dollars an hour. 

So all these insanities are not going to go away even if we cure the pandemic. It's entirely possible that even if everyone got the vaccine tomorrow, there's still going to be these delayed effects in 2021, and eventually there's going to be some kind of crash or collapse that that deals with all these economic insanities.

There's only one fundamental law in macroeconomics, at least in my view, and that's that you can't spend more money than you make. You can do it temporarily through credit, but you can't do it in the long term. The outflow has to match the inflow, and if it doesn't bad things are going to happen. You don't know when. You don't know how, but it's like a ship taking in more water than it's pumping out: Eventually, in a macroeconomic level, things have to crash if they're not sustainable.

One of the things that the pandemic has irrevocably done is wiped out tons of small businesses, leaving only the big guys standing. Big companies like Amazon and Walmart have profited immensely from the pandemic and can now be regarded as monopolies. The people who are let off from those small businesses are now reduced to serfdom. There are still jobs available, but these are what I call fulfillment drone jobs. The computer spits out an order, and you as the drone run around and fulfill it, and that's what millions of people have been reduced to. They are low level automatons, just doing things that the machine itself can't do, and these people aren't happy about it. I see their unhappiness in all the people who voted for Donald Trump, and I also see it in the Black Lives Matter protests. I don't think this is about racism or about Trump. I think this is about people being very unhappy and protesting in whatever way they have.

Now, the dronifying of work certainly didn't start with the pandemic, but the pandemic has accelerated this process by wiping out all those small businesses that offered less drone-like work. After this pandemic is over, it is entirely possible the U.S. will return to the kind of nominal full employment that it had in 2019, but these are unhappy jobs with unhappy workers, and when they go to the ballot box they could do rash and counterproductive things.

One of the few bright spots of 2020 is that America somehow managed to throw off the wretched yoke of Donald Trump, but it was by only the thinnest of margins, and all that unhappiness that got him elected in 2016 is still there and isn't going away anytime soon. Although I don't really want to place any money on it, I'm fairly sure that Trump himself is really gone, and even if he won't shut up, at least he'll fade into ineffectualness, but there will be other Trumps coming along to replace him, and when they emerge, they'll have a willing audience of all these unhappy fulfillment workers.

So 2020 was a pretty bad year worldwide, but I can't predict that 2021 will be any better. Or maybe 2021 will be great but then 2022 will go back to sucking. I just don't know. I just don't see much happiness on the horizon. We're in for a set of devastating collapses. I can't tell you when, where or how, but they're gonna happen.

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Written, recorded and edited by Glenn Campbell. For annotations, links and corrections, see the description on the video version of this podcast. You can also leave comments there. See here for all my podcast scripts on this blog.

Why I Need Another Podcast (Kilroy Cafe #1)

This is the script for my Kilroy Cafe podcast episode #1 recorded on 3 December 2020 (released on 4 December 2020). It may differ slightly from the final broadcast. This episode is available on major podcast platforms, including Podbean, Apple Podcasts and a video version on YouTube. See the description on the YouTube version for extensive annotations, links and corrections. You can also comment on this episode there. My main website for this project is Glenn-Campbell.com

I’m Glenn Campbell. Welcome to the first episode of my new podcast, Kilroy Cafe. This is my second podcast after Demographic Doom which I've been generating for over a year. That podcast is concerned with demographics, macroeconomics and the future of the family, and this new podcast is intended for everything else. Who needs another podcast? Well, I do. I don't expect the following on this podcast to be huge, but I need a place to download stuff from my brain to the outside world.

After two health scares in the past two years, I'm concerned more about my long-term legacy than an immediate audience. I've accumulated a lifetime of experience and hopefully wisdom, and one of my main goals now is to spew out as much as I can of it before I die.

Now I don't plan to die anytime soon. At the moment, I am at the peak of outward health, and I hope to keep it that way for decades to come. My health scare was lymphoma, a cancer of the blood, which was first diagnosed in July 2018. It was cured by the end of 2018, but it came back in March 2020. It was cured again by July 2020, and I'm once again in remission. That means that no cancer can currently be detected in my body. That doesn't mean I'm out of the woods, because this is the kind of cancer that is likely to return.

It's entirely possible that lymphoma is the thing that finally kills me, but everyone dies of something, and it's just a matter of putting off the inevitable for as long as possible. My distress about nearly dying in 2018 and 2020 is that I had a whole lot of data still to download, and this podcast is intended to remedy that.

In the past, I have had three main methods of data download: essays, videos and tweets. My written essays appear in many different forms, but the highest form of my art was a series of 69 one-page printable essays called Kilroy Cafe published between May 2008 and April 2010.

The name "Kilroy" was a meme from the World War II era. As American GI's traveled the world, they left behind graffiti of a nose and two eyes peeking over a wall, along with the caption: "Kilroy Was Here". The guy has only one hair on his head, which is one hair more than I have on mine. To me, "Kilroy Was Here" suggests travel, since this guy appeared all over Europe and the South Pacific, wherever the US military was stationed.

In 2008, when I started a new essay series, I was looking for a name for it. At the time, I could travel for free as an airline employee for US Airways. One of the places I visited was the U.S. Virgin Islands. In the town of Cruz Bay on the island of St. John, I took a photo of a local business called Kilroy's Laundry and Dry Cleaning. The sign above the door had the familiar Kilroy icon peering out from a dryer. I replaces "Laundry" with "Cafe" and had the name of my franchise.

The trouble with essays is that no one reads them. My audience for virtually all of my writings has been miniscule, which has never bothered me much in the past, but I'd like my downloads to be appreciated eventually. Essay writing is also a lot of work, because every word has to be perfect. If I misspell something or my grammar is wrong, it makes me look unprofessional. Writing is a precision medium, whereas a podcast is not. A podcast is more vernacular, just like talking to someone in person. You don't expect every word to come out perfectly so long as you get your point across.

I also put my philosophical thoughts into videos, which are also more casual than writing. I am comfortable doing them because they are just like talking to another person. The main problem with videos is that they are a lot of work and extremely time consuming. You have to select the right location and get the lighting right and spend hours in the editing process. I found that I was spending 90% of my time on the mechanics of making the video and only 10% on the content. I could produce a half-dozen essays or podcasts in the time it takes to make one edited video.

So I've settled on podcasts as my best medium for my data downloads. Unlike written essays, I can convey a lot of information in my tone of voice, and I can in theory engage the audience better. I can post my podcasts to YouTube without having to go through the production hell of generating the video component.

With a podcast, I have three output streams, each of which has its own audience: a traditional podcast, a YouTube video and a script. The script appears in my philosophy blog, philosophy dot baddalailama dot com. The podcast is based at PodBean and should be available on most major podcast platforms. The YouTube videos will appear on my Kilroy Cafe Youtube channel, which was my first YouTube account and more recently a place for unedited travel videos. These three output streams add up to a bigger audience than I would have with just a single stream.

All of my recent Demographic Doom episodes are scripted, meaning that I write them out before I record them. I expect only a portion of my Kilroy Cafe episodes to be scripted. Some of them will be off the top of my head, which works well for some topics where I have a pool of knowledge in my databanks that just needs to get out.

So what will I be covering in this podcast. It could be anything that doesn't fit into the Demographic Doom mandate, but I expect their to be three main categories: philosophy, oral histories, and life advice.

Life advice will include travel advice, based on my 13 years of intense travel since 2007. I have already recorded several videos that I call "Superficial Guides". There's a Superficial Guide to Eastern Europe and another Superficial Guide for the Alaska Highway. 

The idea of a superficial guide is to give you a broad overview of a place rather than too many details. You can pick up all the details you want from the internet, but it is hard to find general evaluations of a place to help you decide, for example, whether or not you should actually go there. I want to deliberately avoid pretty images in these programs, because images can distract you from the big picture. Photography and videography can actually be quite deceptive because they only show you an idealized view of a place.

So in future Kilroy Cafe episodes, I could give you overviews of, say, Western Europe or Canada. I don't have to script these episodes because they are all inside me. I just have to go from East to West or North to South and recall all the places I've been and my impression of them.

Another category I don't expect to script is oral histories. In the past 30 years, since my Area 51 era in the 1990s, I've had a lot of interesting experiences, enough to write a dozen books. The trouble is, I don't have time to write all these books, which have to be perfect just like an essay. The next best thing is to just give this guy a microphone and let him talk. I don't need a script because I can usually just go through events sequentially. I might talk about my Area 51 era, which were my 15 minutes of fame, or any of a dozen other interesting experiences.

Finally, this podcast could be the place for philosophical musings, just like the original Kilroy Cafe essays. These episodes will probably be scripted, because I need to think them through before I record them.

How do I record my podcasts? Right now I'm using a Handy H1N recorder with a furry "dead cat" over the microphone, and I'm editing on my professional video editor, Premiere Pro. My Demographic Doom episodes are heavily edited, but I hope to minimize editing in Kilroy Cafe. I don't have to edit much if I'm talking off the top of my head because you expect stumbles and mistakes.

In both of my podcasts, I'm bound to make factual mistakes, which really bother me. Whenever I detect my own mistakes, I will note the error in the description on the YouTube version of the episode. You should also check the YouTube description for relevant links to other links and resources related to whatever topic I'm talking about.

My output probably won't be too prolific, at least compared to other podcasters. Based on my past experience with Demographic Doom, I can't envision producing more than one Kilroy episode and one Demographic Doom episode per week, and probably fewer. I'm concerned with long-lasting quality, not quantity—although I imagine I'll also churn out the quantity as well.

So I think that's all you know about this podcast before we begin. Now I'll try to record a few episodes and see how it goes.

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Written, recorded and edited by Glenn Campbell. For annotations, links and corrections, see the description on the video version of this podcast. You can also leave comments there. See here for all my podcast scripts on this blog (from both podcasts).

37. How I'm Spending the Apocalypse: In a Hospital Bed in Boston (Demographic Doom Podcast)

This is the script for my Demographic Doom podcast episode (#37) released on 5 April 2020. It may differ in detail from the final broadcast, which was recorded more spontaneously. This episode is available on major podcast platforms, including Podbean, Apple Podcasts and a video version on YouTube. (Only the video version shows you scenes from my hospital bed.) See the description on the YouTube version for annotations, links and corrections. You can also comment on this episode there. (If you leave comments on this blog post, I might not see them.) The main website for this project is DemographicDoom.com

I’m Glenn Campbell. I call myself a demographic philosopher. I’m looking at life and trying to predict the future through the lens of demography, or the study of human populations.

Today is Sunday, April 5, 2020. I had intended to talk about next economic crisis: the collapse of U.S. Federal debt. As bad as things seem right now, they're going to get far worse as the U.S. government progressively becomes insolvent. The simple calculation with this Covid crisis is that U.S. government is gearing up to spend roughly twice as much money as it is taking in, probably on a sustained basis, and this can only end tragically. The government is issuing bonds like there's no tomorrow, and really, truly there is no tomorrow. There's no way to resolve this apart from a currency and sovereign debt crisis on top of all our other crises. The practical effect for you and I is that I'm expecting the return of massive inflation very soon.

But I'm not going to talk about that in this episode. I'm saving that for my next podcast a day or two from now. This episode is a personal one, with only a little demography involved. This is a sort of personal oral history of "Where were you during the shutdown?" Everyone has their own story of how they spent this days when they've been ordered to stay home, and mine is a big exotic and unexpected. For the past 13 days, I have be weathering the Apocalypse is a very comfortable cancer ward at Beth Israel Hospital in Boston.

I'm recording this podcast my hospital gown in the most comfortable possible reclining bed, in nearly perfect health, at least on the surface. I have a blood cancer called lymphoma, which has relapsed since being beaten back in 2018. I'll have to go through about 4 months of chemotherapy, including 30 days in absolute isolation, but I expect the practical discomfort to be mild, and I should be able to type on my computer and work on my podcasts all the way through it. In the short term, my risk of mortality are low—about the same as yours given that I'm protect from Covid epidemic. But in the long term, we all die, sometime before the age of 100, so I'm doing my best to get ready for that.

So to put this moment into historical perspective, we are now in the lockdown phase of the coronavirus epidemic were most U.S. states and European countries have ordered nonessential businesses to close and those workers to stay home. Schools, offices and most stores are closed. Apart from essential things like food and alcohol, the economy has all but stopped, and the streets are nearly empty. I know they're empty because I can see them from my seventh floor window. I spent a lot of time in this hospital ward in 2018, so I know this view, and the intersection below me, in front of the hospital, is a eerie void. This main road, Brookline Avenue, is carrying only tiny fraction of the cars that it normally does, even for a Saturday.

The empty streets are my only visual indication of anything wrong in the world, because I've never personally experiences the lockdowns. I came into the hospital about 13 days ago just as they were getting started. I came into the Emergency Room is Boston on March 23, which was the day before a statewide stay-at-home order in Massachusetts, so I've spent the whole lockdown right here, in the luxury of a private, in a cancer ward I know well. I'm in a bubble right now. The only way I know what's going on is through the media, and there's so much news, so many things collapsing all at once, that is difficult to keep track of it all.

So in this podcast I'm going to focus on my own microscopic issues, not the big picture, I want to talk about my two things: First, own medical condition, because folks like me just love talking about the medical conditions. I also want to talk about how this big-city hospital is dealing with the Covid epidemic, as seen from the inside. Spoiler alert: Things are pretty damn calm from my viewpoint, with none of the chaos you would expect. A hospital is a very compartmentalized place, and much of it continues to operate unchanged.

So let me talk about my medical condition, because I love all its intricacies. Honestly, if you're more interested in the collapse of human civilization as we know it, you should move on to the next pdcast, which will be out in a couple of days. I do have cancer, a blood cancer called lymphoma, but my state is not particularly fragile. In fact, I look and feel perfectly fine on the surface. For the past 9 or 10 days, I would call myself a "malinger." I'm a healthy guy lying in a hospital bed who is only pretending to be sick. To prove how healthy I am, I put in over 10,000 steps on my FitBit on a closed hospital floor, three days in a row. They've since hooked me up to an IV, which slows me down a bit, This means that when I walk the halls, I've got to haul a noisy wheeled stand with me, so it's hard to pick up 10,000. If I didn't have the stand, I certainly could. I could do 20,000 or 40,000 steps, except that I've got better things to do on my computer.

Things were different two weeks ago when I came into the Emergency Room. At that point, things were pretty dicey. Clearly I would have died had I not received prompt medical intervention. I had a fluid build up around my heart, which was restricting its activity, moving in the direction of a complete and fatal shutdown. The problem was quickly diagnosed and easily solved.  The day after I came into the E.R., they inserted a catheter in the middle of my chest to drain the fluid. I was awake for the procedure, because I really love that stuff. Honestly, if I could stay away for open heart surgery because I love participating.

So they put this catheter in my pericardium, drained all the fluid, and almost immediately my symptoms were relieved. The main systems were fatigue, a racing heartrate and a bunch of other minor symptoms relating to my poor circulation. They sucks about a liter of fluid out of my chest in two big glass syringes. It looked to me like blood, but when the fluid was analyzed, is was found to contain lymphoma cancer cells, consistent with my old cancer in 2018.

So back in July of 2018, I came into Beth Israel in pretty sorry shape. PET scans showed tumors everywhere in my body, from my head to my toes. I appeared that the cancer had metastasized and that I would surely die, but they pulled out all the stops with a very aggressive chemotherapy program, and within about two months all the visible tumors had been cleared from my body. It turns out blood cancers like this tend to be widely distributed, and "metastasis" didn't really apply. It took another 3 months of chemo to complete treatment, and in December 2018, I was officially declared "in remission".

I then spent all of 2019 cancer-free. I was physically weak in January from the effects of chemotherapy, and by December, I had regained full strength. This healthy state persisted until around March 18, when I was driving in New Mexico and I began experiencing some unusual symptoms: Fatigue, fast heart rate and a sense that my lungs weren't working like they should. So what was my first self-diagnosis? Why COVID-19 of course. It must be in its early stages. Over the next few days, however, I eliminated that possibility, and reverted to the more logical alternative: My cancer had returned and was causing some kind of anemia.

So on Monday, March 23, I stumbled into the E.R. at Beth Israel. The next day they inserted the catheter, and the day after that I recorded my first in-hospital podcast. It was the last one about Japan and Italy, and it was written, recorded and edited inside the cardiac ICU while I had a tube coming out of my chest and a bunch of wires attached to my body. Now that's dedication!

For the my first 36 hours in the ICU, I was being cleared for COVID 19. Unlike most of you, I've actually been tested for it, twice, and I know definitely that I don't have it. Furthermore, I'm in a cancer ward that's COVID-sterile, so the chances of my getting it here are extremely slim.

So I spent three nights in the ICU getting my cardiac problem resolved and getting cleared for COVID, then I was moved to my favorite cancer ward, Feldberg 7, where I have been in nearly perfect health ever since. It was only yesterday, Day 12, when I actually received my first dose of chemotherapy. It's all on Instagram and Facebook, if you care to check it out. I record everything on social media, in excruciating detail. If you want to find the links you should go to the description in the video version of this podcast.

My treatment is likely to proceed in two phases. In Phase One, lasting about 2-1/2 months, I'll go through 2-week cycles of what I anticipate to be the the most painless, non-intrusive chemotherapy I've ever experienced. The drug is called methotrexate, and in combination with other drugs it's intended to kill cancer cells without killing everything else in my body that divides, like blood and hair cells.

This is not your grandfather's chemotherapy which killed everything that moved and made the patient miserable. It is conceivable I could get through this with little of the weakness or pain associate with traditional chemotherapy. At the beginning of each two-week cycle, I will have to come into the hospital for about four days. This isn't because I'll be sick but because this treatment requires very close monitoring in its early stages. There is always opportunity for things to go wrong, and past performance is no guarantee of future results, but there's a good chance I'll get through the first 2-1/2 months with little pain or weakness.

The main aim of all chemotherapy is to stop cell division. Cancer cells, by definition, are rapidly dividing, so if you can interfere with the biological processes of division, the cancer cells die. Traditional chemo stops all cells in the body from dividing, including blood cells, immune cells and hair follicles, which is why people lose their hair during chemo. This methotrexate method, along with some other chemicals like leucovorin, ought to stop the cancer cells from dividing without interfering much with good dividing cells like red blood cells.

So after 2-1/2 months of this low-impact chemo, sometime around June I'll probably move to Phase Two, which is the radical part. It is called an "autologous stem cell transplant", and if it happens as planned, I'll be locked in a room for 30 days while my immune and blood systems are wiped out and rebooted from scratch. This involves removing stem cells from my own blood and putting them in the fridge. Stem cells, as I understand it, look like blood but they're not. They are the primitive cells from which all other blood cells are made. Once they have a supply of them in the fridge, they will use heavy-duty, scorched-earth chemotherapy that essentially kills everything that divides. This includes my entire bone marrow, where all my blood cells come from.

For a few days, I will be a "boy in the bubble" with absolutely no immune system, which is why I have to be locked in a room for 30 days. After this massive kill-off, they give me back my own stem cells, hopefully without any cancer cells. The stem cells are given intravenously, and they know what to do. They automatically head for the bone marrow and start repopulating it with new blood cells. Hopefully, after this reboot, I get a whole new blood and immune system, minus the cancer.

At this moment, I happen to be assigned to one of those transplant rooms. It's just like any other private hospital room, except that I have my own shower. The main difference is that I'm never allowed to leave during the roughly 30 day period. Staff can come and go from the room, but only in full gowns, gloves, masks and visors. This isn't dehumanizing, because I know all the staff so well. Even behind the masks I know who they are.

Wiping out and reconstructing my immune system sounds terrible, but I'm not too worried. It turns out that most cells in the body do not divide. Brain cells, muscle cells and heart cells never divide once you reach adult, so they are not affected by those scorched-earth chemicals. I expect that my brain and typing fingers will continue to function as normal throughout the 30-day quarantine. This would seem like a prison cell except that I will have my computer and wifi, which makes all the difference in the world. I can still eat regular food, so long as it is cooked. I'm probably going to need a few blood transfusions along the way, until my bone marrow repopulates. Risk of mortality is quite low, but not trivial. Whenever you compromise someone's immune system, there's a risk of an opportunistic infection, which is the main threat here.

In all, I'm not terribly worried. Like everyone else on the planet, I'm going through a period of great uncertainty, but at least I know where I'm going to physically be for the next four months: either in my favorite hospital or out on bail for 10-day stretches. I just need the medical system to hold together for the next four months, to possibly give me a few more years of life.

So is the medical system going to hold together for the next four months? From my standpoint, yes. In spite of the COVID crisis, I see no chaos here. A hospital is a very compartmentalized place. Everyone continues to do their job with various accommodations for the virus.

There are only a couple of obvious differences in my hospital ward between today and the 79 nights I spent here in  2018. The biggest is that no more visitors are allowed in the hospital. None. Only patients and staff, and they all have to pass through a screening checkpoint to get in. It used to be that an average hospital was an open place. Anyone could walk in and go just about anywhere on campus. There was essentially no security two months ago, but now there is. I am told that the hospital entrances looks like Fort Knox now.

This sounds bad for the patients, who lose the in-person support of their family members, but it's a huge boon to the staff and to the relative calm of the ward. Back in 2018, many of the patient rooms would have 3 or 4 people in them. There would be the patient themselves and 2 or 3 family members. Family members can be a management problem for the staff, and now they don't have to deal with them anymore. It's wonderful for them, and it's wonderful for me, because I get more attention from the staff. The corridors are emptier and things are much more relaxed.

They have also banned all the volunteers who used to, quote, help, unquote lift the spirits of the patients. For example, there's no more Reiki program, where volunteer practitioners would provide some kind of New Age energy therapy but gently touching key parts of the body. It did it once, and it was relaxing in the sense that I had to lie still for 15 minutes, but I didn't care to repeat the experience because I had better things to do. Nonetheless, they kept return every time I was readmitted to the hospital, and I had to shoo them away. Now there's no more Reiki, no more visitors, no more unnecessary noise. Everyone on the staff can now be focused on the core medical issues at hand.

They've also eliminated shared hospital rooms. Every patient gets their own private room, which I love. While I adore the staff here, I'm not particularly fond of the patients, who tend to be old and watch a lot of TV. I never relished the times in 2018 when I had to share a room with someone, and now that curse has been eliminated. Since room doors remain closed, I have the illusion that I'm only patient here. It's just me and the staff and a few old patients watching TV who I only see from the distance. Occasionally, I pass another patient walking in the halls. I get to know their names and stories, but I don't particularly connect with them. In most cases, I can't relate to their attitude toward cancer. They think they are prisoners here, while I treat this as a wonderful pleasure cruise.

Another difference with Covid-19 is that all the staff wear facemasks all day long. You're issued one facemask per day, and are supposed to make it last, because there is still a facemask shortage. There is no shortage of rubber gloves, hand sanitizer or any of the other usual supplies, just facemasks, and presumably American industry will rise to challenge of supplying that that. I don't wear a facemask while I'm inside my room, but I do wear it whenever I step out. During the past couple of days, the staff has been required to put on full protective gear whenever they enter a patient's room: mask, gloves, gown, visor. This strikes me as overkill, and it may not last.

The facemasks mean you hardly ever see a staff member's face. This isn't a problem for me, because I know most of these people well and can usually identify them from the top of their head. Smiles and jokes still happen as they used to, but now the smiles are conveyed in tone of voice.

In all, I don't sense a lot of tension in the ward. The Covid restrictions are annoying and time consuming, but at least the staff doesn't have to deal with all those annoying visitors, which I think more than makes up for it.

All elective surgery has been cancelled at this hospital and probably every hospital in America. There are no more hip replacements or shoulder surgeries. Any medical procedure that can be put off, will be, which frees up all those rooms for Covid patients. There's all sorts of construction and reallocation of hospital resources, includes a noisy renovation in the floor above mine. It said the hospital is preparing dedicated floors just for Covid patients, although frankly no one here really knows. If you work in a hospital, you know about your floor and your specialty, but you don't know what's going on in other buildings or on other floors.

What's it like at the Emergency Room of the hospital. Pandemonium? I don't think so, based on my own visit there 13 days ago. I was dreading going to the E.R. because I thought it would be overwhelmed with Covid patients. It wasn't. There was no one waiting at the E.R. at all. I had explicit instructions from my doctor to go there, and I didn't have Covid, so I was waved right in without waiting for even a minute.

They had a really simple system for dealing with Covid cases. When you got to the E.R., you first came to a Covid screening desk. Here a staff member quickly ran through all the symptoms and signs of Covid-19. Since I didn't have any, I was waived immediately into the regular Emergency Room, where there were no lines, no waiting.

If someone answered "Yes" to any of the Covid-19 symptoms, but they weren't in respiratory distress, they would have been sent home to self-isolate. Essentially, they are saying, "We don't want you here." Presumably if someone did have signs of both Covid and respiratory distress, they would be shunted off into a special path for these patients. They would not be allowed into the main E.R. where they might infect other patients. I didn't see what that other avenue looks like, but I assume they have whole floors dedicated to Covid patients, where they are not going to contaminate anyone else.

At some point those floors might get filled up, and the hospital won't be able to take them in. I have no idea what that capacity is, but I don't think they're close to reach it yet. Once they get there, the hospital will have no choice but to stop admitting Covid patients. In theory, they can do this by refusing ambulances with Covid cases or not letting Covid cases come in from the street. No matter how you slice it, it's ugly, but all the ugliness takes place outside the hospital. The inside of the hospital remains an orderly place. In a crunch, they are going to admit as many cases as they have the capacity for, and no more.

There is conflict in medicine that I've touched on in previous podcasts and videos. That's "best practices" medicine and "triage" medicine. In best practices medicine, you pull out all the stops to save one patient. You give him the best of everything, and you try not to expose him to any kind of risk. That's how medicine is practiced in the developed world, and it is backed up in America by our lawsuit system. If a doctor were to every fail to give one patient the best of all possible care, and something bad happened, the patient or his family would sue the doctor. Our whole medical system is geared for this best-practices model, and it works so long as there are plenty of resources to go around. As long as there are plenty of hospital beds and treatment systems and the financing to support them, the best-practices model prevails.

Triage medicine is when you don't have enough medical resources to go around, and you've got to parcel them in such a way as to maximize the number of survivors. The classic case is the wartime field hospital. If a hundred wounded soldiers come it, and you've got facilities for only a dozen.  In that case, you're deliberately not trying to give each patient perfect care. You're giving them "good enough" care, good enough to improve their odds, then you move onto the next patient.

For example, best practices for Covid-19 would be one patient per room, because you don't want one patient to infect another. In a triage treatment for Covid-19, you might be willing to house several patients of similar condition in the same room. There's greater risk there but also great economy of scale.

One of the things that makes Covid such a crisis in the West is that modern medicine doesn't know how to do triage. They can only do best practices, and they are going to keep doing best practices even as the number of patients rise. Each Covid patient will get his or her own room, and no compromises will be made. When the hospital's capacity is reach, no more patients are let in, and all those outside patients aren't the hospital's. This method is going to maximize the survival chances the people who did get into the hospital, but it may result in greater death overall because so many people can't get in.

I brought up this topic with my doctor today, because I am annoyed by my current status. As of this moment, I am in an isolation room 48 hours being "Covid cleared". This is when they keep you in isolation for a couple of days while they run two Covid-19 tests on you, 12 hours apart. I already went through this when I first came into the hospital, and I passed. I don't have Covid-19.

Last night, however, they put me back into isolation to test me again. The only reason? I had a very slight fever last night—101.3—following my chemotherapy regime. I had no other symptoms, just the fever, and my temperature quickly went back to normal. Nonetheless, they felt they needed to test me for Covid-19 all over again. The chances of my having it are close to nil, but best-practices dictate that you've got to cover all the bases and obey all the rules. I understand why they would test me the first time, 12 days ago, because they were bringing me in a cancer ward with a lot of immuno-compromised people, but the second time seems silly. The hospital could have used the last two tests for someone with actual symptoms.

All of these state and community lockdowns are an expression of the Best-Practices model. We're going to protect every citizen from every possible source of infection, which is why we're even shutting down the beaches and other activities that have virtually no chance of spreading the virus. The trouble with the Best-Practices model is that it is frightfully expensive, in this case absolutely devastating the economy. Yes, you've protected the patient from every possible source of medical infection, but you've stolen his job, killed any chance of making a living, and sooner or later these costs become more deadly than the infection itself.

Philosophically, the solution to the coronavirus crisis is shifting gears to the triage model. We are no longer going to try to protect everyone from everything. Instead we're going to focus on the few vectors that are the main source of infection, thing like shaking hands and touching door knows. Everyone can learn to manage these vectors without completely shutting down all economic activity.

Note: The second half of the final podcast deviates significantly from this script. For a better transcript of the last few minutes, see Podcast #42, Best Practices Medicine vs. Triage Medicine, which includes a 6-minute excerpt of this episode.

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For annotations, links and corrections, see the description on the video version of this podcast. You can also leave comments there.