Tall Tales from Kansas

oh me and oh my it's sweet

On the list of extraordinarily, regular things, that are keeping my head in a good space this week are reliable tulips I can see from my kitchen window, breakfast, a blooming bush I can never remember the name of, doing the kids crossword puzzles in the NYT, a Japanese fern emerging from the ground for another year, eating a leftover pancake as toast, and finally finally finally.... well go see it for yourself, at the very end.

It's not a great photo, and truly it's a face only a mother could love, but oh me and oh my it's sweet. 

It slowly leads you up to what I am assuming is someone getting killed

On the book here at Tall Tales Headquarters there is this to report: Finished, Almost finished, and Just started. In that exact order. 

My Brilliant Friend took me awhile to get through. Good writing, which initially hooked me, but I got a bit irritated at some of the characters at times. It is book #1 of 3 (I think) and so I should try #2.  The end of #1 leaves you ready to jump into it, but I'm not sure I care enough.  Sister says I need to listen to them and I will like them better so I may try that. 

Big Little Lies is FABULOUS! I have been trying to make it last. It slowly leads you up to what I am assuming is someone getting killed? Don't tell me, if you know. I think I am the only person in the world that has not seen this series on HBO. It's in the car for the drive to and from work, the reader is Australian and a delight to listen to. 

Drive your Plow Over the Bones of the Dead I started last night. Sister recommended it highly and after the first 2 pages I know I am going to LOVE it.  Such a delight to open a new book and find yourself instantly captivated. 

check, check, and check

Chris and I have a regular rotation of neighborhood walking routes, but we like to mix things up every once in a while by taking a short drive for some different vistas. Today our destination was up on campus, for the the big trees, hills, and the pond. A nice change of pace. 

Good signs, busy squirrels, trees, grass, clouds, and boys investigating ponds were all seen. Check, check, and check. It made for a perfect Sunday. 

as she goes about the business of worm wrangling

Saturday things. Beginning with that teeny tiny little baby bird beak that you have to look really hard to see.

Second in importance is the return of flower arranging with whatever is blooming in the yard.

Thirdly was the savory quick bread monkey I got off my back. It will be good in the lunchbox this coming week. Glad I tried it. Not sure this recipe will be repeated, but I did thoroughly enjoy a slice spread with soft cream cheese, for an early afternoon pick me up accompanied by the last of the morning coffee over ice.

The first Iris have started to bloom, if one of you wants to come buy and pull all those weeds growing amongst them that would be just great.  

Meanwhile, I'm just going to hang out on the porch, with the robin, who doesn't seem a bit disturbed by my quiet presence as she goes about the business of worm wrangling. 

 

it was a sweet moment

For those who are interested in the experiences of one midwestern academic medical center's experiences with COVID-19, here is my update this week. 

In the state of Kansas we have had 2,482 COVID-19 positive patients and 112 deaths as of early Friday am. There are now 3 counties with more than 150 cases each, compare this to Douglas County where I live that has 43 cases. This is related to workplace clusters, mostly in meat packing plants. The numbers of tests in Kansas has been slowly increasing from 700 per day last week to 1100 a day as of Friday. At our hospital we are able to do around 500 tests per day and have begun to do more screening. Patients and employees are now able to be tested if they have only 1 symptom, in an attempt to catch things earlier, isolate appropriately, and do contact tracing. 

As of this morning we have 24 COVID-19 positive patients in our hospital and 10 additional patients that are under investigation. To date 69 patients who have been COVID positive have been discharged.  We continue to admit 4-5 new patients per day and this number has not changed much.

We have not been hit with what was predicted in terms of the volume of patients who might require hospitalization.  For this we are grateful, and believe it is related to social distancing, and our ability to learn from what was happening in other parts of the world.  We continue to work on plans for increasing capacity if a surge happens. We are anticipating beginning to be able to do some more routine surgeries beginning next week - only those that require regional anesthesia (blocks) and not intubation and a general anesthetic. We are also preparing for the return of some clinic visits that can not be conducted using telehealth. Processes are being changed to ensure social distancing in these settings.   

What you have read/heard about African Americans and Hispanics being disproportianately affected and dying of this disease is absolutely what we are also seeing in Kansas City. One of the most heartbreaking aspects is how often we see multiple family members affected as well. A husband admitted to the hospital the day his wife died in another hospital, 2 brothers both on ventilators in the same hospital. All of this coupled with the inability to be together and comfort one another or have traditional funerals. 

One of our pulmonary specialists spent a week in NYC and reported back on his experiences there this week. Two things really struck me in his report back to us. #1 there is no clear front runner in the medications that are being trialed to combat this virus. We are doing our best to enroll patients in studies as much as possible, it is important for scientific and not anecdotal evidence to guide our therapies. #2 the nurses in ICU's at the hospital he went to were each caring for 8 to 10 patients. If you have ever been in an ICU you know that the typical nurse to patient ratio is 1 to 2. I can not even imagine. 

In closing tonight, let me share the absolute delight I felt today when a very dear 80 year old woman gave me the thumbs up sign and a big smile as I waved at her through her glass door. I put my hand over my heart, she replied with a wink. It was a sweet moment.

then I remind myself that is unnecessary

Three things that I enjoyed this past weekend were: store bought flowers, reading about war time journals in the Sunday NYT, and discovering that I really do actually like fresh raspberries. Especially with meuslix or yogurt for breakfast. I have in the past thought they had too many seeds. It's good to continue to expand your food horizons at any age. Sister said "blackberries are next". I told her I was drawing the line there.  

There were also puffy white clouds with sunshine, a short period of rain, and the ongoing parade of blooming things to make it all pretty much good.

I got sucked into looking at recipes for savory quick breads, because. Just because. Sometimes I find myself just sitting and staring when I could be "accomplishing" something. Then I remind myself that is unnecessary.

When/if I do decide to make some savory quick bread because it sounds like it would be good right out of the oven, slathered with butter, and accompanied by a glass of wine, I will be certain to let you know. So you can join me as a card-holding member of the "because movement". 

following the rhythms of life

The Robin is holding steady on the nest. Ever mindful of her duties. I watched a video on Sunday about all things related to birds and egg laying and hatching and feeding. Oh dear, it's a lot of responsibility having a nest on the porch. 

I am extremely unclear about my accountability as the landlord in shooing away predators, digging up worms, helping to discard shells after hatching, and the like. Apparently only 25% of eggs that are laid actually yield a baby bird that is able to fly away from the nest eventually. 

I have not gotten close enough to see how many eggs are actually in the nest, not wanting to cause undue anxiety for the mama. She doesn't try and peck my head and I keep my distance. No matter what happens to the occupants of the nest, when I think of the coronavirus pandemic, I will always think of the red red robin, going about her business, following the rhythms of life, the only way she knows how. 

new ways of doing business

Today marks the beginning of week #5 (in Lawrence, Kansas) of mandated social distancing and non-essential businesses being closed. I had to look back to see when we actually started this because the days are running into one another, and each individual one is a blur.

What we are doing at work continues to evolve as we figure out how we, as palliative care providers, fit into this pandemic. Infectious disease specialists direct antibiotic and antiviral therapies, ICU physicians manage the care of critically ill patients, and surgeons operate. Palliative care providers' niche is in communicating. Putting together the big picture for patients and their families about how they are doing. That is really hard with a virus that is so unpredictable. Deadly for some and milder for others.

What has been clear from the start is the need to have conversations with people before they get sick, or at the outset of their illness. When they are able to tell us how aggressive they want to be in terms of treatment, how much are they willing to go through, and when is it time to stop putting their bodies through things that are unlikely to be helpful? But it's hard to get across to patients and families that what we are seeing is an illness unlike those we have encountered before. Just when we think the corner has been turned, we have seen the bottom fall out. Most of our sickest patients are on dialysis in addition to being intubated, and requiring very high levels of oxygen on the ventilator. I have never seen so many patients require paralytics so they could be flipped over on their abdomens to see if that will help their lungs.

Not being able to visit is incredibly hard for families. Can you even imagine dropping your loved one off at the hospital and then having to rely on doctors and nurses for regular reports about how they are doing? Having to talk by phone and then not at all when the patient is unable because they are too critically ill. 

What we are doing is trying very hard to be a connection between patients and families in this time of isolation. Making sure they are hearing the latest updates, reassuring them that those caring for their loved ones are being respectful, careful, tender, in the care they provide. Letting them know we hear and see how impossibly hard this is. Using virtual technology has been helpful in being able to show families what their loved one is looking like. It is only when we are not able to see a loved one, do we realize how much we rely on what we take in with our eyes to help us understand a situation. I never thought that being a ZOOM "operator" would be such an important part of my job, but it's a good example of how circumstances dictate new ways of doing business. 

Finally today, in the event that you missed the One World at Home show on Saturday night - this was a highlight.  

 

keeping everyone in line proved to be too much

The Moss Family sing-a-long this morning went exactly as you might expect. Dottie was right on time and wearing a hat, so I had to go get a hat. Sister was late, but it was early in California so we gave her a break. Brother had not downloaded ZOOM as instructed until the meeting already started, and once sister joined the meeting I was forced to mute her so we could get started. Unfortunately she is familiar with ZOOM and knew how to unmute herself and thus chaos ensued.  Also, for some unknown reason, Brother decided to wear a cloistered monk ensemble using a kitchen towel in lieu of a scapular and a cowl.

There will have to be more practicing in order for this unruly bunch to pull off a REAL sing-a-long but I am not giving up yet.  I have been informed that cocktail hour would be a more suitable time to schedule it. By the way, I did record part of our session with my phone, but trying to run the camera, sing the song, moderate the ZOOM room, and keep everyone in line proved to be too much, resulting in a very unsatisfactory video.  As you will see below.  

To make up for this atrocity, I want to share this link below. Maybe you all already know about it, but on the chance that you don't, let me share Songs from Home from Mary Chapin Carpenter (and her dog Angus & white kitty who likes to nap a lot). 

Nothing heals, or touches the soul, like music. Mary Chapin Carpenter is one of the greats. Happy Saturday!

holding hands with you across the oceans and mountains and deserts

Tonight it's a hodgepodge of jumbled thoughts. Take what applies, ignore the rest.

Today, after my second full shift of working from home, Chris and I went out for a walk as soon as I closed up shop in my virtual workspace upstairs. When I saw this, I wanted to do a ZOOM sing-a-long with my siblings.  Oh give me a home, where the buffalo roam, where the deer and the antelope play..... I am going to open a meeting room with them tomorrow am and if they participate I will video us all singing together and post it tomorrow.  Do definitely hold your breath waiting for this.  Brother and Sisters - I will send you the lyrics tonight so you will be ready in the am. This is going to be fun. Take my word for it!

Have any of you considered what you will do if someone in your family is ill and tests positive for COVID-19 and you are caring for them at home? In case you were wondering about things, maybe this video below will be helpful?

In Kansas our governor (who is a rockstar by the way!) has extended our mandatory stay at home order through May 3rd.  It was disheartening to learn that Kansas is the 3rd lowest state in the US in terms of numbers of coronavirus tests done.  All the more reason for us to be staying at home.  

I wish you all flowering fruit trees and blue skies with white puffy clouds. No matter where in the world you are social distancing, I want to extend my thanks to those who have reached out to me here recently, I am holding hands with you across the oceans and mountains and deserts.

no wonder I look like I have some sort of spasm

I did unpin my blocked botanical cowl from the floor and wear it last week.  It is a perfect weight, did not get too hot all day long, and in fact, I liked it enough to know that I will make a similar style, different pattern, to wear through the spring, and maybe even in summer when the air conditioning is sometimes too cool. 

I got the yarn at a local yarn store in Lake Tahoe so won't be able to tell you where you can get that. But I will tell you it is the perfect pattern for that skein of fingering weight you picked up because you couldn't resist it and haven't been able to figure out what to make with it.  

This image provided so you can better see how the scarf lays overall. A nice thing about this cowl is you just loop it around twice. No tying, no knot coming undone. It stays in place. No fuss. No muss.  The picture taking on the other hand did involve some fuss. Here were my instruction from Chris - "chin down, less teeth, shoulders up, head back". No wonder I look like I have some sort of spasm, somewhere. 

Pattern available here as a free download on Ravelry.  A very enjoyable knit. 

sweet, funny, a little madcap...

In case you are interested, incubation continues on the front porch of Tall Tales headquarters. The porch has been divided and agreements signed. Chris and I stay away from the nest, the robin avoids the rocking chairs, especially at cocktail time. 

The Japanese maple turned on the charm overnight this past weekend. It's just splendid. 

A Japanese maple leaf in the right light is just about one of the most beautiful things there is. Amen to a whole lot of beauty right now. 

The oak leaf hydrangea is pushing out new leaves like nobody's business. I think the maple and it are competing for some kind of award. 

Out back this statue from Angie's garden stands guard over a small bunch of tulips that were planted way back in 2008. I don't know why they have not been eaten by squirrels or how they keep performing when most of the rest that I have planted over the years have stopped. I am grateful. 

By the way, we did end up watching Harvey on Easter. Just the kind of viewing needed during Coronavirus times. Sweet, funny, a little madcap, and of course it's got Jimmy Stewart in it.  What more needs to be said?

 

keeping our loved ones close in new ways

As a new week begins, let me give you a glimpse into how things stood at the end of last week at my hospital in Kansas City.  We continue to have an average of 25-30 COVID-19 positive patients in the hospital and roughly half of those are in the ICU - mostly intubated. There also continues to be 25-30 patients who have been tested and are referred to as PUI - persons under investigation.  We have had deaths and have also had people who have been able to be liberated from the ventilator and discharged.

Overall, in the metro area, the number of patients admitted to the hospital who are COVID-19 postive continues to slowly increase.  It's too early to know where we are on the curve. There is no evidence that it has flattened. In our facility we are prepared for a "mild to moderate" surge. We are ok on amount of PPE but continue to be very judicious with use.  An area of greater concern is the potential for/likely shortage of medications required to keep patients sedated and comfortable while on breathing machines.  

There are still no FDA approved medications for COVID-19 though we continue to use hydrochoroquine and azithromycin following specific protocols. The use of convalescent serum is also being investigated.  

There remains much that is unknown about this illness. Patients are staying on ventilators for weeks instead of days. Generally when someone is on a ventilator for longer than 10-14 days a tracheostomy is done to prevent further damage to the vocal chords and allow for longer term weaning from the vent. We are not doing tracheostomy's right now because surgery on a COVID-19 patient poses significant risk for transmission of disease.  In addition, once a patient gets a trach they have significant ongoing aerosolization of secretions, and this creates a constant high risk for transmission of the virus.  We have seen patients who seem to be getting better precipitously take a turn for the worse, and some patients we thought would not survive, suddenly improve.

We are treading water, trying to be realistic and prepare families for potential deaths, while also understanding their need to hold on to the potential for a miracle. 

What we do know is that it still makes the most sense to continue our current state of social distancing, being vigilant to avoid transmission, washing hands, working from home if we can, reaching out to others virtually, keeping our loved ones close in new ways. 

ah-ah-ah-ah-ah-le-lu-oo-yah

Happy Easter from Tall Tales Headquarters, where I found a favorable ruling from the Kansas Supreme Court along with some chocolate malted eggs in my Easter basket this morning. They went quite well together.  

Temperatures are supposed to drop throughout the course of the day so I was also delighted to be able to get an early morning walk in. I sent my siblings a MarcoPolo in which I reminisced about going to church on Easter Sunday in Harrison Arkansas with mom in the early 90's, when all the women wore their best hats, and services ended with a rousing rendition of "Christ the Lord is risen today ah-ah-ah-ah-ah-le-lu-oo-yah". I sang it for them so they could get the complete experience.

A carrot cake for 2 was also made using this recipe except I added raisins and instead of the brown butter cream cheese frosting I used the Pioneer Woman's cream cheese frosting recipe that goes with her red velvet cake because it is so good and never fails to disappoint. 

Then I called my friend Mary Joan because I love to surprise her with FaceTime calls when she may have a few hairs out of place. I don't know about you guys, but I am finding it important to FaceTime, MarcoPolo, and/or Zoom regularly with my friends and family. 

And just because we are in the midst of a pandemic, I still find it essential to put out some bunnies and make mini flower arrangements. 

As soon as I post this I am going on the hunt for an old Easter movie for tonight's viewing. We watched "Meet Me in St. Louis" in the last few years and it was delightful. Chris suggested "Harvey", which I think sounds perfect.

things I have "put up" from the market

In case you were wondering (which you probably weren't), I did use a bag of blueberries, uncovered by accident in the bottom drawer of the freezer, carefully preserved from last year's farmers market, to make Blueberry Snack Cake last week.

When lunch time comes, and I pull our a jar of soup and a piece of this carefully wrapped cake, and sit down at my desk, it feels like I have been seated at a roadside diner off a two lane highway in the middle of the great midwest. It's not fancy. It's just good.  

I was lamenting the fact that I had 2 bags of these that I hadn't used. Until I learned this week that the farmers market opening has been delayed from April 11th until May 30th. I can't recall if that means I will miss the height of blueberry season.  I don't think so.  I think that's late June in Kansas. But the thought of one more of these cakes will help me get through not seeing all my farmer friends.   

I am luxuriating in baking these days. Especially a simple recipe like this that requires minimal ingredients, that I usually have on hand, with the exception of the buttermilk that is easily substituted with regular milk with a bit of vinegar. I do LOVE using things I have "put up" from the market. 

the trifecta of of holy water, frankincense, and myrrh

I do NOT engage in political discussions on this blog. BUT, I am going to have to respectfully insist that those responsible for overturning the Kansas governor's ban on gatherings of larger than 10, on the basis that it is a violation of religious freedom, please instead go to church - instead of coming to the hospital if they become ill. 

Those of us on the front lines of the pandemic, who have witnessed the death of individuals whose illness can be traced directly to contact from a church gathering, can not understand the logic behind politics as usual. Not in the face of science and the evidence that social distancing will help decrease illness and death.

While I can not enforce it, I would like to absolutely insist that those individuals who insist on attending services and not following social distancing guidelines, who subsequently become sick and infect countless others, shelter at home and utilize the trifecta of holy water, frankincense, and myrrh and forgo standard treatment with hospitalization, oxygen, and perhaps an opioid.

If this seems harsh, and I realize it does, please imagine your sister, brother, spouse, or child as one of the ICU providers I witnessed this week working tirelessly, at tremendous risk to themselves, to resuscitate a patient who ultimately died.   

Thanks for allowing me to rant. Just a bit. 

P.S.  in case you hadn't heard what our legislators have been up to - read about it here.

P.P.S.  I also want to say that the vast majority of religious organizations in this area, have already cancelled services voluntarily.

let's talk ventilators

You are going to need to click on the photo below in order to make it large enough to clearly read (you may then print it out). BUT - it's worth it. Over the years, on this blog, there have been a number of posts focusing on the need to have advanced care planning conversations with those you love. Now it is more important than ever.  

Here is why. While all people may contract COVID-19, regardless of age and how healthy (or not) they are, we also know that individuals who are older, that have pre-existing medical problems, are more likely to get a severe form of the illness and are also more likely to die as a result.    

Unlike other posts, where I have discussed "code status" or consideration of what it means to be "DNR" (do not resuscitate), this handout is specifically to help you with a discussion of whether or not you would want to go on a ventilator.  This is not a decision that should be made at the last minute, and it is best made by a well informed patient rather than their family member. Which means YOU have to think about it in advance and be sure the person who is your designated medical decision maker knows what YOU want. In the very best case scenario, you as a patient would have this conversation with your primary care provider AND your medical DPOA.  

These are unprecedented times. It is very possible, some would say likely, that we are going to face a shortage of ventilators in this country. For some, a decision to go on a ventilator is the absolute right thing for them. I also think it would be a terrible thing, in a time of shortage, to put someone on a ventilator who knows they would not want to be on one, or who likely wouldn't want to be on one, but haven't taken the time to think about it in advance.  

As always, post your questions/reflections about this in the comments section. 

Pink Moon

Just because I wanted to try. "Pink Moon" as seen from Tall Tales Headquarters. April 7, 2020 at 8:21pm.

It's always good to try. 

is doing "good enough" ok for these times?

Chris and I feel very fortunate to live where we can easily walk outside, in relative isolation, and admire the arrival of spring.

As we walk it's easy to forget what's going on, until I reach to touch something and Chris says "I wouldn't do that"... and I wonder if he's being too cautious, or am I being too lax?  

Flowers, sun, color, fresh air, the whole of it; a balm for things that are troubling. 

Tomorrow I will be working from home for the first time.  It likely won't be different from working from my office, but it feels different. I won't be able to just run up to a unit if I feel like someone needs me.

What I am struggling with is that I know what we are doing right now, using Telehealth, is maybe not doing the very best I am capable of in person. At the same time, understanding that we must be cautious, and maybe doing "good enough" is ok for these times. All of this against a backdrop of knowing we MUST preserve PPE for the most vital staff members. These are the thoughts in my head tonight.

On a positive note, I was able to address all the technology "stuff" required to work from home. With only 2 calls to the hospital help desk. Plus a bit of sweating and some nervous laughter that turned into a full throttle guffaw.

doing your part to get our world through this

I began my nursing career in 1981 in a small local hospital in Salina Kansas. In the early 1980's, when we were faced with what we initially referred to as HTLV-III, we were forced to change our practices. We had to learn to be more cautious with blood and body fluids.  In retrospect, it's hard to believe that we didn't always use "universal precautions" when caring for all patients. But we didn't.  I remember thinking to myself "I will never be able to start an IV wearing gloves, I won't be able to feel the vein as well, I will not be as precise". And yet we did change, for the better. And we learned to be quite skilled at starting IV's with gloves on. 

Once again, as we face challenges with COVID-19, we are learning new ways to do our work. I would not have believed it was possible to communicate with multiple family members using an iPad, on a pole, taken into the room by the nurse caring for the patient. But it is. Is it the same? No, it's harder because we must coordinate with the nurse, so they can take us in virtually when going into the room to provide care. While at the same time making sure we are not interfering with the life saving interventions going on. We must prepare the family for what they will see and make sure they are able to use the technology. Connecting with families and conveying compassion is harder virtually. But it can happen. We have been deeply touched by the emotions of families who have not seen their loved one "since we dropped them off at the hospital". That was obviously before they were intubated and on a breathing machine. It's hard to see someone you love like that in real life, much less on an iPad. I can only imagine the helplessness families feel, being quarantined or isolated at home, worried and unable to be present at the bedside.

These times call for innovation coupled with caution, using what we know, going in new directions, always working to be sure we are safe. Last week we worked differently than we did the week before. This coming week, I am already thinking about ways that we can work smarter than we did when we walked out of the hospital on Friday. All of this in preparation for the surge of patients we fear are coming. 

Thanks to every single one of you who is staying home. Being safe. Washing your hands. Doing your part to get OUR world through this pandemic. 

follow my lead and do them all

This morning after cleaning off the table, drinking a cup of coffee, and making sure the redbud tree out front had suffered no ill effects from the "hard" freeze overnight, I FaceTimed brother. 

I told him I was about to spend $195.00 on a pair of mail order shoes that I could not try on, and wondered what he would do in this situation. Truthfully, I was thinking he would talk me down. He responded "well sister, I have two schools of thought on that". He noted we are older, our feet our important, we have always been of the mind that it's ok to pay "good money" for quality things, and dad used to tell us to buy the best in terms of our golf shoes.  I stopped him before he presented position #2 so he wouldn't change my mind. The one he had just helped me make up with his 4 salient points.

Once this critically important decision had been made, I took a photo of the cauliflower I was about to roast because it seemed really beautiful to me. On my quick walk today I noted the appearance of the yellow flower that blooms after forsythia and daffodils. 

Tonight we are watching Yours, Mine, and Ours with Henry Fonda and Lucille Ball. 

The garden, talking to your family, making questionable decisions, ordinary beauty, looking at the bright side of things you cannot change, and a good dose of old fashioned humor are all examples of the coping skills I am employing today. Along with a dinner of Chris made salisbury steak, mashed potatoes, mixed vegetables, a crusty roll with butter, and a generous glass of cabernet. I can recommend each of these things individually but really encourage you follow my lead and do them all. Substitutions that satisfy your personal preferences are encouraged. No extra charge. 

what's your name

In between feeling "vaguely unsettled" at work and isolating at home, there are still a whole lot of ordinary moments happening. Some that I took pictures of include: a drink on the porch, the walk around the block, a handwritten card in the mail, an unusual sun/cloud thing, and the grocery store tulips.

Things that went un-photographed include a 4 year old boy, that is a daredevil on his bike, and who sometimes wears his mom's sunglasses, who hollered "what's your name?" at me from across the street. I found out his name is Owen by the way, and I think we may become fast friends from a distance. Questions from curious children who will take my responses at face value and allow me to make up all sorts of stories feels like a good thing. From 6 feet away. With a mask on. After washing my hands. And only for about 2 minutes. 

it was me and the trees and the breeze

This Sunday, since all my usual places of worship (the churches of the holy bean aka my favorite coffee shops) were closed, I found myself giving thanks at the sacred spots shown below.  

All of these photos taken very early Sunday morning, when no one was about, it was me and the trees and the breeze. Spiritual uplifting accomplished. 

P.S. For the foreseeable future it seems that I will be going to the Blackjack Coffee House, luckily there is both indoor and outdoor seating, they serve a robust dark roast in most excellent mugs, and I don't have to drive to get there.