I’m back, and I want to thank everyone for their patience. As faithful readers of my blog know, I lost my wife – my best friend, my soulmate, and the person who kept me grounded – of nearly 45 years, suddenly and unexpectedly on May 5 due to a sudden cardiac arrest. She was 71 years old. While she had been in gradually declining health for many years, I thought we still had at least a few more years together. She had even had a thorough medical evaluation the month before, and her doctor was very impressed with the overall control of her medical problems. I am so grateful for our time together from my late college years all the way through 5 years of retirement; the fact that despite her deteriorating health, Lynette had a great quality of life filled with much happiness all the way up to the end; and that she went quickly, without suffering, and at home.

Nonetheless, I have needed this time to pause from writing my blog. I still am grieving, but the main problem with respect to writing has been a lack of motivation, a lack of ability to focus for extended periods of time, and much more difficulty in organizing my thoughts, especially around complicated matters. None of these have ever been challenges for me in the past. Fortunately, as I process my grief, as I learn to adapt to my new life, and as I receive comfort and encouragement from so many friends, family, neighbors and colleagues, I also feel that all of these impediments to writing are gradually improving; improving enough that I can return to writing.

It is important to me that if I am going to spend the time and effort to write my blog posts, that they are high quality in the mind of the readers. To me that means they have to be understandable, they have to give you new information or at least new insights or perspectives, and they need to be of value to you in terms of informing your own health care decisions or those that you provide information and advice to.

While my perhaps “writer’s block” is understandable under the circumstances, what I have not lost is a sense of urgency to get back at it. There is more disinformation than ever, still coming from social media and the usual suspects, but now also coming from some of the highest levels of our government and public health agencies, that I feel the pressing need to get facts and truth out to my readers, especially as our children and grandchildren will be soon be restarting school and in 2 – 3 months we will be experiencing the onset of respiratory virus (so-called cold and flu) season here in the U.S.

So, I am back at work and just wanted to let you know that next week I will post a comprehensive review for the lay person as to what we know, what we think we know, and what you need to consider about COVID-19, including updates and my recommendations about the COVID-19 vaccines. I will follow that with reviews and recommendations about influenza and RSV, since these are the major respiratory virus threats we will be facing for which we have vaccines.

So, thank you for your patience for the past three months and look for new blog posts to resume next week.

Mary Lynette Pate

November 2, 1953 – May 5, 2025

Our Love Story

I knew that I wanted to be a doctor from an early age. The problem is that anytime I went to the hospital for a visit, I would pass out. It wasn’t that I was squeamish about blood, it was that I had an overwhelming sense of empathy for my friends or family members we were visiting that would overwhelm me suddenly and intensely upon seeing them. In high school, for career day, I went to our local general hospital and we were taken to the neonatal intensive care unit. For some reason, I was the only boy in the group. When I saw a newborn with a gastroschisis (internal organs outside of the abdomen), I passed out, hitting an incubator on the way down. Unfortunately for me, none of the twenty-some girls who accompanied me on this tour day passed out, so I knew I was in for a razzing when I returned to school the next day.

My parents, of course, suggested a number of alternative careers that might suit me better. But, after consulting with a neighbor of ours who was a doctor, he told me to stick with it and one day, I would stop passing out (he turned out to be right). So, while an undergraduate student at Rice University in Houston, I went to the Texas Medical Center hospitals to see if any of them had a paying job for me during the summers that would allow me to begin a program of immersion that would hopefully result in fewer and fewer fainting spells over time. Failing that, I offered to volunteer, if they would just agree to assign me to the grossest unit in the hospital.

Memorial Hospital took me up on my offer and assigned me to the Surgical Intensive Care Unit (SICU), where the most severe surgical, trauma and burn patients were cared for. I was essentially an orderly and my duties were to assist the nurses with whatever they needed an extra pair of hands with. Sometimes, it would be bathing or lifting a patient; other times I might be holding pressure on a bleeding site or assisting with a burn scrub (my least favorite thing to do).

When accepted to Rice, it was with the condition that I live off campus since they had already run out of campus dorm living. So, I lived with my parents because I got a great deal on food and rent. One day, the SICU was particularly busy, and I was asked if there was anyway that I could stay past my assigned shift to help. I immediately agreed. I called my Mom on the unit’s phone (we didn’t have cell phones back then) and told her they needed me, I was planning to stay late, and so don’t hold dinner for me. Unbeknownst to me until she told me years later, Lynette, one of the SICU nurses, overheard my conversation and told one of the other nurses, “Whoever marries him is going to be a lucky woman.”

Back then, I played a lot of tennis. One day, I asked the head nurse, who happened to be Lynette’s roommate, whether she might like to play tennis the next weekend. She told me she couldn’t (a frequent refrain when I asked girls/women out in high school and college), but not surprising to anyone who knew her, Lynette stepped up and told me she was available that weekend. That was the start of our relationship 48 years ago. We played tennis, she let me beat her, preserving my fragile male ego, but I could already tell that there was something very special about Lynette that I had never seen or felt with prior dates or infatuations. She told me that what she first noted and appreciated about me was my thick hair and what she thought were beautiful eyelashes (I don’t think I had ever noticed my eyelashes). But, with Lynette, I can tell you that what set my heart on fire was her huge smile, made even better on those occasions that I or someone else made her laugh. (I had tried over the subsequent 48 years to convince her that I am hilarious, but she never could get herself to acknowledge that). Don’t misunderstand me- I thought Lynette was beautiful then and was always beautiful to me as we aged together, but her smile, her laugh, and her inner beauty was what set her apart from everyone else.

After that first tennis date, we continued to date, and before long, we were what we called in those days, “going steady.” I had bought a used red Volkswagen beetle convertible for $300 just before we started dating that had a lot of miles on it and a rusted out floor board in the back. I played in the Rice University MOB (Marching Owl Band) and so when we had home games, I put Lynette in the front seat with me and stood my 45 pound sousaphone in the backseat with the giant bell sticking up with the top down to drive to the games.

I continued to work in the SICU during summers, and the next year, finally achieved a paid position as the unit clerk processing doctors’ orders, requesting lab and radiology tests for patients, and ordering the supplies the unit would need. Meanwhile, knowing that I wanted to go to medical school, Lynette taught me how to read EKGs and laboratory results on the patients we had in the unit. She also began teaching me all the things that I should not do once I became a doctor. Chief among those things were: (1) don’t order weights on patients who are on a ventilator and in traction and then don’t even look at them when you make rounds; (2) don’t do a procedure and leave a mess for the nurses to clean up; and (3) don’t take out your frustrations or fatigue on the nurses. I can honestly say that I took everyone of those teachings to heart. I remember years later being at the hospital and conducting a spinal tap on a patient late at night when I was sleep deprived and very busy. I completed the procedure and began cleaning up everything, and the two nurses that were assisting me said, “that’s alright, doctor. We’ll clean this up.” I replied, “My wife will kill me if I don’t do this myself.”

While I was at Rice and while we were still dating, Lynette asked if I wanted to attend Sunday school with her. Lynette and a man co-taught a popular Sunday school class for single adults. At that point in my life, I was not interested in church, but I was interested in her, so I agreed to go. We continued to go every Sunday. At some point, the adult singles went on a ski trip with the pastor (Dick Stafford) who eventually would marry us. When I spoke with him just a few days ago following Lynette’s passing, he told me a story that I am pretty sure I never knew. He said that on that ski trip, I was off somewhere on the slopes, but he was standing with Lynette at the chair lift, and she told him, “He’s the one.” He had not anticipated this and asked, “He’s the one what?” Lynette replied, “He’s the one I am going to marry.” Dick, still unprepared for this and not connecting all the dots asked, “Who, David?” She confidently answered yes.

I suspect it was after about a year of attending Sunday school and church services with Lynette that she asked me, “Don’t you think it is about time for you to join the church?” Now, I had been raised in the Midwest in a very conservative church, and I did not have a full understanding of just what “joining the church” meant when you are talking about a Southern Baptist church. So, I immediately responded, “okay. What do I do?”

Well, that next Sunday, there was an invitation at the end of the service, so I walked down the aisle to the front of the church. They then directed us to another room where Lynette joined me. Several associate pastors began making their way through to each person who had accepted the invitation until one reached me and Lynette. We introduced ourselves and then he asked me to recount my salvation story. I really didn’t know what that was a reference to, but I answered, “Well, I believe in God and I try to be a nice person.” I think the pastor appeared a bit unprepared for that answer because there was a very long pause. Then, in typical Lynette fashion, she stepped in to intervene and said to me one sentence that would change my life and my assurance of eternal life: “You do know that the Devil believes in God, right?” That hit me like a sledge hammer.

She was right (as usual). Believing in God doesn’t make you a Christian or assure you of the promise of salvation. The problem is that I was like many today who profess to be Christians, but who never have read and studied the Bible. Lynette didn’t have to tell me the answer, she just planted that one sentence in my brain that made me realize the internal inconsistency in my thinking.

So, I began praying that God would help me understand, I began reading and studying the Bible in earnest, and I began praying that I could have the same joy that I noticed in those around me who were mature Christians. Before long, I came to several important passages from the Bible:

Matthew 7:21-23

²¹ “Not everyone who says to me, ‘Lord, Lord,’ will enter the kingdom of heaven, but the one who does the will of my Father who is in heaven. ²² On that day many will say to me, ‘Lord, Lord, did we not prophesy in your name, and cast out demons in your name, and do many mighty works in your name?’ ²³ And then will I declare to them, ‘I never knew you; depart from me, you workers of lawlessness.’”

I realized that Lynette was exactly right. More is required than just believing there is a God. In fact, many people who tout themselves as Christians today claim a belief in God, but express hate for those who do not look like them or believe like them, ignore the needs of the poor and the vulnerable, and spend their time fighting culture wars and when they die, may find themselves receiving the same reply from Jesus on His throne as the “workers of lawlessness.”

So, then I began to understand what salvation really meant when I read the book of Romans:

Romans 3:23: “for all have sinned and fall short of the glory of God.”

First, I had to acknowledge that I was a sinner and as a consequence was not entitled to salvation.

Romans 6:23 “For the wages of sin is death, but the gift of God is eternal life in Christ Jesus our Lord.”

In fact, as a sinner, I would face eternal separation from God. To ask for God’s forgiveness and grace, I needed to admit I was a sinner, profess my sins, and repent of my sins.

I also realized that I was wrong about something else. I thought that the combination of me believing in God plus being nice and doing good things was the recipe for eternal life. However, that isn’t what the Bible teaches us. Romans 6:23 tells us that eternal life in Christ Jesus is a “gift.” It is not something we earn, because by virtue of being sinners, the same verse tells us that if we got what we deserved, it would be death.

Ephesians 2:8 “For by grace you have been saved through faith. And this is not your own doing; it is the gift of God, ⁹ not a result of works, so that no one may boast.”

Ephesians also clarifies that salvation is achieved through faith and by grace. In other words, faith is required and specifically what we must have faith in is explained in Romans 10:9 below, but we only receive salvation through grace. Grace means that we are receiving something we don’t deserve. And, to make sure we understand this, the verse goes on to state explicitly that salvation is not of our own doing. Romans 3:23 above already made clear that we all have sinned and fallen short of the glory of God (i.e., salvation). Therefore, according to Romans 6:23, we all deserve death (not just physical death in this case, but worse – eternal separation from God. Salvation is not compensation, reward or something otherwise earned – none of us have earned it. It is a gift to which we are not entitled, and it is by grace that God gives us eternal life, even when we don’t deserve it. I realized that being nice and doing good things does not result in eternal life, but rather flows naturally from our faith and a true desire to follow His teachings.

So, what is the faith we need to have?

Romans 10:9  “If you declare with your mouth, “Jesus is Lord,” and believe in your heart that God raised him from the dead, you will be saved.”

In other words, we must have faith that Jesus is who the Bible says He is – the son of God, God incarnate, who died for our sins and was resurrected from the dead. If we believe it, we must profess it according to this verse. And, the reason we must believe in our heart that God raised Jesus from the dead after crucifixion is that if God could not raise His son from the dead, how can we have any assurance of eternal life following our own physical deaths. In fact, Christianity is the only religion for which there is a claim and evidence for the death and resurrection of the head of the Church.

That simple question that Lynette asked me set me on the path that ultimately led to my salvation and changed my life forever.

Lynette and I continued to date. I told her that I only planned to marry once, and thus, I wanted to make sure that she was the person that I wanted to be the mother of my children and that I would want to spend the rest of my life with. After a bit more than two years, I asked Lynette to marry me, and she accepted without reservation. I graduated from Rice University in 1979 and began medical school that summer.

We were married on September 13, 1980. My knees nearly gave out when I first saw her walking down the aisle holding her father’s arm. She was stunningly beautiful in her wedding gown and the glow of her face that I could see through her wedding veil. The Reverend Dick Stafford officiated our ceremony, but we had the special added treat that each of our brothers were ordained ministers and able to assist in the ceremony.

Given that I was in medical school, we could only take off a weekend for our honeymoon, which worked out fine since we didn’t have much money saved for the honeymoon.

My role model for the kind of physician I wanted to be was Dr. Richard Blakely, a general internist. Lynette left the ICU and worked for him as his hospital nurse. I continued my medical studies and Lynette decided to go back to school to get her BSN degree.

We eventually decided that we wanted to start our family. Lynette became pregnant and was due at the beginning of December 1982. Around six or seven months, Lynette was crossing the street between the medical office building and the hospital and began bleeding. She called me crying, fearful that we were losing our first child. I told her to get to the ER and I would meet her there. Thankfully, Lynette and the baby were fine, but they told her she had just worked her last day and would have to spend the remainder of the pregnancy in bed.

I was graduating from medical school on November 19, 1982, my birthday and two weeks before we anticipated the birth of our first child. We didn’t know if Lynette could make it to my graduation, however, she had improved so much with the bed rest that the doctors permitted it.

We were ready for our first baby with a decorated nursery and clothes for a baby boy, as the ultrasound had revealed fairly clear evidence of the baby being a boy, and I was glad because I could do all those father-son things, and had no idea what to do with a girl since I grew up with my brother, my sister being 11 years younger than me. On the other hand, my grandma kept telling us it was going to be a girl given the way the baby was lying. I explained to grandma that we had sophisticated tests now (even though the ultrasounds today are of far better quality than those we had 40 years ago), and the tests had revealed that the baby would be a boy.

Lynette had reached her due date without any indication that baby Richard, as we had planned to name him, had any intentions of coming out of the womb anytime soon. The obstetrician gave us another 10 days to see if the situation improved, but alas, it had not. Thus, induction of labor was begun. No dramatic results, so the induction was suspended overnight to begin anew the next day. Again, all day of induction, with little to show for it.

But it was worse. I had the brilliant idea that made perfect sense to me as a man, that I should go get the nurses lunch when I went to eat so that the nurses would be grateful to Lynette and in turn give her more attention and great care. I, again, thinking like a man, thought that I should get them What-a-burgers because, after all, those were my wife’s favorite hamburgers. The flaw in my thinking became exposed when I returned to the unit, dropped off the fresh What-a-burgers with the onions and distinctive mustard smell that I then discovered that a woman who is laboring and unable to eat or drink can smell and identify through the ventilation system. She quickly put two and two together and realized that I had brought her favorite hamburgers to the nurses. She was none too happy with me (which by the time of two days of induced labor, I already had the distinct impression she was planning a vasectomy for me), and in her state of starvation, had no appreciation for my intentions that seemed so clearly in her own best interests, and may have mentioned something about me being an idiot in between contractions.

Finally, after a third day of induced labor with artificially ruptured membranes, progressive doses of Pitocin, and a threat of having to undergo a C-section, the obstetrician delivered a healthy baby proclaiming, “It’s a girl!” “A girl?!?!?” I replied. And, yes, I could see that it was a girl and what the obstetrician and I thought we had seen on the ultrasound must have been the umbilical cord between her legs. I will never forget the cackle that my grandmother made when she learned of the news. She had been right all along. So, the name Richard was quickly changed to Lindsey, the nursery was redone and Lynette sewed lace on to the bottom of infant blue jean overalls that we had ready for her. Lindsey slept in a blue onesie.

I had two weeks left in the break between medical school graduation and the beginning of my residency in internal medicine. I was able to help rock, feed and diaper Lindsey. Then, I was gone for 36 hour periods of time while I took call at the hospital, and returned home with 8 hours to eat, sleep and talk to my wife before returning to the hospital to work a 12-hour day before returning to repeat the 36-hours of new admissions, patient rounds, conferences, pages, and code blues. (These were the days before there were limits on the number of hours residents could work in a row and in a week.)  But, while I was away taking care of patients, Lynette was at home taking care of Lindsey. And, Lindsey had colic every night between 11 pm and 2 am during which this little infant was capable of constant blood-curdling screaming and crying. I would walk in the door, barely able to keep my eyes open, and Lynette would hand me the baby. We would sit down to eat, talk a bit and then both try to go to bed, only to be awakened around 11 p.m. Lynette, God rest her soul, would get up first. She would try holding Lindsey, rocking her, applying a pacifier and various other techniques to get Lindsey back to sleep, almost always to no avail. Soon, both Lindsey and Lynette would be crying and pillows over my head could not obscure the distress of both. I would have to get up, go in and see what more I could possibly do to get them both to stop crying.

I tried everything I could think of. I even had another clever Dad idea. Let’s tape record her crying, then we will put headphones on her and play back the crying so that she thinks she is crying and doesn’t have the need to actually cry. (Well, you try going without sleep for nearly two days and nights and see if you come up with something better). To my disappointment, it didn’t work. Praise God, eventually, Lindsey grew out of it.

For survival of the species, God inflicts amnesia upon young parents so that the mother forgets the three days of labor she went through with the prior baby and the dad forgets all the sleepless nights (and Lynette forgot the visions of me undergoing a vasectomy while smelling What-a-burgers in the labor and delivery department). Nearly three years later, we decided to have another child. This time, the ultrasound would correctly identify that we were having another girl. The due date was projected to be in March of 1986, right after I completed my residency training in internal medicine and during the six-month period of time that I was given the privilege of serving in the prestigious position as Chief Resident in Internal Medicine for the hospital. Laurie was born in March after another three-day induction of labor that shaved only one hour off from the length of duration for Lynette’s labor with Lindsey.

I finished my Chief Residency and went into medical practice. Lynette asked the first patient I saw if he would mind paying part of his bill with a one-dollar bill. She then framed that for me. I still have it today.

There are some couples whose relationship could not withstand too much togetherness. That was not the case for Lynette and me. For a period of time, Lynette served as my office manager. It was wonderful. First, she was really good at her job. Secondly, being married to a doctor, especially back in those days when it was common for doctors to see patients all day in their office, but also have to run to the hospital to see a patient in the ER or to consult on another physician’s patient, and to take calls even once home, and occasionally have to get up from dinner, leave a social gathering or get up from bed and go to the hospital to see an emergency case. With Lynette working in the hospital, she understood the demands on my time, and understood the commitments we both had to make in order to make a medical practice successful. It also gave us brief moments throughout the day that we could see each other, smile at each other, have a quick hug, or go over a matter that just came up rather than having to wait until we were both exhausted at the end of the day.

By the time the girls were old enough to begin kindergarten, we were finally getting on our financial feet and Lynette wanted to work less and spend her time volunteering at the kids’ school. I thought it would be great for her to be actively involved in the school. She went all in. She became an invaluable asset for the school, leading the fund-raising effort to develop the school’s playground into a Spark Park – a program to expand and enhance the playground into a community park that enhanced the playground of the public school, while embracing and involving the community in the school by utilizing the grounds as a park when school was not in session. Lynette also did whatever else was needed to help out at the school – decorating rooms and hallways, buying and selling school supplies, organizing events, you name it. The principal and teachers loved Lynette. The elementary school our kids attended was a magnet school, meaning that attendance wasn’t determined solely by your geographic distance from the school, but children excelling in the areas for which the school was recognized as a magnet program were also eligible to attend.

I still remember the first day of elementary school for Lindsey. I can remember the shoes she was wearing, her backpack, and the way I fixed her hair. I had forgotten the first rule from husband school: do not show your wife that you know how to do anything that you don’t want to be assigned as your permanent job. When I would get the girls up for school, they would tell me whether they wanted a pony tail or pig tails (to this day, I still have no idea why these hair styles are named for these animals). After fixing Lindsey’s hair, she would run her hand across her hair to determine whether there were any “bumps,” which were completely unacceptable and required a revision. Being the first grandchild, not only were Lynette and I there to see her off to school, but my parents were there, as well.

It was a very different experience three years later when Laurie had her first day of elementary school. Keep in mind that schools typically have a fairly high tolerance on the first day of school for kindergarteners, realizing that this is a new experience and perhaps the first day away from home. Nevertheless, I received a call at my office from Lynette saying that we needed to come to the principal’s office. I couldn’t imagine why this would be the case. I met Lynette at the school and she explained that Laurie had called one of her fellow students a “bit…” I am quite certain I gave Lynette one of my looks as we walked into the school and down the hallway towards the principal’s office. On our walk, we ran into Mr. Lockley, the Magnet Coordinator. We both loved him. He was full of energy, vey funny and great with the kids. He knew Lynette well from her years of volunteering at the school, and asked, “What are you two doing here?” Lynette explained that Laurie had called (Lynette supplied the name of the girl) a “bit…” Mr. Lockley unhelpfully replied, “well, she is!”

On the way home, I could not help myself in asking Lynette where she thought Laurie would have picked up that word. Being a man, I never quite learned that trying to have the last word or assign fault will always backfire. Even as an attorney, when I thought I had an iron-clad case against her, even at times with a Perry Mason moment, it always seemed to end with me apologizing to her. I do think that I won one argument with her during the 48 years, I just unfortunately can’t remember what it was.

My favorite picture of the two of us was when she was pregnant with Lindsey and we were seated at a table with her to my right. She was even more beautiful with her pregnancy glow. The picture might as well have been a video as I can see it playing out with her pleading her case for something she wanted or wanted me to do, and me giving her the hand as though that might stop her incessant pleas. And, while I told her “no” many times, I turned around afterwards and did it or gave it to her anyway. She used to tell me that our two daughters had me wrapped around their little fingers, but she never acknowledged that in reality, all of the women in our household had me wrapped around their little fingers, none so more than her.

Through the years, Lynette was my confidant, a great resource for advice, and amazing mother. She served as the president of our kids’ PTA. She did countless fund-raisers for worthy causes. She wrote a song for a friend’s wedding. She and I planned, arranged for and chaperoned a group of Lindsey’s fellow students from the High School for the Performing and Visual Arts to go to Broadway to see some shows and to get a back stage tour of The Lion King and an after-performance Q&A with William H. Macy.

When Lindsey subsequently became a costume designer, there were many times, Lynette hopped on a plane at the last minute and went up to stay with Lindsey to work day and night in what she referred to as “Lindsey’s sweat shop.”

The girls went to Camp Ozark, a Christian camp in Arkansas during the summers. They offered two-week sessions, and Laurie would have stayed all five, if they would have let her. Most years that I can remember, she went for two sessions. We most often drove to camp in a suburban for the closing session. We would put down the seats in the back and lay sleeping bags down, and the girls usually slept the entire ride home.

Eventually, I started volunteering to be the camp doctor for one of the sessions. I always had a blast, and one summer I had to stitch Laurie’s knee up, but I don’t recall it slowing her down a bit.

I used to describe our marriage like that of Lucille Ball and Desi Arnez on I Love Lucy. I suspect that all wives have at one point or another done something their husbands might not have anticipated. But, at one point, we purchased a piece of property in Central Texas on a river that we could escape to on the weekends to get away from it all. Then, without telling me a thing, Lynette bought a house and had it moved onto the property. Of course, despite my protestations, I loved it, and it was just right for the property, but every day I had to be prepared for something totally unexpected.

Besides keeping me on my toes and never knowing what to expect, I continued to learn new things about Lynette even after 40 years of marriage. For her 69^th birthday, her brother, sister-in-law, and Lynette and I went to Galveston for a birthday celebration. It turned out that there was a motorcycle convention in town at the same time. Everywhere we went, Lynette would go up to bikers and begin to learn all about them. She loved everyone she met and loved listening to the motorcycles going up and down the seawall in front of where we stayed. She told us she wanted to return for the next year’s event.

I soon began my plotting with brother-in-law Len and his wife Cathie. I found a company in Canada that would make a leather bike jacket with the inscription on the back – “Born to Ride. I just had to wait until I was 70.” Lynette’s birthday, November 2 is during the Dia de los Muertos, a Mexican holiday to honor the dead, and Lynette loved it, collected sugar skulls and various statutes or clothing with that style of decoration. I was able to get the company to add a sugar skull imprint below the inscription.

In the meantime, Cathie worked to find someone that we might know who drove a motorcycle and might be planning to attend that next year’s event. We wanted to surprise Lynette with the jacket and a short ride on the Seawall on a motorcycle.

We made our way to Galveston that next year to be there on her 70^th birthday. The jacket made it just barely in time. However, when we arrived in Galveston, we learned that the friend of a friend of Lynette’s who was to take her on the ride was not going to be able to make it. Unfortunately, I had no Plan B. Lynette’s brother, Len, said, “follow me.” We headed to the lobby of our hotel. I could already see where this was headed. I explained to Len that I can’t very well tell the police that we asked a complete stranger to take my wife on a ride down the Seawall who then abducted her. After all, I have watched Dateline before. However, we both did decide that if someone did take her, he would likely be back soon begging us to take her back, after Lynette gave him a piece of her mind. So, we watched and waited. Len saw his target, a man with a biker vest on, staying at the same hotel we were staying at, which we surmised that not too many of America’s Most Wanted would hang out, who was at the desk to see if he could get late check-out the next morning. Then, we made our move. He was extremely nice. We explained our predicament, and he said he would be glad to fill in. It turned out that he was Timothy Paisley, the cousin of country music superstar Brad Paisley.

That next morning, we escorted Lynette out the back door of the hotel to the parking lot with the ruse that we were going out to eat. Timothy pulled up on his motorcycle, and I presented Lynette with her jacket. It fit perfectly, and she hopped (well, more like Len and I helped her climb) onto the back of the motorcycle, and she wrapped her arms tightly around this very handsome biker (not that I was jealous or anything). He drove her across the parking lot down the Seawall to the sound of the crashing waves of the ocean and back. I thought Lynette was as happy as she had ever been.

It is now a year-and-a-half later. In September we would celebrate our 45^th wedding anniversary. In November it would be Lynette’s 72^nd birthday. I was contemplating a return to Galveston for her birthday.

Last year for our anniversary, Lynette surprised me by getting me a used Volkswagen beetle convertible, just like the one I drove when I was dating her. Its not really a winterized car, so I kept it in our garage over the winter, and not surprisingly, the battery died. On Sunday, May 4^th, it was a beautiful day, and God put on my mind that I should go ahead and replace the battery that day, which I did. The car was running. I went inside and told Lynette, “Let’s go for a ride. It’s a beautiful day.”

It was not a trivial event for Lynette to go out. She was weak to the point that I usually had to help her get up and get dressed. Her balance was not good, so I would have to hold on to her as she ambulated. A lot of times, I would suggest us going out to grab a bite to eat or run to the bookstore, or other such excuse to get us out of the house, but often Lynette thought it was more trouble than it was worth. But, this day, she didn’t protest, and she got right up and I walked her out to the car. Our grandson, Clif, hopped in the back seat, and I helped Lynette into the front passenger seat and buckled her in. We took off and I drove her to the park. Then we stopped for ice cream. On our way home, I placed my hand on her thigh and I said, “This is just like it was 48 years ago.”

We laid in bed that night and held hands and talked. When she was beginning to fall asleep, I tucked her in with her favorite blanket that I had given her from Christmas. I kissed her and gave her a hug, and told her “I love you and I will see you in the morning.” She replied with her last words: “I love you, too.” She passed away in the early morning hours of May 5, 2025.

Her mother had died of a heart attack in the early morning hours as she sat on the couch sipping her morning coffee. Lynette had always expected that she would die of a heart attack, as well. It appears that she did.

The pain of losing her at times seems almost unbearable. She has left such a huge hole in my life, because my life centered around her. I find myself at times seeing or hearing something and saying to myself, I have to remember to tell that to Lynette, only to quickly realize I can’t. I went to a choir concert that two of my grandchildren performed in. As they took the stage, I thought to myself, be sure to record this so I can share it with Lynette, again to then realize she isn’t here. But, as so many people have shared messages that they had observed our marriage over the years and realized that there was something special in our relationship, and shared that they had never found their soul mate, or that they thought they had, but the relationship didn’t last, I realized that what Lynette and I had is not ordinary; it is not common these days. So, as I long for what I had and grieve that I have it no longer, I also make an effort to express gratitude for what I had and express sorrow for those who have never experienced it.

I am a better man because of Lynette.

Over the past five years, I have felt that my main responsibilities were to protect her and keep her healthy, and equally important, to protect myself – not for me, but for her. I knew that if something happened to me, others would step in to care for Lynette, but I did not believe anyone could provide her with the same level of love and care that I provided.

I had always told my daughters when we were raising them to be sure that the man you marry is someone who will treat you like a princess. Later, I explained to them what I meant. That man should always treat you with respect. He should never lay a hand on you, never curse at you or call you a bad name. He should put your needs ahead of his own. Finally, that man should thank God for you every day and feel blessed to have you as his wife. I thank God for Lynette to this day. It doesn’t mean that Lynette was perfect, I was perfect, or our marriage was perfect. But I knew that I was loved and by accounts of her friends, adored; and I am confident that Lynette was reminded every day of how much I loved her, adored her and thanked my lucky stars that we got to make this journey together.

I hope that I was that example for my daughters of how a man should treat his wife. In turn, now, I am trying to set the example for my grandsons of what a man is and how he should treat his wife. It may be working. A couple nights after Lynette passed, after an exhausting day of visits to the funeral home, looking at venues for her memorial service, receiving friends and family, and making so many decisions as to our plans for the days ahead, Laurie and her four boys and I finally had a chance to sit down for dinner together hours past the usual dinner time. As we were eating and talking, my youngest grandson, age 7, said, “Papa, you took really good care of Gigi.” My heart overflowed with joy at seeing that a boy so young could see that.

I want for my grandchildren to have the kind of relationship that I had with their grandmother. I want them to know that being a man doesn’t mean being right, being controlling, being harsh, or being emotionless. For me, being a man meant loving my wife more than myself and willing to protect her at all costs for as long as I could. Being a man never was about winning an argument or being right for me. In fact, I learned that it didn’t matter who was right or wrong if I was not meeting my wife’s needs or if what I did was not caring for her and making her happy. Being a man was never about control. Our relationship was special because we respected each other’s views and opinions and tried to reach better decisions because we both had valuable input into the important decisions we made. I don’t recall being harsh with Lynette, mostly because I loved her so much that I couldn’t stand the thought of hurting her. I tried to show Lynette affection every day, in my words and in the little things I did for her. I want my grandsons to treat their future wives like princesses, and I want my granddaughter to know that she is special and deserves that treatment from her future husband. I think Lynette was right. If you want to know whether a man will make a good husband, look at how he treats his mother. For me, the advice is marry your best friend.

As her health declined over the past few years, I would prepare all of her meals other than when we went out to eat. I awoke much earlier in the day than she did and worked in the living room or my office so as not to awaken her. Once she did wake, she would text me with her breakfast request. I would stop what I was doing and prepare it and bring it in to her, and she would always ask me to sit down and review the world news with her while she ate.

One day, I came into the bedroom with her breakfast, and I told her, “You know that I am on to you, right?” She involuntarily smiled and asked what I meant. I replied that I knew that many days she was probably capable of making her own breakfast. She said that was true but she liked it better when I did it, because she knew that I did it for her because I loved her.

She was right, and I never again brought it up as I prepared her breakfast every day after for the rest of our time together. I would give anything if I could make breakfast for her tomorrow.

Long-time followers of my blog may remember the perplexing occurrence and significant number of cases of hepatitis (liver infection/inflammation) in 2022, first noted in the U.K. occurring in COVID-19-unvaccinated children under the age of 16 years that we have since referred to as acute hepatitis of unknown origin (AHUO) at a time when fewer mitigation measures were being taken to protect children in schools against airborne transmission of viruses. Clinically significant hepatitis is not a predominant feature of most cases of COVID-19, yet, many of these children were quite ill with the liver disease, some critically ill and still some requiring liver transplantation. Tests for the usual suspects (e.g., hepatitis A, B, C, D and E viruses) were all negative. After all the testing and review of cases, the major remaining differential diagnoses were narrowed down to adeno-associated virus co-infection with adenovirus or autoimmune hepatitis. We may now have a different answer.

We have known since the early days of the pandemic that SARS-Co-V-2 RNA can be detected in the stool of patients with acute COVID-19. Subsequent investigation and a publication by Zuo et al demonstrated that SARS-CoV-2 RNA can continue to be detected in some COVID-19 patients in the convalescent phase of the infection (when symptoms are resolving or have resolved).

Given mounting evidence of viral persistence in some people following SARS-CoV-2 infection and the fact that detection of viral RNA after the infection has supposedly resolved can be an indication of viral persistence, a group of investigators began to search for evidence of the virus in other organs of the gastrointestinal tract Residual SARS-CoV-2 viral antigens detected in GI and hepatic tissues from five recovered patients with COVID-19 | Gut. Using conventional immunohistochemistry (this is a process by which investigators create antibodies that are specific to the protein they wish to search for, tag these antibodies with a substance that will show up under the microscope, inject the antibodies into the tissues, then cut up the tissue into sections that can be stained and examined under a microscope), these investigators examined the tissues obtained from five patients who seemed to have recovered from COVID-19.

The protein they targeted was the nucleocapsid protein (NP) of the virus, as this protein is not present in any of the vaccines used in the U.S. or most other countries, only being an issue in the few countries that utilized whole inactivated virus in their vaccines, such as China. Thus, in those who have not received inactivated whole virus vaccine, the presence of NP (and by extension antibodies to NP) is a consequence and indicator of prior infection regardless of vaccine status.

These researchers detected SARS-CoV-2 NP in the colon, appendix (this is a finger-like projection extending from the colon very close to the location where the small intestine connects to the large intestine), ileum (this is the last part of the small intestine just before it connects to the large intestine (or colon), hemorrhoid tissue, liver, gallbladder and lymph nodes from these five patients who recovered from COVID-19, ranging from 9 to 180 days after testing negative for SARS-CoV-2 by nasal swabs. In fact, two of the five had NP detected in each of these locations, an indicator of how far and extensively the virus spreads within the body even in “mild” cases. The findings were validated by confirmatory identification of SARS-CoV-2 spike (S) protein and in some cases the presence of SARS-CoV-2 RNA.

Building on these two studies, with good evidence for viral persistence that can involve the liver as long as six months after even what appeared to be a “mild” infection, in an environment of a rapidly evolving virus with increasing immune escape capabilities, and especially at the time (2022) when we were seeing new Omicron variants as often as every several months, the case for autoimmune hepatitis has become strengthened.

Given the persistence of nucleocapsid protein embedded within liver cells following a prior infection, the potential for hepatitis due to cell-mediated killing of the liver cells as a consequence of efforts to clear the virus or autoimmune hepatitis upon subsequent reinfection with a similar, but distinct antigenic variant of SARS-CoV-2 are reasonable hypotheses.

This leads us to a new study published this year, Characteristic immune cell interactions in livers of children with acute hepatitis revealed by spatial single-cell analysis identify a possible postacute sequel of COVID-19.

These researchers examined the liver biopsies obtained from 12 patients (mean age 9.5 years) who were hospitalized between February 2022 and December 2022 in European countries who tested negative for acute adenoviral or SARS-CoV-2 infection and who met the WHO criteria for AHUO. Three of the 12 showed serological evidence of past adenoviral infection and 10 of the 12 had a history or serological evidence of past COVID-19. Eight of the 12 were known to have had a recent bout of COVID-19 with a median onset of 2 months prior to the hospitalization for AHUO. Unlike the original cohort noted in the U.K., a third of these children had a history of past COVID-19 vaccination.

Imaging mass cytometry (my apologies in advance to laboratory scientists who might be reading this as I have no expertise in this area – this is a technique that utilizes metal tags of antibodies designed for up to 40 antigens found in different types of cells that is applied to a tissue specimen. A machine then scans the tissue with a laser that generates signals from the metal tags that create detailed pictures of the cells in the tissue. The pictures reveal the location of the antigens targeted within the cells to allow identification of their intracellular locations as well as to help us understand how they are interacting with the cell) identified significant infiltration of the liver tissue with CD8+T- cells, which are cytotoxic T-cells (the cellular part of the immune response that identifies infected cells and kills them in order to rid the body of the virus within). The degree of infiltration and immune activation correlated with the severity of the hepatitis.

Further, the investigators detected SARS-CoV-2 antigens in ACE2- expressing cells in the areas of the liver with significant pathology in 11/12 samples using several different detection methods (we have known for some time that not everyone who has had COVID-19 will test positive on serological testing (measurement of antibodies in the blood).

The identification of immune-mediated liver injury associated with the detection of SARS-CoV- 2 antigens suggests a possible association of AHUO with prior SARS-CoV- 2 infection, further suggesting that the hepatic disease could have manifested as a part of Long COVID or post-acute sequelae of COVID-19.

PCR testing for adenovirus in liver specimens was negative in all of the subjects. Conversely, detection of SARS-CoV-2 proteins occurred in 11 of the 12 subjects. Notable was the extent of immune-cell infiltration in all subjects, and the degree of infiltration correlated with the clinical severity of each child’s course of illness. Further, the colocation of infiltrating cytotoxic T-cells in areas where SARS-CoV-2 proteins were detected suggests an antigen-mediated pathology.

The fact that the SARS-CoV-2 virus itself was not detected in the liver tissues and cells raises the concern that has already been raised as a possible underlying explanation for Long COVID, that virus is persisting and residing in areas of the body that are more difficult for the immune system to surveil and remove virus from (one candidate in these patients was already identified in the earlier studies I referenced above – the small and large intestines). In this instance, the thought would be that the persisting virus is replicating, although likely far less than in an acute infection, and shedding viral proteins that are entering the venous system that returns blood from the bowels that passes through the liver where the proteins can be deposited prior to the blood returning to the right side of the heart. Support for this theory is the fact that a biomarker for a disturbance of the gut integrity with subsequent leak into the vascular system (zonulin) has been detected in plasma along with spike protein. As a result, in at least some cases, immunopathology results and hepatitis may be the presenting illness as a result of liver cell injury due to the infiltration of immune cell infiltration targeting cells for destruction due to the presence of viral protein.

Of interest, this same situation of persistent SARS-CoV-2 virus in the GI tract with SARS-CoV-2 RNA detected in stool weeks after initial infection at a time when nasal swab testing for SARS-CoV-2 had long since turned negative has been postulated as the mechanism behind MIS-C (multi-system inflammatory syndrome in children) that we often saw present weeks to months following acute infection.

Of course, nothing from this study rules out the possibility that adeno-associated virus 2 (AAV2) contributes to the development or increases the risk for AHUO, but clearly, prior or co-infection with AAV2 does not appear to be necessary for the development of AHUO.

In conclusion, it appears that AHUO may be a post-COVID-19 immune-mediated hepatitis, another potential part of the spectrum of illnesses that may occur as part of the post-acute sequelae of COVID-19.