May 2019 – Go Retire Psychiatrist

Reset Day

Well, I spoke too soon yesterday after following complicated instructions to fix the File (or Windows) Explorer Not Responding” issue. The fix didn’t stick and I wound up doing a system reset after all. It took up most of my day, which is a long time to grind my teeth.

Not that I have a lot going on in the off phase of phased retirement. But I could think of better things to do than reset the computer.

And whose idea was it to embark on a crusade to instigate yet another Microsoft debacle—Windows 11 or 12 in the pipeline? After grinding my teeth a bit more, I dug into the web a little more deeply. I was relieved to find out that this was a rumor only, according to a news story about a week ago.

I think reporters do that just to get your dander up.

I can remember hassling with tech support on the phone for hours after I got our first computer and tried to cope with Windows 95. Thank goodness I missed Windows Bob, which I had never even heard of until yesterday.

One of my earliest memories of Windows 95 mania was a TV news spot showing a long line of customers at Best Buy clutching their godforsaken copies of the cursed operating system—and when the register opened, a guy leaped up to the counter, obviously ecstatic to get his treasure first.

And from then on, it was one disaster after another, with every iteration of Windows crashing our machine or prompting calls to tech support with wait times often exceeding half an hour or longer.

Remember all of that? It’s no different now. And there’s no compelling reason to switch back to Mac.

Oh yes, I started off with a Mac when I started working at the hospital as an assistant professor. That was on the advice of one of my senior faculty teachers. I soon learned that, with all the support staff in the administrative office using IBM PCs, it didn’t make much sense to push through with a Mac, no matter how much I liked it.

Now, after all these years pounding on the PC, I don’t think I could get the hang of the Mac OS—although I have considered going back many times in the past few years, especially since yesterday.

Computer Nightmare

OK, so maybe “nightmare” is too strong a word for the problem I had (and may still be having) with my computer today. I couldn’t open any of my Microsoft Word documents. I’ve had this issue in the past and I think my solution was to do a system reset, a frustrating inconvenience.

I tried system restore, looked around the web and tried various suggestions from people who sounded knowledgeable. Nothing worked. It didn’t help that File Explorer is also called Windows Explorer. I kept getting the “File Explorer Not Responding” message. I’m sure many out there recognize it.

I was reminded of many computer disasters I’ve been through, starting with Windows 95 and running through nearly all of the versions since then including Windows Me (Millennium). I never had to deal with Windows Bob, thank goodness. I notice they’re bringing back Windows 95 as an app. Why?

After a few hours, I found one web page that described a long multistep process called “File Explorer Not Responding in Windows 10 [Solved]” by Sophie Luo at drivereasy dotcom I thought couldn’t hurt—since I was resigned to the reset option anyway.

I went through all the steps. Much to my amazement, it worked. There is a long list of comments with other suggestions that I’ll likely try if this solution isn’t permanent.

Don’t Panic

Well, this is not the usual post. It’s just a message that I’ve been watching the Iowa severe weather reports. I’ve just come up from the basement because the Tornado Warning for our area has expired. Don’t panic.

Now it’s just a severe thunderstorm warning with the possibility for 60 mph wind–nothing really.

The Don’t Panic image is just the back cover of “The Ultimate Hitchhiker’s Guide to the Galaxy” by Douglas Adams.

Front
Back

Coming to Terms with Retirement

I’m in the off phase of phased retirement right now. It reminds me of the consuming question, “What are you going to do when you’re retired.” Coming to terms with retirement is not a one-step thing.

It’s probably easier to think of things I’m not going to do. I can think of at least a couple of books I’m probably not going to finish reading: “The Social Transformation of American Medicine” by Paul Starr and another title I rather not type but the picture of which I’m not squeamish about showing.

Deep
Also deep

I’ve already read a new book by Dave Barry, “Lessons from Lucy,” which is about coming to terms with getting older. And I’m going to reread a book I read years ago, “The Ultimate Hitchhiker’s Guide to the Galaxy” by Douglas Adams.

Wise booger jokes
Autographed
Worth re-reading

I read the Hitchhiker’s Guide and lost it in one of our many moves. I bought a new hardback copy a few days ago and just restarted it.

I can’t remember when I got The Ultimate Hitchhiker’s Guide. It was published in 1986. Around that time, I had graduated from Iowa State University and could not find employment for about a year. It was a difficult time. Anyone who has been through something like that might understand how hard it could be to retire.

I’m not going to write another work-related book. Editing a multi-author book was too much like herding cats. And as one of my friends put it, once you’ve done that, you ask, “Now what?”

I’m still checking my office email every day. You never know. It’s FOMO, I realize; on the other hand, there are still legitimate work-related things I need to do and some have deadlines.

This makes me think of my YouTube video, “A Day in the Life of a C-L Psychiatrist.” It’s a little tough to come up with something like “A Day in the Life of a Retired C-L Psychiatrist.” Of course, there would be nothing connected with psychiatry in it.

My day in the life after C-L Psychiatry?

I’m reminded of an exchange between Men in Black agents J and K (2^nd sequel) after K is deneuralized out of “retirement” to return to the active job of defending this little green planet from aliens.

Agent J: “So what was it like on the outside, not doing this every day?”

Agent K: “It was nice; Sleep late on the weekends, watch the Weather Channel.”

My life is more or less like that, except every day is a weekend day…sort of. And the Weather Channel has gotten way too political for me.

I watch Men in Black reruns. I wait for the garbage truck. How does that guy know exactly where to brake in order to operate the automated side load mechanical arm grabber? I carry my POS camera on my belt. You just never know when an opportunity for great snapshots might arise. I trim and edge the lawn boundaries. I vacuum. I fold the fitted sheets, Hondo. I really don’t cook; I stick frozen pizzas in the oven and make microwave popcorn—not very often, Slick. I exercise and do mindfulness meditation and yoga. I take clothes out of the dryer and put away. I dry the dishes and put away. No, we do not use the dishwasher, pal. It’s about coordination and timing.

I realize that I might sound like Agent K. But I’m more like Agent J—still a rookie around the house and in the yard. This is going to take a while.

Our Garden So Far

Short post again today in view of the Memorial Day holiday. However, the mood is light here today as Sena adds Gomphrena to our garden. It’s an annual that will attract hummingbirds, like the feeders.

It rained this morning and she got caught in it. She just stayed out there, planting flowers. I stayed dry, trying again to catch videos of hummingbirds through the window.

More hummingbirds…they drink and they fly.

Hummingbird Adventure

It was a long day so this is a short post. It’s different from other long days in that my wife and I had fun besides doing all the yard work.

Sena got the hummingbird feeders (3) and I mixed the sugar water since I need all the practice I can get regarding cooking. It’s 4 parts water to 1 part sugar.

We’ve got Columbine flowers in our garden and that helps attract hummingbirds.

I’m pooped. That’s all I got.

Hummingbirds think my sugar water recipe is bangin’, dog!

Looking for Hummingbirds

My wife and I are trying to attract hummingbirds this weekend. This is a new project for us. She got a couple of feeders and some nectar we mixed with water and a little beer. No, I’m kidding; we wouldn’t try to get any hummingbirds drunk.

One of the feeders is pretty fancy. You know, it sort of looks like an upside-down beer bottle–just sayin’.

I’ve tried to get snapshots and videos of hummingbirds before. They’re usually pretty blurry and jittery, just like the birds.

We’re hoping that the flowers will help lure them to our garden.

They probably don’t care for Allium; it’s in the onion family.

We’ve got a garden ornament that might help draw them. And as long as our garden goonbird (a well-known cryptid) behaves and doesn’t scare them off–we might see the little guzzlers in a few days.

The Medical-Psychiatry Unit

I guess I’m incorrigible; there are now 4 eggs in the robins’ nest. Progress there reminded me of another kind of progress–in integrated health care.

On that note, this is just a brief update on the Medical-Psychiatry Unit (MPU). I thought it would be a good time to do this since a hard-working Pennsylvania psychiatrist notified me of the very successful Medical Complexity Unit (MCU) in operation at Reading Hospital. See my post from May 23, 2019.

I co-attended on our MPU for 17 years before I chose to concentrate on the Consultation-Liaison Psychiatry (CLP) service. The health insurance payer system challenges have probably not changed much. I still believe that the MPU is a great place to teach trainees to appreciate the rewards and challenges of caring for patients with complex, comorbid psychiatric and medical issues.

I hope the video makes the case for that. I decided it didn’t need a voice over. I welcome any comments and questions.

Brief News Item

I received exciting news from Dr. Kolin Good, M.D., a colleague in Reading, Pennsylvania. There is a thriving Medical-Psychiatry Unit (MPU) at Reading Hospital. Dr. Good consulted with The University of Iowa several years ago on how to get it started, since we have a 15 bed MPU.

They call it the Medical Complexity Unit (MCU) and the highlights of her message are:

“We now have 19 beds.

Nursing 1:4 ratio.

Staffing is 1 internist ( hospitalist) and 1 psychiatrist ( me) with a psychiatric social worker and physician’s assistant.

We have a LOS that is the same as other units of the hospital.

We have decreased 1:1’s throughout our entire hospital ( > 650 beds ).

We are a favorite rotation for training.

Most important: we provide excellent care for complex patients.”

Congratulations are in order!

Reading Hospital is also looking for a Consultation-Liaison Psychiatrist (although not to staff the MCU).

A former teacher of mine and a major mover and shaker in the integrated care effort is Dr. Roger Kathol, MD, the leader of Cartesian Solutions, Inc. Check his web site by googling the name. The credit goes to him, Dr. Good, and the rest of the Reading Hospital staff who made the MCU a reality.

I Wonder

There are now 3 eggs in the robins’ nest. I saw a big turkey vulture soaring close by. I wonder if that’s what got the House Finch chicks. The bird that made a noise with it’s wings that was as loud as a big sheet flapping on a line in the wind, and looked too big to be a crow or even a raven–I wonder.

I wonder if I somehow was partly to blame for the murder of the baby birds, always messing around the tree. Still, I take pictures–and maybe draw death nearer.

And that leads to other strange thoughts. It’s odd that the nearer I get to retirement, the more I think about my life way before I ever even thought about medical school.

I remember the first time I ever heard about death was when I was in kindergarten. My mother woke me up early one morning to tell me that Steven, one of my schoolmates, was killed the evening before. He was playing around the railroad yard just a few blocks from our house. A train ran over him.

I remember my mother talking about it but I didn’t make any sense out of it. I was too young. I only wondered what it meant.

When I was a difficult teenager and made a conscious effort not to smile for pictures, I remember hitchhiking along a lonely highway in a bad rainstorm. I was glad when the man pulled over. I was not glad when he began to rub the back of my neck and asked, “How about a ride for trade?” I was not too young to know what he meant. When I said, “Let me out,” he did. I was too young to know that was miraculous.

I sometimes catch myself wondering if my life has been a grand illusion since then, only to protect my fragile soul from knowing the true horror. Maybe the driver really didn’t let me out. Why should I wonder that?

I remember a man who taught me how to do the work of a land surveyor. I looked up to him. He committed suicide by shooting himself in the chest over a failed relationship. I couldn’t help wondering why.

Of course, death visited me several times after I became a physician. They sometimes led to decisions I would rather I had not made about the direction of my career. I always wonder.