Market to Market Memories

I’m a fan of Iowa Public Television (IPT) and I recall watching the show Market to Market, a show which I knew nothing about because it dealt with agriculture. Not everybody who lives in Iowa is a farmer, you know. I remember the days when Chet Randolph was the host. He had a wonderfully deep, resonant voice, a focused yet congenial manner when interviewing guests—and his left ear stuck out.

It was a show for farmers and there were two main reasons I watched it. I enjoyed listening to Chet (even though I never understood a single thing he said), and listening to the snippet of the catchy tune which introduced and closed the show.

It was years before I found out that the tune was Buy For Me the Rain by the Nitty Gritty Dirt Band. The song came out in 1967 (Baby Boomer era) and it’s a love song that hints at mortality.

Chet started out in Mason City, Iowa as a farm news broadcaster and in his early days, he made part of his show an offer to do chores for farm families who otherwise would never have had the time to take a vacation. He spent about 16 years (1975-1990) hosting Market to Market back when it was first called Farm Digest in 1974. That’s just what I picked up about him on the web.

Even though I enjoyed Market to Market mainly for the homey, trustworthy, practical feeling I got from it, I just plain never followed the farm lingo.

I can give you my sense of it in this sample fictional broadcast:

Hello, I’m Chet Randolph and welcome to yet another incomprehensible edition of Farm Digest; oops, I mean Market to Market, in which I talk rings around topics like corn and soybean markets and how that affects your horoscopes. Today our guest is Ernie J. Kudzuclamper representing Beans R Us CO-OP. How the hell are you, Ernie?

Ernie: Hay muchos libros en la biblioteca. Sorry; I mean, I’d be a darn sight better, Chet, if the sowbelly futures were trending up like they would if the Mariana Trench weren’t so full of plastic bottles and pastel pampers.

Chet: I couldn’t agree more, Ernie. It makes my left ear stick out even farther than usual when I think of the Dumbo Octopus population overcome by anxiety about that and the new restrictions on silo height. Moving right along, what do you think of the fungus market so far?

Ernie: Well, Chet, I’d be inclined to be leaning toward but not too far, mind you, prices going through a teal-tinted wormhole on the way to higher prices in the 2 cent per bushel range—provided aliens reduce their tendency to get distracted into making fancy crop circles when they ought to be abducting  catchy tune earworms.

Chet: Good point, Ernie. That earworm has been spreading all over Iowa; seems like I hear the darn things every time our show starts. But we have to move along because I have this list of 500 issues that we have to discuss in the next half hour.

Ernie: Fine. Mind if I take a little dipping tobacco?

Chet: Go right ahead, I think there’s an old empty coffee can around here somewhere. Are you strong on spring wheat futures?

Ernie: I would be cautious about it for just a few seconds, or at least until I pass gas.

Chet: I’ll notify a technician to switch the fans up to high speed. I’ve been watching the chicken hindquarters market in the last few weeks and I’d like your opinion about whether anyone ever cleans out the cloacas on those things before they ship them.

Ernie: If I were a betting man, I’d put a few hundred bucks against, Chet. Why, just last week my whole family was in the emergency room with projectile vomiting and bloody diarrhea that drove all the nurses…

Chet: Moving right along, we should talk about the state legislature’s plan to actually pass a bill that would favor agricultural progress.

Ernie: Chet, I assume from the rhythmic wagging of your left ear that you’re referring to the bill to regulate cow tipping?

Chet: No, but go ahead, I’m easy.

Ernie: I think there’s a petition opposing it on the grounds of religious freedom, but I expect this bill to be signed by the governor because he signs everything put in front of him, even blank checks.

Chet: Strong words, coming from you, Ernie. Do you come from a long line of cow tippers?

Ernie:  Going back hundreds of generations, we’ve been tipping cows and I doubt there’s any regulation that will make an appreciable difference.

Chet: And just how do you do it, Ernie? Do you use a front-end loader? Cows tend to be pretty heavy.

Ernie: We learned the technique from Himalayan monks originally. Diligent practice allows you to tip a cow over with just one finger.

Chet: That’s how I learned to wag my left ear. Thanks, Ernie. And that’s a wrap for another edition of Market to Market, folks; thanks for watching.

I’m sure you get the same feeling I do.

The Iowa River Landing Sculpture Walk

I had so much fun with the giant chicken post on January 25, 2020 that I thought it would be nice to revisit the subject, only this time take a butt-freezing tour of the entire Iowa River Landing (IRL) Sculpture Walk.

We took the walk Tuesday, January 28, 2020. The weather was typical for Iowa in January. The temperature was in the teens and there were brief flurries. My wife, Sena, and I dressed warm and took a meandering journey through the Sculpture Walk, guided by a small map.

It was a little more challenging because snow and ice covered up many of the plaques identifying the works (and parts of the sculptures as well) although this lent even more visual interest to them. They’re three dimensional objects anyway and you really have to walk around them to fully appreciate their complexity. You have to watch out for yellow snow.

What made this adventure even more special was the Iowa Writers’ Library in the lobby of the Coralville Marriott Hotel and Conference Center. It’s maintained by the Coralville Public Library. One of the issues I had was being unfamiliar with the text of the poems and other literary works (all were connected with the Iowa Writers’ Workshop) referenced by the artists. The library was cozy, had a fireplace warming the softly lit room lined by bookshelves and a couple of ladders on wheels to help you reach the books higher up.

I have always felt comforted in libraries, ever since I was a little boy. Every day I got the chance, I would walk to my hometown library (which was about a mile trip), browse the stacks for hours, then tote home piles of books in both arms.

The hotel library had most of the books pertinent to the literary references cited by the artists for their sculptures. I even found David B. Axelrod’s book, The Man Who Fell in Love with a Chicken. It turns out that the title of Axelrod’s poem is “The Man Who Fell in Love with His Chicken.” There, I’ve said enough already about that chicken.

Of course, I couldn’t take the time to find and read every book; we would not have had time to freeze our butts off touring the sculptures.

I didn’t wear my heavy winter boots and had to crunch through the crusty snow nearly up to my ankles to reach certain sculptures. Sena was dressed better for the weather but we both slipped around on the ice and I began to think more and more about things like broken hips.

But we soldiered on because it was necessary to walk completely around the Made of Money sculpture by Aaron Wilson in order to see the message printed, “HOW CAN WE HELP YOU?” It’s funny because that’s what I typically ask patients in the general hospital when I sit down on my little camp stool after I introduce myself to them as a consultation-liaison psychiatrist.

The sculpture To Dorothy, by artist James Anthony Bearden, was in a difficult spot and initially we thought we’d have to either rappel down from the roof of the building it was in front of or climb up the big retaining walls to get a good look at it. We found a way out to it and ignored passersby who gawked at us. They needed to admire us for how unique we are (not how eccentric and possibly a danger to ourselves and others), which is what I think Iowa Poet Laureate Marvin Bell was getting at in his poem of the same title as Bearden’s sculpture.

The sculpture, A Thousand Acres, by artist V. Skip Willits was another piece you really have to walk around to fully appreciate, although you generally have to do that with any sculpture. The book of the same title by Jane Smiley is based on Shakespeare’s King Lear—which I have also never read—but which I got an earful about in my undergraduate days from a fellow student who thought he knew everything there was to know about King Lear. He was garrulous in the extreme and bested me in debating class mainly because he never let me open my mouth.

The sculpture by artist Victoria Ann Reed, called Convergence, was very intriguing and looked more like a human figure who had been through a wormhole than a memory.

The Tipping Point, by artist Sarah Deppe, was a convincing image of persons with holes in their heads (several holes in fact). Bureaucrats come to mind.

We nearly dismissed the sculpture called After Trillium by artist Anthony Castronovo as a broken lamppost with dysfunctional solar panels, only partly because snow and ice covered the panel describing it. On the other hand, the top part does resemble a flower called a Trillium, not to be confused with Trillian, a character in the book by Douglas Adams, The Ultimate Hitchhiker’s Guide to the Galaxy. I’m glad I could clear that up for you.

The Prairie Breeze Bench by artist Bounnak Thammavong is a sculpture you could actually sit on and watch the Bald Eagles. However, it’s made of steel and the seat was covered by snow. After you wipe away the Bald Eagle droppings, you can read the poem by James Hearst, “Landscape Iowa.” You can also hear it set to music and performed by Scott Cawelti, a former University of Northern Iowa educator who taught film, writing, and literature courses. He also edited The Complete Poetry of James Hearst (University of Iowa Press, 2001).

The Alidade sculpture by Dan Perry was the one Sena and I both really liked. I know Perry says the alidade was used by astronomers but I remember it as being a part of an instrument used by land surveyors, also for measuring distance and angles in topographical surveys. I used to work for consulting engineers as a surveyor’s assistance and draftsman many years ago. Perry links it to the poem entitled “1,2,3” from James Galvin’s book of poems, X: Poems. I confess I don’t see the connection yet. The poem for the most part reminds me of spelunking although Galvin describes a hole that he and a friend rappel into as being a planet. Much of the rest seems to be about something very painful. I’m sorry I can’t do better, but that’s why he’s a poet and I’m not.

Next, we encountered Bounnak Thammavong’s second sculpture, a very recognizable fish, a “lowly river carp,” entitled From the River. It’s linked to the poem “Where Water Comes Together with Other Water” by Raymond Carver. When I was a boy, I used to fish for bullhead in my hometown river. I sometimes caught carp and thought that was the poorer catch. It didn’t matter. I always threw both back into the river. My mom would not clean fish and neither would I.

Finally, by a pretty circuitous route, we saw the last sculpture, Gilead, by artist Kristin Garnant. The snow plow had piled up a lot of snow around it. I probably won’t read Gilead, the epistolary novel by Marilynne Robinson.

In fact, I probably won’t read a lot of the literature connected with the sculptures we saw. I did read Margaret Walker’s poem “For My people.” Sorry, Jubilee is way too much for me. She was the first African-American woman to be accepted into the Iowa Writers’ Workshop, of course depending on which story you believe about when the program formally began (Invisible Hawkeyes: African Americans at the University of Iowa during the Long Civil Rights Era, in Chapter Four: Obscured Traditions: Blacks at the Iowa Writers’ Workshop, 1940-1965, by Michael D. Hill, University of Iowa Press, 2016).

In some ways, I identify way with her, one of the reasons being obvious and skin-deep. The other is that she taught school at Jackson State, a historically black college in Jackson, Mississippi.

I wonder if the IRL Sculpture Walk could include another one for her, just to make it an even dozen?

I spent my Freshman and Sophomore college years at a historically black college. It was then called Huston-Tillotson College (now Huston-Tillotson University) in Austin, Texas. That was back in the mid-1970s. I had grown up in largely white neighborhoods and gone to predominantly white schools prior to going to H-TC. It was a culture shock and that’s probably about all I’ll say about it for now, since this post is way too long.

I can say one other thing about H-TC. I submitted a poem for the college’s annual poetry contest. Winners would have their work published in the school’s small anthology called Habari Gani (Swahili for What’s Going On?). Mine didn’t make it but years later I scoured the web looking for a way to get a copy of Habari Gani, finally succeeding only a few years ago after tracking a copy of the Spring 1975 volume down at the H-TU library. I like the short introductory poem:

“Let your hum be the dream

Of an understanding universe…

Let your hum be a perfect

Utopia of Love”

–Patricia Lloyd

A Giant Chicken

Last week, we were out at the Iowa River Landing (IRL) and saw a giant chicken. It’s actually a metal sculpture entitled Iowa Blue: The Urbane Chicken, 2013, one of 11 such works (all installed in 2013) of art making up the Iowa River Landing Sculpture Walk, located in the Coralville Marriott Hotel and Conference Center.

All of them are linked to literary works by authors associated with the Iowa Writers’ Workshop at the University of Iowa. The artist is Amber O’Harrow’s and her statement about the chicken is:

“I have created a sculpture of the noble chicken, as described in the poem by David B. Axelrod. The Iowa Blue Chicken is the only breed of chicken that was created in the state of Iowa and bred to survive Iowa’s harsh winters and its hot summers.”

The literary reference is to David B. Axelrod’s poem, The Man Who Fell in Love with a Chicken.

The chicken is made from cast aluminum and is taller than I am.

This set me off on an internet journey to find out more about the Iowa Blue chicken breed and Axelrod’s poem. It took a while, because there’s a lot to know.

If you’re a poultry enthusiast and an Iowan, then you know the story about the Iowa Blue Chicken Club (IBCC), not to be confused with the sandwich of the same name which doesn’t yet exist but should. The IBCC is an organization dedicated to making sure that the public at large realizes that the sculpture’s name is Betsy and that there is a big effort to get the breed recognized officially by the American Poultry Association (APA). So far, the APA has deferred, but the IBCC is not giving up.

The story of the origin of the Iowa Blue is somewhat apocryphal in that the breed was said to arise from the union of a White Leghorn (or Red depending on what you’ve been drinking) and a pheasant, which serves to explain the chestnut to striped colors of the feathers and certain behaviors of the chicks, which includes antics like crouching, fast fleeing, and something called “popping” which apparently means a kind of hopping which resembles popcorn popping. I gather this is typical for pheasant chicks.

Iowa Blue roosters will fight hawks, even slapping them with their wings and crowing challenges like “Have some of that!” or “You got something on your face, dude!” They’ll fight just about any critter: opossums, raccoons, snakes, rats, cats, congressmen.

Iowa Blue chickens are bred to thrive in Iowa’s harsh winters and oppressive summers. When the barnyard gets snowed in, they just grab little ergonomic shovels and scoop their way out—they just flip the bird at snow blowers.

Visit the IBCC web site to see photos of these beautiful birds.

Turning to Axelrod’s poem, The Man Who Fell in Love with a Chicken, the web search got a little complicated. For the longest time, I couldn’t find it. All I wanted to do was read it. Heck, you can look up Robert Frost’s The Road Not Taken in half a second at the Poetry Foundation web site.

I finally stumbled on it at a web site (the poetrydoctor) the owner of which I eventually found out was Axelrod himself! I found the chicken poem but the title was The Man Who Fell in Love with His Chicken. Now, I realize that even he says there are typos in the extremely long list of his works which you cannot search by the way, even though the author says there is a search box. The book of his poetry of the same name is 16 pages long and the title is The Man Who Fell in Love with a Chicken, which you can order through Amazon.

Interestingly, one publisher, Cross-Cultural Communications, says the book is “humorous poetry playing on poultry puns.”

This makes me wonder about O’Harrow’s description above including the phrase “…the noble chicken as described in the poem by David B. Axelrod.”

I can’t copy the poem here because that would be copyright violation (despite Axelrod’s making it available on his website—I guess he can do anything he wants with his own work). On the other hand, I think I can say that the poem does, in fact, contain several chicken puns and the man eventually does something to the chicken which is something less than noble and could involve lettuce, tomato, and possibly secret sauce.

The poem is dedicated to someone named Russell Edson, who I learned was called the “grandfather of the prose poem in America.” Edson wrote a few whimsical poems which could have been very much like Axelrod’s poem about the love affair with a chicken. One of them, Let Us Consider, was about a “farmer who makes his straw hat his sweetheart” and “an old woman who makes a floor lamp her son.” See the entry about him at the web site Poetry Foundation—where Axelrod entries can’t be found.

Well, that was my journey through the web about the Iowa Blue chicken sculpture. I’m next to clueless about chickens, unless their roasted, barbecued, fried, or what have you and I’m a terrible poet, as you can see from my video, Pseudobulbar Affect Top Ten—which somehow gets more views than almost anything else on my YouTube Channel.

My own poetry

Bridges: An Essay on MLK Day of Service 2020

The Martin Luther King Jr. Day of Service is today and the University of Iowa has taken a quote from King to set the tone each year for this event. This year it is:

“Let us build bridges rather than barriers, openness rather than walls. Rather than borders, let us look at distant horizons together in a spirit of acceptance, helpfulness, cooperation, peace, kindness and especially love.”—Dr. Martin Luther King, Jr.

Dr. Martin Luther King, Jr.

As I look back on my career in medicine, it’s only natural for me to think of my role as a consultation-liaison psychiatrist as a sort of bridge between medicine and psychiatry. I’m pretty sure most would agree that as I chased around the hospital up and down the stairs doing the 3 and 30 (3 miles and 30 floors; I never take the elevator), I was doing my level best to bring psychiatric care to the patients in the general hospital who were suffering from medical illness as well.

The featured image shows the cover of a little book of kind remembrances I received from colleagues and trainees when, during one of my two such lapses in good judgment, I left the University of Iowa to have a try at private practice. The book has an image of a bridge on it. At the time, I thought of it as a depiction of my path between academia and community psychiatry. We need bridges there too, although one person let me know that someone has to teach new doctors.

I also got a fancy birdhouse as a going-away gift. I still do some bird-watching.

As I head into retirement, I hope that I’ve been a bridge of sorts between the old ways and the new to the next generation of doctors. After all, I’m the institutional memory of psychiatry on the medical and surgical units, in a manner of speaking.

The Medical-Psychiatry Unit (MPU) at University of Iowa Hospitals & Clinics was where I learned how this ward of patients with both medical and psychiatric illness served as a bridge between the departments of psychiatry and medicine. My teachers were doctors who were and still are great leaders. I still recall Dr. Roger Kathol, MD, an internist who also trained in psychiatry, and who designed and started the MPU decades ago, gave readings during sit-down rounds in the unit conference room. He read passages from the works of Galen, the Greek physician, surgeon, and philosopher in the Roman Empire.

Dr. Kathol assigned to me a task one day, which was to give a short presentation the following day on hyponatremia and how to distinguish psychogenic polydipsia from the Syndrome of Inappropriate Antidiuretic Hormone (SIADH). That night I was on call and got 4 admissions on the unit, which was chaotic. One patient actually broke a bed. I didn’t get any sleep. I was up running around until we all sat down to discuss patients.

I struggled through presentations of the 4 patients I had admitted the night before. I could barely talk. I had actually looked up a little information for my assigned presentation on hyponatremia but I was sweating it because I could barely stay awake. I was not the first resident to have episodes of microsleep on rounds and I knew Dr. Kathol saw it happening to me. That was in the days of 32 hours of call. They don’t make trainees do that now.

Dr. Kathol gave me sort of a sidelong glance as we finished discussing patients, which was usually when trainees were expected to give short educational talks. That day, he skipped me.

I should mention that he thought the proper name for the MPU was the Complexity Intervention Unit (CIU), owing to not just the medical and psychiatric complexity of our patients, but also to their social environments and the U.S. payer system which often led to many having inadequate, dis-integrated health care, meaning that there was no bridge between psychiatric and medical illness treatment and split health insurance coverage even though research showed that mental illness definitely lessened quality of life and increased health care costs. He has his own company, aptly named Cartesian Solutions, and it’s a major organization dedicated to helping hospitals and clinics set up collaborative ways to bridge the needs of patients with comorbid psychiatric and medical illness.

The University of Iowa model for the MPU has been disseminated to a number of other hospitals in the country, one of them in Pennsylvania, which I mentioned in a previous post, “Brief News Item,” on May 23, 2019. I’ve just received word a couple of days ago from Dr. Kolin Good that the unit, called the Medical Complexity Unit (MCU), a name which bridges the underlying intent of MPU and CIU, has saved the hospital a great deal of money, has drastically cut the use of sitters doing one to one observation (an extremely expensive intervention), is treasured by patients, and popular with trainees. They are very proud of it and have every right to be so. They are bridge builders too.

Dr. Louis Kirchhoff has been one the most notable internal medicine co-attendings on the MPU. He’s an infectious disease specialist, but has a knack for communicating effectively with patients who are mentally and medically ill, even speaking fluent Spanish with some of them. He and I shared triage call to the MPU every other night before the triage system was changed to a more humane schedule. He was a bridge between internal medicine and psychiatry trainees rotating on the ward. He could explain psychiatry to the medicine residents as well as I could.

I have had a penchant for finding a chair to sit down when I interview patients in their hospital rooms. There are usually not enough chairs in the rooms. A few years ago, Dr. Tim Thomsen, a surgeon and Palliative Care Medicine specialist as well, lent me a camp stool which I carry around with me so that I’m never at a loss for a chair. Everyone likes it. I think the camp stool helps build an emotional bridge with patients.

The little chair

There are special combined specialty residencies at the University of Iowa Hospitals and Clinics which bridge Internal Medicine and Psychiatry and Family medicine and Psychiatry. Slowly but surely the siloed departments of academic medical centers are broadening their curricula and training regimens to rebuild the bridge between mind and body.

It’s been evolving for years. I’m proud to have played a small role in it. This is a place where teachers, researchers, and clinicians build bridges in many ways, foster openness, and search the “distant horizons in a spirit of acceptance, helpfulness, cooperation, peace, kindness and especially love.”

Thoughts on Etiquette

I sometimes wonder about etiquette. Take the sandwiches in the featured image today. Of course, you can’t actually “take” them; don’t be so literal. My wife, Sena made them for lunch yesterday, after we’d worked on clearing a lot of snow and ice from our driveway and sidewalks. We were ravenous.

Sena ate the neatly cut sandwich with her hands. I ate the messy one and you can see why it’s messier—I used a knife and fork.

I looked this up so there can’t be any dispute: it’s perfectly acceptable according to the rules of etiquette to eat a sandwich with knife and fork.

That said, there are questions about why there would be rules of etiquette about how to eat sandwiches in the first place. Without any research on it, I surmise it’s all about messiness.

Is it messier to have the condiments and contents of your sandwich smeared all over your plate or your face? You be the judge; but just so you know, since I’m writing this post, I’m the authority and I say you ought to keep your sandwich off your eyebrows and your earlobes in polite company.

This reminds me of other points of etiquette I’m often not sure about. What about coconut? I just happen to be one of the many souls who cannot stand the texture of shredded coconut. It’s like chewing pieces of paper. I just can’t bring myself to swallow it.

What do you do if you’ve discovered, too late, that you’ve just taken a mouthful of shredded coconut? What is the proper etiquette? You’ll be happy to learn that I have the answer although I didn’t do any research on the matter.

You should discreetly expectorate the papery mess on the left side of your dinner plate—without making any kind of noise as though you were hawking up a lunger. You’re welcome.

And what do you do with those beer bottles made by knuckleheads who think it’s clever to wrap paper around the neck all the way up over the cap which you can’t just twist off? You try your best to pop the top with a standard bottle opener and you can bet your bottom dollar a piece of paper will end up in your beer. It’s a small piece, just big enough to make you worry that you’ll choke on it like you would on a piece of shredded coconut.

Etiquette might say you should adroitly hold your bottle opener so that paper doesn’t end up floating in the foam. But you’ll have plenty of foam everywhere if you try to be adroit about it; trust me, I know. The bottle will slip, tip over, and smack the countertop which will lead to an eruption of suds all over the place, including you. No matter how hard I scrubbed and how much air freshener I sprayed in the kitchen, Sena called out from down the hallway in the front of the house, “Boy, sure smells like beer in here!”

You could just leave the paper in the bottle, which is the easiest. However, it’s pretty tough not to try to drink around it. Etiquette doesn’t cover that, probably because there is no way to gracefully drip beer from your chin.

Moving on to another point about etiquette although not involving food, let’s get back to shoveling snow, which we did an awful lot of yesterday.

We don’t own a snow blower, even though we live in Iowa, which gets a fair amount of snow. Yesterday morning we woke up to about 5-6 inches (not counting the driveway plug, courtesy of the city plow) of heavy snow and ice. We got out there and I was poised to plunge my ergonomic shovel in the plug when the neighbor across the street walked over and shouted over the roar of his snow blower, telling me he would be happy to let me use it. He offered more than once, pointing out that he was already finished clearing his driveway.

It was tempting. We usually spend about 2-3 hours shoveling after a heavy snow. On the other hand, I had no idea how to operate a snow blower. What would etiquette say about how to respond to repeated offers from a friendly neighbor to allow me to borrow his?

I could have just said “OK” and borrowed it. The only problem with that is I would then demonstrate my total ignorance about the machine. I would probably have the augur cranked down too low and sent spears of shattered driveway into his chest (I’m sure he would stand out there and watch me). How about rotating the chute so that the snow and ice hits me in the face? What does etiquette have to say about that? That’s probably more about first aid and the emergency room than etiquette.

On the other hand, I couldn’t let him know I didn’t know how operate a snow blower. Etiquette amongst guys is clear on that point. I would have had to turn in my man card. So, I did the only thing I could, which was to politely decline the offer, “I appreciate you so much, but I do this mainly for the exercise!”

Then I would proceed to throw my ergonomic shovel into the drifts, twist and hurl the load of snow clumps that were more like stones over my shoulder and slam the shovel into the drift in order to make an impressive show of the proper technique for removing the frozen residue from the inside of the shovel. I paid dearly for that later.

Anyway, those are some of my thoughts about etiquette. It’s time for blueberry tartlets. Etiquette clearly allows eating them with a shovel.

blueberry tartlets

Kitchen Table Cribbage

Well, Sena and I are making progress with our cribbage playing skills. We’re in the Kitchen Table Cribbage league for sure. I think one of the main differences between American Cribbage Congress (ACC) rules and Kitchen Table Cribbage rules is that no penalty points for mistakes are scored in the latter. I’m sure there are many other differences; but you know, when I googled the term “Kitchen Table Cribbage,” I came up empty.

For us, the learning curve is pretty steep but it’s a lot of fun. We made a YouTube video of our latest efforts. We must have made at least a half dozen tries at it before we settled on one which we think had the fewest mistakes. That doesn’t mean there weren’t any. I edited out glaring errors, but I’m sure viewers will find others.

We’re also using our new v-tournament cribbage board, on which it’s easier to peg (although the video shows me fumbling with my pegs!).

New cribbage board!

I hope cribbage enthusiasts give us some credit for at least trying to illustrate the basic rules and play of the game. I could find very few videos on the web that used a demo game to help tyros pick up the basics from the players’ perspective. We had a hard time just figuring out where to place the board and how to play the cards, which I had to piece together from different web sites and a surprisingly small number of YouTube videos.

You’ll notice Sena and I help each other with the pegging and scoring hands and cribs. You can’t do that by ACC rules. And there’s a Muggins rule you can apply that lets you take advantage of your opponent’s mistakes.

I also got a free cribbage scoring app for my smartphone, although we don’t use it that much. I’m sure you can tell.

Hey, we’re Kitchen Table Cribbage players. We’ll leave Muggins to the pros.

Go Kitchen Table Cribbage!

An Auspicious Chair

I took the picture of the little chair one of the residents brought to the psychiatry consult office yesterday. I got a big charge out of it, especially because I’ve been using a version made of wood and leather for a few years now. I think it’s possible that it could be an auspicious chair.

The resident actually used his, too. It was a busy day; I put in about 4 miles and 40 floors on my step counter—which meant the residents did too. The chair is obviously useful to rest our feet, but I think Thomas P. Hackett summed up the best ever rationale for sitting with patients:

“As a matter of courtesy, I sit down when interviewing or visiting patients. Long accustomed to the ritual of making rounds, many physicians remain standing as a matter of course. Standing, physicians remind me of missiles about to be launched, poised to depart. Even if that is not necessarily true, they look the part. Patients sense this and it limits conversation. In addition, when standing, the physician necessarily looks down on the patient. This disparity in height is apt to encourage the attribution of arrogance. Looking down at a patient who is prone emphasizes the dependency of the position. Sitting at the bedside equalizes station. Sitting with a patient need not take longer than standing with him.”— Hackett, T. P., MD (1978). Beginnings: liaison psychiatry in a general hospital. Massachusetts General Hospital: Handbook of general hospital psychiatry. T. P. Hackett, MD and N. H. Cassem, MD. St. Louis, Missouri, The C.V. Mosby Company: 1-14.

I had a little fun with the chair in a YouTube video as well.

The chair I use now is a replacement for the first one I got as a sort of loaner from a colleague in Palliative Care Medicine. That one broke during a consultation visit with a patient and his family (circumstances disguised to protect confidentiality) in the emergency room in which we were asked to evaluate for catatonia. The patient was mute but there was little evidence otherwise for catatonia, one of the chief features of which is the inability to react to any stimulus in the environment. I was sitting on the chair explaining in detail the intravenous lorazepam challenge test for catatonia (which often interrupts the episode of muteness and immobility).

I was sitting in front of the patient but facing the family and the consult service trainees while expatiating on the topic. As I was droning on, I heard a sudden pop—and I fell unceremoniously on my rear end as the chair collapsed beneath me.

My audience exploded in loud laughter, of course, as you’d expect when a pompous ass falls on his ass. But they also pointed to the patient. When I turned to look at him, he was convulsed with apparent mirth although still unable to make a sound.

I considered this a novel test for catatonia, negative in this case. Of course, it would be impractical for regular use.

Where was I? Oh, the little chair the resident brought for consult rounds. I was honored by it. It seemed to show that I was leaving a legacy as I head for retirement in June.

Another sign of leaving a legacy was a New Year’s email message I got from a former resident, Dr. Paul Thisayakorn, MD, who has been making an auspicious beginning in the field of consultation-liaison psychiatry in Thailand. He’s working very hard and is an outstanding clinician, researcher, and teacher. He has a lovely family. He and I respect each other a great deal.

Speaking of auspicious, when Paul graduated from our psychiatry residency and before leaving for his Consultation-Liaison fellowship program, he gave me a necktie with white elephants printed on it. I still have it. I may not have the symbolic meaning of the white elephant exactly right, but I think the white elephant in Thai culture is called “chang samkhan,” or maybe “chang phueak” which means “auspicious elephant.” In general, I think the idea is they symbolize success or at least the promise of success. Paul’s gift showed his gratitude and respect for me because I was one of his teachers. I am still honored to have been a part of his education and his life. I will always treasure his gift of gratitude.

An auspicious tie

Paul is very hard-working and very successful.  And if the residents now start to use the little camp stools to sit with their patients, I would treasure that legacy as well.

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