Month: March 2023

Face Masks Optional at University of Iowa Hospitals & Clinics Starting March 8, 2023

As of March 8, 2023, face masks will be optional for visitors, patients, and employees at University of Iowa Hospitals & Clinics.

More On Taming the Juggling Balls

I’ve been juggling for about 5 months now and reflecting on my progress. I think I’m doing OK for a geezer. Sena would call me a hot dog although I would still call it ugly juggling by any standard.

What’s striking, at least to me, is the little bit of science I can find on the web about juggling. I hear the term “muscle memory” when it comes to learning juggling. Actually, there’s some truth to that. There are different kinds of memory. For example, most of us know about declarative memory, which about memorizing facts, because we use it to prepare for exams. Those of us who went to medical school remember the agony of taking tests for the basic sciences.

But so-called muscle memory, or the memory for learning new skills like juggling, takes place in the brain. There was a study published in 2009 which found changes in both gray and white matter of subjects before and after learning to juggle (Scholz J, Klein MC, Behrens TE, Johansen-Berg H. Training induces changes in white-matter architecture. Nat Neurosci. 2009;12(11):1370-1371. doi:10.1038/nn.2412).

The study about correlation of the inability to stand on one leg for 10 seconds with higher mortality in older patients, which I relate to the ability to do the under the leg juggling trick, was published last year (Araujo CG, de Souza e Silva CG, Laukkanen JA, et al. Successful 10-second one-legged stance performance predicts survival in middle-aged and older individuals. British Journal of Sports Medicine 2022; 56:975-980.)

I talk a lot about juggling as though I’m a teacher. I’m not a juggling instructor by any means. You can find better juggling teachers on the web. But my approach to talking about juggling in terms of it being a hobby for me is really not different from how I talked about consultation-liaison psychiatry before and after I retired. I’m still a teacher—just evolving in retirement.

However, you can find much better resources for learning how to juggle at the following websites:

Juggling for Beginners
How to Juggle

https://www.renegadejuggling.com/

Have fun!

Why Does My iPhone Not Ring?

This post is squarely in the “Duh” category. For the last several days now, I’ve been wondering why my iPhone doesn’t have a ring tone. Before this, I haven’t thought about it, probably for years. I’m not sure why it came up.

I looked on the web for solutions to the silent ring problem.

The solution is clear, which is to slide the ring/silent switch so that the orange color doesn’t show. That turns the ringer on. The switch is just above the volume up/down buttons on the side of the phone.

But I couldn’t see the switch. Then yesterday, for some reason I thought to look at my Otter box protector flaps. That was the “Duh” moment. It doesn’t belong in the “Eureka” category for obvious reasons. “Eureka” is for geniuses, “Duh” is for dummies.

The problem was I couldn’t see the switch because the Otter box protector tab covers it. It may have been that way for years because I’ve had my iPhone for a long time and might have switched it off so that it wouldn’t audibly ring during meetings.

The other possibility is that I might have accidentally switched it off just by wrestling with the Otter box cover to get it wrapped around the phone.

In either case, I just stopped seeing the Otter box tab which covers the ring/silent switch. It’s not an out of sight, out of mind thing. It’s more like out of mind, out of sight.

Which makes me wonder, if “pareidolia” means seeing patterns in random data including visual information (in other words seeing things that aren’t really there), then what is not seeing obvious objects in the setting of normal vision?

Could that be inattentional blindness, sort of like the invisible gorilla test, in which subjects were asked to keep track of the number of times a basketball is passed in a video of a basketball game, and then half of the subjects failing to notice a woman dressed in a gorilla suit walking on to the court and thumping her chest, then walking away?

Is that similar to the oft repeated statement, “not seeing the forest for the trees” or “missing the elephant in the room?”

Don’t mind me; I’m just trying to salvage what’s left of my ego.

More Knockdown Furniture

We got another chair—for the master bedroom closet. It’s called the Jasmine Chair. It came with all assembly hardware and other parts. This one was a 15-minute assembly job, which amazed me. However, there were sharp staples protruding from the upholstery, so you have to watch out for them.

Teaching an Old Dog New Tricks

While we were out for a walk yesterday, we ran into someone walking her chocolate Labrador retriever. His name is Hunter and he had a tree branch longer than him in his jaws. He looked like he was having a great time gnawing on it and swinging it around.

I didn’t envy his owner when it came time to going home and taking it away from him.

Mostly younger dogs like to chew on old sticks and some say it might be a good idea to bring a chew toy along with you when you take a dog outside for a walk. It can be tough to persuade a dog to just let the stick go.

As a retired consultation-liaison psychiatrist, I sometimes compare myself to a dog who latches on to a stick and is reluctant to let it go. I’m an old dog that way and, as I’ve mentioned before, it’s a little hard to teach an old dog new tricks.

There are examples of this issue. I rarely go grocery shopping and I still have a lot to learn. I was not good about grocery shopping and other non-work-related chores when I was a doctor for about 28 years, counting residency. Medical school kept me pretty busy too.

Anyway, I went grocery shopping yesterday and I thought I did OK although I had to wander around quite a bit to find everything on my list. Sena doesn’t need a list. She pointed out that I got the unsalted butter—which she never buys. I wondered how I managed to pick up unsalted butter. I thought I was doing good to get the Great Value brand rather than the more expensive brand.

The package was blue instead of red. You mean I have to read the package?

I got a package of chicken breasts and congratulated myself on that. Sena said they were really thin and noticed that they included rib meat—which she normally doesn’t buy. That slipped by me.

I bought a lot of items that we needed; you know, things like milk, eggs, bread, nuclear weapons, etc. But I really didn’t get anything that you could actually make a bona fide meal out of in the sense of cooking something.

Well, I did get a couple of frozen pizzas. This brought the total of frozen pizzas in our freezer to a number I’m not willing to divulge at this time.

I had to maneuver around several shoppers who were filling orders for customers who ordered their groceries on line. I tried that a very few times and it’s more difficult than I thought.

When I got up to the cashier, I just stood there while she rang up my purchases, bagged them—and then she started to put the bags in my cart. She didn’t say anything but a tiny bell in my brain rang somewhere and it occurred to me that I was supposed to put the bags in the cart. I apologized and got to work right away when I noticed. I recalled that it was probably just that mistake that led to my leaving an item at the store the last time I shopped.

Sena went to the grocery store after I got home and returned with items that could be used in menus. I think that is called meal planning.

But I did make dinner last night, meaning I reheated left-over chili and chopped up some vegetables for salads. Oh, and I got the saltines out for the bread group.

Sena is still trying to coax me to let go of the stick.

About Those Stages of Retirement

We got our new wall clock on the wall the other day. It got me to thinking about how I view time and other matters now that I’ve been retired for about two and a half years.

I actually tried to ease into retirement by getting a 3-year phased retirement contract. I thought that might help me get adjusted to not being a fire fighter as a consultation-liaison psychiatrist. I don’t know how helpful that was.

So, I looked up the stages of retirement on the web. There are slightly different versions but most of them have 5 stages:

  • Realization
  • Honeymoon
  • Disenchantment
  • Reorientation
  • Stability

I guess I’m somewhere at the tail end of disenchantment and the beginning of reorientation. I have to point out a few things about me and the clock on the wall to help get my point across.

When I was running around the hospital, I used to pay a lot of attention to the clock. One example is how I helped medical nurses and doctors diagnose and manage catatonia. That’s a complicated and potentially life-threatening condition linked to a lot of medical and psychiatric disorders. It can make people afflicted with it look like they have a primary mental illness and they can look and act spooky.

Most people with catatonia are mute and immobile. They could also have wild, purposeless agitation but the mute and immobile type is more common. I would recommend administering injectable medicine in the class of benzodiazepines, often lorazepam.

Often the catatonic person would wake up and start answering questions after being like a statue only minutes before the injection. I watched the clock very closely, and the nurse and I watched the vital signs even more closely.

The recovery from a catatonic state looks like a miracle, which often made me look like a hero—despite the fact I could not explain exactly the mechanism of how catatonic states begin or how injectable benzodiazepines work to reverse the state. In most situations, on the general medical and surgery wards, the cause was not infrequently a medical emergency.

That made retirement difficult. I often didn’t notice time passing when I was working. In fact, my job as a C-L psychiatrist was marked by a series of emergencies, hence the fire fighter feel the job held for me.

Somehow, interrupting my schedule (if you can call firefighting a schedule), didn’t help me very much in my adjustment to retirement.

Right from the start, I noticed I missed being a hero. By the time I got to the first stage, Realization, I was already part of the way into the Disenchantment stage. I don’t really recall the Honeymoon stage.

Time passed slowly after full retirement for me. Not even the phased retirement schedule prepared me for it. It was excruciating. I have never slept very well, but my insomnia got worse after retirement.

I had fleeting thoughts about returning to work, and that’s the surprising thing. You’d think I would have just dropped the whole retirement thing and get right back in the fire truck.

But I didn’t. Part of me knew that the job consumed me and burnout was a consequence. My focus on work did not help me be a good husband. On the other hand, retirement by itself didn’t help either.

It’s still hard, but not as difficult as it was at first. I would say that I’m somewhere between the latter part of Disenchantment and the beginning of Reorientation. I’m not anywhere near Stability.

I have replaced my schedule to some degree. Most days, I exercise and practice mindfulness meditation. I have also recently taken up juggling, as many of my readers know.

But any YouTube videos of me “cooking” are bogus. Sena takes video of me messing around making pizza and whatnot as if I know what I’m doing—but she’s giving me cues every step of the way. I’m allergic to kitchens and I probably always will be.

Anyway, I have a different relationship with the clock nowadays. I’m still hoping that I’ll evolve into somebody who knows how to manage not just retirement better, but a whole lot of things in a more adaptive way.

I sure hope so. According to some statistics, at my age I’ve got a limited time to improve. So, I need to get busy.