Month: June 2023

Mayo Wars

Okay, so it’s Mayo Wars again at our house evidently. Remember that challenge of Mayonnaise vs Miracle Whip Sena and I had a while ago? Well, now Sena is planning to make a Korean cheddar corn dish. It’s supposed to be made with Japanese mayo, which I gather refers to a product called Kewpie Mayonnaise.

She also ordered a couple of other mayo products: Blue Plate Mayonnaise and Duke’s Mayonnaise. She plans to use them in egg salad and a fish sauce.

All of them use mainly or only egg yolk instead of both the white and the yolk as other mayo makers do. Hmmm. One reviewer says that this avoids the “cloying sweetness” of Miracle Whip.

The nerve!

The other annoying thing is that the Kewpie Mayo took its name from the Kewpie doll. Let’s be clear, the word “Kewpie” is not Japanese. It was coined by an American illustrator, Rose O’Neill. The name comes from “cupid” the name for the rosy-cheeked babies and the Greek god Eros. The Romans called him Cupid. A Japanese businessman shrewdly applied the name to the mayo his company made because kewpieness was getting a lot of attention in America. Kewpie dolls are collectible.

“Cloying sweetness of Miracle Whip” for crying out loud!

Move Your Way!

I saw the HHS Move Your Way campaign regarding the new strategy on encouraging older people to exercise, namely the Midcourse Report: Implementation Strategies for Older Adults.

There are many ways to get and stay fit. We could all do better, including me. I exercise pretty much daily for about 30 minutes. Following that, I usually sit in mindfulness meditation for 30 minutes.

The report says we should do moderate intensity aerobic activity for at least 150 minutes a week and muscle strengthening activity for at least 2 days a week.

I do a combination of stationary bicycle exercise, weight exercises with dumbbells, planks, body weight squats. I also do one leg stand, one minute each leg.

And juggling is great aerobic exercise. I struggle a bit with advanced thumb wrestling.

Raccoon in the Mulberry Tree

I was not sure what exactly I saw this between 6:30 and 7:00 this morning shaking the mulberry tree branches in our backyard. It seemed too big to be a squirrel and I dismissed the thought, telling myself that it was most likely the usual squirrel getting its mulberry breakfast.

Just prior to this incident, I had seen and heard what I thought was a blue jay in the mulberry tree. It gave a series of short whistles while bobbing up and down on the branch. I had never heard a blue jay make whistle notes, just the usual screeches. I doubted what I saw and heard. I checked my bird book, “Birds of Iowa: Field Guide” by Stan Tekiela. It didn’t mention anything about blue jays making short whistling notes and bobbing up and down as they did so. I didn’t bother to get up and try to get a video of it. It would have been through the window of our sun room and the jay didn’t sit for more than a few seconds.

So, I looked it up on the web. It turns out blue jays make a variety of noises besides the jeer. They bob up and down as a part of a courtship ritual. They make what is termed a “pump handle call” and I found a video which duplicates what I saw and heard.

Anyhow, getting back to the critter in the mulberry tree, it turned out to be a large raccoon. It was eating mulberries and I tried to take video of it as it was climbing down the tree. This reminded me of an essay by E.B. White entitled “Coon Tree.” If you’ve ever read essays by E.B. White, you probably know already that this one is about a lot more than raccoons.

It’s basically about the conflict between nature and technology. The main essay was published in 1956 and a post script was added in 1962. The coon represents nature which White idealizes and contrasts with references to new inventions, including nuclear devices which represent the destructive side of technology.

I guess we can forget for the moment that raccoons can carry diseases like rabies and roundworm. I’m also reminded of an old TV commercial in the 1970s about margarine (an alternative to butter) in which an actor says angrily, “It’s not nice to fool Mother Nature!” The idea was that margarine (which was a new invention in the late 19th century) was healthier than the natural spread, butter—although the trans fat in it makes the comparison a bit more complicated.

White also says something interesting about unsanitary homes, claiming that children who live in them become more resistant to certain diseases like polio than the kids who grow up in clean homes. The polio scourge raised its ugly head recently in New York, which renewed the recommendation by the Centers for Disease Control recently that people who didn’t get vaccinated against polio should get vaccinated—regardless of how dirty your home was.

And then there is the artificial intelligence (AI) technology. I wonder what E.B. White would say about that? AI can improve detection of some diseases and assist in medical research. On the other hand, AI can still make mistakes and it needs human surveillance.

I read you can sometimes use loud noises to keep raccoons out of your yard. For example, you could try recordings of blue jays.

What Do the Personal Brain Specialists Recommend?

Dr. George Dawson’s post “The Freak Show” reminded me of how coarse and cruel we can be to each other, even when we’re not aware of it. Maybe I should say especially when we’re not aware of it. Dr. Dawson emphasizes the importance of the empathic approach. In the same way, Dr. Moffic in the articles in his column, “Psychiatric Views on the News” draws attention to the need for a socially responsible way for us to relate to one another. The Goodenough Psychiatrist blog expresses poignantly the emotional and courageously humanistic ways we can (or could) relate to each other. Dr. Ronald Pies has highlighted the importance of how human interaction with artificial intelligence must help us find a way to treat each other with respect, and teach that to AI because AI learns from humans.

This reminds me of a character in the book “The Hitchhiker’s Guide to the Galaxy” by Douglas Adams. The character is named Gag Halfrunt who is the personal brain specialist for a couple of other characters. In fact, he’s a psychiatrist who orders the destruction of planet Earth, which is a sort of computer program designed to give us the ultimate question to the ultimate answer for life, the universe, and everything. The reason Gag Halfrunt wants to destroy Earth is, if the ultimate question is revealed, it would put psychiatrists out of work because then everyone would be happy.

Just as a personal comment, I’m pretty unhappy with the author’s position on psychiatrists in general, which tends to overemphasize our importance. And I’m pretty sure psychiatrists are not that important, having been employed as one for many years and seeing how much impact of any kind we have. We can’t make people more or less happy at all.

In fact, Adams also takes a shot at philosophers, who are also upset at being thrown out of work should the ultimate question to the ultimate answer be revealed (the ultimate answer, by the way, is 42 if you’re interested).

Giving psychiatrists and philosophers and anyone else who might have a stake in taking credit for making people happy is nonsense. We all bear responsibility for ourselves. You can argue about whether or not we have any responsibility for each other.

Rather than arguing about it, we could give something else a try. We could try a mindfulness approach like the Lovingkindness Meditation. I’m not an authority or expert on this, but you can check it out on the Palouse Mindfulness website, the link to which is in the menu on my blog. You can find the link to the Lovingkindness Meditation there.

There is no guarantee the Lovingkindness Meditation will make you or anyone else happy. But it doesn’t hurt anything to try it and, as far as I know, Gag Halfrunt is not opposed to it.

Selected Highlights of CDC ACIP Meeting on Covid-19 Vaccines

Today I’m highlighting a few items of interest to older adults from the summary slide set on Covid-19 vaccines presented on June 23, 2023 at the CDC ACIP meeting last week. Information for other age groups are included in the slide set.

Covid-19 continues to be a major health threat for the population, especially older adults and the immunocompromised. Vaccines are still the most effective intervention. However, the bivalent vaccine uptake was very low; most people didn’t get it.

A new Covid-19 monovalent vaccine with an XBB.1.5 composition, is expected to be available this fall.

In the fall, the vaccine manufacturers will switch to the commercial marketplace. In order to continue making Covid-19 vaccines available to the uninsured, there is a Bridge Access Program for Covid-19 Vaccines and Treatments” which is described at the HHS website.

Covid-19 Variants in the News

Sena alerted me to a CBS news item with the headline “CDC tracking new Covid variant EU.1.1.” The story seemed a bit misleading because the FDA just announced approval of vaccines for XBB.1.5. beginning in the fall.

I checked the CDC Data Tracker for variants and noticed XBB.1.5 is still the most common Covid-19 subvariant in the U.S.

While the EU.1.1 is on the list of subvariants tracked, it’s pretty far down the line and is much less common than the news headline seems to suggest. And it’s not clear the new vaccine for XBB.1.5 wouldn’t protect against EU.1.1 as well.

Thoughts on the Passing of Dr. Russell Noyes Jr.

I recently found the obituary of my mentor, Dr. Russell Noyes, Jr. MD. He died on June 21, 2023. This is the first time I’ve ever said that he was my mentor. I probably just didn’t realize it until I found out he passed.

Dr. Noyes was my teacher during the time I was learning consultation-liaison psychiatry back in the 1990s at The University of Iowa Hospitals & Clinics. His knowledge was vast. He contributed greatly to the scientific literature on anxiety disorders. He also wrote about near death experiences.

Dr. Noyes retired in 2002. As his students, we chipped in to get him a retirement gift. It was a large bookstand. We were just a little uncertain about whether a bookstand was the right gift for someone who was a tireless researcher and teacher. He was also an avid gardener and musician. He soon returned to work in the department, staffing the outpatient clinic. He also continued to regularly attend grand rounds and research rounds. Years later at a grand rounds meeting, someone asked him about his retirement. Dr. Noyes retorted, “I don’t believe in retirement.”

I remember I could hardly wait to retire. Since then, I’ve been ambivalent about retirement, but not so much that I ever seriously considered returning to work. I sometimes have dreams about being late for college lectures because I can’t find my way to them. A couple of times lately, I’ve had dreams about not being able to find my way through a hospital to conduct a consultation evaluation. I don’t know what that means.

I was an avid student of consultation-liaison psychiatry but I was not a scientist. That was part of the reason I left the university in 2005 for a position in a private practice psychiatry clinic. He cried at the going away party my students and co-workers held for me. I still have a little book in which well-wishers wrote kind messages. Dr. Noyes’ note was:

“Jim

We’re going to miss you. You are the consummate consultation-liaison psychiatrist and your leaving is a great loss to the Department. We wish you the best and hope to see you at the Academy meetings.

Russ”

His sentiment was one of the main reasons I soon returned to the department, only to leave again a few years later—and return again after a very short time. I came back because he was a consummate teacher and I wanted to learn more from this beacon of wisdom.

Many who knew him, including me, often saw him riding a bicycle on Melrose Avenue to and from work at the hospital. We wondered why he didn’t drive instead. His son James wrote a beautiful remembrance of him and posted it on the web in 2006. It’s entitled “My Dad (Russell Noyes, Jr).”

James says his dad was a terrible driver. This triggered a memory of how it was Russ’s wife, Martie, who drove the rental car when we rode with them from the airport to the hotel where an Academy of Consultation-Liaison Psychiatry meeting was to be held. I remember gripping the armrest and wishing we’d hired a taxi as Martie steered erratically through heavy traffic.

Dr. Noyes knew how to guide his learners through their careers. He also knew how to write and was a stern editor. Even as I wrote this remembrance, I could see how he might have critiqued it. I tried to do it on my own, and of course I failed. It will have to do.

Brief Remarks on CDC ACIP Vaccines Meeting This Week

My impressions of the first couple of days of the CDC ACIP meeting on vaccines will be brief. My wife and I were interested in learning more about the new Respiratory Syncytial Virus (RSV) vaccine. It sounds like the vaccine was upvoted with only a few no votes. Most committee members thought the vaccine was a good idea. It sounds like the decision to get the RSV vaccine should be in the context of a shared-decision making conversation with your doctor.

We didn’t get a chance to hear the presentation on the Polio vaccine. The slides were available and it looks like most people are vaccinated. The recommendation is that if you’re not already vaccinated or incompletely vaccinated, or you’re a health care worker likely to encounter patients with polio, a laboratory worker who might handle material with the polio virus in it, or traveling to regions where you might contract it, then the vaccine would be recommended.

Here is a link to the presentation slides.

Sena Gives Me a Haircut

Sena gave me a haircut the other day. She’s been cutting my hair almost 30 years. She bought a new barber cape recently which has snaps instead of Velcro to hold it around my neck. I still have Velcro tennis shoes, though.

The first time Sena cut my hair she left a bald patch on the back of my head. The only way I found out about it was when somebody noticed it in the psychiatry department administration office where I hung out when I was chief resident.

Since then, she’s done an excellent job of cutting my hair. And she does a great job cutting her own hair too.

After the haircut, I had to trim my beard again because I looked a little lopsided.

CDC ACIP Meeting Today on Vaccines

The ACIP meeting on several vaccines begins today and runs through Friday, 8:00 a.m-5:30 p.m. on the 21st-22nd and 8:00 a.m.-12:40 p.m. on the 23rd, ET.

The committee will discuss vaccines for Respiratory Syncytial Virus in adults, Polio, and Influenza vaccines on the 21st. There will be a vote for each.

They will discuss vaccines for Pneumococcal, Dengue, Chikungunya, Respiratory Syncytial Virus (pediatric and maternal) on the 22nd. They will vote on the pneumococcal vaccine.

They will discuss Mpox, Meningococcal, and Covid-19 vaccines on the 23rd.