I saw a news item headline which mentioned Covid-19 Variant. BA.2.86. The CDC website tracking respiratory variants has a definitive update as of November 27, 2023:
“What to know about BA.2.86
The virus that causes COVID-19 is constantly changing over time. Sometimes these changes allow new variants to spread more quickly or effectively. If that occurs, the new variant may become more common relative to other variants that are circulating.
Since CDC’s first post on BA.2.86 in August 2023, the proportion of infections caused by BA.2.86 has slowly increased. In the CDC Nowcast posted Nov. 27, 2023, BA.2.86 is projected to account for 5-15% of currently circulating variants.
CDC projects BA.2.86 and its offshoots like JN.1 will continue to increase as a proportion of SARS-CoV-2 genomic sequences.
At this time, BA.2.86 does not appear to be driving increases in infections or hospitalizations in the United States.
Updated COVID-19 vaccines are expected to increase protection against BA.2.86, as they do for other variants.
As mentioned in previous updates, COVID-19 tests and treatments are expected to be effective against this variant, including its offshoot JN.1.
It is not possible at this time to know whether BA.2.86 infection produces different symptoms from other variants. In general, symptoms of COVID-19 tend to be similar across variants. The types of symptoms and how severe they are usually depend more on a person’s immunity than which variant causes the infection.
Regardless of what variants happen, CDC will continue to track them, working closely with partners around the world to understand how they are spreading and how they respond to vaccines and treatments.”
I ran across this study showing Mindfulness Based Stress Reduction (MBSR) is “noninferior” to escitalopram in the treatment of adults with anxiety disorders.
I passed my Biostatistics course in medical school—barely. I have been practicing MBSR daily (for the most part) since 2014 when I really needed to address my struggle with burnout. I’m probably a worrier but I doubt I have a clinically significant anxiety disorder. I’m admittedly biased in favor of MBSR. Otherwise, I wouldn’t still be practicing it after about 10 years.
On the other hand, I don’t have a great handle on the statistical concept of noninferiority in clinical studies. I found a little YouTube presentation on it and I think I’m a little more comfortable with it now. I said “a little bit.” I’m not taking questions.
Reference:
Hoge EA, Bui E, Mete M, Dutton MA, Baker AW, Simon NM. Mindfulness-Based Stress Reduction vs Escitalopram for the Treatment of Adults With Anxiety Disorders: A Randomized Clinical Trial. JAMA Psychiatry. 2023;80(1):13–21. doi:10.1001/jamapsychiatry.2022.3679
In answer to the question in the title, I’ll confess right away I don’t know the answer. The impetus for my writing this post is the Medscape article about an 84-year-old physician who was forced to take a cognitive test required by her employer as a way of gauging her ability to continue working as a doctor. She’s suing her employer on the grounds that requiring the cognitive test violated the American with Disabilities Act (ADA), the Age Discrimination in Employment Act, and two other laws in her state.
I didn’t retire based on any cognitive test. I recall my blog post “Gauging My Readiness for Retirement,” which I posted in 2019 prior to my actual retirement. In it I say:
I spent 4 years in medical school, 4 years in residency, and have worked for more than 23 years as a psychiatrist, mostly as a general hospital consultant. Nothing used to jazz me as much as running around the hospital, seeing patients in nearly all specialties, evaluating and helping treat many fascinating neuropsychiatric syndromes, teaching medical students and residents, and I even wrote a book.
On the other hand, I don’t want to hang on too long. When people ask me why I’m retiring so early (“You’re so young!”), I just tell them most physicians retire at my age, around 65. I also say that I want to leave at the top of my game—and not nudged out because I’m faltering.
In it, I mention a blog post written by a physician blogger, Dr. James Allen. The title is “When Physicians Reach Their ‘Use By Date.’ At the time I didn’t make a link to his post because the web site was not listed as secure.
Since that time, the web site has become secure, and you can read the post here. Dr. Allen lists anecdotes about physicians who ran close to or past their “use by” date.
Dr. Allen’s point is that we often don’t realize when we are past our “use by” date. That applies to a lot of professions, not just medicine.
There’s been a shortage of psychiatrists for a long time and it’s not getting better, the last I heard. All in all, I’m OK with the timing of my retirement.
I note for the record that I have not seen any mention in the news that the Rolling Stones have ever been required to take a cognitive test to continue working. I also want to point out that they are around 80 years old and their 2024 tour is sponsored by the AARP, the organization formerly known as the American Association of Retired Persons. I heard that the Rolling Stones new song, “Angry” is up for a Grammy.
I doubt anyone is angry about the obvious fact they’re not even thinking about retiring.
We got our first snowfall that stuck around yesterday. We didn’t have to shovel because it melted off our sidewalk and driveway shortly past noon.
On the other hand, the snow drew the birds out for the berries in the trees. Cedar Waxwings and other small birds feasted in the early morning. Whether they got the winterberries low to the ground or the ones high up in the trees—they got them.
It snowed the better part of the morning. It caught some Iowa drivers off guard. There were pictures in the news of cars rolled over on their roofs in the ditches.
Remember that Beignet mix and rolling pin Sena got back in May? She got around to making them yesterday. The use by date was November 1, 1892! No, sorry, actually it was November 1, 2023.
The day started out pretty cold and it even snowed. Birds and squirrels acted like they never saw snow before.
Anyway, we also tried Kauai Coffee for the first time in our Keurig machine. The pods look really different, but they worked. The flavors are subtle but they go well with Beignets. We’re not sure why they looked more like fried green tomatoes when they were done.
Beignets are delicious. Have plenty of powdered sugar on hand!
We’re big on safety goggles whenever we juggle nowadays. The only problem is that they fit loosely around our ears. We’re always pushing them back up on our noses.
So, Sena got a couple of eyewear retainers for our safety goggles. They were only a dollar a piece. I was a doubtful at first that they’d work, mainly because they don’t fit snug on the back of the head. It turns out they work best by snugging up around your ears.
You have to push pretty hard to get them on the goggle frame. The stitching holds up well, though.
They’re called “floating” eyewear retainers, I think because they’re made of neoprene foam and will float on water—great for boaters and water sports.
They’ll probably mostly eliminate the chance of the goggles falling off our heads when we drop the balls—which is often.
I caught sight of some buck deer contending for some does out in the clearing behind our house. This is probably what you might call the rut for white tail deer. The bucks do a lot of jousting for access to the does. But clearly, the does decide.
We have never caught them mating on film. In fact, the does never display any interest in the bucks as they trot around and fight each other. The only way we know mating eventually happens is when the spotted, frail-looking fawns appear in the spring.
We have noticed that the AARP is sponsoring the Rolling Stones Hackney Diamonds Tour 2024. I don’t think it’s necessary to point out that, with all due respect, the Rolling Stones have long ago passed fossil status.
I guess that means it’s fitting that the AARP sponsor a rock music group the members of which are eligible to join the organization formerly known as Prince. Sorry, I meant to say formerly known as the American Association of Retired Persons.
Obviously, the Rolling Stones are not thinking about retirement. But unless they can come up with a plausible explanation for the name of the tour, Hackney Diamonds, they should probably not be eligible for the free tote bag the AARP offers to those who become members.
A hackney is a horse drawn carriage. A diamond is a precious stone. The Rolling Stones have thankfully clarified that, obviously, the Hackney Diamonds tour name comes from the well-known legend of the hackney cab driver who drove through the streets of a town called Hackney in London in the 17th century, tossing out diamonds to passersby if they could guess how many angels could dance on the head of a pin during a snowstorm in the Sahara Desert.
That’s about as clear as the explanation given by Keth Richards and Mick Jagger in an interview with Jimmy Fallon as reported in an article written by Tom Skinner in NME on September 7, 2023.
Anyway, the Rolling Stones have been a big deal for decades, of course and they get mentioned in a lot of different ways. For example, in the movie Men in Black 3, there’s a conversation between Agent J and young Agent K in a café which is prompted by the need to eat pie in order to clear their minds of the case they’re working on which is trying to stop the murderous bad guy, Boris the animal, from destroying Earth. Young Agent K stipulates the rule is to talk about anything about the case and to let the pie do its magic. You’ll never guess what they talk about but it goes like this:
“Young Agent K: You said we don’t talk, right? Go ahead, ask me any question. Anything you want, just as long as it doesn’t have to do with the case… just let her rip.
Agent J: What’s up with you and O?
Young Agent K: Me and O?
Agent J: Yeah, you and O.
Young Agent K: All right, all right… all right, this is it. A while back, I was assigned to keep tabs on a musician, Mick Jagger. He was in this British group, Rolling Stones…
Agent J: Rings a bell.
Young Agent K: We believed he’s on the planet to breed with Earth women, so I was in London and that’s when I met O. She’s smart, funny… great smile and we find ourselves in this pub, Whistler’s Bar, warm beer and the worst food you ever ate. We just played darts till the sun came up, neither of us wanted to leave…”
And I can remember that Microsoft used the Rolling Stones 1981 song, “Start Me Up” in their promotion of Windows 95 computer operating system. You remember that; it was a total loser which led to the evolutionary creation of a dozen operating systems, all of them laughably dysfunctional. I should know—I bought all of them.
So, the Rolling Stones turn up a lot in pop culture. Everybody knows that. That’s in part because of their stamina—and maybe doggedly persistent denial of aging leading to a refusal to ever retire, just drop on stage because their bones finally disintegrate.
So, returning to the question of why AARP (pronounced arf only with a p on the end) is sponsoring the Rolling Stones tour. I have no clear idea except that I think the organization wants to broaden appeal for the organization so that more dues paying young people join, adding money to help support those over 50 to maintain financial stability and security.
What I don’t understand is that, in part, this implies trying to work as advocates (read “lobby”) in Congress. All those old farts in Congress can do is argue and a some of them should seriously think about retiring. If they can’t command respect, they could at least get a free tote bag by joining AARP.
But the Rolling Stones don’t need free tote bags. They’ve earned their fossil status many times over. On the other hand, I have earned my certificate from the state legislature.
A couple of days ago we saw what I think is called a rafter of wild turkeys in our neighbor’s back yard. It’s fenced in and it looked like they were all toms. They acted like they couldn’t figure out how to get over the fence, even though they can fly.
There’s something ludicrous about a bunch of tom turkeys who are twitchy and apparently unable to just fly over the fence. This is despite the fact that I couldn’t see how the heck they got inside the fence in the first place—other than by flying over it. The gates are usually closed. On the other hand, there is a retaining wall on the other side of the yard that they could have just dropped down from.
Turkey see, turkey do.
I couldn’t see any hens; so maybe that means hens are smart enough not to get into situations like that.
A male and a female cardinal seemed to perch in a tree above the turkeys and maybe were trying to encourage them. A couple of toms who managed to fly out seemed also to be gobbling advice.
They started to get a clue about flying out after a while. Eventually they all flew out, but not before my camera’s battery power drained too low to capture the last escapees.
We like to watch the Weather Channel. One of the meteorologists is very conservative in his forecasts. He’s always hedging:
“And here we see a radar signal that might be indicative of a tornado, not saying it definitely is a tornado, just saying it might be, and over here in this county next to a major or minor highway are what appear to be remnants of an atmospheric river although that’s according to the GPS Model mind you, and you always have to remember the European Model might say something different about what might happen, not what’s going to happen mind you, just that it possibly could transform into a manifestation of the Norse god Thor who could have a huge hammer, although that’s from mythology so you can’t rely on that definitely and if you do, let me remind you that I have a lawyer who might just give you a telephone call if you happen to make the mistake of depending on a meteorologist to forecast anything exact and reliable for goodness sake, like the occurrence of a named storm in your vicinity which might be in the Midwest, or the eastern seaboard, you just can’t know with any degree of certainty now that climate change has us in its indefinable grip as we say, so you want to be prepared for whatever might occur, which could include skies that are clear to partly cloudy to filled with UFOs as far as the eye can see but take it from me you didn’t hear that from me.”
Go Retire Psychiatrist 