Month: August 2024

Casey’s Pizza Deja Vu

We had a deja vu thing with our final move out of the hotel and into our new house.

Just before we first moved into the hotel two months ago, it was really late at night and we stopped at Casey’s to get a pizza. We were exhausted.

Today, we finally moved out of the hotel and into our new house. It was late in the afternoon, and we had been flattening boxes and enduring other tortures of moving. We took the boxes to the recycling center (that will not be the last time by any means). And on our way back, can you guess what we did?

Yep. We stopped at Casey’s and got a pizza. Spooky. Have a great Labor Day weekend!

FDA Approves Updated Covid-19 Vaccines to Better Protect Against Currently Circulating Variants

On August 22, 2024, the FDA authorized new Covid-19 vaccines (2024-2025) “to include a monovalent (single) component that corresponds to the Omicron variant KP.2 strain of SARS-CoV-2. The mRNA COVID-19 vaccines have been updated with this formula to more closely target currently circulating variants and provide better protection against serious consequences of COVID-19, including hospitalization and death. Today’s actions relate to updated mRNA COVID-19 vaccines manufactured by ModernaTX Inc. and Pfizer Inc.”

Hit Them Back with Love

I didn’t get to listen to the Friday blues with Big Mo last Friday because my little Sony Dream Machine radio audio kept cutting out.

But on the Friday blues of August 9, 2024, I heard a tune I liked. It was “Hit ‘Em Back” by Kenny Wayne Shepherd and Shemekia Copeland.

Some blues songs can be gritty and dark, but the title “Hit ‘Em Back” isn’t what it makes you think. The song is really about turning the other cheek, emphasizing the growing importance of getting along with each other.

Getting along with each other is hard to do. I know to most old people (including me) that used to be a lot easier. Old people say that, like saying “What happened to the good old days?”

Well, when I reflect on the past just from my perspective, I have trouble remembering the so-called good old days. In general, we all struggle to get along with each other.

I think the song “Hit ‘Em Back” is a novel way of expressing how relationships between people and nations usually go, but also suggest we “hit” them with love. We mostly hit each other back-in a bad way. The lyrics send an apparently paradoxical message which gets your attention.

And then you get it. Let’s not hit each other. Let’s listen to each other instead.

Thoughts on the Homeless Mentally Ill

The homeless man who lives on the sidewalk outside our hotel reminds me of a couple of things. One is Dr. Gerard Clancy, MD who is University of Iowa Health Care Professor of Psychiatry, Professor of Emergency Medicine, and Senior Associate Dean of External Affairs.

I remember Gerry, who was in the department of psychiatry when I was a resident. I saw his picture in the newspaper and hearing about him riding a bicycle around Iowa City doing a sort of outreach to the homeless mentally ill.

I found an archived article mentioning him published in 1995 in the Daily Iowan. The story starts on the bottom of the front page, entitled “I.C. opens new doors for area’s mentally ill.” It continues on page 9A.

The story mentions Dr. Clancy and what was called then the Clinical Outreach Services and the Emergency Housing Program (EHP). The challenges then sound a lot like what they are now: long waiting lists for psychiatric evaluation and treatment, a lack of funding for the treatment of mental illness, and a lack of preventive care. The most common mental illnesses in the homeless mentally ill are chronic schizophrenia, schizoaffective disorder, and bipolar disorder. The idea of reaching out to them “on their own turf” as Clancy was quoted, was to help them feel more comfortable talking about their mental illness.

The housing situation for this population of those struggling with mental illness was dismal then and it’s still dismal.

The homeless guy I’ve been calling Bob lives on the sidewalk next to a busy street. It’s just my opinion that he’s mentally ill based on my observations of his behavior. I’ve never tried to talk to him. However, Bob gets visits from people who obviously have differing views about the way he lives.

Some of them do talk to him and, although I can’t hear their conversations, the actions tell me important things. Some bring him what I call “care packages,” often food, water, and other items. They may start by acting kind, although may get impatient with him. Others try to clean up his sidewalk, and may criticize him. The police occasionally visit and have so far not taken him into custody.

It looks like things have not changed much since 1995 regarding the homeless mentally ill based on what I write here about my observations. In fact, it’s easy to find current news stories that say things are getting worse.

At the beginning of this post, I said I found a couple of things. The other thing was a very thorough teaching presentation about the current state of formal outreach to this population. It’s available on the web as a power point presentation by another University of Iowa faculty, Dr. Victoria Tann, MD, entitled “Assertive Community Treatment 101.”

Dr. Tann is currently an IMPACT Team psychiatrist. It’s an excellent source of background on the history of this effort at outreach to the homeless mentally ill. It also summarizes what’s happening with the program now.

The Cat is a Witness?

I have watched the Men in Black movies dozens of times, and I still get a little puzzled at the scene in which Agent J ask the deputy medical examiner (Laurel) where the cat Orion is.  Orion is carrying a tiny galaxy on its collar. You’ll have to see the movie to get the context about it.

Agent J asks where Orion is but the way he asks about it is odd. He says he’s looking for the cat because it’s a witness in a murder case and he needs to ask it some questions. Laurel doesn’t bat an eyelash and just says the cat’s not around but wants Agent J to take her with him instead.

Ok, I realize there are a lot of weird things in the MIB movies including a giant, ill-tempered talking cockroach. Nonetheless, it still seems out of place (at least to me) that he tells Laurel he wants to talk to a cat. Laurel has seen the little galaxy hanging from the cat’s collar. That doesn’t mean the cat talks. In fact, all Orion ever says is “meow.”

Why doesn’t Laurel ask why Agent J wants to try to ask a cat questions? After all, Agent K has neuralyzed her a couple of times, so she doesn’t remember seeing or hearing anything weird. I’ve scanned the internet to see if anybody else wonders about it. It looks like I’m the odd man out. You really need to see the scene and the movie for context. I didn’t see any comments about questioning the cat in a YouTube clip below, but I might have missed it.

Alcohol is Bad for Old Guys

I took a quick peek at the study published recently in the Journal of the American Medical Association (JAMA) that a few news agencies are reporting on which says alcohol in moderation is bad for older persons. So much for moderation.

Actually, the full abstract is:

Ortolá R, Sotos-Prieto M, García-Esquinas E, Galán I, Rodríguez-Artalejo F. Alcohol Consumption Patterns and Mortality Among Older Adults With Health-Related or Socioeconomic Risk Factors. JAMA Netw Open. 2024;7(8):e2424495. doi:10.1001/jamanetworkopen.2024.24495

“Conclusions and Relevance: In this cohort study of older drinkers from the UK, even low-risk drinking was associated with higher mortality among older adults with health-related or socioeconomic risk factors. The attenuation of mortality observed for wine preference and drinking only during meals requires further investigation, as it may mostly reflect the effect of healthier lifestyles, slower alcohol absorption, or nonalcoholic components of beverages.”

Conclusions: “This cohort study among older drinkers from the UK did not find evidence of a beneficial association between low-risk alcohol consumption and mortality; however, we observed a detrimental association of even low-risk drinking in individuals with socioeconomic or health-related risk factors, especially for cancer deaths. The attenuation of the excess mortality associated with alcohol among individuals who preferred to drink wine or drink only during meals requires further investigation to elucidate the factors that may explain it. Finally, these results have important public health implications because they identify inequalities in the detrimental health outcomes associated with alcohol that should be addressed to reduce the high burden of disease of alcohol use.”

The news stories play a little fast and loose with the headlines, which tend to gloss over the effect of health-related and socioeconomic risk factors. But, there’s no doubt in my mind that most people could do without alcohol.

Personally, I would have a couple of 12-ounce bottles of beers while watching football games or listening to the Big Mo Blues Show on KCCK Blues and Jazz Radio station on Friday nights. I hardly drank at all in terms of the grams per day metric.

But I’ve not imbibed since we got so busy selling our old house and camping out in a hotel while waiting for our new house to be built. Not surprisingly, I don’t miss it. When I was a young guy, I drank more and even smoked cigarettes. That was a long time ago.

In fact, when I look back on those days, I remember the factors that tended to limit my use of those substances. Take cigarettes—to the landfill if you don’t mind. I was what you would call a “sometimey smoker” because after a few days I suffered a sore throat, blunted taste for food, stuffy nose, lower appetite (bad for a baseline skinny guy) and fatigue. I just couldn’t stick with smoking long enough to make it a habit.

I’m going to pick on wine a little because the article alludes to the idea that it might have some health benefit. When I was a kid, I once had a lot too much wine which led to a longstanding inability to even stand the smell of it for years. I still never drink wine.

There are many things that can be habit forming. I’m beginning to wonder if watching Men in Black movies might be one of my weaknesses. I don’t watch any other movies as often as I do the MIB trilogy films. I’ve watched them dozens of times and I don’t have a good explanation for it. I think they’re funny and I can always use a good laugh.

Agent K: After neuralyzing Officer James Edwards, he and Agent K are finishing a meal in a café while K is delivering the punchline to a joke, “Honey, this one’s eating my popcorn! Get it?” Agent K laughs uproariously.

Officer James Edwards: Looking dazed from the recent neuralyzer blast, asks “Who are you?”

Agent K: “You see, James, you are a nice young man, but you—need to lay off the sauce.”

The quote is probably not word for word. I didn’t look it up on the web. It’s just as I remember from seeing the movie so often. And that’s partly because, for the most part, I lay off the sauce.