James Amos

Resident Physicians on Strike at Elmhurst Hospital in New York City

I read the news story about resident physicians at Elmhurst Hospital Center in New York City who went on strike this past Monday about low pay. The story doesn’t mention whether psychiatry residents joined the strike. The story did mention how difficult it was to work there during the Covid-19 pandemic in 2020.

I looked up the report from the consultation-liaison psychiatry department at Elmhurst during that time. Their report and many others were submitted to the Academy of Consultation-Liaison Psychiatry (ACLP).

The Elmhurst report was submitted April 1, 2020 by Dr. Shruti Tiwari, MD, Professor Consultation-Liaison, Icahn School of Medicine at Elmhurst Hospital Center, Queens, NY.

I read the report in order to figure out what I and my colleagues at University of Iowa Hospitals & Clinics needed to do in order to respond to psychiatry consultation requests in the setting of the Covid-19 pandemic. In general, we followed the Elmhurst suggestions.

I remember how difficult it was to operationalize the consultation protocol in light of the need to control spread of the Covid-19 infection. We worked with our IT department to use iPad devices with video hookups to evaluate patients in the emergency room. Early on, incredible as it may seem, there was limited supply of PPE for emergency room physicians.

We could do curbside consultations sometimes. Often, when I was on service, I found it difficult to use the iPad because of glitches in the device. In order to reduce the number of consultation team members huddling together, residents and I saw patients separately. Often, delirium with agitation demanded we evaluate the patient in person. There was an adequate supply of PPE with some limitations. Psychiatric consultants didn’t have access to N95 masks because of the shortage of them at the time. We wore surgical masks and face shields as well as gowns and gloves. We were not to see patients in the ICUs other than by video assisted means.

I couldn’t tell from the news story when the residents formed a union. One them was interviewed for the story and said that their immigrant status made working conditions more difficult as well as insufficient pay. The story also mentions that the last time doctors went on strike in Manhattan was in 1990.

It would have been difficult for physicians (including psychiatrists) to go on strike during the pandemic, probably impossible. I’ve written about physician strikes before and have given my opinion about that. I hope things work out for the Elmhurst resident physicians and the patients.

No Swimming Order at Terry Trueblood Recreation Area

A no swimming order has been issued as of yesterday for Sand Lake at Terry Trueblood Recreation Area, due to E. coli bacteria contamination. Updates are on Fridays of each week.

Terry Trueblood Birds Show Off in the Spring

Just about any time of year is a great opportunity to walk the Terry Trueblood Recreation Area. The birds are busy competing for mates and nesting spaces.

The nest boxes for the tree swallows are up. Already, vacancies are few. Their iridescent feathers are dazzling.

The music in the first part of the video is a piece called “There Are Chirping Birdies In My Soul” by Reed Mathis.

In the second part of the video, we let the birds themselves make the music. The birds don’t just show off; they sound off. All the birds are singing—except for the one killdeer for some reason. I managed to save a few clips of them singing their songs. They are in the last minute or so of the YouTube video. The first is the tree swallow. The next is the red-wing blackbird. Last is the song sparrow.

You’ll need to crank the volume to hear them. The tree swallows have a subtle trilling chirp. The male red-winged blackbirds have a distinctive call that probably sounds very familiar to most of us. We also saw and heard a song sparrow, a first for us.

Familiar Backyard Birds and One Sort of Familiar

We were bird watching the other day and saw a few birds we definitely recognized. One of them we puzzled about but finally decided was a sparrow.

The Red-Bellied Woodpecker is familiar. We think it was a male. The Blue Jay is still interesting because when it’s not in the sunlight it looks like what it really is—a blackbird. When we first saw it, the bird looked sort of grayish black. Finally, it turned just right and its feather bent the light into the familiar blue color. The Northern Cardinal is instantly recognizable, especially the male. They like to sit a long time, which is great for getting pictures.

The last bird looks like a sparrow but the tail seems longer and the bill is narrower. The breast is not streaked. It has head feathers which stick up. It resembles a female house sparrow, but it seems a bit larger than that. We looked around the web to try and identify the sparrow-like bird we saw.

We wonder if it might be a Cassin’s Sparrow. Although it would be out of its range since it’s found mostly in the southwest United States, Cassin’s Sparrow has been known to wander.

On the other hand, it’s not listed on the websites we saw featuring sparrow species seen in Iowa.

I think the reason it had a greenish breast was because it was reflecting the surrounding tree leaves. We’re calling it a Cassin’s Sparrow for now, but if you know better, shout it out.

Can anybody help us identify this mystery bird?

Claw Catch Circus Juggle

I found another juggling trick I might be able to handle. It’s the claw catch. I saw a number of YouTube demonstrations. As usual, I tend to confuse them.

I slapped the balls down instead of catching them. And I think I’m going to need safety goggles or just quit wearing my eyeglasses when I juggle. I miss a few throws and the ones I do get look pretty wild. That’s how I get my exercise.

The claw catch really does look better if you use both left- and right-hand throws. I hope my left shoulder holds up. Being ambidextrous will help me do continuous right and left claw catches—maybe.

Beard Kit Passes Muster and Makes Me Glow!

I tried the new beard kit stuff yesterday. I washed my beard with the beard wash and conditioner. Then I applied a little beard oil and beard balm. I combed it and brushed up with the boar bristle brush. Try saying “boar bristle brush” three times really fast right now!

I trimmed the flyaways with the very sharp scissors and—oops. I accidentally nipped my left earlobe off. It ricocheted off the mirror and splashed into the toilet. This was not a problem and from my internet research, I knew exactly what to do.

I quickly got a soup ladle and fished my earlobe out of the toilet bowl. Wrapping it in a wet washcloth, I then tossed it into a little watertight bag. Immediately, I put that into a sandwich bag with ice to preserve my earlobe. It would not have been a good idea to put it directly on ice. That would have worsened the damage. I knew better than to put it in milk, especially skim milk! That stuff doesn’t even taste like milk.

The emergency room doctor at first didn’t believe I accidentally snipped off my earlobe. He wanted to get a psychiatric consultation, but I assured him that I’m a retired consultation-liaison psychiatrist and I’m OK. I may have a screw loose but I would never cut off any of my own body parts. He reattached my earlobe and I’m as good as new.

I guess that means I’m officially anointed from a beard kit standpoint.

Sena says I glow now. Judge for yourself from the unretouched before and after photos.

The Beard Kit and the Promise of Beignets Arrive

Yesterday, the beard kit and other items were delivered. The other items were a barber cape and Café Du Monde Beignet Mix. I took a picture of all of them and can’t readily explain why the odd item out seems to be the Beignet Mix. Sena cuts my hair and the old cape just needs to be replaced.

We got the Café Du Monde mix and the rolling pin because Sena plans to make Beignets in the near future. We were in New Orleans while I was attending an Academy of Consultation-Liaison annual meeting in November 2015. We actually got Beignets while we there and we’re pretty sure it was at the Café Du Monde. It was sprinkling rain and a bit chilly that day, but the Beignets were delicious.

Maybe Sena plans to sprinkle powdered sugar in my beard after I get it rehabbed with the beard kit.

Anyway, the unboxed beard kit, which is made by a company called Viking, was very well packed and contained many tools and products. A couple of them are worth commenting about because they raised puzzling questions, at least for me. The beard wash and beard conditioner both contain cautions about using them if you’re pregnant, advising consultation with your physician. I’m sure about the wording because I had to use a magnifying glass to read the labels.

Initially I was not sure why women would use them at all. I searched the internet and it turns out that a woman can use beard oil (which also comes with my new kit) for the hair on her head, face, cuticles, and more. I guess when you think about it, beard wash and conditioner are not that different from products women use for their own hair. I’m still not sure why they should consult a physician before using them.

The kit came with beard balm. I gather from reading on the internet that it conditions and softens the beard. The beard brush is used after applying beard balm, to spread it out. It looks kind of like softened butter. Wild boar bristle brushes are frequently recommended for exfoliating skin and distributing the oils on skin. Brushing with it actually feels good. I’m not so sure about claims that it can promote more beard growth, but the bristles are stiff enough that I can spread the hair I do have over the potholes!

Sometimes badger bristles are used in brushes instead of wild boar hair but it’s far less common. I suggest avoiding this topic with anyone from Wisconsin, especially if he played football in college.

The kit also came with both a beard comb and a smaller mustache comb. Many advise using both but caution against using a brush on wet hair. The small pair of scissors is very sharp. My first use of it was to cut the foil seals glued very tightly to the bottles of beard wash and beard conditioner. They’re very good for snipping off the flyaways.

There’s a lot more to know about getting this beard thing right than I ever imagined. And Sena has a rolling pin and will make Beignets. We’ll pretend we’re in New Orleans. I’ll get powdered sugar in my beard and I won’t have to brush it out with a wild boar bristle brush because my beard is already white.

Thoughts on Gaming Disorder

I just read an interesting article in the latest print issue of Clinical Psychiatry News, Vol. 51, No. 5, May 2023: “Gaming Disorder: New insights into a growing problem.”

This is news to me. The Diagnostic and Statistical Manual lists it as an addiction associated with the internet primarily. It can cause social and occupational dysfunction, and was added to the DSM-5-TR in 2013 according to my search of the web. I’m not sure why I never heard of it. Or maybe I did and just failed to pay much attention to it.

There are studies about treatment of the disorder, although most of them are not founded in the concept of recovery. The research focus seems be on deficits. One commenter, David Greenfield, MD, founder and medical director of the Connecticut-based Center for Internet and Technology Addiction, said that thirty years ago, there was almost no research on the disorder. His remark about the lack of focus on recovery was simple but enlightening, “Recovery means meaningful life away from the screen.”

Amen to that.

That reminded me about the digital entertainment available thirty years ago. In 1993, the PC game Myst was released. Sena and I played it and were mesmerized by this simple, point and click adventure game with intricate puzzles.

Of course, that was prior to the gradual evolution of computer gaming into massive multiplayer online role-playing and first-person shooters and the like. It sounds like betting is a feature of some of these games, which tends to increase the addictive potential.

Sena plays an old time Scrabble game on her PC and other almost vintage age games. I have a cribbage game I could play on my PC, but I never do. I much prefer playing real cribbage with Sena on a board with pegs and a deck of cards. We also have a real Scrabble game and we enjoy it a lot. She wins most of the time.

This is in contrast to what I did many years ago. I had a PlayStation and spent a lot of time on it. But I lost interest in it after a while. I don’t play online games of any kind. I’m a little like Agent K on Men in Black II when Agent J was unsuccessfully trying to teach him how to navigate a space ship by using a thing which resembled a PlayStation controller:

Agent J: Didn’t your mother ever give you a Game Boy?

Agent K: WHAT is a Game Boy?

Nowadays, I get a big kick out of learning to juggle. You can’t do that on the web. I like to pick up the balls, clown around, and toss them high, which occasionally leads to knocking my eyeglasses off my head. I usually catch them.

Juggling is a lot more fun than playing Myst. I would prefer it to any massive multiplayer online game. I never had a Game Boy.

Off The Head Juggle Trick So Wrong but My Way

My take on the off the head juggle trick is that I have to do it wrong, otherwise I just drop all the balls. It was Juggle Man who said “Doing it wrong makes you an artist.”

I have to take my eyeglasses off for this trick. I knocked them off my head the other day and they don’t fit well enough to even stay on my head too well.

I think, with more practice, I can mix up the off the head variations to make it interesting, as long as you don’t look too closely.

I can always say I did it my way.

Addendum May 17, 2025: I just noticed that my video is third from the top on a google search of “off the head juggle”. Please ignore my “version” of the head stall juggle (off the head). It’s just wrong!

Sena Making Progress in Juggling

This is a progress report on Sena’s progress in juggling. She has been dedicated to practicing 2 or 3 minutes every other day. Frankly, she does more than that on some days.

She has been trying to move up to doing a 4-ball toss and catch. She thought she got it yesterday, and for a while so did I, even as I filmed it. The practice routine is to toss the balls 1-2-3-4 and catch. We thought she nailed it.

Then I looked at the video clips in slow motion. She wasn’t getting to 4 but she was getting to 3 more consistently. And part of what fooled us is that she’s now beginning to be ambidextrous. She can start the cascade from both her right and left side now!

Sena suggests I change the title of my YouTube section on juggling. As of yesterday, I changed it from Ugly Juggling to Ordinary Juggling. This distinguishes it from all the jugglers from whose videos I learn so much. They are extraordinary.