I'm a retired consult-liaison psychiatrist. I navigated the path in a phased retirement program through the hospital where I was employed. I was fully retired as of June 30, 2020. This blog chronicles my journey.
I read a short article, “The case for pursuing a consultation-liaison psychiatry fellowship” by Samuel P. Greenstein, MD in Current Psychiatry (Vol. 1, No. 5, May 2022). After 3 years as an attending, he found his calling as a C-L psychiatrist, especially after getting teaching awards from trainees. But when he applied to academic institutions for position as a C-L academic psychiatrist, people kept advising him to complete a fellowship training program in the subspecialty first. He gave it careful thought and did so, even he called it going “backwards” in his career.
On the other hand, he believes C-L fellowships will help meet the challenges of addressing rising health care costs and improving access to what most people see as the critically important goal of providing access to integrated mental health and medical care.
I’ve been retired from consultation-liaison psychiatry for two years now. I get an enormous sense of achievement on the rare occasions when I hear from former trainees who say things like “For me you were…one of the most outstanding attendings I had at my time at Iowa.” And “I can at least take comfort that University of Iowa is still at the forefront of psychiatry.”
Several years ago, one of the residents suggested starting a Psychosomatic Medicine Interest Group (PMIG). This was before the name of the subspecialty was formally changed to Consultation-Liaison Psychiatry in 2018. I know many of us were very pleased about that.
I sent a short survey (see the gallery below the slide show) to the faculty and residents in an effort gauge support for the idea and readiness to participate. I used a paper published at the time to guide the effort, (Puri NV, Azzam P, Gopalan P. Introducing a psychosomatic medicine interest group for psychiatry residents. Psychosomatics. 2015 May-Jun;56(3):268-73. doi: 10.1016/j.psym.2013.08.010. Epub 2013 Dec 18. PMID: 25886971.).
You’ll notice on slide 4 one faculty member’s comment, “I think it doesn’t matter whether faculty are certified in PM.” As Dr. Greenstein discovered, it probably does matter, at least if you want to be board certified.
I was initially certified by the American Board of Psychiatry & Neurology (ABPN), but I objected to the whole Maintenance of Certification (MOC) program, as did many other psychiatrists. I eventually declined to continue participating in the MOC process. However, I notice that the Delirium Clinical Module that I and a resident put together is still accessible on the ABPN website.
Although response numbers were low, there was clearly an interest in starting the interest group. There was also an incentive to reapply to the ACGME for approval of a Psychosomatic Medicine (Consultation-Liaison Psychiatry now) fellowship.
My attempt years earlier had been frustrating. While it was approved, I couldn’t attract any fellows, forcing me to withdraw it without prejudice (meaning another application for approval could be attempted). Fortunately, that situation changed later. The Psychiatry Department at The University of Iowa now has an early career C-L psychiatrist who graduated from the reinstated C-L fellowship.
As the saying goes, “What goes around comes around.” Although the origin of that saying might have originated in the 1970s, at least one person thought his grandmother had her own version in the 1950s: “You get what you give.”
I have a couple of questions about the total lunar eclipse that’s occurring tonight. First, where’s the best place to observe it? If you consult the best advice on how to watch it, you learn that the first phase (which in Iowa City, Iowa happens at 8:32 PM) is visible in the Southeastern part of the sky and at 3.4 degrees altitude.
Great, it sounds like I need to be where there are no trees or buildings and lying on my belly. The next phase is at 9:27 PM, which is not much better because the altitude is only 11.4 degrees, at 129 degrees azimuth. I’m still learning this jargon, but again, do I need to be able to fly above the tree line to see the first couple of phases?
Should we climb up on our roof to see the lunar eclipse?
Any suggestions are welcome. The next question involves the well-known strangeness that happens during eclipses. Insects and other animals can get goofy about their diurnal cycles and, oh yeah, aliens get really gassy and develop uncontrolled farting.
The Alien Flatulence Syndrome (AFS) is well-described in the scientific literature. No, I’m not going to have a list of references at the end of this post, and it’s for the same reason Beetlejuice won’t tell Lydia his name:
“Because if I tell you, you’ll tell your friends, your friends are callin’ me on the horn all the time, I gotta show up at shopping centers for openings and sign autographs and shit like that and it makes my life a *hell*. Okay? A living hell.”
You can ask anyone on the Ancient Aliens crew for all the evidence you want that Blood Moons cause aliens to fart, then the bowel gas eruptions levitate them to the Blood Moon—where they open used flying saucer dealerships. And that’s the reason why you see so many UFOs.
Which leads us to the explanation for aliens shape-shifting into humans in order to live among us, and do things like play baseball like Exley in the historically accurate X-Files documentary “The Unnatural.” The real reason is they want to be able to buy Beano without being mobbed and forced to show up at shopping centers for openings, sign autographs and so on. Aliens hate lunar eclipses.
I may have to update this post as the lunar eclipse drama approaches tonight—if I can stay awake. This thing gets pretty close to our bedtime.
Just to update us on the total lunar eclipse Blood Mood tonight, we can see the livestream on timeanddate if we’re yawning around the time it starts. Or you can wait for my snapshots, similar in quality to my previous shots of the Worm Moon and Snow Mood in 2021 (I’m just kidding, don’t do it!):
I got a nice surprise recently after my one-month follow-up postop clinic visit following my retinal detachment surgery. The scheduling desk clerk gave me a pair of post-dilation sunglasses. That was the first time in years that I’ve been offered them after getting mydriatic drops for eye clinic exams.
The last time I got mydriatic drops, I didn’t get a pair of post-dilation sunglasses and I had to drive myself home. It was pretty uncomfortable and I almost stopped along the way to just park somewhere. I was really light sensitive and I don’t have a regular pair of sunglasses. My eyes were tearing and I had a strong urge to squint so tight, I’d have been driving blind.
That experience was the inspiration for my blog post “Mydriatic Madness” on March 16, 2022.
The eye clinics I’ve been to in past years always used to hand out post-dilation glasses after eye exams in which pupillary dilation was done. It was automatic.
However, in recent years it seems this practice has been abandoned—until just a couple of days ago. The scheduling clerk offered me a pair, for which I was grateful.
Ironically this was after she gave me a form to evaluate whether any of the nurses and doctors had washed their hands before examining me. For the life of me I couldn’t recall if any of them had! I felt embarrassed for them because the rating form was a yes/no format. Essentially, I had to say “no” across the board.
And yet the pair of dilation glasses was the first such courtesy I’ve encountered in years after an eye examination. It’s really more than a courtesy. It could be a safety issue if you’re driving after the exam. And it was the scheduling clerk’s responsibility, evidently. The glasses are kept in a little slot and if you’re not standing in just the right place, you wouldn’t even see them.
I’m not sure if the scheduling clerk ought to be the one offering the glasses. Wouldn’t it be more appropriate for a health care professional to do that? I guess I’m quibbling in a situation where nobody offers them.
Maybe the patients should learn to just ask for post-dilation glasses. They’re even a little stylish. Mine look like what you can buy on Amazon (Scheaffer-Vicron Slip-in) for about $16 for a pack of 25. That’s about 64 cents each so it’s not breaking any eye clinic budget to offer them for free.
And hand-washing should be automatic—or at least noticing when it’s done in front of you.
I remember talking about wanting to hear Big Mo spin the song “Space Captain” back on April 29th on KCCK 88.3 , ‘da Friday Blues. I got it tonight. It included Herbie Hancock and the Tedeschi Trucks Band.
Okay, so I’m nobody’s personal trainer, but I have an update on my exercise routine, which I’m doing daily for the most part. I spend about a half hour on the “workout” which starts with a floor yoga warm up. I get on the exercise bike for 5 minutes. Then I do 3 sets of body weight squats, dumbbells, and planks. I finish off with another 5 minutes on the bike.
Obviously, my goal is not to be ripped. I just want to keep my bowels moving, to sleep OK, and stay reasonably fit for a geezer. I also do daily mindfulness meditation.
I still have a lot of work to do on being more well-rounded. And I mean a lot.
This is just a reminiscence. I know the word “wherefores” in the title is old-fashioned, but I’m an old guy and so what? When I was a young guy living in Mason City, Iowa where I grew up, I could not afford to rent an apartment. Shortly after I became an emancipated minor, I was lucky to be able to rent a dormitory room at the YMCA at 15 North Pennsylvania Avenue. The building was placed on the National Register of Historic Places in 2002.
Reference: M, Ben and Clio Admin. “Mason City YMCA (1926-200).” Clio: Your Guide to History. September 30, 2021. Accessed May 10, 2022. https://theclio.com/entry/140366
I guess that makes me sort of historic too. It was built in 1926. I think it rents out apartments now. I recently read a Globe Gazette article about the beginnings of the YWCA on 2 South Adams and it was built in 1918. The current Mason City Family YMCA is located on 1840 S Monroe Avenue.
There is a local legend that bank robber John Dillinger and his gang stayed at the YMCA while planning their robbery of the First National Bank in 1934. Track star Jesse Owens stayed there briefly in 1937, starring for a basketball exhibition.
I recently read a Globe Gazette article on the web about the beginnings of the YWCA on 2 South Adams. As I said, it was built in 1918, but I don’t know when it closed. The YWCA sat empty for years until a couple of artists got a loan from a local realtor. They’re renovating it. (Zachary DuPont. “Old YWCA building takes strides toward renovation,” Globe Gazette on line, 10/29, 2021, updated 1/18/2022).
They plan to build artist studios on the 2nd floor, performance space where a basketball court is presently, a community area and art gallery on the first floor, and make single apartment/dormitory rooms cheaper than regular apartments (maybe similar to what the YMCA had many years ago, up to 12 units on 3rd floor). My wife, Sena, stayed there briefly and that was very helpful.
The YWCA is not on the National Register of Historic Places. It’s not clear why. The artists have raised some money with a GoFundMe campaign toward the renovation project. The website is titled “Save the Historic Mason City YWCA.” So why is it not on the National Register of Historic Places?
Anyway, I moved into a very cramped room at the YMCA on either the 3rd floor in my teens. I was working as a draftsman and surveyor’s assistant for WHKS & Co., a consulting engineering company. It was mainly a place to sleep. Most of the time I was traveling, working on out-of-town jobs such as relocating Highway 13 between Elkader and Strawberry Point (really more like straightening out all the curves in it), land surveys and the like.
Portrait of the legacy blogger as a young man
I also have a distant memory of learning how to swim at the YMCA when I was a kid. I was terrified of even putting my face in the water and used to get fierce headaches just getting into the pool. I’m not sure how I got over it, but I did.
There were a fair number of eccentric characters who lived at the YMCA back in my day. I didn’t consider myself one of them and that’s probably why I didn’t end up staying there for decades. I could have worked in Mason City for the rest of my life, having breakfast at the café in the old Brick and Tile Building on East State Street, and eating all of my other meals in restaurants along Federal Avenue until I was too old to do much more than sit in Central Park.
But I didn’t. I’ll get to that.
There were a number of guys who stayed long term at the YMCA. It was kind of uncomfortable for that. There was only one communal bathroom and shower. There were no kitchens. There was barely enough room for a bed, a kneehole desk and chair, and you had to listen to the cast iron heater radiator clank most of the night. They were just sleeping rooms, but it was a little too loud to sleep sometimes because of the banging noise from the radiators.
I found out one of my neighbors was building a motorcycle in his room. He was very proud of it. It was a large machine and took up a lot of space. He kept it very clean. The Director of the YMCA at the time was John Calhoun and he’d been involved with the YMCA since 1943. He had a reputation for being pretty strict about the rules, which likely included one prohibiting the building of motorcycles in your dormitory room. We kept the motorcycle a secret of course.
There were some guys whose wives kicked them out of the house. They were always going out for coffee. They could drink a lot of coffee, smoke a prodigious number of cigarettes, and talk non-stop about how bad things were in the world in general.
There was an old candy bar vending machine on the floor. I got what must have been an ancient Butterfinger. I bit into it and found what I thought was half a worm wriggling around. Finding a worm was bad enough, but half a worm alarmed me. Where was the other half?
I even telephoned the local hospital emergency room to ask if I were in danger of some kind of poisoning. There was only a pay phone available at the YMCA, even for the guys who lived there. The ER doc couldn’t stop laughing long enough to say more than I’d most likely be just fine. “Fine,” he said. I haven’t eaten a Butterfinger since.
I met one guy who kept saying basically one thing over and over: “So my ancestors came over on the Mayflower. All well and good…” Then he would sort of trail off. His expression didn’t change at all. In fact, he looked flat most of the time. I didn’t know it at the time, but he probably had a chronic, severe mental illness.
I don’t remember who told me that the athletic director was gay. I don’t know if he was or not, and it didn’t matter. He treated everybody with kindness and respect and we treated him likewise. I remember he gave me sound advice about the safest length of time to spend in the steam room after I almost blacked out after sitting in there way too long.
I learned the dollar bill jump trick from an older guy in the weight room. He didn’t call it that, but it was a similar challenge. The idea is to bet you that you can’t bend over or squat, grab just your toes and jump over a broomstick—without letting go of your toes. I think he actually showed it to me and another youngster. We tried over and over. All we did was fall and laugh. It’s a good thing he didn’t make us bet.
There wasn’t much to do around there except play pool. There was this underfed-looking guy who used to play a deadly game of call shot eight ball. He amazed me because he worse eyeglasses that were as thick as pop bottle bottoms. I didn’t understand how he could even see his own hands. He won every game.
I know it sounds a little dull, living at the YMCA. On the other hand, I’d have probably been in a tight spot if the YMCA had not been there when I was young.
I read a Wikipedia article about the song in the late 1970s, “Y.M.C.A.” by the Village People. The author noted that in the early days of the YMCA, the single room occupancy dormitory rooms were for guys who moved to the city from rural areas to find work. Later, YMCA tenants tended to be youth “…facing life issues” or the homeless.
And I met Sena there. She switched jobs from working across the street at a school administration building to work at the YMCA.
I never hung out at the front desk as much as I did after she showed up. I pretended to read the newspaper a lot. She probably wondered why I was always there. We played bumper pool. I don’t remember who won the games, but I had trouble concentrating on my shots.
She does everything. There must be a God because she is God’s gift to me. I guess after all, I did just fine after eating half a worm.
We’re filling a bag to help families in the program affiliated with the National Association of Letter Carriers (NALC). Letter carriers in Iowa City will be picking up bags of non-perishable food items placed beside mailboxes on the second Saturday in May, which is on May 14, 2022 this month. Edward James Olmos is the food drive’s celebrity spokesperson, which gives the title of the movie he played a role in, “Stand and Deliver,” a special meaning in this context.
We’ve never seen a total lunar eclipse, but it’ll happen May 15-16, 2022. It happens over several hours. For us in Iowa City, Iowa it starts at around 8:30 PM on May 15, 2022 and ends at around 2:00 AM on May 16, 2022.
You don’t need any special eclipse glasses and you can see it with your bare-naked eyes. A lunar eclipse occurs when the Earth passes between the Sun and Moon and lines up precisely so that it blocks the Sun’s light, which otherwise reflects off the Moon. Find more at the Farmer’s Almanac.
There’s a web site to find out when you can see it where you live.
I’m not a fan of country music, generally. I usually listen to the Big Mo (AKA John Heim) blues show on KCCK 88.3 on Friday nights. I also listen to the Music Choice channel on TV, either Easy Listening or Light Classical.
However, a few nights ago I heard the song “Grandpa, Tell Me ‘bout the Good Old Days” on Easy Listening. It was a haunting instrumental that I can be a sucker for sometimes. I noticed the rhythms that alerted me to its country genre, though.
On the other hand, the melody had that quality which makes me want hear nothing else for a while. An artist named Danielle Nicole sang “Bobby” on a Friday night blues in the second week of February, which did that for me.
How I feel about this kind of music reminds me of the Greek myth of Odysseus, who on his long journey back to Ithaca following the Trojan war, he and his crew of sailors encountered the island of the Sirens. Their voices made anyone who heard them forget everything but their haunting voices. The sailors wasted away, leaving hills of their skeletons. The only way to pass the Sirens safely was to stop the ears of the crew with wax. But Odysseus wanted to hear the song and made his men lash him to the mast so that he could not join those who gave up their lives to hear the music. He ached for knowledge in the lyrics even more than the melody of the songs the Sirens sang, and for the deepening of the spirit which absorbed the souls of those who heard the hypnotizing cadences. Just hearing the melody could extinguish the will to live.
The good old days melody didn’t extinguish my will to live, of course. But it was easy to get caught up in it and I noticed how deeply I reminisced. I looked up the lyrics and, at first, thought they were just quaint. Then they began to sound ironic to me.
The song (and I mean mainly the melody although the irony of the lyrics was part of the spell) seemed to raise the image of a bubble, which I know sounds strange. I remember blowing soap bubbles when I was a kid. They are delicate, bright, beautiful, but fragile—just like those so-called memories of what some older people call the good old days. You don’t even want to breathe too hard on them, which would hurt the spell, the illusion that there are such things as shiny, clear, light as air memories of a past without sorrows that float forever.
Of course, the bubbles burst as I got older. Innocence doesn’t last long in the world. It seems like every generation has to learn this all over again. The joys are replaced by broken promises, sorrows, and regrets.
Eventually, a golden haze settles over the anger, shame and guilt, softening the broken edges of the world which cut our souls. And the golden stories of the good old days that never happened save us for a little while every now and then—as long as there are those willing to sing them. Because we can almost always find the bubbles when we need them. Be careful not to listen to the Sirens too long. And if you do, be careful not to breathe too hard on the beautiful and fragile bubbles.
How much better would it be if we make the good times happen here and now?
Well, Sena ordered a new Sharp calculator and we just got it. It’s a Sharp EL-M335. It has a bigger, easier to see display and larger keys than the vintage Sharp ELSI MATE EL-505. We stuck with the Sharp brand because it’s durable and reliable.
I’ve mentioned the old Sharp EL-505 in previous posts, mainly to highlight the idea that vintage doesn’t necessarily mean useless. It served well for over 30 years believe it or not, and we didn’t change the two double AA batteries for more than a decade. You can call me a liar or demented, but it’s the truth.
I’ll probably use the new one to do things like total up our Scrabble game scores to find out how badly I lose each time we play and to spell words on it. It’ll be used for other tasks.
And an added plus—the words I spell on the new calculator are larger and easier to read than on the old one.
I remember buying the old one shortly before we moved to Ames, Iowa so I could start college at Iowa State University. I got the Sharp ELSI MATE EL-505 because it had special scientific functions on it because I was planning to study engineering.
I quickly found out I didn’t have the head for the mathematics necessary to get through an engineering program. So, I ended up using it for things like—scoring Scrabble games and spelling words.
The Sharp EL-M335 actually uses a solar cell and a backup Alkaline manganese battery. I wouldn’t have been able to tell you that unless I used a magnifying glass to see the operation manual’s tiny print. It’s a good thing the display uses bigger characters.
However, replacing the battery in the new calculator will require using a very tiny screwdriver to remove 6 very tiny screws. It’s a good thing we have a very tiny Kobalt screwdriver set with Phillips and flat head bits that you can store in the handle.
So, there you have it. We have a brand new, modern Sharp calculator. And it looks sharp. But we don’t plan to throw away our vintage calculator. It’s been good to us.
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