Author: James Amos

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.

Wings in the Garden

We’ve got more videos of birds and a butterfly (which I think is a swallowtail) in our garden. The catbirds and oddly, song sparrows (I thought they were rare in our part of the country?) are turning out to be regular visitors. They like the mulberries and spend a lot of time preening. They visit every day and they’re always a welcome sight.

The Lesser-Known Quote by Wonko the Sane

A couple of days ago, Sena and I were playing cribbage and she thought she had a higher scoring hand than she actually did. She immediately realized it and scored it right. She commented that, at first, she thought she saw something she didn’t actually see. I quipped that “First you have to see it.” She thought that was pretty funny.

I actually said that because I remembered a quote from Wonko the Sane in Douglas Adam’s book “So Long and Thanks for All the Fish.” Wonko is a guy who lives “outside the asylum” because he saw the instructions on a box of toothpicks and thought it was so bizarre that he didn’t want to live in a society which needed that kind of instruction.

Now, you can find a lot of references on the web for the quote that arises from the toothpick instruction:

“It seemed to me, said Wonko the Sane, that any civilization that so far lost its head as to need to include a detailed set of instructions for use in a package of toothpicks, was no longer a civilization in which I could live and stay sane.” Douglas Adams, So Long, and Thanks for All the Fish.

You can even buy tee shirts printed with this quote. But that’s not the Wonko the Sane quote I was thinking of. In fact, I’m not the only one who thought of it and the first person I want to give credit to for calling attention to it is a WordPress blogger whose name seems not discoverable on his blog, but instead has the title Eppur Si Muove. It’s Latin and it means “…and yet it does move.” It’s attributed to Galileo who muttered it after being forced to recant his claim that the earth moves around the sun.

The quote is:

But the reason I call myself by my childhood name is to remind myself that a scientist must also be absolutely like a child. If he sees a thing, he must say that he sees it, whether it was what he thought he was going to see or not. See first, think later, then test. But always see first. Otherwise you will only see what you were expecting. Most scientists forget that…. So the other reason why I call myself Wonko the Sane is so that people will think that I am a fool. That allows me to say what I see when I see it. You can’t possibly be a scientist if you mind people thinking that you’re a fool. ~ Wonko the Sane, from So Long, and Thanks for All the Fish by Douglas Adams.

The blogger who wrote the post entitled it “Wonko the Sane—On Being a Scientist…”

Seeing what’s really there is very difficult to do. I’m fettered by expectations, desires, prior misinformation, and so on. Often, I see what I want to see rather than what’s there.

The toothpick quote gets more interpretations often by writers who sound like they trying to prove something. What’s even more interesting than them (and funnier) are the great number of actual instructions on how to use toothpicks, even how to do tricks with them.

What seems impossible to find are actual instructions for how to see.

New Mayos and New Braunschweiger Not Cutting the Mustard

Sena bought a new brand of Braunschweiger and a new mayo and we tried them yesterday. The new mayo was Blue Plate Mayo. Frick’s Braunschweiger was the new lunchmeat.

So far, we’ve tried Field’s, Jones Dairy Farm, and Frick’s Braunschweiger. We’ve sampled Kewpie’s, Duke’s, and Blue Plate mayo.

We both thought Blue Plate Mayo was not better than Miracle Whip and the Frick’s Braunschweiger was OK but a little short of earthshaking. Frick’s is a family business in Missouri, and their website looks similar to Jones Dairy Farm (which also makes Braunschweiger). They’re both solid family businesses.

Blue Plate Mayo (“born in New Orleans”) has been around since 1927 and make a decent mayo. We just like Miracle Whip better.

In fact, of all the mayos we’ve tried, we both like Miracle Whip the best although Sena, most of the time prefers Hellmann’s Mayo. But that’s just her.

UI Hospitals & Clinics Gets U.S. News & World Report Recognition

This is just a shout-out to The University of Iowa Hospitals & Clinics for once again being recognized as one of the top hospitals in the nation by U.S. News & World Report.

The Ophthalmology and Visual Sciences Department ranked 6th in the nation.

Doctors Still Oppose Board Mandated Maintenance of Certification Programs

I got a pang of anti-nostalgia after reading the latest article calling for abolition of Maintenance of Certification (MOC), posted by Medscape on August 1, 2023. There is a petition by oncologists to end MOC. So, what else is new? So far it has almost 10,000 signatures.

I remember my own petition in 2014 to end the American Board of Medical Specialists (ABMS) attempt to establish Maintenance of Licensure (MOL), a kissing cousin of MOC, which would have blocked physicians from getting a state medical license if they didn’t comply with MOC requirements. It was supported by both the Iowa Psychiatric Society and the Iowa Medical Society. It got a lot of signatures and many comments in support of opposing both MOC and MOL. The glaringly obvious motive by member boards to require MOC is money and always has been, in my opinion.

I’m baffled at why this debate still rages on. It looks like almost no progress has been made in the last decade, apparently because the American Board of Internal Medicine (ABIM) and other boards ignore the clear messages from rank-and-file doctors about how MOC actually interferes with efforts to pursue practical continuing medical education.

I have always been a staunch supporter of physician-led continuing medical education. At the hospital where I worked as a consultation-liaison psychiatrist, the consult service ran the Clinical Problems in Consultation Psychiatry (CPCP). It was a weekly case-based conference, which I have written about in a 2019 post.

Ironically, the Performance in Practice (PIP) delirium clinical assessment tool module that I and one of the residents created is still offered for credit on the American Board of Psychiatry & Neurology continuing education web site. I think it demonstrates the ability of individual doctors to establish practical methods for developing their own continuing education programs.

Tickle Tickle Tickle!

I saw an interesting article about how lab rats react to researchers tickling them. I had no idea rats had a funny bone. They’ll even chase your hand to get tickled. When they’re tickled, they make laughing noises that are just under the threshold of human hearing, but the sounds can be heard when converted to our range of hearing. They like to be tickled on their bellies or backs.

What scientists have found is that an area in the brain called the periaqueductal gray (as medical students we had to learn about this area to pass anatomy class) that is associated with tickling and laughter. The upshot is that play is important for growing brains.

Many of us remember being tickled as children. We could get hysterical even if someone just approached us with hands outstretched, saying “kootchy kootchy koo.”

Something happens when we grow up and we lose that ticklish sensitivity. And you can’t tickle yourself to get that sensation.

Tickling sensitivity may go away, but a sense of humor usually doesn’t, at least for most of us. I can’t count the number of times Sena has caught me sort of stifling a chuckle over some funny thought that happens to cross my mind. I’m sure I look half-crazy. Sometimes I think I should come up with a semi-plausible explanation for this behavior (“Oh, I’m just being tickled by invisible extraterrestrials!”).

Scientists are still working on finding out why we’re ticklish. I don’t know exactly why we lose ticklishness as we grow up. But I don’t think building a tickling robot would fix it. It might be difficult to calibrate its finger strength, resulting in broken ribs and punctured lungs—at first. But those aren’t problems, just details to be worked out.

Tough TV Choices

I have a couple of choices for TV shows tonight. I could watch an X-Files rerun on the Comet network or the “season finale” of The Secret of Skinwalker Ranch.

Sena and I have been watching the X-Files reruns the last few nights. We didn’t know it was on until Sena happened to catch a couple of episodes. It comes on weeknights between 8-11 pm. They’re the early ones, which were pretty good.

We used to watch X-Files and munch popcorn a long time ago when the show was new. It was good entertainment.

On the other hand, it’s hard to know what to call The Secret of Skinwalker Ranch. Is it entertainment or investigative reporting? I don’t know how you can say it’s investigative in nature when mostly what you see are guys firing off dozens of hobby rockets to annoy the interdimensional entities who then lob UFOs back at them.

Calling a show a “season finale” doesn’t make me think about scientific TV programs.

I’m betting the skinwalker season finale will be an extravaganza of hobby rockets and dozens of Sasquatches flinging their hairy legs in the air in unison Rockette-style while munching on beef jerky.

I can’t afford to miss that. Sena will watch the X-Files on the TV downstairs.

The Empire Fires Back

I saw this reply tweet posted to the web. It was the reply of Sean Kirkpatrick, PhD, the director of the All-Domain Anomaly Resolution Office (AARO) in reply to the testimony of the witnesses at the House Committee’s UAP hearing on July 27, 2023. I’m not sure we’ll hear much more about it.

We Are All Still Learning to Play Pong

I noticed an article the other day about Monash University in Australia getting funding for further research into growing brain cells onto silicon chips and teaching them how to play cribbage.

Just kidding, the research is for teaching the modified brain cells tasks. They succeeded in teaching them goal-directed tasks like how to play the tennis-like game Pong last year. You remember Pong from the 1970s? Shame on you if you don’t. On the other hand, that means you probably didn’t frequent any beer taverns in your hometown while you were growing up—or that you’re just too young to remember.

The new research program is called Cortical Labs and has hundreds of thousands of dollars in funding. The head of the program, Dr. Razi, says it combines Artificial Intelligence (AI) and synthetic biology to make programmable biological computing platforms which will take over the world and bring back Pong!

It’s an ambitious project. The motto of Monash University is Ancora Imparo, which is Italian for “I am still learning.” It links humility and perseverance.

There’s a lot of suspicion out there about AI and projects like the Pong initiative in Australia. It could eventually grow into a vast industry run by robots who will run on a simple fuel called vegemite.

Shame on you if you don’t know what vegemite is!

Anyway, it reminds me that I recently finished reading Isaac Asimov’s book of science fiction short stories, “I, Robot.”

The last two stories in the book are intriguing. Both “Evidence” and “The Evitable Conflict” are generally about the conflict between humans and AI, which is a big controversy currently.

The robopsychologist, Dr. Susan Calvin, is very much on the side of AI (I’m going to use the term synonymously with robot) and thinks a robot politician would be preferable to a human one because of the requirement for the AI to adhere to the 3 Laws of Robotics, especially the first one which says AI can never harm a human or allow a human or through inaction allow a human to come to harm.

In the story “Evidence,” a politician named Stephen Byerley is suspected of being a robot by his opponent. The opponent tried to legally force Byerley to eat vegemite (joke alert!) to prove the accusation. This is based on the idea that robots can’t eat. This leads to the examination of the argument about who would make better politicians: robots or humans. Byerley at one point asks Dr. Calvin whether robots are really so different from men, mentally.

Calvin retorts, “Worlds different…, Robots are essentially decent.” She and Dr. Alfred Lanning and other characters are always cranky with each other. The stare savagely at one another and yank at mustaches so hard you wonder if the mustache eventually is ripped from the face. That doesn’t happen to Calvin; she doesn’t have a mustache.

At any rate, Calvin draws parallels between robots and humans that render them almost indistinguishable from each other. Human ethics, self-preservation drive, respect for authority including law make us very much like robots such that being a robot could imply being a very good human.

Wait a minute. Most humans behave very badly, right down to exchanging savage stares at each other.

The last story, “The Evitable Conflict” was difficult to follow, but the bottom line seemed to be that the Machine, a major AI that, because it is always learning, controls not just goods and services for the world, but the social fabric as well while keeping this a secret from humans so as not to upset them.

The end result is that the economy is sound, peace reigns, the vegemite supply is secure—and humans always win the annual Pong tournaments.