Members of the Human Club

I just read Dr. Moffic’s column, “Join This Club for Mental Health” in which he described the Clubhouse movement which got started in the 1940s to help those with mental health challenges to cope with their illness and, more importantly, to recover, grow, and achieve success in life.

It made wonder if there are any chapters of the Clubhouse model in Iowa. It turns out there is and it’s Carol House in Davenport, Iowa. It’s connected with the Vera French Mental Health Center. Its namesake is Carol Lujack, who was a member when the center was called “The Frontier Community Outreach Program” in the 1980s in downtown Davenport.

I was looking at the Carol Center website where you can find many interesting features of the people and activities that go on there. The April newsletter is fascinating and funny. You can find out in the April Newsletter about a few of the current members, April holidays (there’s a slew of them), and famous quotes. One of the quotes is familiar and it’s by F. Scott Fitzgerald,

“Vitality shows not only in the ability to persist, but in the ability to start over,” The quote is worded in various ways, but I remember it because I used it as an inspirational quote when The University of Iowa honored me and several of my colleagues with a Feather in Your Cap award back in 2011.

This was shortly after I returned to Iowa after an unsuccessful stab at trying private practice psychiatry in Wisconsin. And it was the second time I did that—the first time was in Illinois.

Did you know that April is National Humor Month? And have you heard the joke “What kind of candy is never on time?” Choco-Late.

One April holiday is not mentioned and that’s Arbor Day, which varies according to what part of the world you’re in as planting times differ. Sena planted a couple of new trees in the back yard.

Starting new chapters of Clubhouse is a little like planting new trees. They need watering.

SAINT Therapy for Treatment Resistant Depression at The University of Iowa

First of all, if you looked up Saint therapy for depression, you might have accidentally found information on Saint Dymphna, the Catholic patron saint of those living with mental illness.

Actually, SAINT stands for Stanford accelerated intelligent neuromodulation therapy. It’s a personalized protocol for using transcranial magnetic stimulation (TMS) to treat severe depression. The University of Iowa is the first academic center to offer it in the Midwest.

This is a big step forward from the days many years ago when we were starting use right unilateral electrode placement for applying electroconvulsive therapy (ECT) to treat depression because it was thought to lead to fewer cognitive problems post-treatment.

SAINT is a game changer according to Dr. Nicholas Trapp, MD, assistant professor of psychiatry, who describes it as a method to pinpoint the best location in each patient’s brain to target with TMS to treat major depressive disorder. The procedure is quick and recovery from depression can be sustained for months.

Kudos to The University of Iowa. And maybe thanks to Saint Dymphna.

The Goldwater Rule and The Golden Rule

I read Dr. Moffic’s column today about the challenge in finding a rational solution to the objections many psychiatrists have to diagnosing President Donald Trump with a psychiatric disorder, despite the Goldwater Rule against doing that in any public forum.

Dr. Moffic points out that the high emotions aroused on both sides of the political aisle by the president has resulted in proposed legislation by Minnesota republican lawmakers to create a novel psychiatric diagnosis, Trump Derangement Syndrome (TDS), which may justify revising the Goldwater Rule, allowing psychiatrists to go public with diagnoses of President Trump.

I suspect that the TDS law was provoked by the conflict between democrats and republicans about the president. In fact, one of the Minnesota lawmakers has basically admitted that the bill was a prank by calling it “…tongue in cheek…” On the other hand, if this is just frustration between politicians, then I would expect that the whole thing might have been dropped a couple of weeks ago.

Yet, the bill still stands, albeit without any movement forward to committee. One of the authors, Senator Glenn Gruenhagen, has posted a comment on Facebook on March 17, 2025 (the day the bill was introduced), indicating that he knows democrats “…will never allow this bill to pass anyway, so take a breath and calm down.”

Can we do that, please? A good start might be to withdraw the bill.

 I also saw a news story posted by The Guardian on March 26, 2025, quoting a New York City Child Psychiatrist, Leon Hoffman, MD, suggesting that the Goldwater Rule is too often broken, and, in response to the TDS gambit, that it might be preferable “…to develop a comparable national rule prohibiting political personnel, both elected and appointed, from creating psychiatric diagnoses as a tool against their political opponents.” Would anyone like to second that emotion?

You can’t just legislate restraint, respect and kindness in public or private discourse. Policies and laws can lay the groundwork for the eventual development of tolerance and maybe even acceptance of others. The Goldwater Rule is too often broken. The Golden Rule is too often broken as well.

How to Support University of Iowa with the One Day for Iowa Fund Drive Today!

Okay, so here’s my pitch on how potential donors can support programs at The University of Iowa. Today the One Day for Iowa fund drive kicks off, and it ends at 11:59 PM today on March 26, 2025.

I got a soft spot in my heart for The University of Iowa College of Medicine and University of Iowa Health Care (UIHC), even though my undergraduate Bachelor’s degree was from Iowa State University.

You can find in the UIHC Medical Museum a description of the historical development of the medical school. Following the Flexner Report in 1909 which found fault with all U.S. medical schools including Iowa’s, there was a drive to avoid “inbreeding,” meaning hiring of one’s own graduates. Nowadays, there are legislative efforts to keep as many as we can of Iowa’s best and brightest.  

Go Hawkeyes!

Stead Family Children’s Hospital NICU Gets a Wave from the AAP with New Designation

The University of Iowa Stead Family Children’s Hospital Neonatal Intensive Care Unit was recently recognized by the American Academy of Pediatrics (AAP) as one of only two such units in the U.S. having the highest levels of neonatal care.

It reminds me of the Iowa Hawkeye football games where, at the end of the first quarter, all the players and football fans wave from the field to the pediatric patients and their families watching the game from UI Stead Family Children’s Hospital. It’s called the Wave, one of the best traditions in college sports.

Well, the AAP waves to Stead Family Children’s Hospital NICU.

The Red Green Show “Twinning” Episode A Model of Cooperation

I just read Dr. H. Steven Moffic’s post on Psychiatric Times, “The Space Station as a Model for Intercultural Cooperation.”  I also read the blog of another psychiatric I consider a colleague and friend, Dr. George Dawson, MD, and it’s sort of in the oppositive vein, being about the recent snafu of some Republican Minnesota legislators deciding to submit a bill to the legislature mansplaining Trump Derangement Syndrome (TDS) to the Democrats why TDS needs to become a law. It’s going over like a lead space station.

Incidentally, one legislature activity tracking website (Bill Track 50) has an Artificial Intelligence (AI) summary of the bill which says in part, “…the bill appears to be satirical or politically motivated…”

And the Minnesota Senate Minority Leader, Mark T. Johnson, said the bill was “a little bit tongue in cheek,” and possibly unintentionally joked that “Senate Republicans have always supported mental health funding…” while also calling attention to problems that the two political parties have cooperating with each other (story source WCCO News Minnesota, “Minnesota bill to define “Trump derangement syndrome” as mental illness provokes backlash” by Eric Henderson, Caroline Cummings; accessed March 18, 2025). Obviously these two pieces present opposites when it comes to collaboration.

The other issue pertinent to my post today has been the recent tariff and trade war going on between Canada and America, which is all about competition rather than cooperation.

Therefore, I did a web search for any Red Green Show episodes that demonstrated cooperation as a theme. In fact, the usual AI guidance (which I never ask for) pointed out that The Red Green Show didn’t present episodes about cooperation per se, but satirized the topic. For once, I had to agree with AI for the most part.

On the other hand, I did find a Red Green Show episode called “Twinning” that actually seemed to involve collaboration between Canada and Iowa, if you can imagine that nowadays. Back in the year 2000, The Red Green Show sponsored a survey of all 50 states in America, offering an opportunity for persons from an American city to twin with persons from Canada, I think it was Ontario. This meant that Americans would visit Canada and Canadians would visit America. I may not have the exact details right, but the idea of cross-cultural collaboration and getting to know each other was the main idea.

The whole state of Iowa endorsed the twinning offer with The Red Green Show, which of course, represented Canada. At the time, the Iowa Public Broadcasting Service (PBS) network was supporting the Red Green Show.

 I never knew about that when it happened in 2000, probably because I was pretty busy working as a consultation-liaison psychiatrist here in Iowa City, Iowa. Anyway, the “Twinning” episode was one of the funniest I’ve seen. You know, identical twins are not exactly identical in every way.

If You Want Peace and Quiet from Government…

I’ll bet a lot of people are like me and would like more peace and quiet from government. There’s a crisis every day. There’s even some Minnesota Republicans who want to get a bill through the state legislature defining Trump Derangement Syndrome (TDS) as a new mental illness, applicable only to Democrats. Given the intensely adversarial atmosphere among most politicians, this has made things even more noisy amongst lawmakers.

Because of this highly charged atmosphere which seems to get worse by the hour, I thought it might be instructive to suggest everyone eat some fruit and watch the Red Green Show episode “Good Government.”

Things are much quieter where Red Green lives. Although Jerome, the elected representative of the district, has supposedly been working hard for his constituents for 9 years, it turns out that, in fact, he has been dead for the last 8 years. Things must be pretty quiet in government there because nobody seems to have noticed.

How Red Green and his henchman, I mean co-conspirator, I mean his fellow constituent, address this problem does not involve high drama, although the question of legality does arise—which is hardly a problem provided you ignore the law.

I guess that’s pretty much what happens in real life.

Politics on the Brain

I just discovered the news item about 5 Minnesota Senate Republicans who introduced a bill this month seeking to classify “Trump Derangement Syndrome” (TDS) as a mental illness. This is not a new idea, I think, and it targets Democrats as having the syndrome. There’s a big Wikipedia article about the history of the origin of it.

It reminded me of a Dr. Henry Nasrallah’s editorials about “neuropolitics” a term he used in an effort to understand how much politics can affect the human brain. He published a series of 3 articles in the journal Current Psychiatry. The one published in the October 2018 issue is entitled “Neuropolitics in the age of extremism: Brain regions involved in hatred.”

Dr. Nasrallah is a neuropsychiatrist who has an entertaining and thought-provoking writing style. I met him briefly when I was interviewing for psychiatry residency at the University of Cincinnati.

The political situation now is difficult and it makes me wonder even more if there is a problem with the human brain when it comes to politics.

Dr. Nasrallah article 1

Dr. Nasrallah article 2

Dr. Nasrallah article 3

Iowa Bills to Ban Vaccines and Require Vaccine Manufacturers to Waive Immunity Die

This week was what the Iowa Legislature calls funnel week. Today determined what bills stay alive and which one die.

The bills opposing vaccines died for this legislative session:

mRNA vaccines: Senate File 360 proposed a ban on health care providers administering gene-based vaccines, like the COVID-19 vaccines developed by Pfizer and Moderna. Under the proposal, health care providers who administered vaccines that use nucleic acids like messenger RNA (mRNA) would face punishments of a misdemeanor charge and a fine of $500 for each violation.”

Vaccine manufacturer immunity: House File 712 proposed requiring vaccine manufacturers waive their immunity from lawsuits over injuries that result from a “design defect” in a vaccine in order to distribute or administer the vaccine in Iowa. Under the 1986 National Childhood Vaccine Injury Act, there is a National Vaccine Injury Compensation Program providing no-fault compensation to individuals and families injured by childhood vaccines. While supporters of the bill said the current compensation program has problems, medical practitioners and advocates said allowing for lawsuits to be filed against manufacturers would prevent vaccines from being available in Iowa.”

Story published in Iowa Capital Dispatch, “Funnel week 2025: What bills are alive, dead at Iowa Statehouse after first deadline” by Robin Opsahl. March 7, 2025.

What Does “Design Defect” of a Vaccine Mean In the Iowa Bill to Require Vaccine Manufacturers to Waive Immunity from Lawsuits?

Beats me. Sorry, just kidding. I’m just a little bleary from looking at the web sites about the definition of “design defect” related to vaccines as it applies to the Iowa bill to make vaccine manufacturers waive their immunity from lawsuits about vaccine related injuries.

I am sympathetic to anyone who in fact has suffered a vaccine related injury.

That term “design defect” has been bugging me for days now and I just found out that this has been the subject of states vs federal legal wrangling for years. I’m not up to explaining all the legalese but there is a really tangled trail of cases in Georgia and Pennsylvania roughly around 15 years ago that ultimately led to a U.S. Supreme Court decision saying, essentially, the Vaccine Injury Compensation Program and the federal Childhood Vaccine Injury Act of the 1980s preempts all state level vaccine design defect claims.

I think that explains why the Iowa bill says that vaccine manufacturers have to waive their immunity from suits if they want Iowans to get their vaccines.

I can hear the groans and shouts of dissent even as I write this. Hey, you can’t make this up. Talk to your legislator or lawyer about it.

I’m not sure why Iowa would want to repeat the grind that Georgia and Pennsylvania went through which led to the conclusion that you can file vaccine design defect claims at the state level and not have to repeat history which would likely lead to any decisions made there being reversed in federal court.

And I’m not sure why any vaccine manufacturer would want to fight that battle in Iowa either. They might just steer around us and take their vaccines elsewhere.

The beginning of the Georgia story.

The end of the Georgia story.

The beginning and the end of the Pennsylvania story.

Vaccines aren’t perfect. They are neither 100% safe nor 100% effective. However, I support having vaccines available to help keep us healthy and the right to choose getting a vaccine. That’s why I don’t support a bill that I believe would make them less accessible.