Category: health care

Who Let The Puns Out?

Well, we were out for a walk around Terry Trueblood Trail yesterday and a woman stopped us and excitedly asked, “Do you want to hear a joke about Covid?”

Believe it or not, we didn’t know anybody made jokes about Covid—but we said “Yeah, go ahead.” And then she said it was about dogs, and added that dogs don’t get Covid, as if to reassure us. In fact, it turns out that the CDC says you can’t catch Covid from pets, including dogs. It went like this:

The World Health Organization, or WHO, had feared the dogs could spread Coronavirus and ordered all dogs that were exposed to the virus be held in quarantine. After review, the WHO announced that dogs cannot contract Coronavirus. Dogs previously held in quarantine can now be released.

To be clear: WHO let the dogs out.

Sena and I immediately thought of the Men in Black II scene with Frank the talking Pug, who is actually an alien—and if you don’t like it you can kiss his furry little butt! I exclaimed, sort of singing (God help everyone within earshot) “Who let the dogs out!” I forgot the barking part, but we all had fun.

Incidentally, my mondegreen for the song “Who Let the Dogs Out” used to be “Who left the dog pound?” For the record, the word “mondegreen” means:  a misunderstood or misinterpreted word or phrase resulting from a mishearing of the lyrics of a song. It often totally changes the meaning of a lyric, resulting in something ludicrously comical.

I think Dave Barry wrote about mondegreens in his book, “Dave Barry’s Book of Bad Songs,” a book I used to own but somehow lost in one of our many moves. I’m hoping he’ll find this blog post somehow and send me a free, autographed copy of the book.

If we’d had our new Polk Signa S2 sound bar when I first heard the line, I could have used the remote control Voice Adjust dialogue level to reproduce clearer, crisper dialogue.

For the record, I’ve never heard the full song “Who Let the Dogs Out,” which was performed by a “Bahamian junkanoo” band formed in 1977 and released in 2000. I had to look up “junkanoo” and it’s a Bahamian cultural celebration, a festival of music, dance, and dog pounds.

There are conflicting opinions about what the song means. Some say that it was about men calling women filthy names and women fighting back by shouting “Who let the dogs out?” On the other hand, I also read that the song won a Grammy.

When we got home, I googled Covid jokes and found a lot of them. One of the better hits was RJ Julia Booksellers, advertising a book entitled Coronavirus Humor. The author was just called “Mad Comedy,” which means several “top comics” contributed. It was published in April 2020 by Indy Pub.

The best part? There was a statement saying “A portion of the proceeds of this book benefit the hard-working ‘essential workers’ who are sacrificing so much to help us all during the 2020 epidemic.”

Who let the wags out?

Featured Image picture credit: pixydotorg

Managing Difficult Conversations Without a Neuralyzer

I think I was the last lone ranger Chief Resident in Psychiatry, meaning doing the job solo. After that, there were always at least two senior residents managing that. One of the things I did was to give lectures on various topics that were not strictly related to how to work on the wards and clinics, but how to communicate with other professionals and with patients.

The other big task was fielding outside telephone calls from doctors in other hospitals trying to transfer patients to The University of Iowa Hospital psychiatric units. That’s right, that was a resident’s duty. I had some pretty difficult conversations. I couldn’t just accept every referral.

The hospital didn’t issue neuralyzers, so it was impossible to make difficult conversations go away.

I used a couple of books as guides: “Getting to Yes” by Fisher and Ury, and Difficult Conversations by Stone, Patton, and Heen. I should seriously have reread those books during my entire career and even now. Nobody’s perfect. I encountered racism from patients, so I was no stranger to a variety of difficult conversations in many different situations.

Anyhow those two books are on the short list at the University of Iowa Conflict Management web page. There’s a ton of resources there available for learning about how to manage conflict and recognize what implicit bias is and what it is not.

Implicit bias gets a lot of press. I think it can tend to set people on edge before and during seminars on equity, diversity, and inclusion. Not everybody is a racist. But our brains are wired for implicit biases. I think we all need to get busy, and I mean everybody, including me. A good place to start is understanding implicit bias.

University of Iowa Health Care Black History Month Lecture: “Pursuing Health Equity—A Call to Action”

Yesterday Sena and I listened to the Zoom lecture “Pursuing Health Equity—A Call to Action,” delivered by Louis H. Hart, III, MD from noon to 1:00 PM. Dr. Hart is the inaugural Medical Director of Health Equity for Yale New Haven Health System and Assistant Professor of Pediatrics and faculty member in the Yale School of Medicine. The lecture was sponsored by the University of Iowa Office of Diversity, Equity, and Inclusion in the College of Medicine. The introductory remarks about him were that his “leadership work addresses unjust structural and societal barriers that lead to inequitable health outcomes for the patients we serve.” His lecture was intended to “focus on efforts to ingrain an equity lens into clinical operations.”

Sena and I talked a lot about Dr. Hart’s presentation, as usual in a spirited way. We don’t always agree on everything and we’re not shy about saying so to each other. The lecture was recorded. However, since I don’t know when it might be publicly available, I looked on the web, and as luck would have it, I found a YouTube (see below) of a similar lecture he gave on June 22, 2021 in New York. The message was basically the same, and included many of the same slides.

Dr. Hart is very committed and passionate about health equity. Calls to action typically, as you’d expect, are delivered with passion, which sometimes entails emphasizing the “whys” of what must be done over the “hows” regarding implementation of changes to our health care system.

He began by letting the audience know that we’d all probably be a little uncomfortable about some parts of his message. He had a little original one-liner about comfort zones, which I unfortunately can’t recall exactly, but it conveyed a message similar to the one below:

A comfort zone is a beautiful place, but nothing ever grows there.

John Assaraf

In the YouTube video below, Dr. Hart reminds me of myself in my role as a consultation-liaison psychiatrist many years ago, when I was trying to persuade our general hospital medical staff to take delirium much more seriously, stop seeing it as a psychiatric problem, and treat it as a complication of severe medical disease. I got acquainted with a famous critical care doctor, Wes Ely, MD, who recently published a fascinating book, “Every Deep Drawn Breath.” He has worked tirelessly for most of his career to teach his colleagues, nurses, and trainees, especially those in critical care, to get the point he made so succinctly in his research notebook: “Hypothesis: The lung bone is connected to the brain bone.” I wish we could keep it that simple.

I was a crusader at the time. I often took nurses and doctors and medical students out of their comfort zones, driven to ingrain in them the delirium lens that would help save patients from developing dementia and dying from the deadly syndrome of delirium.

My approach sometimes probably didn’t sit too well with my peers and my trainees. My call to action for preventing delirium likely moved a few clinicians—but just as likely alienated others.

I can see how some people might get that feeling from Dr. Hart in the video, although when I compare him with others who beat the drum loudly about structural racism in general and get pretty confrontational, I think he does a pretty fair job of moderating that approach. I get his passion and his urgency, which is for the most part balanced by his impressive ability to articulate all the “whys” about what must be done. I was reasonably confident he could collaborate with all of the people he needs to figure out the “hows.”

Now, to throw you a curve ball, I’m giving you the link to a podcast in which, if I close my eyes, I nearly don’t recognize Dr. Hart as he describes in polished detail the “hows” of his plan to improve health equity. It seemed almost miraculous. He’s just as passionate about his mission, but the crusader gives way to the thorough, confident, caring and even witty administrator presenting his very sophisticated vision of what the health care system of the future might look like. See what you think.