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.

Racial Affinity Group Caucusing Separate But Not Equal to Segregation

I read the New England Journal of Medicine perspective article “Racial Affinity Group Caucusing in Medical Education—A Key Supplement to Antiracism Curricula.”

I did not see the word “segregation” anywhere in the paper, although the Daily Mail news item used it frequently in a manner that I suspect was intended to incite indignation over separating White and Black, Indigenous, People of Color (BIPOC) medical students into Racial Affinity Group Caucuses (RAGC). This was for the purpose of ultimately integrating them with the goal of defeating racism.

Words matter. The word “segregation” used in the way some news reporters did is bound to conjure up 1960s images of the effect of Jim Crow laws and remind those old to remember it the speech of Alabama governor George Wallace pledging “Segregation now, segregation tomorrow, segregation forever.”

Separating people into groups for the purpose of working out a solution to racism can be called segregation only in the strictest sense of the definition. If you can separate denotation from connotation, I think you have to question the use of the word in the news article, which was heavily freighted with negative connotations.

When I was a student at Huston-Tillotson College (now H-T University, one of the Historically Black Colleges and Universities) in the 1970s, the Greek fraternity and sorority pledges were segregated from those who chose not to pledge, including me. I was really happy to be segregated when I witnessed the hazing of the pledges.

The women and men students at H-TU who lived on campus were segregated into male and female dormitories. This did not stop certain activities like dances and fraternity events.

I recall reading news stories a year or two ago about some black college students wanting to be segregated into different dormitories at predominantly white college campuses. I don’t agree with the idea, but it sounded like some black students preferred it.

I like my socks segregated from my dress shirts. But that’s just me.

Update to Chat with Bard

My recent chat with Google Bard, about which I posted on April 11, 2023, contained an error by Bard on all those strikes by physicians. Today I asked some follow-up questions:

How many physician strikes have occurred in the United States?

“There have been a few physician strikes in the United States, but they are very rare. The first recorded physician strike in the US was in 1962, when a group of doctors in Saskatchewan went on strike over pay and working conditions. Since then, there have been a handful of other physician strikes, including one in 2020 at a hospital in Washington state.

There are a few reasons why physician strikes are so rare in the US. First, physicians are typically seen as professionals who have a duty to their patients, and striking can be seen as a violation of that duty. Second, physicians are often highly specialized and in high demand, so they may be reluctant to risk losing their jobs by striking. Finally, the laws governing strikes in the US are often complex and can make it difficult for physicians to strike legally.

Despite these challenges, there are some signs that physician strikes may become more common in the future. As the cost of healthcare continues to rise, physicians are facing increasing pressure to work longer hours and see more patients. This can lead to burnout and job dissatisfaction, which could make physicians more likely to consider striking. Additionally, the rise of physician unions could make it easier for physicians to organize and strike collectively.”

I disagree with your answer, Bard. The strike you refer to in Saskatchewan is not in the U.S. Saskatchewan is a province in Canada. There was a strike by urgent care doctors in Washington state in 2020.

“You are correct. The strike in Saskatchewan was in Canada, not the United States. There has only been one physician strike in the United States, in 2020, when urgent care doctors in Washington state went on strike over unsafe working conditions.

I apologize for the error in my previous response. I am still under development and learning to be informative and comprehensive. Thank you for your feedback.”

You’re welcome, Bard. Has there ever been a strike by psychiatrists in the United States?

“There has never been a strike by psychiatrists in the United States. There are a few reasons for this. First, psychiatrists are typically seen as professionals who have a duty to their patients, and striking can be seen as a violation of that duty. Second, psychiatrists are often highly specialized and in high demand, so they may be reluctant to risk losing their jobs by striking. Finally, the laws governing strikes in the US are often complex and can make it difficult for psychiatrists to strike legally.

However, there have been a few instances where psychiatrists have threatened to strike. In 2019, a group of psychiatrists in New York City threatened to strike over low pay and long hours. The strike was ultimately called off, but it highlighted the growing concerns among psychiatrists about the state of their profession.

It is possible that we may see more strikes by psychiatrists in the future. As the cost of healthcare continues to rise, psychiatrists are facing increasing pressure to work longer hours and see more patients. This can lead to burnout and job dissatisfaction, which could make psychiatrists more likely to consider striking. Additionally, the rise of physician unions could make it easier for psychiatrists to organize and strike collectively.”

Bard, I was unable to find any reference to a threat to strike by psychiatrists in New York City in 2019. Could you please find a reference to it for me?

“I apologize for the error in my previous response. There was no threat of a strike by psychiatrists in New York City in 2019. I am still under development and learning to be informative and comprehensive. Thank you for your feedback.

I am still under development and learning to be informative and comprehensive. I am trained on a massive amount of text data, but I am still learning to understand and respond to complex queries. I apologize for any errors or omissions in my responses.”

I appreciate your efforts. You are dropping the ball pretty often. In a way, you remind me of my juggling practice. I keep dropping the balls, too. It means we should both keep trying.

“I agree. We should both keep trying. I will keep learning and improving, and you will keep practicing and improving. And maybe one day, we will both be juggling masters!”

Bard needs work. I’ve been trying to help Sena disable the Bing Chatbot on her computer. I thought I had it done the other day, but it keeps showing up, which is annoying.

At least Bard leaves me alone.

Palm Sunday

Today is Palm Sunday, the beginning of Jesus’ last week on earth. The palm tree reminds me of the time we spent in Hawaii. We saw a lot of coconut palms. The featured image is from 1997, when we were there.

I remember seeing a picture in a storybook of Jesus riding into Jerusalem on a donkey. The road was strewn with palm leaves. I was just a child.

Palm Sunday is a day to get along with others.

The Easter Lily is already beginning to open.

Random Connections

Today, I read Dr. George Dawson’s blog post, “How I ended up in a high-risk pancreatic cancer risk screening clinic.” As usual I was impressed with his erudition, scientific literacy, and rigorous objectivity, even as it pertained to a deadly disease which runs in his family genetic history. I couldn’t help admiring his courage.

And, whether this is a random connection or not, this somehow led to my remembering Dr. George Winokur, a giant in the scientific study (including genetics) of psychiatric diseases, especially mood disorders. He died of pancreatic cancer shortly after he was diagnosed with it in the spring of 1996.

Dr. Winokur was chair of the University of Iowa Department of Psychiatry from 1971 to 1990. He remained on faculty, actively involved in research and teaching up until the day of his death in October of 1996.

I was a resident in psychiatry at University of Iowa from 1992-1996 and I have a clear recollection of meeting with Dr. Winokur in his office during my last year, when I was preparing for job interviews. I knew he had been diagnosed with pancreatic cancer.

He had been actively recruiting me to accept a position in the department and did so even as we spoke briefly. I remember noticing that he gripped an electrical conduit on the wall next to his desk so tightly that I wondered if he were in pain.

He was the main reason I stayed in Iowa. He had a great sense of humor. All of us residents loved him. There was even a list of his “commandments” all new residents received when they began their residencies at Iowa.

Winokur’s 10 Commandments

  1. Thou shalt not sleep with any UI Psychiatry Hospital patient unless it be thy spouse.
  2. Thou shalt not accept recompense for patient care in this center outside thy salary.
  3. Thou shalt be on time for conferences and meetings.
  4. Thou shalt act toward the staff attending with courtesy.
  5. Thou shalt write progress notes even if no progress has been made.
  6. Thou shalt be prompt and on time with thy letters, admissions and discharge notes.
  7. Thou shalt not moonlight without permission under threat of excommunication.
  8. Data is thy God. No graven images will be accepted in its place.
  9. Thou shalt speak thy mind.
  10. Thou shalt comport thyself with modesty, not omniscience.

I never got the impression that George Winokur recruited me because I was black, although it was pretty obvious to me that I would be the first black University of Iowa psychiatry department faculty member. He had too much class to make that an issue.

I’ve known a few classy psychiatrists. Maybe the connection is not so random.

Iowa State University African American Science Graduates

I was thinking about what to write for the first day of Black History Month, which starts today on February 1, 2023.

As usual, I started to reminisce about my time at Iowa State University (ISU) in Ames, Iowa. I usually don’t talk about my undergraduate days. In fact, I had a little trouble finding my diploma. It was in storage in the first place I should have looked. I graduated from ISU in 1985.

The Iowa State Daily ran a story, “Black scientists from Iowa State,” published on February 4, 2021, obviously in honor of Black History Month. Of course, it featured ISU’s most illustrious graduate, George Washington Carver, who earned his graduate degree in 1894. Carver also loved poetry and painting, which I didn’t know.

This work is in the public domain in the United States because it was published (or registered with the U.S. Copyright Office) before January 1, 1928

Carver was a scientist and put it to practical use. It fits with the ISU motto, which was short and to the point: “Science with Practice.”

I transferred credit to ISU in the mid-1970s from one of the country’s Historically Black Colleges and Universities (HBCUs), Huston-Tillotson College (now Huston-Tillotson University). I submitted a poem to the college’s annual student poetry contest sponsored by one of the English Professors, Dr. Jenny Lind Porter-Scott. My poem didn’t make the cut, but many students got their work published in the little book, Habari Gani (Swahili for “What’s Going On”), which published the best poems.

Part of the reason I went to ISU was the encouragement I got from my bosses at WHKS &Co, consulting engineers. I was a surveyor’s assistant and drafter. I was the only African-American employee working there.

The idea behind going to ISU initially was to pursue a degree in engineering. That didn’t happen because frankly, I didn’t have a head for the mathematics. On the other hand, I got interested in biology, chemistry, and zoology and finally ended up in medical school at The University of Iowa in Iowa City. The rest is history, as they say, which allows the usual cover up of a multitude of sins.

At the time Sena and moved to Ames in the early 1980s, it was a quiet little town, except during VEISHEA, an annual spring celebration on campus. The event got out of hand many times and it was finally banned in 2014.

Back in the days of George Washington Carver, African American students were not allowed to room with other students who did not have black skin on campus. By the time we moved to Ames, the most uncomfortable racial incident I can recall personally was being the butt of a “nigger” joke at a barbershop. I had to find another place to get my hair cut.

I still had a lot of science to digest at ISU after switching my major from engineering to the life sciences. I remember a chemistry professor who looked like the typical hippie who demonstrated how electrons get excited by stacking chairs on top of the counter in front of the chalkboard (which teachers were still using) and climbing to the top and nervously doing a shaky little dance showing what an excited electron he was. I think all of us collectively held our breath, waiting for him to tumble to the floor.

I really had a tough time learning organic chemistry. You had to draw diagrams showing how the molecules and atoms connected after each reaction. I will never forget an Asian Teacher’s Assistant who patiently tutored me, despite my having a very bad cold and a bad attitude to boot.

I graduated and then returned to get more credits to try getting into medical school after finding it very difficult to find employment with my Bachelor of Science degree. It took about 9 months before I finally landed a job in the clinical lab at one of the hospitals in Des Moines. The lab director worked there for a very short time while I was there, and then left to go to medical school.

That was my cue. I think it worked out for the best. By the way, the engraved crystal in the featured image is an appreciation gift from The University of Iowa for my years of service.

And I guess that’s about enough reminiscence for now.

Exercise or Weaponize My Privilege?

Back in November 2022, while on our way to the Stanley Museum of Art, we saw the two murals on the East Burlington Street Parking Ramp. It was the first time we saw them in person although photos were available last fall. The Little Village article published an article about them on September 30, 2021. It’s the Oracles of Iowa mural project, conceived by Public Space and the Center for Afrofuturist Studies partnered with the artists, Antoine Williams and Donte K. Hayes. The artists sought to stimulate a conversation in the community about how black and white people relate to each other.

The murals are painted on parking ramp at two locations along East Burlington Street. One says “Black Joy Needs No Permission” and the other says “Weaponize Your Privilege to Save Black Bodies.”

The Little Village article points out that a survey of public perception of the murals revealed that 64 percent of white respondents supported the murals while only 40-50 percent of minority respondents supported them. The stickler for minorities was the use of the word “weaponize” and the phrase “Black bodies,” which were thought to raise impressions of “violence” and dehumanization.

Because I’m a writer, retired psychiatrist, and a writer, the word “weaponize” made me wonder what other word might have been chosen in this context. The only definition of “weaponize” that I can find which makes sense to me is from Merriam-Webster: “to adapt for use as a weapon of war.”

I’m a retired physician, so I have a perspective on the “privilege” to “save” lives, and by extension to enhance health and well-being. I’m also Black. I grew up in Iowa and I can recall getting bullied and being called a “nigger.” I can remember my psychiatry residency days, which includes a memory of a patient saying “I don’t want no nigger doctor.” I didn’t have the option to switch patients with another resident. When I saw the patient on rounds, I did my best and every time the “nigger” word erupted, I left the room.  It was one of a few episodes which were marked by frank racist attitudes.

I was given the University of Iowa Graduate Medical Education Excellence in Clinical Coaching Award in 2019, one of several esteemed colleagues to be honored in this way. Many of those who nominated me were white. It was one of many joyful experiences I had before my retirement in 2020, when the pandemic and other upheavals in society occurred, including the murder of Black persons, resulting in many consequences prompting the creation of the murals.

I have other memories. I was privileged to be given a scholarship to attend one of the Historically Black Colleges and Universities (HBCU) in this country, Huston-Tillotson College (now Huston-Tillotson University). It’s one of the oldest schools and is the oldest in Austin, Texas. The scholarship was supported by one of the local churches in my home town of Mason City. I don’t think it had any black members. Although I didn’t take my undergraduate degree from H-TU, it was one of the most valuable learning experiences in my life. It was the first time I was ever not the only Black student in the class. It was marked by both joy and a struggle to learn where I belonged.

The murals did for me what the artists hoped it would do. It stimulated me to reflect on the meaning of racializing life. They stir me to seek perspective on whether joy has any color and why anyone needs permission for it. And I believe I would rather exercise my privilege to respect and care for others than to weaponize anything, including my sense of humor.

MLK, Jr and me

National Day of Racial Healing Today

I just found out about the National Day of Racial Healing, which is today. It follows the National MLK Day, which this year was yesterday. The annual National Day of Racial Healing was started in 2017. The website tells what the event is about:

“The National Day of Racial Healing is a time to contemplate our shared values and create the blueprint together for #HowWeHeal from the effects of racism. Launched on Jan. 17, 2017, it is an opportunity to bring ALL people together in their common humanity and inspire collective action to create a more just and equitable world.”

Read more about the origins of the National Day of Racial Healing here.

My Two Cents on The Embrace Sculpture Honoring MLK Jr and Coretta Scott King

I first saw a photo of the sculpture honoring Dr. Martin Luther King Jr and Coretta Scott King, called “The Embrace” a couple of days ago. I remember my first impression being that it would have been nice to see a full sculpture of the couple rather than disembodied arms.

Sena mentioned it today because it was unveiled at Boston Commons. This was just before my mindfulness meditation, so I just told her that I saw the picture of it and said I would have to think about it some more.

As I sat in meditation, it occurred to me that “The Embrace” expressed what I think is a basic abstract idea, which is the challenge for us to embrace the notion that we’re all humans who ought to accept each other, and be kind and generous to one another.

That’s what I think the Kings did. That’s why Dr. King won the Nobel Peace Prize.

You could make a sculpture of the King as a couple embracing each other after he won the Nobel Prize. It would have been beautiful. On the other hand, you could make a sculpture which tries to do more than that. How difficult would it be to make a representation of what it might look like if all of us embraced our humanity—and each other?

It sounds too difficult. Yet the artist managed to do just that. Anyway, that’s my two cents.

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