Category: History

Thoughts on Doctors Going On Strike

I read Dr. H. Steven Moffic’s two articles in Psychiatric Times about the strike by mental health workers at Northern California Kaiser Permanente (August 16 and 26, 2022). So far, no psychiatrists have joined the strike.

However, this piqued my interest in whether psychiatrists or general physicians have ever gone on strike. I have a distant memory of house staff voicing alarm about a plan by University of Iowa Hospital & Clinics to reduce health care insurance cost support many years ago. It led to a big meeting being called by hospital administration to discuss the issue openly with the residents. The decision was to table the issue at least temporarily.

It’s important to point out that the residents didn’t have to strike. I don’t recall that it ever came up. But I think hospital leadership was impressed by the big crowd of physician trainees asking a lot of pointed questions about why they were not involved in any of the discussions leading to the abrupt announcement that support for defraying the cost of house staff health insurance was about to end.

That’s relatively recent history. But I did find an article on MedPage Today written by Milton Packer, MD (published May 18 2022) about what was called the only successful strike by interns and residents in 1975 in New York. I don’t know if it included psychiatric residents; they weren’t specifically mentioned.

In 1957, the Committee of Interns and Residents (CIR) in New York City and voted to unionize to improve appalling working conditions. They won the collective bargaining agreement, the first ever to occur in the U.S. because they went on strike, which hamstrung many of the city’s hospitals. Medical faculty had to pitch in to provide patient care.

After 4 days, the hospitals agreed to the residents’ demands. However, the very next year, the National Labor Relations Board ruled that residents were classifiable as “students,” not employees, which meant they weren’t eligible to engage in collective bargaining. This led to a reversal of the gains made by the strike.

Residents who are unionized voted to strike at three large hospitals in California in June of this year. They reached a tentative contract deal at that time. The news story didn’t mention whether there were any psychiatrists in the union.

There has never been a union of residents at The University of Iowa Hospitals & Clinics. I was a medical student and resident and faculty member for 32 years. I saw changes in call schedules and work loads that were the norm for the exhausting schedules that led to horrors like the Libby Zion case in New York.

Even as a faculty member on our Medical-Psychiatry inpatient unit, the workload was often grueling. I co-attended the unit for years and during the months I was scheduled to work there I shared every other night call with an internist for screening admissions. I was sometimes scheduled for several months at a time because it was difficult to find other psychiatrists willing to tackle the job.

If residents had wanted to unionize and voted to strike then, my internist colleague and I probably could have filled in for them.

But I would never have considered going on strike myself. It would have been next to impossible to find any other psychiatrist to fill in for me. And if other psychiatrists had gone on strike? We might have won a better deal—but only by hurting the patients and families who needed us.

I suspect my attitude is what underlies the impressions shared in Robert G. Harmon’s article, “Intern and Resident Organizations in the United States: 1934-1977,” in the 1978 issue of the Milbank Quarterly.

The house-staff choice of unionization as a formal process has disturbed some health professional leaders. One has pointed out that for a house officer to don another hat, that of striking union member, in addition to those of student, teacher, administrator, investigator, physician, and employee, may be a regrettable complexity that will further erode public confidence in physicians (Hunter, 1976). Others have seriously questioned the ethics and morality of physician strikes (Rosner, 1975). -Milbank Memorial Fund Quarterly/Health and Society, Vol. 56, No. 4, 1978.

When I graduated from medical school, I believed in the cultural view of the physician as a professional. My first allegiance was to the patient and family. I paid dearly for holding that stance. Sena reminds me of the times my head nearly dropped into my soup when I was post call. And I did struggle with burnout.

But I retired because I thought it was time to do so. I don’t think of it as a permanent strike. I hope things turn out all right.

59th Anniversary of MLK’s “I Have a Dream” Speech on August 28, 1963

Sena reminded me that today is the 59th Anniversary of Reverend Martin Luther King Jr’s “I Have a Dream” speech in Washington, D.C. After she reminded me about it, I found this anniversary mentioned in only a few headlines on the web.

But that’s no excuse. It doesn’t matter that I was just a small child on August 28, 1963. And when I hear the speech, it still makes the hair on the back of my neck stand up.

All About the Potato Salad

I recently got a checkup for my retinal tear surgery about 4 months ago. My surgeon was pleased with the outcome. Partly based on my good outcome, he shared that he was guiding his trainees on the wisdom of not necessarily always going with the new surgical procedures for the disorder, which happens not infrequently in those over the age of 50.

In fact, the trend seems to be to do more than just the oldest operation, which is the scleral buckle, in favor of adding vitrectomy as well—a relatively newer approach. I got the scleral buckle.

Progress is good. But just because something is old doesn’t mean it’s outmoded.

We saw the Iowa State Fair episode on old farm machinery the other night. It showed how much progress has been made in farming over many years. However, those old machines replaced a lot of hard labor, so they were definite improvements back in the day.

You can learn something new and valuable by considering what is old. We saw a short film called The Foursome. On the surface, it’s about 4 old guys who have played golf together at an annual tournament for 50 years in Waukon, Iowa. Waukon is in the Northwest part of the state, close to the Mississippi River, which borders the eastern side of the state.

The show is not really about golf, of course. But before it came on, I almost decided not to watch it because of that misconception. The description gives it away, saying that it’s about friendship, small towns, golf—and potato salad.

I think it’s also about getting older. Not everybody ages gracefully and I’m including myself as a pretty good example. I’m not so sure about my memory or my hearing these days. I can stand on one leg for 20 seconds. But one day not too long ago I cracked an egg and instead of emptying the contents into the poaching pan, I dumped them on a paper towel on the countertop. I was mortified.

Sena covered for me and brushed it off, saying it was because we had been talking about the finer points of poaching eggs and I just got distracted, and some hogwash about how she’s done that too. Maybe.

In the film, one of the Foursome was showing some of the artwork he has on the walls at his home. He stopped at one and seemed to fall into some kind of reverie. The camera operator had to sort of whisper to the guy that he needed to move on.

Let’s change the subject and talk about potato salad. They filmed the wife of one of the guys making this potato salad, the recipe for which you can get for free on the web. She used Miracle Whip instead of Mayonnaise. I pointed this out to Sena, who said nothing. Miracle Whip has been around since the 1930s and I grew up eating it on sandwiches at home. I favored it over Mayonnaise.

There has not been a jar of Miracle Whip in our house in almost 45 years—which is how long we’ve been married. I have learned to like Mayonnaise.

This reminds me of one segment on the film showing the wife of one of the other guys shopping for food (including burgers, chips, and whatnot as well as potato salad fixings) for the cookout, a part of the annual golf outing for the four guys. She said it really didn’t matter what she got because “They’ll eat anything you put in front of them.”

Some of them will eat nothing but the potato salad.

There is something poignant about the irascibility alternating with poignancy in the film. Their friendship is deep enough to move one of the four guys to tears. At least that’s what it looked like.

They have the usual flaws men have, including the tendency to be stoic in the face of oncoming frailty and the specter of death.

I don’t know if I’ll age as well as they do. But I do know I will never take up the game of golf. And I wonder if you can substitute Mayonnaise for Miracle Whip in that potato salad.

One thing I’m sure of, Sena is my best friend.

Factual or Fictional or Felgercarb

I’ve been watching a couple of shows about Alaska that are pretty much Bigfoot tales. One of them is The Alaska Triangle and the other is Alaska Killer Bigfoot.

And when I looked on the web to find out more about the TV shows, I learned a new word, “Felgercarb” (alternate spelling “felgercarb”). It means “crap” and I read that it originated from a 1978 Battlestar Galactica episode. The word was used by a reviewer of The Alaska Triangle. He called the show felgercarb and it obviously means he had a low opinion of it.

Incidentally, I never watched Battlestar Galactica.

I remember an English professor in Texas who made it clear that fact and fiction were not distinguished from each other by simply saying that fiction is anything that is not true. After all, fiction can be about the truth in various contexts, such as science (as in science fiction), and social and economic forces. And facts are mathematical and scientific data including formulas and historically verifiable events.

On the other hand, felgercarb is distinguished from facts and fiction by being notable for being non-satirical, non-parodical writing or performances—and by being unconvincing, amateurish, and—crappy.

Just to clarify, the Bigfoot show Mountain Monsters, which I think is a parody of all the Bigfoot shows, would not be classified as felgercarb, mainly because they obviously are making fun of the Bigfoot sagas.

Anyway, both of the Alaska shows have been labelled as felgercarb (whether they use that name or not) by a significant number of viewers. I acknowledge that a lot of people like them.

One reviewer of The Alaska Triangle who identified himself as living in Alaska all his life said he had never even heard of the Alaska Triangle.

Supposedly, a lot of people have disappeared in the Alaska Triangle, the borders of which connect Anchorage, Juneau, and Utqiagvik (formerly Barrow). Bigfoot is not the only cryptid people claim to see. One bus driver says he saw a dinosaur cross a road, specifically a velociraptor, that scientists say has been extinct for about 75 million years. No tourists on the bus saw it.

This prompts the question, why did the dinosaur cross the road? Because chickens didn’t exist yet.

Actually, the question is why didn’t the bus driver snap a cell phone picture of it? Because he didn’t want to get cited for distracted driving.

Another wild story on The Alaska Triangle is a circle of mutilated animals found far from any body of water. Why the connection to water? Because one of the animals was a whale. I guess the whale was in the middle of evolving and growing lungs. Sorry, actually it was accidentally dropped from a flying saucer driven by a distracted alien scrolling for barbecue blubber recipes on his cell phone.

I guess nobody’s heard of the Iowa corn mutilation phenomenon. Every year there are reports of several ears of corn completely denuded of kernels found near cornfields. Only the cobs are left. Weirdly, explorers and paranormal researchers often don’t find them in circles, but in terrifying little piles, not uncommonly surrounded by savagely ripped beef jerky wrappers and beer bottles completely drained of all liquid.

The Alaska Killer Bigfoot is even more mystifying—or stupefyingly felgercarbish. The explorers are investigating a place abandoned many decades ago because a special breed of Bigfoot monster called Nantinaq slaughtered people and knocked over the clothesline poles, making it impossible to dry overalls and flannel shirts.

The explorers on Alaska Killer Bigfoot occasionally barf for the pleasure of viewers. Maybe it’s the Nantinaq effect or spoiled beef jerky; it’s not clear which is more likely. It’ll have to await further study by various guest experts like spirit mediums and elderly Bigfoot experts.

Buoys somehow get into the tops of trees and holes mysteriously get dug where explorers find ancient coins, which they fail to clearly identify and maybe wonder if they can buy beer with them.

I wonder if Tony Harris, host of the show The Proof is Out There, will travel to Alaska and investigate Nantinaq or the inland whale circles. That show tends to retain some skepticism and usually errs on the side of saying something is unknown rather than saying thing like “Bigfoot has been proven to make infrasound” noises.

You know, so far nobody on the Alaska Killer Bigfoot took advantage of what might be a fact of infrasound, which is that it can nauseate people and possibly make them barf.

Oops, I just made a contribution to felgercarb.

The Kindness of Strangers in a Parking Lot

This is a post about how easy it is to forget where you parked your car in a big parking lot, say at the grocery store, and ways to help prevent it. This sometimes attracts the kindness of strangers, which is puzzling because it’s not very clear how helpful they can be in this situation.

But you want to say more than something like, “Oh, that’s too bad, hope you find it before the ice cream melts.”

The other day, Sena forgot where she parked the car at the grocery store. The circumstances were a little unusual. She parked near one entrance to the store and after getting the groceries, left from an entrance on the other side of the store way across the parking lot. The landmarks were all different.

This is how things started: she ran into a guy with his little boy. The guy actually couldn’t remember where he parked his car and was trying to use his car key fob remote to locate it. This is actually pretty common nowadays. I remember leaving the eye clinic a few months ago and hearing a small symphony of beeps from a number of people using their key fob remotes this way trying to find their cars in the large parking garage.

Sena was sympathetic to the guy, but it was understandably really difficult to help him. He eventually found his car using the key fob trick.

Then the situations were reversed. Sena had trouble finding our car. She was roaming about the parking lot, pushing the grocery cart, obviously looking lost. This attracted 4 different persons (including the first guy she met) who were sympathetic and offered advice—mostly on how to use a key fob to locate the car by pressing one of the buttons (probably the lock/unlock although there might be a panic button). They demonstrated it by pressing the key fob button while standing right next to their cars. They suggested holding it far above your head.

This trick usually works best when you’re fairly close to the car because the key fob remote is a transmitter which uses low-power signals. The operating range may sometimes be limited. Sena was probably pretty far away from our car. She actually began to suspect our car had been stolen. She eventually found it by trial and error.

This episode resulted in attracting a number of people who were kind to her. That’ s encouraging since it looks like kindness is often in short supply. On the other hand, it’s not always good to be alone in a large unfamiliar parking lot, perhaps at night, looking lost and surrounded by strangers.

We can’t remember having this problem years ago before the era of keyless fob remotes, which I read was in the mid-1990s. And we didn’t have them until years after that. I guess we were just more careful about noting landmarks in large parking lots.

There are few things to do in order to avoid forgetting where you park.

You can try to find your car using your key fob remote, although the effective range of the signal might be too short to trigger the horn or the lights. And it might not work if the fob remote battery power is low. And if you’re surrounded by a lot of other people hunting for their cars using the same method, you might have a little trouble discriminating which beep is yours. This could become a YouTube meme, especially with different beep tones (like the 5 tones in the movie “Close Encounters of the Third Kind”).

You can pick a landmark which will make it easier to remember where your car is. Many parking lots have large signs with numbers and letters which can help you.

You can take a picture of your car’s location using your cell phone, including more permanent landmarks than just the other cars adjacent to it—which can be driven off by their owners.

You can also use a cell phone with Google Maps or another geolocation app to help guide you back to your car. Just about all smartphones have this feature. You can consult the owner’s manual for instructions for flip phones, some of which have this function. I don’t think car owners’ manuals typically have instructions for how to use the key fob remotes to find your car. At least ours doesn’t.

Good luck.

The Cigarette Waltz

A couple of days ago we heard a ballet called The Cigarette Waltz by a French composer, Edouard Lalo, on one of the Iowa Public Radio (IPR) classical music programs. The announcer told a little anecdote (most of which I didn’t hear) about the saying “Smoke‘em if ya got’em” which he traced to the World War II era, reflective of the general idea that you can do what you like if you have the means. I didn’t get the connection, frankly.

I was curious about why the ballet Namouna (Valse de la cigarette) was connected with cigarettes. The first thing I did was to look up the ballet on the web. I found the version done by the Royal Philharmonic Orchestra, conducted by—Yondani Butt. That’s actually a better joke than the one by the IPR radio show host.

At first the only thing I could find out about Lalo was that his name is the answer to a crossword clue, which is “composer of the Cigarette Waltz.” I followed several dead-end leads. There’s no real connection with Lalo himself that I could find, unless you count his “hemiplegic attack” (a stroke from smoking?) which prevented him from finishing the score for the ballet.

I read the Wikipedia article summarizing the ballet, which didn’t mention cigarettes.

And finally, I found a Google book entry after using the search terms “why is Namouna called the cigarette waltz.” The book’s title is “Traveling Sprinkler Deluxe: A Novel,” written by Nicholson Baker, published by Penguin Group in 2013. It might help to read the Wikipedia synopsis of the ballet before you read Baker’s passage, which mentions a cigarette:

“It’s true that there is an opera by Edouard Lalo called The King of Ys about the flooding of Ys, based partly on a forged Breton ballad by Theodore Hersart de la Villemarque, and true that Debussy had wildly applauded Lalo’s ballet Namouna while at the conservatory, and had memorized parts of it, including perhaps the scandalous waltz in which Namouna rolls a cigarette for her paramour…”

It’s still not exactly clear what’s going on with the cigarette, but because the waltz is described as scandalous, I wonder if there was something salacious about the rolling of the cigarette. The slave girl Namouna is, after all, flirting with Ottavio.

Baker’s point is probably that the ballet is not so much about the cigarette as it is about a larger issue, judging from my general sense of his passage. Larger than a cigarette anyway.

There’s a book titled “Cigarette Waltz: Seventeen Short Stories Adaptable for Theater” by Philip-Dimitri Galas” but I was unable to access any inside text.

Alas, I couldn’t find Cliff Notes about it.

Wendy’s Offers the Impossible Strawberry Frosty

Sena told me that Wendy’s will now be offering the strawberry Frosty, for which she and many others have been clamoring for years. The media announcements call it historic. Was there ever a strawberry shortage to explain the absence of a strawberry Frosty? It never seemed that way. It was predicted in December 2021, but now sources say we’re all good.

On the other hand, they tell us that my favorite, the vanilla Frosty, will be going away in order to make room for the strawberry. It turns out that vanilla is the base for the strawberry.

 I understand the strawberry Frosty will be offered only through July 3. We had thought that it was nothing short of impossible for Wendy’s to make the strawberry dessert. Now we know different. Impossible is nothing.

Impossible quote mural on ICOR Boxing Iowa City, IA

On the other hand, why do they have to sacrifice the vanilla?

There can be no success without sacrifice.

John C. Maxwell

There must be another way. Maybe it involves too much sophisticated chemistry.

After we ordered, the cashier laughed and said she had at first thought the whole thing was a rumor.

It looked pink, tasted good but didn’t have quite as much strawberry flavor as we expected. Are there real strawberries in it? I couldn’t find that out just by googling it.

But even the chocolate Frosty is a combination of vanilla and chocolate. When Wendy’s first opened, it started with the chocolate Frosty, then in 2006, the vanilla was added. There were others that didn’t last (even a pickle Frosty, believe it or not), but the strawberry is finally here.

But it’ll go away July 3. It’s a just a summer fling. And here’s the thing—Sena still likes the chocolate best, and vanilla is still my favorite.

D-Day for All Soldiers in World War II, Including African Americans

Today is D-Day, which was the largest amphibious invasion in the history of warfare, and there is plenty of history to read about it. It was the Battle of Normandy during World War II, which lasted from June to August of 1944.

There is also the history of African-American soldiers in World War II. Unfortunately, it was marred by segregation. But African American soldiers played important roles nonetheless.

Notably, Waverly Woodson, Jr. served as a medic on Omaha Beach and treated at least 200 men while sustaining injuries himself. By many accounts, he should have won the Medal of Honor, but did not, despite ample evidence demonstrating he deserved it.

His family and the office of General John C. H. Lee are still working to get that corrected. Part of the barrier is a fire that destroyed Woodson’s records, along with those of millions of other veterans. Woodson died in 2005, but his wife is still working to get him recognized.

We are grateful to all of the soldiers who gave their lives at Normandy.

Ransom’s Cigar Store in Mason City

I was thinking yesterday about Ransom’s Cigar Store in Mason City, Iowa. There are actually a couple of reasons why it’s on my mind now.

The first thing about Ransom’s is that it’s an old pool hall on 120 North Federal Avenue. It looks like it has been there for a century. Decades ago, probably in the 1970s, I played a game of eight-ball with Bart Curran. Bart was the host of Bart’s Clubhouse, which I found out has a substantial Facebook following. Bart’s Clubhouse was a popular kids TV show back in my day and it aired on station KGLO (later KIMT) in Mason City.

Anyway, Bart and I played eight-ball (or was it nine-ball?) and drank a short beer. He was shorter than I imagined. He was a real nice guy. I think he asked me what my dad’s name was and when I told him it was John, he looked a little doubtful and said something like “Not the actor John Amos?”  I don’t remember who won the pool game. It’s unlikely to have been me.

The second thing is, I searched Ransom’s Cigar Store on the web and found a couple of links to something called Ransom’s Pleazol. I can’t find the word Pleazol in any dictionary, including the Scrabble Dictionary. If anyone knows what that means, please drop a comment.

All Gave Some…Some Gave All

Yesterday, Sena and I drove out to Oak Hill Cemetery to get some snapshots and video clips of the new Coralville Veterans Memorial.  It’s still in progress, with plans for stone medallions from each branch of the military. Even now, it’s beautiful and inspiring.

That includes the inscription on the Tribute Walkway: All Gave Some…Some Gave All…

This quote has been attributed to Korean War veteran Howard William Osterkamp. It’s all over the internet that’s it originated with Sergeant Osterkamp, who was the recipient of the Purple Heart from wounds he suffered while in combat.

Because the words “has been attributed” made me curious (is there doubt?), I looked on the internet, which led to many blind alleys and side streets. Sena and I wanted to find out if the quote originated with Osterkamp, we looked for and found a couple of recordings of interviews with him that took place several years ago.

One of the recordings is in the Library of Congress in a collection called the Veterans History Project. It’s an 88-minute audio from an interview in 2008 and he says a lot about his military history between when he was drafted into the Army in 1951 to when he was discharged in 1953.

Osterkamp says a lot that is arguably more interesting than even the quote often said to originate with him. But nowhere in it does he say “All gave some, some gave all.

The other recording is a YouTube interview posted in 2018. Osterkamp died in 2016 and it’s not clear to me when the interview was conducted. But it’s shorter and less punctuated by the details that made the audio recording so much longer, which was probably because it was to be part of the Veterans History Project.

It is in the YouTube version at around 44 minutes into the interview that Osterkamp says after describing the wounds he suffered, “that’s why they say ‘All gave some, some gave all…that’s a great slogan.”

Saying it that way probably means that the quote didn’t originate with him, although he did, indeed, say it.

I’m going to try to summarize the internet lore around this quote and then circle back to say why I think many people believe it originated with him.

If you just type the quote and hit the search button, you’re likely to get a lot of hits. One was in Special Ops web magazine, the author of which says Osterkamp originally said it. However, below the article is a comment from someone who says it probably was probably around before Osterkamp. He included a link to a May, 1952 newspaper article in about a veterans memorial planned progress for Electra, Texas. The article describes the proposed inscription:

“Dedicated to those who rendered service to their Country…all gave some…some gave all.”

I got to thinking about the ellipsis in that quote as well as the one at the new Coralville memorial. The ellipsis usually indicates something that is left out of a quote or passage in writing.

The bread crumbs were spreading out, leading me to a web site that mentioned a lot of different sources for the quote, none of which included Osterkamp. One of them was a book published in 1882, The Nineteenth Century, “Instructions to My Counsel” pg 988. I found this on the Internet Archive as well. The context appears to involve the history of the Egyptian history:

“The Egyptian people have made heavy sacrifices for the sake of (Pg. 989—ed.) securing to their country liberty, justice, and independence; some gave all they possessed, others the half, but all gave some mite to the National cause, as can be proved by letters and telegrams to the War Minister.” (Bold type mine).

The quote used today is in there, albeit with the two phrases switched. You could place ellipses between them and have the quote used today.

The internet lore doesn’t stop there. There is the song by Billy Ray Cyrus (1992), “Some Gave All” in the album of the same name. Cyrus has told the story about meeting a Vietnam veteran who inspired the song. He’s variously called Sand Cane or Kane, and he reportedly said to Cyrus some version of “After we got back from Vietnam, in rehab camp they told us, “All gave some, but some gave all.” The story changes slightly depending on who’s telling it.

There is even a stranger twist to the Kane story. In the comment section following a review of the best soldier songs, there’s an anecdote from someone who says he met a guy named Sandy Cain, a Vietnam vet who was promoting a song very similar to the one Cyrus wrote with the same title. He recorded it on a small label. The commenter evidently was in a band that recorded it for a radio station in Portsmouth Virginia in 1973 and wonders if it’s the same Sandy Kane (or Sandy Cane, the spelling of the name differs depending on who’s telling the story). It’s puzzling that Cyrus says he couldn’t find the veteran despite contacting state police to help look for him in 3 different states.

Okay, to return to why Sena and I think it probably doesn’t matter whether the quote “All gave some, some gave all” originated with Sergeant Howard William Osterkamp. Although in our opinion, based on our trek through internet lore, he did not create the phrase, it’s fair to say he certainly lived it. The recorded interviews are fascinating and we recommend they be used as the main references for Osterkamp and the Korean War.