Category: History

What Questions Should We Ask on MLK Day?

I ran across this quote from Dr. Martin Luther King, Jr. in my notes:

“Human progress is neither automatic nor inevitable… Every step toward the goal of justice requires sacrifice, suffering, and struggle; the tireless exertions and passionate concern of dedicated individuals.”

― Martin Luther King Jr.

This week we’ll be getting the two biographies of Martin Luther King, Jr. One of them is a biography published a couple of years ago by Jonathan Eig, titled “King: A Life.” The other is an autobiography, “The Autobiography of Martin Luther King, Jr.”

This morning, I was focused on puzzling over Eig’s book, in which there is a focus of how depression affected Dr. King. Gradually, I found out more about his struggles with mental health than I ever knew, and people were aware of them many years before Eig.

Dr. King never shared his emotional problems with anyone while he was alive in order to avoid the stigma in those times. Initially I asked “Why?” type questions. Why does anyone dig into a person’s private health information? That’s called PHI for short and it’s not supposed to be readily available to just anybody. Health professionals know that.

And then I remembered something I learned gradually over the course of my career as a psychiatrist. It’s hard to frame useful answers to “Why?” questions. It’s often more helpful to ask “What?” questions, mainly because they lead to actionable replies about things we might need to change.

What did I do as a teacher before I retired from consultation-liaison psychiatry in order to train those who would improve on what I did?

I shared with my students what I thought would be most helpful to them in their careers going forward:

The shortage of psychiatrists in general, and of C-L psychiatrists specifically, still leads me to believe that George Henry was right when he said:

“Relegating this work entirely to specialists is futile for it is doubtful whether there will ever be a sufficient number of psychiatrists to respond to all the requests for consultations. There is, therefore, no alternative to educating other physicians in the elements of psychiatric methods.”– George W. Henry, MD, 1929 (Henry, G.W., SOME MODERN ASPECTS OF PSYCHIATRY IN GENERAL HOSPITAL PRACTICE. Am J Psychiatry, 1929. 86(3): p.481-499.)

There was so much in Henry’s paper published in 1929 that still sounds current today. I can paraphrase the high points:

  • Practice humility and patience
  • Avoid psychiatric jargon
  • Stick close to facts; don’t get bogged down in theories
  • Prevent harm to patients from unnecessary medical and surgical treatment, e.g. somatization
  • “The psychiatrist deals with a larger field of medical practice and he must consider all of the facts.”
  • The psychiatrist should “…make regular visits to the wards…continue the instruction and organize the psychiatric work of internes…attend staff conferences so that there might be a mutual exchange of medical experience”
  • Focus on “…the less obvious disorders which so frequently complicate general medical and surgical practice…” rather than chronic, severe mental illness

The advantages of an integrated C-L Psychiatrist service (here I mean integrating medicine and psychiatry; mind and body) are that it increases detection of all mental disorders although that requires increasing the manpower on the service because of the consequent higher volume demand in addition to other requests, including but not limited to unnecessary consultation requests.

Further, what still astonishes me is the study which found that among consultee top priorities was an understanding of the core question (Lavakumar, M. et al Parameters of Consultee Satisfaction With Inpatient Academic Psychiatric Consultation Services: A Multicenter Study. Psychosomatics (2015). The irony is that the consultees frequently do not frame specific questions (Zigun, J.R. The psychiatric consultation checklist: A structured form to improve the clarity of psychiatric consultation requests. General Hospital Psychiatry 12(1), 36-44; (1990).

Moreover, it is sometimes necessary to give consultees bad news. A consultant should be able to tell a colleague what he or she may not what to hear. This principle is applicable across many disciplines and contexts. And it is best delivered with civility.

A former president of the ACLP said:

“A consultation service is a rescue squad.  At worst, consultation work is nothing more than a brief foray into the territory of another service…the actual intervention is left to the consultee.  Like a volunteer firefighter, a consultant puts out the blaze and then returns home… (However), a liaison service requires manpower, money, and motivation.  Sufficient personnel are necessary to allow the psychiatric consultant time to perform services other than simply interviewing troublesome patients in the area assigned to him.”—Dr. Thomas Hackett.

I don’t think it’s too much to expect things to improve. Speaking of improvement, Stephen Covey called it “sharpening the saw,” one of the 7 habits of highly effective people. For this, The University of Iowa Hospitals and Clinics C-L Psychiatry has the Clinical Problems in Consultation Psychiatry or CPCP. This was started by Dr. Bill Yates in the 1990s, and it was originally called Problem-based Learning. “PBL…emphasis on the development of problem-solving skills, small group dynamics, and self-directed methods of education…most common types of problem categories identified for the conference were pharmacology of psychiatric and medical drugs (28%), mental status effects of medical illnesses (28%), consultation psychiatry process issues (20%), and diagnostic issues (13%) …PBL conference was ranked the highest of all the psychiatry resident educational formats.”

  • Yates, W. R. and T. T. Gerdes (1996). “Problem-based learning in consultation psychiatry.” Gen Hosp Psychiatry 18(3): 139-144.Yates, W. R. and T. T. Gerdes (1996). “Problem-based learning in consultation psychiatry.” Gen Hosp Psychiatry 18(3): 139-144.
    • Covey, S. R. (1990). The seven habits of highly effective people: restoring the character ethic. New York, Simon and Schuster.         

What did I do when burnout made me a less effective teacher? In 2012 I started getting feedback from colleagues and trainees indicating they noticed I was edgy, even angry, and it was time for a change.

After reflecting on the feedback from my colleagues and students, I enrolled in our university’s 8 week group Mindfulness-Based Stress Reduction (MBSR) program. Our teacher debunked myths about mindfulness, one of which is that it involves tuning out stress by relaxing. In reality, mindfulness actually entails tuning in to what hurts as well as what soothes.

Maybe we should ask what helped Dr. Martin Luther King, Jr. persevere in spite of the inner turmoil and external pressure.

Dr. Martin Luther King Jr Day Events 2026

Here’s a list of events I know of so far regarding the observance of Dr. Martin Luther King Jr Day:

The city of Iowa City has day of service and other events you can find at this link.

The city of Coralville has events starting on January 16th and more, which you can learn about here.

The Iowa Children’s Museum has scheduled events that sound very fun and interesting for families and which you can find out more about here.

Glue Myself to My Biography

There’s a reason for why I so often tell Dad jokes. In keeping with my post from yesterday about Dr. Martin Luther King, Jr’s biographies:

I glued myself to my autobiography. You may not believe it, but that’s my story and I’m sticking to it.

We’ve ordered a couple of biographies about Dr. King. One of them is his autobiography and the other is Jonathan Eig’s book, “King: A Life.”

I’m getting to be too old to write my own autobiography—guess it’ll have to be done by autopen. Sorry about that one (no I’m not).

I’m a psychiatrist so I know when I’m using humor as a defense mechanism. A lot of good that does.

I’ve never seriously considered writing my autobiography. I could have it tattooed on my back—it would be my backstory.

Seriously—no, I guess that’s impossible. On the other hand, every year about MLK Day, I think about the blog I wrote that the Iowa City Press Citizen published in 2015 on January 19th. It’s becoming almost something like a tradition. I think I need to repost it annually around this time. The title is “Remembering our calling: MLK Day 2015.” 

“Faith is taking the first step, even when you don’t see the whole staircase.”

-Martin Luther King, Jr.

That quote is interesting because Jonathan Eig’s biography of MLK can be said to reveal more of the staircase, so to speak, at least from the standpoint of his flaws as well as his strengths. But I stray from the tradition:

As the 2015 Martin Luther King Jr. Day approached, I wondered: What’s the best way for the average person to contribute to lifting this nation to a higher destiny? What’s my role and how do I respond to that call?

I find myself reflecting more about my role as a teacher to our residents and medical students. I wonder every day how I can improve as a role model and, at the same time, let trainees practice both what I preach and listen to their own inner calling. After all, they are the next generation of doctors.

But for now, they are under my tutelage. What do I hope for them?

I hope medicine doesn’t destroy itself with empty and dishonest calls for “competence” and “quality,” when excellence is called for.

I hope that when they are on call, they’ll mindfully acknowledge their fatigue and frustration…and sit down when they go and listen to the patient.

I hope they listen inwardly as well, and learn to know the difference between a call for action, and a cautionary whisper to wait and see.

I hope they won’t be paralyzed by doubt when their patients are not able to speak for themselves, and that they’ll call the families who have a stake in whatever doctors do for their loved ones.

And most of all I hope leaders in medicine and psychiatry remember that we chose medicine because we thought it was a calling. Let’s try to keep it that way.

You know, I’m on call at the hospital today and I tried to give my trainees the day off. They came in anyway.

I used to joke that they would erect a playdoh statue of me in the Quad (Quadrangle Hall was there) on the University of Iowa campus someday. Unfortunately, the Quad was demolished in 2016, so I guess I can’t put that in my autobiography.

Since I retired in 2020, I keep meaning to write my memoirs, but I never get around to it. I guess that makes it my oughta biography.

A Few Thoughts About the New Biography of Dr. Martin Luther King, “King: A Life”

I just learned today about the new biography of Dr. Martin Luther King, Jr. written by Jonathan Eig. It was published a couple of years ago and I found a lot of YouTube interviews of him. I didn’t look through hardly any of them and saw only one in its entirety, which is below.

Like many people, I was surprised by what Eig found out about Dr. King’s life. It’s pertinent for the upcoming observation of the upcoming MLK holiday. It’s probably not going to be without some controversy. No doubt, some might find it a bit cringeworthy at times. It’s noteworthy that he consulted many who were personally acquainted with Dr. King.

During Eig’s presentation, I was uncomfortably aware of never having read any of the biographies of Dr. King that have already been published, including his autobiography. I was stunned to hear that there has not been a new biography published since the early 1980s.

It’s probably high time I read one.

11 Card Cribbage Now!

Hey, it’s New Year’s Eve and it’s time for 11-card cribbage! Recall, the American Cribbage Congress (ACC) website has a cribbage variations page in which the unknown author reports there being many cribbage variants, including 11 and 13 card cribbage.

So, yesterday we played 12-card cribbage and we decided to address the 11-card variant today. We intend to tackle the 13-card variant “next year.”

We did OK, although I had a miscount (counted 31 in the play instead of 30 near the end of the game). Again, it took us about 20 minutes to play it.

Scores can be difficult to count so you might want to check on this link for the calculator.

We made up the rules because, of course, there are no rules. This puts any of these game variants into the Calvinball Crib category. This is because there are no established rules and the name just has a little fun with that name because of the definition of the name Calvinball:

“Activity reminiscent of the imaginary game of Calvinball (see etymology), in not following any 1994- discernible rules, or in which individuals act in a self-servingly inconsistent manner. Also (and in earliest use) as a modifier.”

Did you know there’s a place in Canada that makes a Calvinball Cribbage board? It’ll set you back $140. We can’t tell if there’s a tariff on it.

Did you know that Artificial Intelligence (AI) has confabulated a description of Calvinball Cribbage? I copied it for you:

“Calvinball Cribbage is a humorous mashup of the chaotic, rule-free game from Calvin & Hobbes with traditional Cribbage, often involving themed boards or rule modifications, where the core idea is applying Calvinball’s fluid, make-it-up-as-you-go spirit to Cribbage’s scoring and play, adding wild, non-sensical rules like using mallets, changing hand values, or scoring points for silly actions, making each round unique and unpredictable, not a single defined game but a creative approach to Cribbage. 

What it is (The Calvinball Aspect):

  • No Fixed Rules: Just like original Calvinball, there’s no single set of rules; the players invent them as they go.
  • Rule Changes: A key rule is that rules can’t be repeated, and players constantly invent new scoring, actions, or penalties.
  • Props & Actions: You might use mallets, balls, trees, or make up actions like “scoring three points for pointing at a cloud” or “losing a turn for looking left”. 

How it Applies to Cribbage:

  • Themed Boards: You can find or make custom cribbage boards featuring Calvin & Hobbes, adding visual flair.
  • Modified Scoring: Instead of just points for pairs and runs, you might add a “Hobbes Bonus” for a specific card or penalize for “too much logic”.
  • Strategic Chaos: Players still play cribbage (cards, pegs, crib), but the gameplay is constantly disrupted by invented rules, turning strategic plays into potential jokes or absurd victories. 

Example Calvinball Cribbage “Rules”:

  • “If you play a 7, you must hop on one foot until your next turn”.
  • “The crib gets 5 points if it contains a card with a face on it” (referencing Calvin’s drawings).
  • “A ‘skunk’ is achieved by making your opponent laugh out loud”. 

In essence, Calvinball Cribbage is about injecting unpredictable fun and silliness into the structured world of cribbage, making it a game of spontaneous creativity rather than strict strategy. “

How do you feel about AI now? You know, I wonder why somebody hasn’t yet come up with a new club: Calvinball Cribbage Congress (CCC). Somebody could make a cool tee shirt for the club.

We wish everyone a Happy New Year in 2026!

The Missing 29 Cribbage Board and a Little History

We’ve been searching around for our 29 Cribbage Board. It’s in the shape of 29 which is the highest score you can get in cribbage. The hand is typically shown with three 5’s and the nob Jack and the cut card is the other 5. This is usually a diamond 5, but the heart or the spade 5 is also shown on some boards. The odds of getting this hand are 1 in 216,580.

Sena didn’t find it after a thorough search top to bottom of our house, so it must have gotten lost in the move last year. One of the reasons why this suddenly became an issue of national importance is that I read another one of those long historic articles on the American Cribbage Congress (ACC) website—which never lists the bylines of the persons writing them.

It turns out that a guy named Edward M. Hirst in Canada who first designed and started making the 29 board by himself back in the early 1950s. Customers would wait months for them. They weren’t mass-produced until two years after he died. Crisloid, Inc. (based in Rhode Island) made them for a while and this name is familiar to me because I shopped for a giant cribbage board from them a few years ago. They had stopped making the 29 board long before then. Interestingly, they made one of those very complicated continuous 3 track cribbage boards with complicated scoring for things like “Legs” and other features that eventually were more of a hallmark with another famous cribbage board maker–Drueke Co. And then Drueke Co. started making the 29 boards.

Eventually manufacturing of the 29 boards moved to Taiwan because they could be made more cheaply there. Nowadays, America’s role in sales has moved to vendors, such as Hoyle, Bicycle, Walmart, etc. There’s a reddit thread which shows a picture of a 29 board which contains a short history of the board.

Anyway, by way of personal history, we started playing cribbage again in 2019 after a 20-year hiatus. I have a dim memory of us experimenting with several card games back then, including cribbage. And then we dropped card games for a long time. And about 5 or 6 years ago we got a 29 board, because it was interesting and cheap.

I made a YouTube video of the game. It got about 1,800 views. It had some of the features discussed in the ACC history, which we think is really interesting. The nob Jack and 5 cut card were diamonds. There was a 121 hole (which some boards don’t have, believe it or not!).

And there’s also a Cribbage Board Collector’s Society (CBCS). The interesting thing they point out is that no one has ever reported to them about finding a 29 board with the Jack and the 5 cut card in the club suit. I couldn’t find one on the web, even on Ebay.

We immediately shopped for another 29 board but the one we want is sold out. Until then, we can reminisce.

Thoughts on Comebacks

I watched the first half of the Colts vs 49ers game last night and I thought Philip Rivers didn’t look half bad for a 44-year-old guy who’s been out of the game for five years. Did you know he has 10 kids? OK, now that I’ve got that out of my system and that would be, what—the 44th time you’ve heard that since he took the field?

So what the Colts lost? His big family was up in the stands going crazy, cheering him on.

I read an article this morning which had Steve Young saying he could make a comeback at his age—which is 64. I couldn’t believe it. The same story mentions that George Blanda played for the Oakland Raiders when he was 48 back in 1975.

It got me wondering whether I could make a comeback as a general hospital consulting psychiatrist. Could I gallop up 6-8 floors of University of Iowa Health Care? You bet your bottom dollar—I couldn’t.

It’s hard to retire. Every once in a while, I miss hiking up and down the hospital with my camp stool, deftly swinging it around and sitting with the patients and families, telling medical students and residents all kinds of lies (I mean “wise old adages and pearls of clinical wisdom”).

I get a kick out of just wondering what it would be like. I get a vision of myself with a big, golden glowing aura of greatness around my head—until I come to my senses. Hey, nobody’s going to pay me a quarter million dollars to run the consult service for the few months I’d be able to limp around the hospital, falling off my camp stool when my legs go numb or the chair breaks.

It’s not like I can just throw a football like it’s nothing after 5 years. I’d have to prove I still have enough clinical smarts to figure out how to introduce myself (Hi! I’m Philip Rivers and you need to go long!”).

The Maintenance of Certification Circus is still a thing and it’s worse. I’m not saying doctors don’t undertake the arduous task of essentially retraining to be what they once were—because that’s not good enough anymore.

Last night, the camera caught Phil more than once being just as hard on himself as he was with other members of the team who weren’t in the right spot at the right time. Most physicians are perfectionists and if you’ve been out of the game for a while and you try to squeeze back in, you could wind up mumbling to yourself, “They don’t make footballs like they used to!”

I didn’t stay up for the second half of football game. It wasn’t because of anything Philip did or didn’t do on the field.

I just can’t stay up that late nowadays.

Pearl Harbor Day Today

Today is Pearl Harbor Day and it reminds me of the time we made a trip to Hawaii in 1997 and visited the USS Arizona Memorial. There was a guy named Norm in our tour group and he and his wife Lee (Leota) made friends with me and Sena. They were in their seventies at the time. Norm wept openly when we stood inside the memorial and viewed the names of those killed in the attack. I don’t think he served in WWII. He would have been only 16 years old at the time. I think he was just very affected by the loss of so many lives. Standing in the place where so many died can make us want to cry. You could call it normal—and it is sad. We exchanged Christmas cards with Norm and Lee for years afterward until they passed.

USS Arizona Memorial
Pearl Harbor Day

Big Mo Pod Show: “Garage Blues”

I heard the Big Mo Blues Show last night and the Big Mo Pod Show today. I can say that the Garage Show title refers to a get together during the Covid pandemic that Big Mo threw and held in his garage and featured local Blues artists including Bryce Janey, who is number 5 on the list of songs with “Down Home Blues.”

Big Mo Pod Show 084 – “Garage Blues”

Anyway, the most interesting part of the podcast was the 3rd song, “Coal Black Mare” (misspelled as “Cold Black Mare”) which was produced by Bob Corritore and released as part of historical album released October 17, 2025 entitled “Bob Corritore and Friends—Early Blues Sessions.” It includes songs recorded between 1984 and 2007. Corritore was on harmonica and blues artist Clarence Edwards sang the song (he died in 1993).

I looked up Clarence Edwards on Wikipedia and he was born in Louisiana in 1933 and became more widely known in the 1980s when he performed on a national blues festival circuit. I found a version of Coal Black Mare recorded in 1961 by Edwards.

The song “Coal Black Mare” has a very interesting history all by itself. Most internet articles say Arthur “Big Boy” Crudup, was probably best known for writing the song “That’s All Right” in 1946 which Elvis Presley make famous later. Some say “That’s All Right” was the first rock and roll song. The Blues Hall of Fame says that Crudup was the “The Father of Rock ‘n’ Roll.”

I found references that say Crudup wrote “Coal Black Mare” and released it in 1962 or 1965 (the Fire Sessions) depending on which web site you read. I also found a song entitled “Black Pony Blues” which on most web sites is the same as “Coal Black Mare” and was recorded in 1941 under Crudup’s name. They both sound like the same song.

Opinions differ about the meaning of the song “Coal Black Mare.” While I think most would say that it’s about a black race horse that won a lot of races, I think the “gold earrings” and “gold teeth” lyrics could make some people wonder if this is a metaphor for a woman. I found a web reference hinting at this, speculating that Charley Patton’s 1929 “Pony Blues” might have inspired the song and say that in all versions, including Crudup’s, the black mare stands for “…a black lover.”

I got lost in the internet forest on this one and I’ll be the first to admit I don’t have the first idea of whether or not “Coal Black Mare” was inspired by Charley Patton’s “Pony Blues.” And while I think gold earrings and teeth would look odd on a horse; I also suspect Crudup was probably singing about a race horse.

Your thoughts?