humor – Go Retire Psychiatrist

Confabulation in Artificial Intelligence

I saw an excellent post on Artificial Intelligence (AI) in Dr. George Dawson’s post today, “The Problems With AI Are More Readily Apparent.” He mentions AI producing confabulations which are sometimes called hallucinations in AI. I distinguish hallucinations from confabulations because the former are sensory or perceptual problems while confabulations are making things up. In dementia, confabulations are often described as attempts to fill in gaps in knowledge or memory without any intention to deceive.

I sometimes read that AI is being sycophantic in its interactions with humans, which sounds a little strange to me. The definition of sycophancy is more about trying to please someone else by being obsequiously flattering. It’s puzzling but I have gotten that impression from AI, yet it’s a machine and I don’t know how anyone would program AI to be sycophantic because it’s a human trait.

On the other hand, I got a comically sycophantic reply from AI to my question inquiring about the definition of Calvinball Cribbage. It’s just a made-up term and, to be fair, I’ve also gotten bluntly frank denials from AI that there is any such thing as Calvinball Cribbage.

As a reminder, Calvinball is a term that arose from a comic strip called Calvin and Hobbes. In the strip, the characters invent a game called Calvinball and the only rule is making up the rules as you go along, although there is a goal of capturing your opponent’s flag. But you can’t play it the same way twice.

The most recent hilarious AI confabulation I’ve previously posted about was when Sena and I played our game of 11-card cribbage. There are cribbage players out there who make fun of such variations from standard 6-card cribbage and the name for it from one such player was “Calvinball crib.” My simple question was as usual, “What is Calvinball Cribbage?” The reply is copied below:

“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. “

This could be an example of sycophantic confabulation because almost all of it was probably cooked up by AI from scanning my blog posts about the subject. What’s a little eerie about it is that I never published any specific rules or strategies about the fictional game of Calvinball crib. You can actually find and purchase a Calvin and Hobbes cribbage board from a shop in Canada.

While this is an example of the occasional comicality of AI, that shouldn’t lead us to deny that it can do scary things, some of which Dr. Dawson describes. My early experiences a couple of years ago with what used to be called Google Bard were somewhat alarming because it confabulated then. And it still does.

Connections Between Psychiatry, Artificiality and Blues Music?

I heard a song on the KCCK Big Mo Blues Show that I first heard in June of 2025. The song is “Artificial” by Walter Trout.

At first blush, I agree with what I think is the point of the song, which is basically a protest against artificiality which could manifest in a range of ways from superficiality and dishonesty in communications, attitudes, style of clothing, relationships, and all the way to Artificial Intelligence (AI).

The other connection I make is to the artist himself. Walter Trout developed Hepatitis C (eventually leading to liver transplant) according to a Wikipedia article which connected his lifestyle to contracting the disease. In my role as a consultation-liaison psychiatrist, I saw many patients with Hepatitis C who were referred to psychiatry from gastroenterology.

I was the main psychiatrist who evaluated them for treatment with Interferon-alpha. At the time it was the only treatment for Hepatitis C and was frequently associated with many side effects including depression. I was also one of the psychiatrists consulted as part of liver transplant evaluations.

Trout got very sick from Hepatitis C and made a remarkable (even miraculous) recovery after his liver transplant. Interferon is no longer used to treat Hepatitis C. It has been replaced by direct-acting antiviral (DAA) agents. They’re much better-tolerated and more effective.

The other aspect relevant to Trout’s song is ironic. The newest scientific literature supports the idea that AI can be helpful for diagnosing Hepatitis C, predicting its progression and response to treatment.

That doesn’t mean I’m completely sold on AI.

Aside from that, there’s interesting research suggesting that there may be a link between schizophrenia and bipolar disorder and Hepatitis C infection (which could be hiding deep in the brain’s choroid plexus lining the cerebral ventricles). In other words, some people might have mental illness because of the liver disease itself.

If you think about the dictionary definition of the word “artificial,” you can hardly dismiss this kind of research as insincere.

Snow Squalls Predicted in Iowa Today!

The National Weather Service predicts “snow squalls” for parts of eastern Iowa today in the afternoon.

I’m only using this GIF because I couldn’t find one for the State Farm commercial captain “A squall’s a’comin’!

Sena recognized the guy in the GIF above as W.C. Fields and wondered if there were any other videos of this scene with audio as well. They aren’t hard to find.

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.

Kudos to Dr. George Dawson on Today’s Blog Post!

I want to give a shout-out to Dr. George Dawson on his post today, “Enthusiasm is a plus…” It’s right on the mark.

Having a zest for medicine is the reason why many physicians undertook the rigorous training in medical school, residency, and beyond. A sense of humor is evident in George’s essay—and he doesn’t need to be comedian.

His essay reminded me of the many trainees who took their rotation through the psychiatry consultation service when I was running it (or tried to, anyway!). Many deserve a shout out as well for not only working hard on the service but teaching as well. I prevailed on them to make a short presentation during the rotation. I called it the Dirty Dozen.

They picked a topic often about an interesting consultation case we had seen and put together a talk with a dozen slides. They gave a Dirty Dozen called: “Neurology and Psychiatry: Divided or United?” It included some of Dr. Ron Pies ideas on a subtopic of whether psychiatry and neurology can ever be combined as a discipline (three diagrams of his are in the slides). You can also see a sense of humor, especially in the first slide.

Note: Because I couldn’t locate all of the trainees to get their permission to leave their names on the title slide, I chose to identify them as “Trainees.” I’m still very proud of all of them.

Slides from trainees on Neurology and Psychiatry: Divided or United? from UIHC Psychiatry Consultation Service, 2017. Figures included from Dr. Pies’ article in Psychiatric Times (see below):

Citations:

Arzy, S. Danziger, S. (2014).. “The Science of Neuropsychiatry: Past, Present, and Future.” The Journal of neuropsychiatry and clinical neurosciences 26.4 2014): 392-395.

Daly, R. Pies, R. (2010). Should Psychiatry and Neurology Merge as a Single Discipline? Psychiatric Times.

Fitzgerald, M. (2015). Do psychiatry and neurology need a close partnership or a merger? BJPsych Bulletin, 39(3), 105–107.

Pies, R. (2005). Why psychiatry and neurology cannot simply merge. J Neuropsychiatry Clin Neurosci; 17: 304-309.

Schildkrout, B., Frankel, M. (2016). Neuropsychiatry: Toward Solving the Mysteries That Animate Psychiatry. Psychiatric Times.

Price, BH., Adams RD., Coyle, JT. (2000). Neurology and psychiatry, closing the great divide. Neurology January 11, 2000 vol. 54 no. 18

Ronald W. Pies, M., & Robert Daly, M. (2026, January 5). Should psychiatry and neurology merge as a single discipline?. Psychiatric Times. https://www.psychiatrictimes.com/view/should-psychiatry-and-neurology-merge-single-discipline?

Svengoolie Movie: “Blood from the Mummy’s Tomb”

Svengoolie Intro: “Calling all stations! Clear the air lanes! Clear all air lanes for the big broadcast!”

So, you can give me credit for watching the Svengoolie movie “Blood from the Mummy’s Tomb” last night instead of the Seattle Seahawks vs San Francisco 49ers football game. Sena watched a little of it and probably not enough to rate it. You need to know there is such a thing as scalp psoriasis to get the joke in the featured image.

Before I get into this Hammer horror flick, I need to have a little fun at Svengoolie’s expense about his Too Drawn Out picture. You have to know that this is a puzzle game. Svengoolie draws a few cartoons, gives some hints about what the pictures suggest, and puts them together to make a word that is connected to the movie. Some fans give him a hard time about them because, frankly, the clues occasionally reach a little too far.

His first picture in this bit would be familiar to people mainly in my generation or older. Although it’s a bit unfair to kids, you have to give him credit as an artist. The figure actually did resemble a character in a popular (to some of us) TV sitcom years ago. I guessed this one right because we watched The Honeymooners. It was Ed Norton climbing out of (or into?) a sewer because that was his occupation. Art Carney played Norton. Jackie Gleason played the “bus driver” that Svengoolie gives as another clue. The main goal is to name the common underground drainage feature in cities, which was “sewer.”

The next drawing is of a guy either sneezing or coughing and Svengoolie makes it clear that it’s not the former. The clue was “cough.”

The drawing after that was of an ugly old crone, which was a bit difficult to get but turns out to be “hag.”

The last drawing was of some guy with a speech balloon with the cartoon symbols often used to indicate foul language or swearing. This clue was “cuss.”

The final answer? It’s “sarcophagus.” Sewer-Cough-Hag-Cuss. OK, almost there. I’ve done my own version of these in the past and I thought of this one for “sarcophagus.” The word “sewer” is a stretch, especially if you’re not from my generation, given the hints. I use different clues with different hints:

Sir: the drawing is that of a soldier saluting. What do soldiers often say when they salute? “Sir!”

Cuff: the drawing is a shirt cuff with a cufflink. What is this part of a man’s shirt called?

Hog: the drawing is that of a big sow. A large pig, either sow or boar, is often called a hog. What is this large farm animal?

Gust: the drawing is of gusts of wind blowing a flag. What is making the flag fly and flap? A “gust” of wind.

It ends up as Sir-Cuff-Hog-Gust. You’re supposed to say these fairly fast, running the words together to solve the puzzle. If you sound this out right, you get…that’s right, Art Carney!

Moving right along, we need to discuss this 1971 Hammer production movie which doesn’t really have a mummy in it. The gist of the story is that a group of archeologist explorers go digging around somewhere in Egypt and find this tomb with the beautiful but blurred Queen Tera (Valerie Leon) who is more mammarized than mummified, which accounts for the blurring of her chest area. In fact, even the ancient drawings of women on the tomb walls blur their boobs.

The film makers go to a lot of trouble hiding parts of Queen Tera’s anatomy, yet could not come up with a way to prevent Ms. Leon from flinching when one of the priests shoves what looks like a nasal irrigation device up her nose. I mean he really jammed it in there and she reacted by nearly jumping off the table, sneezing blood repeatedly and cussing like a stevedore! In general, this is not the way dead people behave…unless they’re in a Hammer film.

Anyway, after the nasal sinus irrigation leads to the flushing of about a pint of blood and a fairly large mosquito from her nose, the priests proceed to cutting off her right hand, along with a ring with a huge ruby (although not nearly as big as other parts which I will not mention and which are massively blurred in any case). The ruby contains a replica of a constellation of 7 stars which do not include Art Carney.

Actually, the seven stars thing is adapted from Bram Stoker’s novel “The Jewel of Seven Stars,” although, technically, only seven stars would not count as a galaxy, according to Zed from the well-known documentary film, “Men in Black” who had to school Agent J that the galaxy was not on Orion’s Belt, as anybody knows.

The group of explorers take Queen Tera and a lot of artifacts from the tomb, which turn out to be very bad for their health, including the daughter, Margaret (also played by Valerie Leon) of one of them named Fuchs (Andrew Keir). Margaret apparently has a partial exemption from the blurring clause.

Margaret seems to have no fear of the groping chopped off hand (played by Thing from the Addams Family, if you’re curious) of Queen Tera. But the explorers get their throats torn out either by Thing or the Pharoah Hound (also lifted from Bram Stoker), which has an annoying tendency to bark along to “Who Let the Dogs Out” by the Baha Men.

I’m not going to reveal the ending although I can tell you that it involves the only scene which reveals anything that even remotely looks like a mummy.

I think the movie is OK, but a bit blurry in places. I give it a Shrilling Chicken Rating of 3/5.

Big Mo Blues Show and The Elvis Connection

The Big Mo Blues Show was really interesting last night. I’m just going to highlight a number done by John Hiatt called “Riding with the King.” The lore about this that I picked up from the internet is that Hiatt originally wrote and sang the song for the 1983 album Riding with the King. It was a tribute to a king known as Elvis Presley. The short story is that the song was inspired by a weird dream that the album’s producer, Scott Matthews, had about flying with Elvis Presley.

Years later, in 2000, the song was covered in an album by Eric Clapton, and the other king, B.B. King. The album was also called Riding with the King. Some reviewers thought the product was too slick, although to be frank about it, Hiatt’s production didn’t chart in the U.S.

The first time I heard Hiatt, I think it was on the Big Mo Blues Show. He sang “Gone,” which was on the album Crossing Muddy Waters, produced in 2000, the same year Clapton and King made the album which had the cover of Hiatt’s original song “Riding with the King.” I liked “Gone” because it was funny. I’m partial to humor in just about any context.

That reminds me of the Elvis Presley connection here about “Riding with the King.” About 8 years ago Sena and I made peanut butter and banana sandwiches, which Presley made famous. I blogged about it but I can’t find that post anymore. We didn’t really like the sandwich, although I wonder if the guy who had the dream that inspired the song “Riding with the King” had a PB & Banana sandwich just before bedtime. I kept the pictures but the post is—Gone!

Shoveling Through Retirement Thoughts

I was just musing on Philip Rivers. You know about him. I blogged recently about his coming out of retirement to play quarterback for the Indianapolis Colts. I guess you already know this, but he retired again.

Unlike Philip Rivers, I’ve not even considered coming out of retirement since I left my position at The University of Iowa Health Care (UIHC) over 5 years ago. I never looked back.

But that doesn’t mean I never think about looking back. I look back a lot and that’s mostly because I’m an old guy. I was a consulting psychiatrist in the general hospital.

Anyway, occasionally I search my name on the web and laugh at what comes up. I never went to Baylor College of Medicine, much less graduated from there.

I did a few things when I was a doctor. Not all of them were about work, but most of them were.

Those who know me know that I always hated Maintenance of Certification (MOC). I checked the American Board of Psychiatry & Neurology website and my MOC contribution to continuing education is still there. It’s a clinical module on Delirium, which a lot of doctors and other health care practitioners see every day in the hospital. Dr. Emily Morse worked on it as well. She’s still working at UIHC.

I co-edited a book about consultation-liaison psychiatry with my former chair of the Psychiatry Dept, Dr. Robert G. Robinson, may he rest in peace. It’s “Psychosomatic Medicine: An Introduction to Consultation-Liaison Psychiatry.” You can buy it on Amazon—please.

I wrote a case report on catatonia caused by withdrawal from lorazepam (a benzodiazepine), and it’s still available. It was first published in Annals of Psychiatry.

But one of the things I’m proudest of doing was writing a short article for the University of Iowa Library for Open Access Week.

In it, I tell a short anecdote about my lofty (OK, a better word is “greedy”) thoughts about how much money I could make shoveling snow. I was just a kid and I never made it outside to shovel anybody’s walk because I was too busy calculating my income. I wrote that way back when I had another blog, The Practical Psychosomaticist. The photo of me shows my Leonard Tow Humanism in Medicine pin fixed to my lapel—another thing I’m proud of. By the way “Tow” rhymes with “Wow.”

Libraries have always been my one of my favorite places to hang out. Anyway, I’ve got more time to do things like hang out in general. I think Philip Rivers will adjust.

13 Card Cribbage to Ring in the New Year 2026!

Well, we played the 13-card cribbage game today and we survived it! I got to tell you; I don’t know how anyone would invent such a hairy cribbage variant. I got so mixed-up Sena had to bail me out on counting a complicated run.

We did use a special cribbage scorer that I picked up from a Reddit cribbage thread.

What is ironic, if I had not had a problem with one of the counts, the game would have lasted about 20 minutes, give or take—just like the last few Calvinball Crib variants we’ve played. We’ve been through 6-card through 13-card versions and those are just the ones we’ve heard about.

It still makes me wonder whether there should be a new organization, the Calvinball Cribbage Congress (CCC), analogous to the American Cribbage Congress (ACC). The CCC could have their big annual tournament in Reno, Nevada (I think it’s at the J Resort (Casino/Sands). And we’d have to have special tee shirts with a distinctive logo.

Certain requirements would have to change, like the amount of time you have to finish a cribbage game at the CCC. In the time it takes to play 13-card cribbage, Santa Claus could shave his beard and grow it back. Of course, as you know, you have to be able to play a 6-card cribbage game in 15 minutes.

We’d need a special cribbage board and the likely candidate would be the Calvinball Cribbage board made in Canada.

Based on the currency exchange rate, the board would cost a little over $100 in U.S. dollars. The board is on the small side (11in x14in), so it would be easy to provide them for the thousands who would flock to Reno for the big CCC tournament—as long as you charge for them. The going rate for a tournament board the size and brand (CreativeCrafthouse, made in the good old USA) of the one we use is about $75.

You should write to the CCC President about it—except there isn’t one yet.

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:

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!