Iowa – Go Retire Psychiatrist

Ivermectin Bill Looks Like It’s Dead-For Now

This is a quick followup on the progress of Governor Reynolds MAHA bill which included a piece endorsing making Ivermectin available over-the-counter in Iowa. I just read a story about what looks like the disappearance of the ivermectin from Reynold’s bill. The story, written by Laura Belin, comes from a webpage called Bleeding Heartland: An independent website about Iowa politics.

I don’t follow politics avidly (putting it mildly), but I think I understand a short paragraph from Ms. Belin’s article”:

“The Senate didn’t advance the governor’s bill. Instead, Senate Health and Human Services Committee chair Kara Warme introduced her own “health-related matters” bill, which got through committee and is eligible for floor debate. That legislation (Senate File 2367) incorporated the governor’s proposals on nutrition education, certificates of need for health care facilities, federal food assistance, and food dyes in schools, but left the ivermectin language on the cutting room floor.”

It looks like another anti-vaccine bill bit the dust—for now. I would cheer, but I know better. I expect somebody will resurrect it at some time in the future. I hope Dr. Austin Baeth is still around when it happens.

Rash of Bigfoot Sightings in Ohio, So What About Iowa?

Actually, I should refer to the multiple sightings of Bigfoot as a flap. That’s proper terminology. The news story shows a video with the cryptid on it although I think it looks more like somebody smeared a chocolate bar on the camera lens.

There’s an organization called Bigfoot Society that is tracking the story. The Bigfoot Society Podcast by Jeremiah Byron of Earlham, Iowa posts weekly about Sasquatch sightings and lore. Here’s one about Iowa. There are a lot of ads periodically, so be patient.

There’s one thing I couldn’t find on the web and that’s the Iowa Bigfoot Information Center. There was a guy named Kevin Cook who was the head of it, but that was back in the late 1970s, which supposedly is when there were a lot of Bigfoot sightings. I found a really short article from September 24, 1978 published in the Des Moines Register about him.

I did a little digging and Kevin Cook partnered with another Bigfoot researcher named Clifford Labrecque to start the Iowa Bigfoot Information Center. Jeremiah Byron’s full YouTube presentation is sponsored by the Bigfoot Society Podcast and, unfortunately is available to members only. But there is a short teaser.

In the teaser, Byron interviews Kevin Cook and, although I can’t tell exactly how recent it is, I believe it was done shortly after Labrecque passed in 2021. The discussion mentions a prominent scientist, Dr. Jeff Meldrum, who has been interviewed on TV about Bigfoot. Unfortunately, he also passed in September of 2025. He was a full professor of Anatomy and Anthropology in the Dept of Biological Sciences at Idaho State University. He was a guest on some popular TV shows about Bigfoot (one of them misidentified him as being on faculty at Iowa State University). People are always getting Iowa mixed up with either Idaho or Ohio.

I’m reminded also of the Bigfoot Field Researchers Organization (BFRO), which keeps records of Bigfoot sighting around the country and they also sponsor annual Bigfoot hunts in Iowa. They had one last year, but I couldn’t find out how that went. There’s 2026 Iowa BFRO Expedition, which starts next month, April 30-May 3. Details are available below the announcement. Guns and dogs are not allowed.

Sena and I have done our own Bigfoot expeditions and one of them is below. No need to thank us; it’s our pleasure to contribute to the scientific endeavor.

Upcoming Sven Squad Movie “Friday the 13th”

The upcoming movie with the Svengoolie Sven Squad this Saturday the 14^th comes a day late. It’s the very first “Friday the 13^th.” I’ve never seen it, but I think I’ve seen a couple of the 35 sequels. I always have to stop and think about how to distinguish the 1978 slasher “Halloween” from the 1981 slasher “Friday the 13^th,” which I think I saw.

I can’t, but that’s OK because I’ve been too busy trying to figure out why the name of the star of the first Friday the 13^thfilm sounds familiar to me. You’ll be thrilled to know that I finally remembered it’s Betsy Palmer from the old 1960’s TV show “I’ve Got a Secret.”

I think she wanted this movie to be a secret until it started making some real money.

Anyway, the movie starts with some guy in a hockey mask slashing various people who then hire a guy in a fancier mask to slash the first guy so they can go back to having casual you-know-what-kind of relations and shoplifting candy cigarettes from K-Mart, which by the way used to be Kresge’s which I am old enough to remember although I never shoplifted anything I swear. What happens next is that Slasher 1 and Slasher 2 meet on the street at high noon and threw samurai swords at each other, often missing and breaking Kresge’s windows until this wakes up Chuck Norris who is pretty annoyed and roundhouse kicks both Slashers into Saturn’s orbit although they manage to hitch a ride on one of those newfangled UFOs which resemble orbs, the extraterrestrial pilots of which hit the warp drive and shoot through a wormhole portal sending them backwards in time to 1977 and boy does that ever mess with the gyroscopes and scorch the spark plugs making it necessary to jettison a load of poorly mixed nuclear grade molten metals into a field in Council Bluffs, Iowa which for some reason did not lead to that fine community becoming a major tourist attraction, so…well, the film probably doesn’t go exactly that way but then I’ve never seen it so it doesn’t hurt to speculate a little bit.

Iowa Flags at Half Staff in Honor of Two Iowa Soldiers Killed in Kuwait

Iowa Governor Kim Reynolds has ordered all Iowa flags to be flown at half-staff until the final day of interment in honor of two Iowa soldiers killed in Kuwait: Major Jeffery O’Brien, 45, of Waukee, Iowa and Sgt. Declan Coady, 20, of West Des Moines, Iowa.

Iowa Ivermectin Bill Heads to the Senate

I see the Iowa House passed HF 2676 including the ivermectin section which would make the anti-parasite drug available over-the-counter (OTC) in Iowa, despite arguments against it about the medical indications for the drug, which don’t include treatment of cancer and Covid-19 infection. There’s a high probability that some people might use it to treat those conditions. It now goes to the Senate.

It’s worth pointing out that a stand-alone version of this bill died in the first funnel. The text of this alternative bill, which is sponsored by Governor Reynolds, is distinctly different from the first one. It uses permissive language saying a pharmacist “may” (instead of “shall”) make this prescription drug used to treat parasite infections in humans and animals available OTC to those who want it for what some might call off-label use.

Recall the original version of this bill said the “medical director” of a pharmacy should write a “standing order” for ivermectin to be available “OTC.” This probably blurs what’s actually implied, which is that someone with “prescriptive authority” write the standing order, such as a physician.

This is clarified in the laws recently passed in June of 2025 in the Louisiana legislature stating that “pharmacists can dispense ivermectin to adults pursuant to a standing order issued by a health care professional with prescriptive authority. When administering ivermectin to a patient, the rule requires pharmacists to provide information on indications and contraindications. A screening risk assessment tool is also required. Pharmacists may charge an administrative fee for these services.”

It looks like Iowa might be taking a slightly different approach. By the state making ivermectin OTC in the first place, the “standing order” piece is bypassed to avoid the apparent contradiction of ivermectin (a prescription drug) having both OTC and prescription features.

But it gets more complicated than that because Iowa has authorized a collaborative drug therapy management arrangement by which a licensed prescriber may allow an authorized pharmacist to prescribe certain drugs. Further, even though states can’t override FDA classification of a drug, they can decide on whether a drug needs a prescription or not. Would it make sense to ask what reason would there be for legislators to seek non-prescription status for a drug—other than expedience?

Under this bill, a pharmacist can’t be sued or be held criminally liable if patients suffer injury or even death by taking ivermectin for an indication which doesn’t make sense to medical science. By contrast, if someone suffers an adverse effect from a vaccine, patients and families have access to the Vaccine Injury Compensation Program and if that’s not effective, they can file lawsuits in state and federal courts. If this sounds unfair, there’s a reason for that which people might not discover until it’s too late. A strong mitigating factor is the pharmacist’s ethical standards.

The FDA has provided guidance about unapproved (off-label) use of FDA-approved drugs. It’s possible to use an approved drug for an unapproved use. However, the major reason why a physician might consider doing this is usually because an approved drug is not available to treat a patient’s condition.

In this case, ivermectin is approved for treatment of parasitic infections and there’s no credible scientific evidence it’s effective for treatment of Covid-19 or certain types of cancers. Off label use is not illegal in the U.S. Insurance may or may not cover the cost. There are a number of drugs used off-label, including the popular drug Ozempic, approved for diabetes and used off-label for weight loss.

I hope the Senate considers the potential for medical trouble with HF 2676.

Clinical Problems in Consultation Psychiatry and The Break-Dancing Koala Bear

I ran across an old Clinical Problems in Consultation Psychiatry (CPCP) presentation by a couple of sharp medical students in 2014. They presented it at one of my morning consult rounds and it’s about Charles Bonnet Syndrome.

They did a very nice job and it compares fairly well with the University of Iowa Ophthalmology Dept summary. One of the authors of that summary is my retinal specialist, Dr. Ian Han, who did the surgery on my detached retina about 4 years ago. It also has a link to a great YouTube video of a woman who has Charles Bonnet Syndrome. It’s not a psychiatric disorder although ironically one of the treatments for it may sometimes be antipsychotic medications.

The other thing about this presentation is that the students’ fictional case description mentions that the patient had visions of “a break-dancing koala bear” among other things. I can’t remember whether I was the one who told them about a video on the internet that showed a break-dancing stuffed koala bear—or if it was the other way around! At any rate, I remember seeing it around that time, but of course I can’t find it now.

The Big Mo Blues Show Highlights Women Singers

Last night the Big Mo Blues Show focused on women vocalists, partly because he said he got phone calls urging him to play more music from female performers. It was an exceptionally good show and I can mention 3 of the women singers who really impressed me.

Early in the show, he played a song called “This Train” by Sister Rosetta Tharpe. I can’t remember hearing her recordings on his show before, but then my memory is not what it used to be. This song was first recorded in the 1930s and Big Mo played a version from the 1950s with her accompanying herself on an electric guitar. It was fun to listen to.

She led an interesting life according to biographies I found on line. She was black and queer and while it must have made her life really challenging (especially during the time of the Jim Crow laws in the 1940s), she was a great success. She was inducted into the Rock and Roll Hall of Fame in 2017.

I can pick out a couple of other songs by female artists that were memorable. One of them was “Let the Tears Roll Down” by Marcia Ball. It was haunting.

And I thought the guitar riffs were stunning on Samantha Fish’s “Highway’s Holding Me Now.” The hairs on the back of my neck always stand up when I hear her song “She Don’t Live Around Here Anymore.” She has that kind of voice.

Oppose Iowa Legislature Bill HF 2171 That Seeks to Eliminate Vaccine Requirements in Public Schools

I have been reading the public comments on the Iowa Legislature bill HF 2171 that, if passed, would eliminate the requirement for vaccines in public schools against many diseases such as poliomyelitis, diphtheria, pertussis, tetanus, rubeola, rubella, and varicella. People are overwhelmingly opposed to it and it’s beyond me how it got past the first funnel.

I’ve added some photos documenting the history of polio from the University of Iowa Health Care Medical Museum.

Iowa Legislature Ivermectin Bill A Game of “Captain, May I?”

I’ve been comparing the Iowa legislature bills on allowing ivermectin to be available over-the-counter in pharmacies. There were two of them and then there was one.

In the first bill, HF 2056, the language in it seemed to strongly direct pharmacists to make ivermectin available by using the word “shall”:

” The medical director of the department shall establish a standing order authorizing the dispensing of hydroxychloroquine and ivermectin by a pharmacist.

Notwithstanding any provision of law to the contrary, a pharmacist shall dispense hydroxychloroquine or ivermectin to a patient who is at least eighteen years of age, upon the request of a patient, pursuant to a standing order established by the medical director of the department in accordance with this section.”

The bill goes to say that “A pharmacist shall be immune from criminal and civil liability arising from any damages caused by the dispensing or use of…” these agents.

In Governor Reynolds version of the bill (included in HF 2676, successor to HSB 964), at least today, uses the word “may”:

“Sec. 17. NEW SECTION. 126.24 Ivermectin—prescription drug order not required.

A pharmacist or pharmacy may distribute ivermectin for human consumption as an over-the-counter medicine.
A pharmacist or pharmacy shall not be subject to professional discipline or civil or criminal penalties for the distribution of ivermectin pursuant to this section.”

I think the word “may” in Governor Reynolds’s bill implies a pharmacist can distribute ivermectin, but is not necessarily required to do so. In the HF 2056 bill (which died in the first funnel) the word “shall” implies the pharmacist must do so. Hydroxychloroquine is not mentioned in the governor’s version of the bill.

Although neither of these bills mentioned why the ivermectin bill is being introduced, I think it’s clear that some people think it could be an alternative to vaccines for Covid-19. Because research shows ivermectin is ineffective for treating Covid-19 and because they’re not FDA approved for that, I doubt any pharmacist would choose to do what the bill says.

This seems to be turning into a weird game of “Captain, May I?” I think the majority of pharmacists would rather not play.

Iowa Legislature Offering Cheese and Crackers on the Bill of Fare

I heard a song entitled “Cheese and Crackers” on the Big Mo Blues Show last night. I’ve heard a few times over the years, but I never looked up what it meant until today.

The song was originally written by a rockabilly singer named Hayden Thompson, although I’ve only heard it sung by blues artist Roscoe Gordon. According to a Reddit social media thread, “Cheese and Crackers” was the B side of a record by Thompson and the A side was “Shoobie Oobie.” Thompson couldn’t find anyone to arrange the “Cheese and Crackers” lyrics at a recording studio and left in a huff, leaving the lyrics on the piano.

Roscoe found it and put it in an R&B arrangement. Billboard magazine called it the strangest new release of the week. The song is about a guy repeatedly being offered cheese and crackers although he doesn’t like or want them. According to a Wikipedia article, the term “cheese and crackers” is a kind of mild swear word chilled down from “Jesus Christ.”

That’s funny, because that’s how I feel about all the anti-vaccine bills coming out of the Iowa Legislature this year. One of them is SF 2095, which seeks to penalize private postsecondary colleges and universities if they don’t accommodate students who want to be exempt from all vaccines for any reason and to find clinical training programs who will accept them. An excerpt from the bill:

“A postsecondary school offering a degree requiring a clinical rotation shall, upon request of a student enrolled in the degree program, identify a clinical rotation placement where the student will be permitted an exemption from any vaccination requirements imposed by the placement location during the duration of the student’s clinical rotation.

A postsecondary school not in compliance shall not qualify as an eligible institution for the purposes of Iowa tuition grant.”

The other punishment could be a fine. Unless I’m looking on the web in the wrong place, I don’t find any such facility anywhere in Iowa. That would mean the postsecondary private school would be punished for something it can’t control. I’m pretty sure that would be called unjust—or maybe tricky if the goal is to coerce clinical training program leaders to loosen up their vaccine exemption policies. Right now, the only exemptions are religion or medical.

This sounds like the Iowa legislature is offering us cheese and crackers. No thank you.