We got out today on the Terry Trueblood Trail because it was sunny and 60 degrees. It felt like early spring, although Punxsutawney Phil put the kibosh on that.
The ice was giving way on Sand Lake. The birds were waking up and hungry. And I can’t remember the last time we saw bluebirds at all, let alone the many we saw out in the open grassland today.
It was the kind of day you forget what’s in the news and just celebrate the coming of spring. Just watch the bluebirds fly.
We were reminiscing about our elementary school days following a discussion of news article about what some educators want to do with the school day schedule. Apparently, kids are pretty sleepy in class and teachers think it’s because they’re sleep deprived. Apparently, they’re not getting enough sleep at night and the proposal is that the school day schedule ought to be pushed ahead, the day starting at 9 AM instead of 8 AM.
Maybe the kids should be off their electronic devices a little earlier in the evening.
I guess there have been studies supporting this idea for years, but of course I hadn’t heard of it. Nobody seems to be in a hurry to change the system.
What we remembered were the consequences imposed by teachers and principals when we didn’t perform up to expectations in class, or misbehaved in class or on the playground.
Sena had a little trouble with remembering the vowels, a e i o u and sometimes y. She had so much trouble with it that she had to stay after school to write that out over and over on two big blackboards. It took quite a while. That was back in the days when blackboards were big and covered one entire wall of the classroom. There was always more chalk available if she ran out. Sometimes the penalty for her not paying attention was a few sharp raps on the top of her head with a No.2 pencil. Most often it was for talking out of turn or not paying attention.
I got caught a couple of times for throwing snowballs on the playground. I think it was at least a couple of times. The consequence for this infraction was to sit in the principal’s office drawing little circles resembling snowballs on a sheet of paper. They had to be small so that it took you a long time to fill up the paper. If you made them too big, the principal made you flip the sheet over and do it again. I think if you got writer’s cramp, you had to switch hands.
My brother and I had to walk to and from school. We had to get up early and sometimes the snow was up to our knees. It was about a half-mile walk to school. One winter day, I was walking home and found a dog frozen stiff as a statue next to the sidewalk.
I spent most of time after lunch looking at the clock, wishing the hands would move faster to 3 PM, when school let out. I would walk home and because I was a latchkey kid, I just let myself in the house.
I guess moving the time up so that kids can be more awake during the morning wouldn’t hurt anything. Maybe the curriculum will be simplified a little bit too. Things like geography could be easier. You could change the name of the Gulf of Mexico (or is it the Gulf of America now?) to something that makes more sense—like the Gulf of Water.
If you can’t learn that, maybe you need to have your head rapped with a No.2 pencil.
I’ve heard about the recent contract a drug company (Zoetis) obtained to make chicken vaccine for the H5N1 bird flu virus which is hopping from birds to cows and even to humans. So far, I haven’t heard that the bird flu is transmitted between humans.
As far as eating eggs, I’ve read that the chance of getting bird flu is pretty slim—but experts tell you to cook your eggs to a temperature above 165 degrees. No soft egg yolks for me.
Anyway, Zoetis is making a vaccine for chickens. I got to wondering how you would vaccinate chickens. Obviously, you have to catch them first, wrestle them down to the barnyard floor and stick a needle into them somewhere under all the feathers.
There’s a Wikihow with instructions (including a video) for giving chickens vaccines. One of them says to inject the bird in the spot for which you have the easiest access and which is the “most comfortable for the chicken.”
How do you tell which is the most comfortable spot for the chicken to be impaled by a needle? Maybe it’s marked by a Walgreens sticker. You have to sterilize the spot, maybe with a splash of that moonshine you’re making on your property. Make sure you don’t drink any of it during the vaccination process. You want to make sure of your aim.
When and how do you wrap a rubber band around the beak? You know darn well the chicken is going to peck you. You can tell we don’t have chickens in the backyard.
And then there are all the stories on the internet about how chickens can run around for a short while even after their heads are cut off. If they’re that energetic without their heads attached, how much more frantic are they going to be if they see you chasing after them with a needle? And remember, you’re going to probably poke them in the neck. Chickens know that. They also know you’re wearing only thin rubber gloves.
And aren’t chicken farms or ranches or coops, whatever, just chock full of thousands of chickens? Vaccinating all of them is a dawn to dusk proposition so you better have your Wheaties in the morning.
Are the roosters also up for the vaccine? One way to get them ready is to let them crow until they pass out. Then you can poke them. You’re welcome.
I listened to the Rounding@Iowa podcast of February 11, 2025, “Challenges in Transitioning Seriously Ill Patients from Pediatric to Adult Systems of Care.”
This was a very interesting presentation about the challenges of helping persons with life-limiting conditions (for example, hemophilia, cystic fibrosis, sickle cell anemia and more) transition from pediatric to adult systems of care. Most of the discussion was about the difficulty in finding doctors who would be willing and able to assume care of patients who had survived to adulthood who had been previously seen in pediatrics throughout childhood.
I listened very carefully to the whole podcast, waiting to hear about what the role of mental health care professionals would be in this kind of transition. There was no mention of it, not even after one of the presenters described a patient who was starting to have hallucinations.
My role as a consulting psychiatrist in a general hospital was mainly to see those with chronic diseases who were being treated by colleagues during a bout of cystic fibrosis or sickle cell crisis. I remember they were young adults, struggling with emotional distress and disruptive behavior.
I was surprised at the lack of discussion about the role of mental health assessments, diagnoses, and treatment including psychotherapy during transitions from pediatric to adult health care. Not that I would have had much to offer other than questions about how mental health professionals could be helpful regarding transitions—but I think they would have not been out of place.
I took a quick look at the resources provided. One of them was a University of Iowa website, the Iowa Center for Disabilities and Development: Transition to Adulthood Clinic For Teens and Young Adult Ages 14-30. Even here, the role of a psychologist was to evaluate learning problems.
One of the discussants mentioned a program called Got Transition, which has a very comprehensive website. There was a section for Special Populations and a list of resources and research when I searched the site using the term “mental health.” It was hard to find a section specific to the population under discussion in the podcast. On the other hand, it was very comprehensive.
In this podcast, discussants talked about the importance of a team approach to transitions. I wonder if there’s a place on the team for psychiatry.
I checked on what the FDA is doing about changing or closing down the Clozapine REMS program. It doesn’t look like they’ve taken any action yet. Recall there was a Clozapine REMS Advisory Committee meeting about this on November 19, 2024 that I posted about recently. The upshot was that the committee voted overwhelmingly (14 yes to 1 No) to get rid of the Clozapine REMS program.
What I didn’t realize until today was that a former colleague of mine was a member of the committee. Dr. Jess Fiedorowicz, MD, PhD was on staff at The University of Iowa Health Care in the past and is now head of the Dept of Mental Health at The Ottawa Hospital in Ottawa, Ontario in Canada. I’ve included the YouTube video below of the meeting and you can find Dr. Fiedorowicz’s remarks via Zoom video at around the 8:05 or so mark into the meeting. You can view his vote to shut down the REMS program at around 8:33.
I also found out about a group called The Angry Moms (those who care for family members on clozapine) who are focused on stopping the Clozapine REMS program and one of their web pages makes it pretty clear they’re not happy that the FDA has not made a decision about REMS yet.
They mention Dr. Gil Honigfeld, PhD who I’d never heard of until now. You can tell from his T-shirt how he feels about clozapine. He has been called the “Godfather of Clozapine” and his opinion about the REMS program along with a short history of clozapine can be found at this link.
I don’t know what the FDA will do about the Advisory Committee’s recommendation, but I hope they do it soon.
We got a real snowfall starting last night and into this morning. Sena took the Voltask battery-powered 48V 16-inch snow shovel out and put it through its paces.
We got about 6 inches of snow and it chewed right through it. It threw the snow into the next county! It took her about 30 minutes to make my job a lot easier with the shovel.
I got the Winter 2025 Hopkins Brain Wise newsletter today and there was a fascinating article, “Using AI to Reduce Delirium in the ICU: Pilot Study will explore AI headset can help reduce delirium and delay post-delirium cognitive decline.”
The article has exciting news about what researchers are doing which will, hopefully, reduce the incidence of delirium in the intensive care unit (ICU). Another Hopkins researcher has published a study that has already used AI algorithms to detect early warning signs of delirium in the ICU;
Gong, Kirby D. M.S.E.1; Lu, Ryan B.S., M.D., Ph.D.2; Bergamaschi, Teya S. M.S.E., Ph.D.3; Sanyal, Akaash M.S.E.4; Guo, Joanna B.S.5; Kim, Han B. M.S.E.6; Nguyen, Hieu T. B.S., Ph.D.7; Greenstein, Joseph L. Ph.D.8; Winslow, Raimond L. Ph.D.9; Stevens, Robert D. M.D.10. Predicting Intensive Care Delirium with Machine Learning: Model Development and External Validation. Anesthesiology 138(3):p 299-311, March 2023. | DOI: 10.1097/ALN.0000000000004478
The list of references for the study of course include those by Dr. E. Wesley Ely, who delivered an internal medicine grand rounds about delirium at the University of Iowa in 2019.
Anybody who reads my blog knows I’ve been knocking AI for a while now. However, anybody who also knows that I’m a retired consultation-liaison psychiatrist knows how interested I am in preventing delirium in the hospital. I worked as a clinical track professor for many years at The University of Iowa Health Care in Iowa City.
It’s fortuitous that I found out about what Johns Hopkins research is doing on this topic because the director of the Johns Hopkins psychiatry department happens to be Dr. Jimmy Potash MD, MPH, who’s identified on the newsletter. He was the head of the psychiatry department at the University of Iowa from 2011-2017.
Besides all the name-dropping I’m doing here, I’m also admitting that I’ll probably soften my position against AI if the research described here does what the investigators and I hope for, which is to reduce delirium in the ICU.
We watched the Super Bowl last night and one of the many commercials (always a big thing) looked vaguely familiar only after Sena pointed it out. It was the Fareway Frank commercial about Fareway stores. It was a reprise of the famous 1979 Coca-Cola commercial with Mean Joe Green, defensive tackle for the Pittsburg Steelers and a kid. When you compare them, the similarities are obvious. There are two Fareway commercials that are the same, but have different titles, one of them being “Mean Joe Frank.”
The Hey Kid, Catch commercial with Mean Joe Green featured a 9-year-old kid named Tommy Okon. I couldn’t find a name for the kid in the “Mean Joe Frank” version.
But you can find film information on Turner Classic Movies titled “The Steeler and the Pittsburgh Kid” which is based on the commercial. The kid is Henry Martin who later starred in the movie, “E.T. The Extraterrestrial” (1982).
This led to reminiscence of Fareway Store in Mason City, Iowa. I used to walk to Fareway to get groceries and walked back carrying at least two big paper sacks. My arms were always pretty sore when I got home. I used a wagon later on, but had to be careful crossing the railroad tracks on the way back to ensure the eggs didn’t break.
There are Fareway stores all across Iowa and several neighboring states now, but the first one opened in Boone, Iowa in 1938. It popularized the idea of shoppers picking out their own items from the shelves rather than letting a store employee pick them out from the shopper’s list. The store name was inspired by what was sold (“fare”) and treating customers and employees fairly.
The Fareway Frank character was called Forrest Frank in 2024 although it looks like the company has settled on Fareway Frank.
The other Iowa connection worth mentioning is that rookie defensive player for the Philadelphia Eagles (Super Bowl winners), Cooper DeJean, who played for the University of Iowa Hawkeye football team, made a pick-6 interception touchdown in the game.
While the Fareway Frank version of the Super Bowl commercials line-up didn’t make the short list (or any list for that matter) of favorites, it sure did bring back memories for us.
We heard the Big Mo Blues Show last night and heard a couple of tunes that were fun. One of them was mentioned on the Big Mo Pod Show today, “Feelin’ Alright” by Stuff. The other was a riot but was not on the podcast, and it was “I Feel So Good (I Wanna Boogie” by Magic Sam.
The one that brought back memories was “Feelin’ Alright” by Stuff. It sounded so familiar and we finally figured out it was a cover of song of the same title and sung by Joe Cocker (the one I remember). However, I guess it was originally written by Dave Mason of the group Traffic in 1968. And there’s even an album “Joe Cocker With Stuff Feelin’ Alright.”
The one Big Mo played last night was from the album Stuff Live at Montreux 1976. It was instrumental and hard to recognize at first. The lyrics are sad, though and it’s about unrequited love, I guess. I associated it years ago with drug and alcohol addiction after seeing the 2012 movie “Flight” on TV. Every scene in which the main character Whip Whitaker (played by Denzel Washington) got high, that song was a part of the scene.
Anyway, moving right along, the song that was not on the podcast and which was a whole lot of fun to listen to was “I Feel So Good (I Wanna Boogie) by Magic Sam. We’ve never heard of him but the way he sang the number made us laugh out loud.
The title of the podcast was right on target: “Variety is the Spice of Life.”
We finally got enough snow to test the new shovels today. Recall we have a cordless electric snow shovel and a snow pusher plow shovel with a 36-inch blade. The battery-powered model is a 48V 16-inch Voltask.
I was a little surprised to learn how powerful the electric shovel is. It comes with two batteries. It has a safety button which you have to press at the same time you pull the trigger. It comes with lights so if you ever want to clear snow after dark, you could do that. Of course, there’s no heavy lifting and it’s easy to push. It can throw snow a long way and you can also direct it left or right. It’s like a vacuum in reverse.
Sena selected the Voltask and save a lot of money. There were other models that were priced in the 400–500-dollar range which didn’t have the features the Voltask has.
The snow plow of course, is a simple tool—just the way I like them. The narrow 36-inch blade makes snow clearing quick and there is also no heavy lifting. Spraying a little snow and ice repellent on the blade cuts down on buildup as you work.
I still prefer a shovel.
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