I read the Psychiatric Times article “FDA Issues CRL to Lykos for MDMA-Assisted Therapy.” The short story is that the FDA essentially told the drug company Lykos that their study of the efficacy of MDMA-assisted treatment of PTSD needs more work.
I tried to wade through the on-line documents of the FDA’s meeting on June 4, 2024. There are hundreds of pages and I didn’t go through every page of the transcript. The minutes were succinct and much easier to digest.
I’m going to simply admit that I’m biased against using psychedelics in psychiatry for personal and professional reasons. I’m not a research scientist. I’m a retired consultation-liaison psychiatrist. I saw many patients with a variety of psychiatric diagnoses including PTSD and substance use disorders. I’m not opposed to clinical research in this area, but I’m aware of the difficulty of conducting it.
In that regard, I want to also admit that I’m very susceptible to being influenced by a former colleague’s remarks about the quality of the research in question in the Lykos study. Dr. Jess G. Fiedorowicz, MD, PhD formerly was formerly on staff at University of Iowa Health Care. He’s now the Chief of Mental Health at The Ottawa Hospital where he’s also Professor and Senior Research Chair in Adult Psychiatry, Department of Psychiatry, University of Ottawa, Ontario. His remarks in the transcript are typical for his erudition and expertise as a clinician scientist.
It’s difficult to wade through the pages of the FDA transcript and I couldn’t digest all of it, by any means. But if you’re interested in reading both sides of this issue, it’s a good place to get the best idea of the committee members’ thinking about it. The minutes are much easier to read and provide a succinct summary.
I realize the Psychiatric Times article editor doesn’t agree with the FDA recommendations for further study of psychedelic-assisted psychotherapy for PTSD. It may or may not influence the University of Iowa’s study of psilocybin. In my opinion, the FDA did the right thing.
We can see the man from our hotel window. We assume he’s homeless. He has a small area where he sits on the curb next to the street. He does this most of the day. He has a blanket and a few other loose items which sometimes are strewn on the sidewalk or the grass.
Even in 90-plus heat, he’s out there, sometimes standing beneath a small tree, presumably for shade although it’s inadequate. He waves his arms around in what looks like a futile attempt to cool himself. He might just be restless. Other times he sits on his blanket. Occasionally, people stop their cars and seem to be trying to communicate with him. He most often ignores them.
One of the hotel residents approaches him sometimes. It looked like he gives him something (probably a cigarette). Once, the homeless man left his station by the street and walked over to the front of the hotel, waving his arms, seemingly because the hotel resident was speaking to him. We couldn’t see what happened after that, but when he returned to the street, he lit a cigarette. We also saw he accepted fluid, maybe a can of soda.
Later, some people in a car gave him something they bought in a nearby drive-up fast-food joint. He threw out the ice from his drink, which he didn’t consume and sprinkled the fluid on his arms. The people left and returned later with several items they gave him. Some of it looked like more water, which he again poured on his arms. There was a backpack or something like it. He didn’t seem to know what to do with it.
He couldn’t ignore them when they try to help him (water, food, etc.). One person tried to help him clean up his little camp by picking up his trash. The police came out to check on him. We couldn’t hear the short conversation. After she left, he continued to toss his water bottles and other items into the parking lot. He sleeps on the pavement.
This reminded me of a couple of times when I’ve seen hobos. I don’t see the homeless man as a hobo. The term “hobo” is not synonymous with homeless, vagrant, or tramp. Hobos prefer not to have a home, travel around to find work, may still ride the rails to get around, and don’t see themselves as tramps.
As a young man, I worked for consulting engineers as a draftsman and survey crew worker in Mason City. This was in the 1970s. We traveled to outlying cities. One day, we went to Britt for a job. It was during the Britt Hobo Days Convention. It was not the first time I ever heard of it.
Funny thing, I thought I recognized one of the hobos in the café where we got coffee. He was wolfing down a big breakfast. When he was finished, he left in a hurry. I just assumed he was a hobo in town for the festivities. But he looked so familiar.
And suddenly it dawned on me. He had been a kindergarten classmate of mine. I couldn’t recall his name, but it was him.
Another memory that occurred to me was much later in my life, when I was a psychiatrist and co-attending on the medical-psychiatry unit in University Hospital in Iowa City. We admitted a patient who had been found walking around and around in a circle in the street, and seemed confused. Evidently the patient had an acute medical problem and no diagnosable psychiatric illness.
The patient identified as a hobo and was proud of it. The person was polite, grateful, and cooperative. The person refused any help from us beyond help for the acute medical problem. We discharged the person to the street.
Hobo life is different nowadays, I gather. Many have cars and phones. If you look carefully at their photos on the Britt Hobo Days web site, they don’t make me think of homelessness or mental illness. They have made a choice.
On the other hand, homelessness is often not a choice and severe mental illness is not uncommon. There is a homeless shelter in Iowa City, and the resources include a supportive community living program for those who struggle with mental illness. One member of the board of directors is a psychiatrist. Not every homeless person wants to go there. The University of Iowa Health Care has an Integrated Multidisciplinary Program of Assertive Community Treatment (IMPACT).
The Iowa Interstate Railroad train rumbles past our hotel a few times a day and it reminds me of the Mindfulness Based Stress Reduction (MBSR) course I took 10 years ago. One of the exercises the instructor mentioned was the train visualization mindfulness exercise. I don’t know if I remember what our instructor actually said about it, probably something like what the instructor says in a mindfulness video.
One thing I do remember is that it’s OK to notice my thoughts as train cars running through my head. The other thing is the train cars can sort of hijack me and off I go on a tangent, like a hobo hopping a freight car. And, what if also I notice the spaces between the train cars? What would that be like?
The side of my nose itches.
My left eye is tearing up.
What can I do about anything?
Are we all alone in the universe?
Why is David Attenborough’s voice so calming?
Why do I joke around so much?
Even after 10 years of mindfulness practice, I still notice my thoughts jumping around. I’m still hopping from box car to box car.
Because we’re staying in a hotel waiting for our house to be built, we have to take a different approach with our laundry. There are laundry facilities at the hotel, but there aren’t many machines. Sena usually takes it to a place called Laundromania. The motto is “We Never Clothes.”
I went with her the other day for the first time. There are a lot of machines. As it turns out, there’s also a lot of history at Laundromania. Back in 2008, Iowa City suffered a major flood and Laundromania was under water for a while. There’s even a picture inside of the water line painted on one of the windows. We remember that time. What a mess. You can see a very dirty sign that was framed and which describes the flood.
Laundromania is a modern facility. You can put your cash into a machine which pushes out a sort of debit card-which can only be used in Laundromania. You want to be careful with that. Depending on how long you live in the neighborhood, it could be either a good or a bad thing.
Even though it’s a modern facility, Laundromania does have some quirks. The day we were there, we tried to use a dryer which turned out to have a broken door latch. We lost a little money in it. Sena put one of the Out of Service signs on it. There’s no on-site manager there but, coincidentally, shortly after she put the sign on the dryer, the service guy showed up. I guessed he fixed it.
For a short time, I tried to keep track of the dryer time using the old analog clock on the wall. Two things wrong with that: the clock doesn’t work and all the machines have digital timers on them anyway.
You can buy laundry detergent and other stuff there from a vending machine, but they’re pretty expensive.
There are a couple of old grade school desks that bring back memories. One of them is pretty dirty.
If you’re ever in Iowa City and you need to do your dirty laundry, try Laundromania.
The other day we walked the Terry Trueblood Trail (when do we not do that?) and saw interesting sights. I finally got a video clip of a goldfinch! And a male northern cardinal either sang to us or cussed us out. It was hard to tell.
It was a scorcher out there. We started out looking for a walking trail a guy gave us directions to a week or so ago. It’s a great place for birding. We found it, but here was no parking anywhere close. He told us that we could park in a farmer’s field, but we saw the farmer out there and decided not to chance it.
While we were out doing that, we drove by a cornfield, which really impressed Sena because we could drive right up close to it. She’s never detasseled corn. I have and I don’t think she missed anything. I walked the rows with fellow detasselers and we yanked them. We were in rows right next to each other. We could hear each other collapse from time to time from exhaustion. When you pulled the tassels out, they sort of squeaked. You could hear us: Squeak, squeak, squeak, thud.
On the other hand, we had a pretty good day birding out at Trueblood. I got a better video clip of a dickcissel. We saw a couple of geese scare a turtle off a rock in Sand Lake. We didn’t notice it at the time, but saw it on the video clip after we got home (which is still the hotel, by the way).
We saw several dickcissels. We still don’t think they sound like they’re singing “dick, dick, dick.” I think that’s a load of squeak, squeak, squeak. They are pretty birds, though.
We were driving by the Terry Trueblood Trail on July 28th and Sena noticed there was a new sculpture. We’ve been on the lookout for the new Art in the Parks collection since the announcement in May.
The anticipated opening date is August 7, 2024, but it looks like the artists are already getting started. Not all the new pieces we saw had title plaques yet, but there were 6 of them and they are very interesting.
We visited the parks earmarked in previous years: Terry Trueblood Recreational Area, Riverfront Crossings Park, Iowa River Corridor Trail, Mercer Park, and Scott Park.
So far, Tim Adams’s work, “Exuberance,” at Mercer Park is Sena’s favorite, although I think the sculpture of me and Herky is pretty good.
It was wicked hot, in the 90s and we saw a kid out at Mercer Park selling lemonade! Can you believe it? I peddled papers but I never sold lemonade. I figured he would charge a buck, but it was only 50 cents. He got a tip, believe me!
A few days ago, while we were eating breakfast in our hotel room, the fire alarms went off. We jumped up and got out of the room. Of course, the elevators were off and other people were filing down the stairs.
It was slow going downstairs. Not everybody was fit as a fiddle and able to run down the stairs. We couldn’t smell smoke.
When we got outside, a lot of folks, some with their dogs and a couple carrying their potted tropical plants, were milling around in the parking lot. There were a lot more people in the hotel than we thought. Several were filming the event with their smartphones.
In our haste to get out of the building, I had left my smartphone in our room. We had also left our car keys there.
Ironically, many remembered their cigarettes and had a smoke.
The fire truck seemed to take a long time getting there. The nearest fire station is not that far away. They pulled into the parking lot and a couple of firefighters got out, looking a little bored. They walked in there. A few minutes later, they walked out, looking even more bored.
Everybody re-entered the hotel. A hotel employee said it was a false alarm and everything was OK. Most people hung out in the lobby, waiting for breakfast-another point of irony since, if there had been a fire, the kitchen might have been a likely place for it to start.
It was the first time we were ever in such a situation. We can do without it.
Several days ago, a large wedding guest caravan arrived at the hotel. Fascinating group. The line of people checking in could have stretched outside beyond the front door.
There was this guy who was there for the wedding, but arrived without cufflinks. So, he asked the front desk to help him out. They gave him what might have fooled some people some of the time—big safety pins. They didn’t work out. A couple of women guests also got safety pins, for what I couldn’t guess.
He left and came back later with a Dillard’s shopping bag. He got some smart looking brand new cufflinks! I think the last time I wore cufflinks was in the 1970s in Austin, Texas. They came with a suit that the husband of my English Literature professor, Dr. Jenny Lind Porter, bought for me. They didn’t resemble safety pins.
The hotel staff were pretty busy because the place got hit by the CrowdStrike Outage. The inconveniences included a little more work with programming room keys. One guy asked for a room on the second floor, but it was booked up with extraterrestrials. I doubt they were with the wedding group. And they couldn’t fix the outage-so much for the advancements of those from other galaxies. They probably don’t even know what cufflinks are.
There was a couple of guys (also not with the wedding crowd) who were in town for a disc (what we would call frisbee) golf tournament. It was near the Clear Creek Trail. They were solid in the standings so far.
I don’t think first prize was a pair of cufflinks.
The Iowa State Fair will again have the Cribbage Tournament this year! It’s on August 18 (the last day of the fair) from 11:00 a.m. to 2:00 p.m at the Oman Family Youth Inn. Registration begins at 10:00 a.m.
Hey, I managed to catch the Big Mo Blues Show on July 19, 2024 and then listened to the podcast the next day. Because our big Bose wave radio is packed away in storage as we wait for our house to be built, I had to use our little portable Sony Dream Machine in the hotel. I think it dates to the early 2010s. I couldn’t get the local Iowa City KCCK 106.9 or 88.3 station unless I switched the radio to AM first, then tuned to 106.9, then flipped back to FM. It gets staticky if you hover over it or touch the radio, but if you leave it alone, it sounds OK.
Now I’m just going to comment on the theme of the pod show, which was “King of the Segway.” This is in the spirit of my frustrated grade school English teacher, Miss Piggott. One of her comments on my report card was, “A little too exuberant.”
OK, that segues into my correction of the use of the word “segway” in the podcast theme title. If you listen to the show, Big Mo clearly uses the word as a verb that mean to move without stopping from one theme, song, etc to another. That should be spelled “segue.” The word “segway” is a trademarked name for an electric transportation vehicle. To be fair, the two are often confused.
Big Mo did a pretty good job of getting most of the points on the 5 songs; at least he could name all the artists. The first part of the ‘da Friday Blues show played a couple of numbers that show the funny edge of Blues music. The latter part played Blues numbers that are on the gritty side.
I’ll take the funny side over the gritty side of the Blues any day of the week.
The funniest number was the song “Lustful Earl and the Married Woman,” by Tony Joe White. I remember his tune “Poke Salad Annie” from way back. Lustful Earl is hilarious and had me laughing out loud.