reflections – Go Retire Psychiatrist

Svengoolie Sven Squad Movie: “The Mist”

Last night the Sven Squad presented the movie, “The Mist” on the Svengoolie show. This one is hard to simply poke fun at. It’s also hard to compare to Stephen King’s novella of the same name published in 1980 because I’ve never read it.

The graphic violence throughout the film and the ending left me cold. I think even the Sven Squad had a difficult time making jokes in between scenes.

That said, the story and characters reminded me of certain kinds of people and certain themes. One kind of person is the cult leader. In the film this would be Mrs. Carmody (Marcia Gay Harden). She was this hyper religious person who acted crazy, yet managed to convince a large number of people that she was the savior who could deliver everyone in the grocery store from the horrible fate lurking in the mist. This turns out to be human sacrifice, which is what some ancient cultures did to appease the gods and also gave them a sense of control over nature.

For some strange reason, she was not eaten by one of the monsters, despite the fact it landed on her chest, climbed up on her neck and sprinkled salt, pepper, and oregano on her face.

It also reminds me of cult leaders who managed to persuade many people to commit suicide, e.g., Jim Jones (Peoples Temple) in the 1970s, Marshall Applewhite (Heaven’s Gate) and David Koresh (Branch Davidians) in the 1990s.

I wasn’t sad about Mrs. Carmody’s fate.

One theme I think of from this movie is hubris. Sure, it’s something that will trigger bad memories for some people of their undergraduate college days, but I think it explains why the military decided they could safely open a portal between dimensions. Hubris is overweening pride and means you’re tempting the gods to destroy you when you think you can get away with sticking your chewing gum under your seat at the movies. People think they can control whatever monsters they find in the universe and can stuff trouble back in Pandora’s box.

Another common idea nowadays is that some otherwise unexplainable creatures you almost never see in real life and never find fossils for (like Bigfoot) might be because they are interdimensional beings. Hey, that works for some people.

So, you can go ahead and keep looking for wormholes and portals that open up the gates of hell and there you go. You just let a mosquito the size of an SUV in the house. Are there doorknobs on portals? Did you listen to your mother when she told you to shut the screen door behind you?

No, and you know who you are.

I got a kick out of Ollie Weeks (Toby Jones) who could shoot a monster by turning his back on it and using a mirror and firing backwards over his shoulder, blasting it into next week. How many bullets did that gun have? I thought it was ten but it seemed like there were more, even though it misfired once. Ollie was a hero without hubris.

I didn’t get the ending and I’m not going to put in a spoiler on it. But it’s another place where the number of bullets in the gun gets to be the focus of some reviewers who have horrible suggestions.

This movie is tough to rate because it takes itself too seriously. The acting was riveting in some scenes and just overdone in others, in my opinion. It’s not for kids, yet there was a little kid who played a big role in it. The ending seems to lend itself mainly to instructions on how to commit homicide and suicide. The cavalry arrives too late. It’s packed with action but it lacks heroes to admire, except for self-effacing, deadeye Ollie.

I’m giving this movie a Shrilling Chicken Rating of 3/5.

Iowa Legislature Bills I Could Live Without

I should stop reading the news. I’ve just found a couple of other Iowa Legislature bills that are anti-vaccine.

One of them is the HF 2287 I mentioned yesterday that would make vaccine manufacturers steer clear of Iowa altogether.

Another two I just discovered today:

HF 2171: This one which seeks to make vaccines for school age children voluntary. No child in elementary or secondary school in Iowa would have to be vaccinated against diphtheria, pertussis, tetanus, poliomyelitis, rubeola, rubella, and varicella. This is not safe for anyone.

SF 2095: This one seeks to exempt students from vaccines in medical, nursing, or other health care-related degree programs.

There’s a news article about SF 2095 which makes it clear what it is about. I don’t understand why a person studying medicine or any other health care-related degree program would not need to get vaccinated against communicable diseases. This bill would require private schools to provide some other alternative training program instead of those that require vaccinations. If they don’t, they’d be penalized, either by losing access to the Iowa Tuition Grant Program—or getting fined. None of that makes sense to me. If you’re in training to be a doctor, you should get vaccinated. If you don’t understand why vaccinations are vital to practicing medicine, you shouldn’t be in medicine.

If I sound like a curmudgeon about all this, so be it. I’m a retired doctor and I graduated from the University of Iowa College of Medicine in 1992. I spent my career practicing consultation-liaison psychiatry, so I was always at the interface between medicine and psychiatry. It was always a challenge for me to balance the art and science of medicine. And I didn’t always do it very well.

But I’m puzzled by what looks like an awkward imbalance in the view of medicine today. I’m a little cranky about it, and I like to think my age entitles me to react that way sometimes. I could add a quote from William Osler here, but I’m more prone to jokes as a I get older, probably because I know I’m no wiser than anyone else.

Did you hear Chuck Norris got the Covid vaccine? The vaccine is now immune to everything.

A Funny Thing Happened on the Way to the Pentagon

So, just for laughs I sometimes watch Ancient Aliens (you know, the UFO show with the hair dude). Last night, they were talking about some guy named Valiant Thor as if he were a real person. Maybe some of you know about the book, “Stranger at the Pentagon,” which you can read for free on the Internet Archive. I just quickly clicked through the pdf of it and it’s pretty interesting. The one I saw had sections about Men in Black (MIB) in it, which of course means Will Smith and Tommy Lee Jones are even older than we think.

It was written in 1967 by Dr. Frank E. Stranges and it’s supposedly a story of an extraterrestrial named Valiant Thor who presented to the White House in the 1950s and spoke to President Eisenhower and others, giving the urgent message that Earthlings need to shape up or the planet would be destroyed.

OK, the spoiler is that there’s no evidence this ever happened, although many people, like Fox Mulder, want to believe.

I want to believe, too but there’s no official record Vai (as Valiant Thor is sometimes called in the book) ever lived at the White House, although maybe he snorted something you can sometimes find in the White House but nobody officially will admit that ever happens either.

One person stated that the idea for the book might have come from the 1951 film “The Day the Earth Stood Still.” Artificial Intelligence (who always butts in to my web searches) doubted it’s ever been on the Svengoolie TV show, but I found a Facebook post from 2025 which called it a “Sven fan favorite.” It’s probably never been on Svengoolie because it’s far too classy. There’s an interesting article about it on Turner Classic Movies but I don’t know if TCM ever showed it.

As near as I can tell from just from what I’ve read on the web about this movie is that it was made in the early Cold War days and it’s really sending a message to mankind warning them away from killing everybody and the planet and instead strive to establish peace in the world. It’s long been regarded as a cinema masterpiece.

Did it influence Dr. Stranges to write the book “Stranger at the Pentagon”? I don’t know, but some people think so, judging from one social media comment. I think that person might have been put off by the attempt to make it sound like it was historically accurate, which is what many people seem to think.

In my opinion, the whole yarn about Valiant Thor is fiction that, while not historically accurate, is compelling enough to make you think about how important it is for national leaders and people who live on the planet to try and clean up our act. Efforts to make this story seem like it actually happened backfires and misses the point.

By the way, none of this has anything to do with Bigfoot.

One Anecdote from Dr. Martin Luther King, Jr is Nothing to Sneeze At

I’ve finished reading both biographies of Dr. Martin Luther King, Jr. (the one by Jonathan Eig and the autobiography edited by Clayborne Carson).

Both books were fascinating. Many of the accounts of King’s life were familiar to me mainly because I had seen them written about in other books and articles. Some of them are a strange mixture of pathos, terror, and even a little humor if you can imagine it. For me, one of the most touching anecdotes was the one about the white girl who wrote a short letter to King after he was stabbed by a demented black woman on September 20, 1958. It was in both biographies.

He was at an event in which he was autographing one of his books. A black women pushed through the crowd and asked him if he were Martin Luther King. He didn’t look up and said simply, “Yes.” The woman stabbed him with a letter opener. The blade stopped very close to his aorta and the doctor who treated him said he could have exsanguinated if he had just sneezed.

Dr. King got a lot of kind letters from people about that, but the one that is most memorable to him (and me) was from a 9^th grade high school student who wrote that she was a white girl and said “I am so happy that you didn’t sneeze.”

Later, King would use the phrase several times in his final speech (“I’ve Been to the Mountaintop”) which he delivered at the Bishop Charles J. Mason Temple in Memphis before he was assassinated at the Lorraine Motel there in April of 1968.

Both of the biographies are riveting documents of the life of a preacher devoted to the principle of non-violence. We can still learn from him.

Thoughts on the Book: “King: A Life” by Jonathan Eig

I just finished Jonathan Eig’s biography of Dr. Martin Luther King, Jr and I have just a few thoughts to share on my immediate impression of the book. Before I read the book, I got the impression that there might be a detailed description of Dr. King’s mental health.

Although I didn’t see any specific speculation by Eig on the matter, he did mention psychiatrist Dr. Nassir Ghaemi’s impressions about King based on historical records that Dr. King had suffered from a clinically significant mood disorder. Eig wrote a one sentence summary which followed a comment by King’s wife Coretta about his depression:

“Decades later, the psychiatrist Nassir Ghaemi would write that King probably suffered severe depression, a psychiatric illness that can enhance “realism in the assessment of one’s circumstances as well as empathy toward others.”

This was followed by a comment from a psychologist who cast doubt on the idea that King suffered from depression.

I’ve never read any of Dr. Ghaemi’s books. Eig didn’t list any specific books by Dr. Ghaemi. I think the relevant source might be his book, “A First-Rate Madness: Uncovering the Links Between Leadership and Mental Illness” published in 2011.

In a previous post I expressed my skepticism that the suicide attempts sometimes mentioned (although not consistently called that in Eig’s book). The only two such episodes described in his book are reactions to his grandmother being injured in the first instance and after she died in the second. He jumped out of a second story window both times and escaped serious injury. He was 12 and 13 years old respectively. Neither account describes any formal outpatient or inpatient mental health evaluation or treatment. It sounds like these were impulsive reactions based on the descriptions. I didn’t find any accounts in the book of suicide attempts in his adult life.

The Goldwater Rule which has been in the American Psychiatric Association (APA) Principles of Medical Ethics since 1972 discourages clinicians from diagnosing psychiatric illness in currently living persons. While that may not necessarily apply to deceased persons and may or may not only be relevant to members of the APA, I’m still unsure whether it’s always appropriate for mental health professionals to publicly entertain speculations or inferences about psychiatric diagnoses in anyone without an in-person evaluation. One possible exception might be for a threat assessment.

All that said, I didn’t find anything in Eig’s book that would contradict a non-psychiatric explanation for Dr. King’s emotional states in the context of the extraordinary pressures and burdens in his life. Although at times he was hospitalized for fatigue and “depression” it’s difficult to tell exactly how often.

This blog post so far takes up a fair amount of space discussing Eig’s book regarding the emotional side of Dr. King. There’s a lot more space in the book that emphasizes his incredible accomplishments, despite his being up against terribly high odds.

“It is not the critic who counts; not the man who points out how the strong man stumbles, or where the doer of deeds could have done them better. The credit belongs to the man who is actually in the arena, whose face is marred by dust and sweat and blood; who strives valiantly; who errs, who comes short again and again, because there is no effort without error and shortcoming; but who does actually strive to do the deeds; who knows great enthusiasms, the great devotions; who spends himself in a worthy cause; who at the best knows in the end the triumph of high achievement, and who at the worst, if he fails, at least fails while daring greatly, so that his place shall never be with those cold and timid souls who neither know victory nor defeat.”

Theodore Roosevelt

Still Reading Dr. MLK Jr Biographies

I’m just checking in to let you know I’m still reading Jonathan Eig’s biography of Dr. Martin Luther King Jr. I’m in the last section. I plan to read The Autobiography of MLK Jr., edited by Clayborne Carson next.

I’m not ready to share much right now in the way of my impressions other than to say that it’s at least as painful to read from an emotional standpoint as the other books by great authors I’ve read and which have prompted visits by invitation to The University of Iowa College of Medicine in the past to present the MLK Jr Distinguished Lectures:

“Our Hidden Conversations: What Americans Really Think About Race and Identity” by Michele Norris.

“Caste: The Origins of Our Discontents” by Isabel Wilkerson (who also wrote “The Warmth of Other Suns: The Epic Story of America’s Great Migration,” which won the Pulitzer Prize).

Our Hidden Conversations by Michele Norris

These are often riveting page turners but I need to take a break every so often because of the terrible events described.

Observations on Jonathan Eig’s Martin Luther King Distinguished Lecture

I discovered that the University of Iowa made a video presentation of Jonathan Eig’s speech for the Martin Luther King Distinguished Lecture on January 21, 2026. Mr. Eig wrote the MLK biography, “King: A Life” which was published in 2023. We just got a copy of it along with “The Autobiography Of MLK. We’re reading them now. We both watched the one-hour long video, which is available only in Panopto format to University of Iowa employees who could not attend the event in person.

He’s an engaging, humorous, and humble guy who spoke without using notes and ad libbed the entire talk which covered the most important events and people in King’s life including his wife and several other famous people in the civil rights era of the 1960s.

He had an interesting anecdote about the young National Park Service ranger, Gordon, “Gunny” Gundrum who adjusted King’s microphone repeatedly while he was giving his “I Have a Dream” speech in Washington in 1963. It was caught on camera and interpreted by some as an effort to interfere with the speech. In fact, it was because King was only 5’7” tall and his face was obscured by the microphone. Eig questioned him about it (yes, he was still alive) and at first Gundrum didn’t even recall doing it.

Sena wondered why Eig didn’t mention Rosa Parks in his presentation. In his book, he describes her refusal to take a back seat on a city bus as the catalyst for the Montgomery bus boycott, and her role in considerable detail.

On the other hand, Eig pointed out that King’s wife, Coretta, was the one who taught King about activism in the first place since she had been involved doing that before they ever met.

Eig mentioned that King has attempted suicide twice in his adolescence. On the other hand, even though I’m only partway through his book, I recall these were described early and involved being upset about his grandmother on a couple of occasions. One when his brother slid down a banister, hit his grandmother in the head and knocked her out cold. The other was when she actually died. He was not seriously injured in either incident. Eig also shared that King was psychiatrically hospitalized several times. Some suggested he undergo regular outpatient psychiatric treatment, but he declined because of the stigma.

One of his more moving anecdotes was about what King said just before he was gunned down at the Lorraine Motel in Memphis in 1968. King had stepped outside to get some fresh air. It was a cold and one member of his group suggested he go inside and get a jacket. King replied, “Yes, I will.” As he turned to do so, he was shot and killed. The way Eig framed King’s last words made you think of that statement as an affirmation of how he’d responded to the many challenges and demands in his life.

Thoughts on Martin Luther King, Jr. Day

Today being Martin Luther King Day, I’m reminiscing a little about my short time as a student at Huston-Tillotson College (one of this country’s HBCUs, Huston-Tillotson University since 2005) in Austin, Texas. It’s always a good idea to thank your teachers. I never took a degree there, choosing to transfer credit to Iowa State University toward my Bachelor’s, later earning my medical degree at The University of Iowa.

However, I was a reporter for the college newspaper, The Ramshorn Journal. That’s where the featured image comes from.

Although I didn’t come of age at HT, I can see that a few of my most enduring habits of thought and my goals spring from those two years at this small, mostly African-American enrollment college. I learned about tenacity to principle and practice from a visiting professor, Dr Melvin P. Sikes, in Sociology (from the University of Texas) who paced back and forth across the Agard-Lovinggood auditorium stage in a lemon-yellow leisure suit as he ranted about the importance of bringing about change.

He was a scholar yet decried the pursuit of the mere trappings of scholarship, exhorting us to work directly for change where it was needed most. He didn’t assign term papers, but sent me and another freshman to the Austin Police Department. The goal evidently was to make them nervous by our requests for the uniform police report, which our professor suspected might reveal a tendency to arrest blacks more frequently than whites.

He wasn’t satisfied with merely studying society’s institutions; he worked to change them for the better. Although I was probably just as nervous as the cops were, the lesson about the importance of applying principles of change directly to society eventually stuck. I remembered it every time I encountered push-back from change-resistant hospital administrations.

As a clinician-educator I have a passion for both science and humanistic approaches in the practice of psychiatry. Dr. James Means struggled to teach us mathematics, the language of science. He was a dyspeptic man, who once observed that he treated us better than we treated ourselves. Looking back on it, I can see he was right.

Dr. Lamar Kirven (or Major Kirven because he was in the military) also modeled passion. He taught black history and he was always excited about it. When he scrawled something on the blackboard, you couldn’t read it but you knew what he meant.

And there was Dr. Hector Grant, chaplain and professor of religious studies, and devoted to his native Jamaica. He once said to me, “Not everyone can be a Baptist preacher.” He tried to explain that my loss of a debate to someone who won simply by not allowing me a word in edgewise was sometimes an unavoidable result of competing with an opponent who is simply bombastic.

Dr. Porter taught English Literature and writing. She also tried to teach me about Rosicrucian philosophy for which she held a singular passion. Not everyone can be a Rosicrucian philosopher. But it prepared the way for me to accept the importance of spirituality in medicine.

I didn’t know it back in the seventies, but my teachers at HT would be my heroes. We need heroes like that in our medical schools, guiding the next generation of doctors. We need them in a variety of leadership roles in our society. Most of my former HT heroes are not living in the world now. But I can still hear their voices.

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.

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.