Dr. Feranmi Okanlami MLK Distinguished Lecture

Today, Dr. Feranmi Okanlami, MD, MS, director of student accessibility and accommodation services at the University of Michigan, delivered the Martin Luther King Jr. Distinguished Lecture: Disabusing Disabilities.” It was sponsored by the University of Iowa.

I attended Dr. Okanlami’s lecture by Zoom. I noticed he was wearing a handsomely carved wooden bow tie, which I don’t have an image for, but you can order them on Amazon, if you’re interested. I’m not the only attendee who noticed it. I used to wear cloth bow ties when I was a much younger man. I gave up wearing any cloth ties shortly after the Covid-19 pandemic began because, as everyone knows, fabric neckties of any kind generally almost never get laundered and carry all kinds of germs. The wooden bow tie is easily wiped down with sanitizers.

But this post is not about wooden bow ties. It’s about what Dr. Okanlami called “ableism” which naturally brings to mind other terms like “racism.” He showed a few images on his slides which showed another point he expanded on, which is the difference between equality and equity. The quick way for me to explain this is to quote the Milken Institute School of Public Health definition:

“Equality means each individual or group of people is given the same resources or opportunities. Equity recognizes that each person has different circumstances and allocates the exact resources and opportunities needed to reach an equal outcome.” — MPH@GW, the George Washington University online Master of Public Health program.

Dr. Okanlami impressed me in many ways, but one of them is his ability to give unrehearsed presentations. He hates to “give talks” as he put it, but likes to talk. 

I should explain the reason for this post’s featured image, which might seem puzzling. It’s a photo of the curb ramp connected to the sidewalk outside our home. The city requires homeowners to clear the snow from curb ramps, which, ironically, the city plows plug with snow after every snowstorm. These used to be called “handicap ramps.” I suspect Dr. Okanlami would object to the use of this label and in general it’s probably insulting, but that is what they were called for years. They are an accommodation for those who use wheelchairs.

The word accommodation can have a negative connotation, which Dr. Okanlami clarified. Many believe accommodations give an “unfair” advantage to some people. Actually, they provide opportunities for those with a different set of abilities or altered abilities to participate in society in ways that allow them to contribute to society, and even change it—sometimes in major ways.

Our curb ramp is interesting. The short length of sidewalk beyond it leads to a pile of construction rubble because there is no sidewalk extending beyond our property line on that side. I call it the sidewalk to nowhere, which is now a misnomer. There is a new subdivision under development leading north of our neighborhood. There are houses being built and many have moved in. But for now, you have to walk in the street, which is often muddy and blocked. It’s difficult to walk through it because of heavy equipment and trucks parked along the street. But that doesn’t stop people from walking there. I have never seen anyone in a wheelchair attempt to use the curb ramp. But many people use it who don’t have a visible disability. But it’s there if someone needs it, and we keep it clear of snow on principle.

Dr. Okanlami mentioned those with invisible disabilities. There was not enough time to discuss this in detail, but they include those with mental health challenges. As a consulting psychiatrist working in the general hospital, I saw many of them. They deserve a seat at the table, too.

And I remember one of my medical school classmates who did need to use a wheelchair. There was a special ramp made for him that allowed him to participate in gross anatomy class. Dr. Lance Goetz, MD, graduated with our class and has been a practicing physiatrist in Richmond, Virginia for the last 21 years.

Although Dr. Okanlami’s lecture was recorded today and will, I hope, soon be available for public view, I’m including a YouTube recording of a presentation he gave in 2018 which has the same title and very similar content as the talk he delivered today.

I think his talk evolves every time he gives it. The environment in 2018 was very different than it is now because there was no pandemic and there was a live audience which interacts in a very different way than Zoom allows. That said, the slides were essentially the same today on equity and equality, as were his essential points. He shared a lot about himself in 2018, maybe a little less today mainly because of time constraints and the difficulties inherent to virtual lectures. But he has a great sense of humor.

And he does wear very handsomely carved wooden bow ties.

MLK Human Rights Week 2022: Transforming Ourselves and Others

Sena and I thought today’s Zoom presentation “Racial Perspectives on the Institution of Medicine” by Director and Chair of Emergency Medicine Jenice Baker, MD, from Chestnut Hill Hospital in Philadelphia was fascinating. It was an early feature of Martin Luther King Jr. Celebration of Human Rights week. This presentation stimulated a long discussion between us. The theme of this year’s MLK week is “Whatever Affects One Directly, Affects All Indirectly.”

Dr. Baker cautioned that some of the content of her talk would make us feel uncomfortable about the issue of racism in the social realm of our society extending to the medical realm as well. Sena and I were a little surprised about some of the historical facts, such as that white patients always had to be treated first before black people in emergency rooms, regardless of the severity and urgency of the trauma.

This led me to look up the term “implicit bias.” It doesn’t always denote racism per se. It does mean that we’re all prone to making broad generalizations. This accentuates the conflict between political parties, races, and other groups. People on both sides of the color line can overgeneralize, leading to stereotyping.

I told the following anecdote in a blog post from last year’s MLK Human Rights Week:

When I was a first-year resident on rotation in the inpatient psychiatric wards, one of the patients assigned to me roared at me “I don’t want no nigger doctor!” more than once. I discussed the issue with my supervisor. It was a difficult conversation. It was a long time ago and I recall mostly the sense that we both felt awkward. I asked that the patient, who clearly didn’t want anything to do with me, be transferred to the care of another resident. I don’t recall whether he offered to talk with the patient and he deferred on asking another trainee to take over the patient’s care. My recollection is dim about how I handled it. I suspect that’s because it was emotionally painful. Although I had to see him prior to rounds every day, I think I excused myself as soon as he spat the word “nigger” in my face—which was practically every day. I told him I didn’t’ have to tolerate that.

The flip side of this is a conversation I overheard in the distant past between my father (a black man) and his friend (also black, who I’ll call Mark). My father took Mark in, who had just been released from jail and was homeless. He was wearing poorly fitting clothes he probably found because he was penniless and jobless. While he paced the living room floor, he cursed and said angrily, “Man, I will never let this white man do this to me again.” My father just snorted in a way that made me think he didn’t believe that Mark was in his predicament because of any white man—it was probably Mark’s own bad decisions that led to his problems.

As in past years when Sena and I are intellectually stimulated by MLK Celebration of Human Rights week speeches, our discussions get long and spirited and tend to range widely over the spectrum and durability of human weakness, human evil, and the seemingly accidental nature of human wisdom and human kindness.

We talked at length about James Alan McPherson, long time Iowa City resident and nationally renowned writer, the first African American to win the Pulitzer Prize for short fiction, and acting director of the Iowa City Writers Workshop. He died in in the summer of 2016. An Iowa City neighborhood park was recently renamed James Alan McPherson Park in his honor.

But judging from news stories, this didn’t happen until members of the Iowa Freedom Riders suggested that a park be named “Black Lives Matter Park” in the summer of 2020. In response, more than a dozen people recommended that Creekside Park be renamed in McPherson’s honor instead.

Was the suggestion of renaming the park after McPherson simply a maneuver to avoid naming a park after BLM—and possibly to avoid extremist consequences? Why did it take Iowa City so long to honor him after he died? It is puzzling given that his peers called him the heart and soul of the Iowa Writers Workshop and given that McPherson himself called Iowa a place where he felt welcome. He was even in psychotherapy delivered by a white psychiatrist, Dr. Dorothy “Jean” Arnold, the first female psychiatrist to open a private practice in the state of Iowa in 1957. They were both from the racially polarized South. I wonder how they ever connected.

Why should this matter so much to us? Just like Dr. Baker’s presentation, it’s a very uncomfortable discussion. Sena is very good at doing what MLK suggested in his Letter from a Birmingham Jail, where the quote “Whatever Affects One Directly, Affects All Indirectly” comes from—creating “constructive nonviolent tension.” King always advised against violence or anything other than nonviolent methods of protest, saying that what we need is to create a type of constructive nonviolent tension, which he proved can be more effective than violent confrontation.

Some extremists say that King’s nonviolent approach is no longer relevant for our times, but I doubt violence is the answer. Somehow all of us need to learn how to not just tolerate an atmosphere charged with constructive nonviolent tension—but to somehow transform ourselves directly and thereby transform others indirectly into peaceful agents of change.

Legacy Blogger

I just found out today that my blog’s theme was retired. I don’t know when WordPress retired it, but it gives me a familiar feeling about retirement. Sena gets the credit for giving me the idea of changing the theme (which is how my blog looks on the web) because of the new year. As I looked over the themes, I saw a tiny notice beside the name of my own. “Your blog theme has been retired. Consider getting a new one, you geezer!”

The notice didn’t really say that, of course, but that’s how I felt. I’ve been blogging since 2011. I’ve never had a theme that was retired. I realized that if I changed my theme now, I couldn’t go back to the old, familiar creaky, cob-webbed, old-fashioned theme I’ve had now with my second blog. This one has the theme (using the word in a different sense) of—retirement. In fact, come to think of it, the word “old-fashioned” was used in the WordPress article explaining why some themes get retired.

So, I started looking at the themes seriously today. Most of them had the word “minimalist” attached to them. Frequently, I read how great they were for my “business.”

Hey, I’m retired. I’m not in any kind of business. There seems to be a lack of emphasis on a theme for hobby bloggers, some of whom are retired geezers.

Anyway, I dropped my old-fashioned theme and put on a new one. While I was at it, I got rid of a lot of old widgets. WordPress calls them “Legacy Widgets.” I couldn’t find a clear explanation for why they call them that. I did find a definition on the web. Essentially, in this context, I think it denotes software that has been superseded but is difficult to replace because of its wide use. What’s wrong with sliders? I don’t mean little sandwiches. I mean the featured images with post titles that slide across the theme page, showing off my best posts—or at least what I think my best posts were. Really, no themes with sliders? That’s what minimalism leads to, I guess.

I’m a legacy consulting psychiatrist, meaning I’m retired—something else to feel ambivalent about. Anyway, I kind of like the new theme.

Take a Cup of Kindness and Say Goodbye to 2021

It’s been a quiet day around here. It’s New Year’s Eve. I got a great message from a former resident who has started his own Psychiatry Consultation Fellowship training program in Bangkok, Thailand. Dr. Paul Thisayakorn and his wife are welcoming 2022 with their 2 lovely children and hoping 2022 will be a better year, as we are. The Covid pandemic has been hard around the world.

Paul also looks forward to establishing a C-L Psychiatry academic society in Thailand in the coming year. Paul did his psychiatry residency at University of Iowa and his C-L Psychiatry fellowship in Cleveland. Sena and I wish him and his family all the best in the new year.

Today was quiet, but tomorrow the big snowstorm will come. We’ll be digging out all day because the forecast is for 5-8 inches, high wind gusts, and ice. It’s Iowa, after all.

But for tonight we’ll take a cup of kindness and say goodbye to 2021.

And if you like MacLean’s version of Auld Lang Syne above, you might have a listen to another with the Scottish lyrics translated.

My Definitive Journey Revisited

A couple of days ago, I got my retirement gift from The University of Iowa. It’s a about a year and a half late because of the Covid-19 pandemic, but it’s welcome nonetheless. Normally there is an Annual Faculty Retirement Dinner, but it had to be cancelled. It’s a stunningly beautiful engraved crystal bowl with the University logo on it. It came with a wonderful letter of appreciation. It reminded me of my blog post in 2019, “My Definitive Journey.”

It’s a definitive symbol of the next part of my journey in life. For years I’d been a fireman of sorts, which is what a general hospital psychiatric consultant really is. The other symbols have been the fireman’s helmet and the little chair I carried around so that I could sit with my patients. I have changed a little.

I still have my work email access, which I’m ambivalent about, naturally. I check it every day, partly because of Fear of Missing Out (FOMO), but also to delete the junk mail. I still get a lot of it. I get a rare message from former trainees, one of whom said it “pained” her to learn I’m now Professor Emeritus.

I have not seriously considered returning to work. That doesn’t mean I have not been occasionally nostalgic for some aspects of my former life.

The poem, “El Viaje Definitivo” by Juan Ramon Jimenez evokes mixed feelings and thoughts now. I have gone away. But in looking back at the past, I now see now that the birds didn’t always sing. The tree was not always green.

I don’t miss my former home, the hospital, as keenly now, which is now a much harder place to work since the Covid-19 pandemic began.

And there is little that is definitive about my journey forward from where I now stand. I’m a little less afraid than I was over a year and a half ago. And the birds sing where I am now, sometimes more clearly than before.

El Viaje Definitivo (The Final Journey)

… and I will go away.

And the birds will stay, singing

And my garden will stay

With its green tree

And white water well.

And every afternoon the sky will be blue and peaceful

And the pealing of bells will be like this afternoon’s

Peal of the bell of the high campanile.

They will die, all those who loved me

And every year the town will be revived, again

And in my circle of green white-limed flowering garden

My spirit will dwell nostalgic from tree to well.

And I will go away

And I will be lonely without my home

And without my tree with its green foliage

Without my white water well

Without the blue peaceful sky

And the birds will stay

Singing

                                –Juan Ramon Jimenez

The Park

It’s balmy for December. Sena and I went for a walk on the Terry Trueblood Trail and ran into our neighbors doing the same thing! Seabirds were diving headlong into the lake. We’ve never seen them do that. Maybe they were fishing for minnows. About a week ago we saw a hawk. It might have been a Cooper’s Hawk or a Sharp-Shinned Hawk. It had a yellow spot at the base of its bill, so I’m going to say it was a Cooper’s Hawk.

We also saw a small brown creature in the lake on a stack of tree limbs. It was eating something. I couldn’t see its tail, but it could have been a young beaver or a muskrat. Its nose tapered instead of looking blunt and boxy, so maybe it was a muskrat.

Last week a squirrel chattered at us almost nonstop. It was pretty grumpy for some reason. We sure know a bald eagle when we see one.

Sometimes it’s more fun to enjoy a little mystery than to hunt for all the right answers.

Follow the Trail of the Woolly Bear Tale

Sena and I went for a walk on the Clear Creek Trail today. It’s been about a year and a half since we last saw the place. A few things have changed, but one thing has not. You can nearly always find a woolly bear caterpillar somewhere along the trail, especially in the fall. I know I mentioned the insect not that long ago in a post after we thought we might have seen one on the Terry Trueblood Trail.

But we’re talking banded woolly bear, the genuine article. They have a brown band in the middle bounded by black bands at the head and tail ends. They’re fat and always busy looking for cover. There is a folk tale about it foretelling how hard the winter is going to get. The longer the black bands, the worse the winter will be.

However, the folk tale has long been debunked, according to my alma mater, Iowa State University (ISU). The bands are just indicators of the age of the insect, which is the larval stage of the Isabella moth.

But don’t try to tell that to the people of Vermilion, Ohio where they have the annual Woolly bear Festival. Dang, we just missed it in early October. They have a parade, woolly bear races, and an “official” examination of the woolly bears to nail down the winter forecast. I guess that’s sort of like hauling out the groundhog Punxsutawney Phil in Punxsutawney, Pennsylvania each Groundhog Day on February 2 to predict how much longer winter will last.

That reminds me (too late!) that we also missed this year’s ISU Department of Entomology Insect Zoo Film Festival, in Ames, Iowa, which was in late October. It’s an outreach program which travels all over Iowa to educate the public about insects.

I gather this evolved from another annual ISU Department of Entomology project called the Insect Horror Film Festival. It began in the early 1990s and gradually settled down into the Insect Zoo Film Festival in the mid-2000s.

That reminds me of one of my favorite movies, the 1997 film Men in Black, in which a bad-tempered giant cockroach alien crash lands its space ship on earth, eats a guy to use his skin as a disguise, tries to steal the Arquillian (tiny alien) galaxy, the best source of sub-atomic energy in the universe, and gets enraged every time it sees humans so much as swat a fly.

The other movie this makes me think of is the 1988 film Beetlejuice. Beetlejuice was sort of the star of the show, played by Michael Keaton. Beetlejuice was a dead guy who ate bugs and hired himself out to the newly dead, claiming to help ghosts get rid of a different species of pest—the living.

Finally, that makes me think of how long it’s going to take to get our Zombie Cribbage game delivered, given the recent slowdown of the Post Office. The snow may fly before it arrives.

But if the woolly bear analysis is right, at least there won’t be a lot of snow to slow down the mail truck.

What You See is Not Always What You Get

A couple of days ago I thought of Gary Larson’s Far Side cartoon, the one with the toggle switch in a passenger airplane cabin seat with the message “Wings Stay On; Wings Fall Off.” I googled it just for fun and found that it spawned a lot of web articles obviously trying to reassure the flying public that airplane wings don’t just fall off.

What brought the “Wings Stay On; Wings Fall Off” cartoon to mind were a few events in the last two days. Day before yesterday, Sena took our lease car to one of the local dealership’s car wash. She does this all the time without incident but this time she noticed that the “soap” didn’t rinse off. She drove it home and still couldn’t get what appeared to be soap film off the car. She finally drove back to the dealership and discovered that the car wash attendant had accidentally pressed the hydraulic oil lubricant button instead of the detergent button. A number of other car wash customers also had been victims of the mishap and were complaining to dealership management.

So, what had looked like soap film actually turned out to be hydraulic lubricant meant for the car wash motors. It turns out that accidents like these can happen. Could the button for the lubricant have been situated so close to the detergent button that the attendant accidentally pressed the wrong one? By itself, that reminded me of the Larson cartoon. If the systems analysist for the car wash design was asleep at the desk on the day of manufacture, I guess all you can do is think before you act. And what you see is not always what you get.

The next day, Sena and I were at the dealership sitting in an agent’s office. We noticed a tipped over cup of coffee. I reached over to pick it up, mentioning that he must have had a little accident. Much to my surprise, both cup and mess came up as a spill prank, which I had never seen before, believe it or not. The joke capitalizes on our human tendency to sometimes act before we think.

Finally, a couple of on-line news items caught my eye this morning. They were both about white tail deer in Iowa, discovered by Iowa State University (ISU) researchers to have somehow picked up the Covid-19 virus. One story was much shorter than the other.

The longer story by the Des Moines Register had a lot more ISU research detail in it and didn’t stress certain facts that might reassure readers that there was low likelihood that humans might be vulnerable to catching the virus from deer.

The shorter story by the KCCI news network didn’t present as much of the ISU research details and basically said as long as you used gloves to dress the animal in the field and thoroughly cooked the meat, you were in no danger of infection. Both stories basically carried the same message that there was low likelihood of infection to humans. But there was a slight tendency to overemphasize the risk in one article and maybe a tendency to underemphasize it in the other. These might illustrate the “spin” phenomenon for which readers should just be on the alert.

By the way, the CDC web site carries a message saying the risk of catching Covid-19 from wild animals is generally low.

What you see is not always what you get, especially at first glance. And it pays to think before you act.

Random Thoughts on the Iowa vs Wisconsin Football Game Today

OK, I know it’s in the books. Wisconsin won the football game with Iowa today, 27 to 7. Anybody can have a bad day. Iowa quarterback, Spencer Petras scored the only touchdown for Iowa. We hope the best for Wisconsin player Clay Cundiff, who had to be taken off the field in an ambulance after a leg injury. You know the game is over when the announcers start chatting about things like Wisconsin player, Braelon Allen, who can squat 610 pounds, and Halloween candy. I’m not going to tell you how early that chatter started.

Actually, I learned something new about the Iowa head football coach staff. It was from a trivia question during the game. Kirk Ferentz and Hayden Fry have been the only head coaches for the Iowa football team since 1979. How many head coaches have the other 13 teams in the Big Ten conference run through in the same time period? The answer is 94 (about 7 per school). Are there 13 or 14? I don’t know but 13 is how many the trivia question mentioned. Details.

How’s that for continuity of leadership? I’d say that’s a win.

Anyway, we tend to have a soft spot for Wisconsin. We visited a couple of times a dozen years ago before moving there briefly so I could try private practice psychiatry. My first vivid memory is of some guy walking down the middle of State Street in Madison wearing a live rattlesnake on his head. I can think of safer hats. But a rattlesnake says something more about you than your fashion sense. I’m just not sure what.

We also visited the Henry Vilas Zoo, where we saw, among other things, a real live badger. It doesn’t look like much. I guess the reason why the Wisconsin football team adopted the name of that animal is that it’s said to be totally fearless.

Madison is a not a huge metropolis but there’s a lot of interesting to see and do. I put on a little weight there from all the great food.

Iowa is a great place to live, too. Where else can you see a huge sculpture of a sitting man on the side of a road?

Moderna Booster Jab Today and Mindful Zombies

I got my Moderna Covid-19 booster jab this morning. That was quick. A guy (probably about my age, I’m not sure) waiting for his booster behind me chuckled and asked, “Did she even let you sit down for it?” I was in and out that fast. It’s the same as the primary series, only half-dose. Sena and I are now both fully vaccinated and boosted.

According to the FDA and CDC guidelines, I could have gotten a heterologous booster, but I stuck with what I got for my primary series. There was no problem with vaccine supply; it was already on the shelf, so the only thing different was the smaller dose. Since there’s not much else to say about it, we’ll move on to other more exciting news.

Sena ordered the Zombie cribbage game I just had to have. It won’t get here by Halloween, but that’s OK. I know the board is a folding plastic affair and there’s only enough peg holes for what would be half a full game (61 instead of 121). The pegs are zombie figures—which may or may not fit in the holes.

But it’s zombies! This is what happens to you in retirement, people. My gratitude to Sena for getting Zombie cribbage will be to play Scrabble with her.

That reminds me of a cribbage story I read on the web about a game between a couple of old guys in a senior community in Minnesota. One of them, Harry, was 108 years old and the other, Don, was 105. They were long time cribbage players, but they’d never played each other. The young guy won. As soon as he did, he got back on his walker, saying, “Just another game,” and left. In fact, neither player got as excited about the affair as everyone else including spectators, family, and staff, talking it up like it was a championship boxing match. Don’s family said that his attitude about the win was probably part of the reason for his longevity.

I liked Don’s reaction to winning the game. I don’t know if Don’s approach to cribbage is the same as it is to life in general. Maybe it’s about living in the present. When something is over, it’s in the past and it’s time to move on. There’s probably no point in worrying about the future either, especially when you get pretty old. There’s not much of it left.

Maybe this mean that retirees should be more like zombies—we should just play cribbage, eat brains mindfully, and forget about tomorrow. You’re welcome.

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