I listened to the Big Mo Blues Show last Friday night on June 21, 2024 and wouldn’t you know, he was recorded. He wasn’t there live that night but as usual he put on a great show of blues music.
And I listened to the Big Mo Pod Show a few days later, and the theme was Absorbing Influences. Very thought provoking. The choice of tunes was interesting and Big Mo pretty much got them all identified. He usually does.
I can’t remember all the tunes he played on June 21st, but as usual, I had a different perspective about the selection for the podcast. I think I heard a Catfish Keith number on the Big Mo Blues Show, which I can’t remember too well and furthermore, don’t quite understand. It was “I Don’t Know Right from Wrong.”
And I’ll throw you another curve. That’s not the number I want to talk about in terms of the absorbing influence theme. Briefly, it just means that many blues artists get influenced by a musician they really like, pick up on what they learn from a song and gradually make it their own.
I think Catfish Keith was influenced by Son House, who sang a song called “A True Friend is Hard to Find.” Catfish Keith absorbed the music, and did his own version which I recently heard. I think it’s a gospel number. Memorable lines include:
“Bear this in mind, a true friend is hard to find.”
It’s true. You have a real treasure if you ever find one.
I was thinking of one of the Johnson County judicial mental health referees I often worked with years ago. L. Jay Stein died in 2014. I looked up his obituary the other day and was a little surprised to find I had written a remembrance for him. I’d forgotten it.
“I will always remember my first encounters with Judge Stein. I was a first-year resident in psychiatry at The University of Iowa Hospitals & Clinics. He often presided at mental health commitment hearings at which I was often the nervous trainee providing “expert testimony” as the treating physician. Jay taught me and countless other psychiatry residents about the importance of procedure. His knowledge was prodigious. But it was his compassion, his fairness, and his inimitable sense of humor I will always treasure.”
Judge Stein’s vocabulary was impressive. Even his recorded telephone automatic replies sounded amusingly erudite. Occasionally, when I had a question about legal procedures in mental health I would call him but get his answering machine. These out of office replies were entertaining and sounded very much like the way he did during commitment hearings. I can’t remember all of it, but it began with something like, “Once again, your request has been denied…” It made me think of what I might hear at a parole hearing—not mine of course.
I was just thinking about the old-time land survey crews. When I was getting on the job training as a survey technician, the typical land survey crews were at least 2-3 persons. One rodman, one instrument man, and a crew chief who organized the job, which could be property or construction jobs.
Nowadays, you get by sometimes with one man doing the jobs using a theodolite that measures angles and distances. You don’t always need a physical measuring tape; you can use something they call “total stations.”
It’s cheaper for engineering companies to use one man survey outfits. On the other hand, one disadvantage is the lack of mentoring for learners who want to become land surveyors or civil engineers.
Mentoring from surveyors on the survey back in the day not only taught me such skills as how to throw and wrap a surveyor’s steel tape—it also taught me how to work well with others as a team. Of course, this was transferrable to working on the psychiatry consultation-liaison service in a big hospital as well.
It’s well known that playing cards in the truck while waiting for the rain to stop was an essential skill. I don’t know how they manage downtime nowadays. We didn’t play cards on the consultation service during downtime, partly because we didn’t have much downtime.
Anyway, as I mentioned in a recent post, we played Hearts in the truck on rain days. I always sat in the middle. At the time, I was a terrible card player in general. It was a cutthroat game and I had trouble remembering which cards had been played.
When you consider that the strong suit of engineers and surveyors is math ability, you’d think that survey crews would have figured out a way to play Cribbage during downtime. You can have a Cribbage game with 3 or 4 people although I’ve never played it that way. If there are 3 players, it can still be cutthroat.
The one problem I can see is that, the guy sitting in the middle would have to set the board on his lap. You’d almost need a special, custom-made board which would have a space for placing the cards to keep track of what’s been played. I think that might have made things easier for me.
The other drawback to one man survey crews is that pretty much the only card game you can play is solitaire.
The other day we had some stormy weather roll across central Iowa, although it was not as bad as the tornado that swept through Greenfield. We hope the best for them. We didn’t actually get a tornado, but I remember wondering why the siren went off about 6:00 a.m. It woke me up and I wondered what was the matter. Turns out it was a tornado warning and we had to sit in the basement for a little while. It was a little scary, but the storm moved east pretty quickly northeast out of our area.
For whatever reason, this eventually led to my reminiscing about my younger days. Maybe it was because of a temporary scare and increased awareness of our mortality.
I used to work for a consulting engineers company called WHKS & Co. in Mason City, Iowa. This was back in the days of the dinosaurs when it was challenging to set stakes for rerouting highways around grazing diplodocus herds.
I was young and stupid (compared to being old and stupid now by way of comparison). I lived at the YMCA and took the city bus to the Willowbrook Plaza where the WHKS & Co. office was located on the west side of town.
I usually got there too early and stopped for breakfast at the Country Kitchen. The waitress would make many trips to my table to top off my coffee while I sat there waiting for the office to open. That was fine because I had a strong bladder in those days. I left tips (“Don’t cross the street when the light is red”).
My duties at WHKS & Co. included being rear chain man and rod man, at least when I first started. A “chain” was the word still being used for a steel tape for measuring distances. It was well past the days when land surveyors used actual chains for that purpose. You had to use a plumb bob with the chain to make sure you were straight above the point (usually marked by a nail or an iron property corner pin) you measuring to and from.
You and the lead chain man had to pull hard on each end of the chain to make sure it was straight. It was challenging, especially on hot days when my hands were sweaty and the chain was dirty. Callouses helped.
The rod was for measuring vertical distances and an instrument called a level was used with that. One guy held up the rod which was marked with numbers and the guy using the level read the elevation. Another way to measure both horizontal and vertical angles used a rod and a different instrument that we called a theodolite (older instrument name was “transit”).
We worked in all kinds of weather, although not during thunderstorms. In fact, when it was looking like rain out in the field, a standard joke for us sitting in the truck waiting for rain was to draw a circle on the windshield (imaginary, you just used your finger although if your finger was dirty which it always was, you left a mark) and if a certain number of drops fell in the circle, you could sit in the truck and play cards.
When we played cards, it was always the game Hearts, which I could not play skillfully at all. I always lost. But it kept us out of the rain. If a big thunderstorm blew in, we just headed back home.
Back in 2018, one of my emergency room staff physicians asked me to do a Pecha Kucha on what a consultation-liaison psychiatrist does. If you know what a pecha kucha is, you can understand why it was challenging for me to put it together and present it.
Although you may have seen the video I made of the pecha kucha 5 years ago on this blog, I think it’s OK to present it here again.
Briefly, PechaKucha is Japanese for “chitchat.” It’s a presentation format using 20 slides displayed for 20 seconds each. It took a while to rehearse to get it right.
I think it’s also worth emphasizing because most of the ideas in it are still relevant to consultation-liaison psychiatry. See what you think.
When I was a consultation-liaison psychiatrist I taught trainees in different ways. One of them was what I called the Dirty Dozen slide sets. They were on various basic topics that are important for psychistrists to know. I tried to put the most important points on only a dozen powerpoint slides.
After I started blogging about C-L Psychiatry around 13 years ago, the WordPress blogging platform started offering a way to post slide presentations using what is called shortcode. Presumably, you didn’t really have to know anything about coding language but the instructions weren’t very helpful.
I think I started trying to make slides using shortcode shortly after it was first introduced around 2013. I had to contact WordPress support because I couldn’t learn shortcode. A lot of bloggers had the same problem.
I think my main reason for getting interested in shortcode was so I could cut down on how many powerpoint slides I had to convert to images, which can take up a lot of space on a blog site after a while.
Anyway, in the past few days I tried to pick up the shortcode but couldn’t get the hang of it again. I finally found a WordPress help forum in which I found a blogger’s solution. She made it so clear.
Anyway, the Dirty Dozen on Delirium is below. A few pointers: click in the lower right hand corner of the slide if you want to view the slides full size. Use the directional arrows on your keyboard to click through the slides. You can also just use the arrow handles on the slides if you don’t want to see them full size. . When you click the URLs on the delirium websites, right click and open them in a new tab.
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Dirty Dozen on Delirium by Jim Amos, MD
-What is Delirium?
-Acute brain injury, by definition a medical emergency; mimics many primary psychiatric disorders: affect, behavior, and cognition typically fluctuate
-Systems causes: multiple room changes, absence of clock and calendar, sensory aids, family members, use of physical & chemical restraints
What is Delirium, cont.
-Hospital cultural reasons: assumption delirium is: primary psychiatric problem per se and that it’s the duty of mainly one medical subspecialty (Psychiatry) to manage; nursing management problem; unavoidable consequence of severe medical illness
-Clinical Features of Delirium
-Disorders of consciousness: hyperalert to obtunded
-Disorder of affect, behavior, cognition
-Disorder of perception: hallucinations, often visual
-Predisposing Risk Factors
-Age 65 or older
-Cognitive impairment
-Severe illness
-Dehydration
-20% prevalence in general hospital
-Range up to 80% prevalence in ICU
-Outcomes
-Increases length of stay, admit to long term care, mortality
-Post-discharge decline in ADLs & cognitive function
-Etiology
-Underlying medical cause(s)
-General medical conditions
-Medications
-Substance intoxication and withdrawal
-Delirium Screening (one example)
-The Confusion Assessment Method (CAM) developed by S.K. Inouye, rated in
around 5 minutes
-Acute change in mental status/fluctuating course and inattention; either disorganized thinking or altered level of consciousness
-Preventing Delirium
-Frequent reorientation
-Encourage normal sleep-wake cycle
-Encourage mobility
-eyeglasses, hearing aid available
-avoid anticholinergic, sedative-hypnotic drugs
-prevent organic drivers: hypoxia, infection
-Treatment of Delirium
-First treat underlying medical causes
-Avoid benzodiazepines unless alcohol withdrawal is the cause
-Avoid other drugs that cause delirium
Here’s a suitable sort of dad joke Svengoolie style for the 1941 horror movie classic, The Wolf Man:
What do you call a dirty joke about the wolfman given at the strait-laced werewolf convention? A howler.
See what I did there? It puns on the word “howler” defined as an embarrassing mistake that evokes laughter, and also puns on the werewolf’s habit of howling. So, the mistake is the dirty joke being told to a convention audience of strait-laced (strictly moralistic) werewolves. OK, whatever.
I’m not great at telling dad jokes, although I like to hear them. I almost bought a book of dad jokes the other day, but when I read the copyright notice, I decided against it:
The notice of copyright for this book of dad jokes is to inform the purchaser that it is hereby forbidden to share these jokes in written, spoken, whispered, or telepathically delivered form to anyone else. Only the purchaser may whisper the jokes to himself as long as no other person is within earshot although it is preferable to read them silently. If this copyright notice is violated (and we will know because of the cleverly hidden monitoring device inserted in the text on each and every page), the publisher has the right to pursue every legal action necessary to extract money and suitable vengeance on the perpetrator, which means you.
I’ve been to the bookstore which sells several dad joke books and they all have this kind of copyright notice in them, regardless of who writes the books. I end up not buying any of them. Consequently, I never learn how to tell dad jokes. But that probably won’t stop me from trying.
Anyway, we saw The Wolf Man last Saturday and it’s a classic B horror movie. It was our first time seeing it and Lon Chaney, Jr. was a great werewolf. He didn’t like being called junior. We found out his father was a movie star too. I don’t think anybody called him Lon Chaney, Sr.
You can find attempts on the web to attach psychoanalytic interpretations of the Wolf Man, but I don’t buy them. On the other hand, there are some quotes from the film that sound like psychological observations:
Dr. Lloyd, the family physician: “I believe a man lost in the mazes of his own mind may imagine that he’s anything.”
Sir John Talbot (Larry the werewolf’s father): “Larry, to some people, life is very simple. They decide that this is good, that is bad. This is wrong, that’s right. There’s no right in wrong, no good in bad. No shadings and greys, all blacks and whites…Now others of us find that good, bad, right, wrong, are many-sided, complex things. We try to see every side but the more we see, the less sure we are. Now you asked me if I believe a man can become a wolf. If you mean “Can it take on physical traits of an animal?” No, it’s fantastic. However, I do believe that most anything can happen to a man in his own mind.”
You can see The Wolf Man on the internet archive. You can make up your own mind about it.
I saw this essay about getting your hamster off the treadmill and being in the moment. It’s not just for University of Iowa employees. I do the mindfulness thing, I juggle, I make dumb YouTube videos. And for a little over a month now, I have not scrolled past the first few headlines at the top of the on-line news outlets. It’s a little easier than I thought to give up FOMO zombie-scrolling news habit, if you can even call it the news.
Yesterday, we went out to Terry Trueblood Recreation Area to see the solar eclipse. It was a gorgeous day for it, although a bit chilly. When we got there about 11:30 AM, the parking lot was pretty empty and only a few people were there. We even ran into a few on the trail who didn’t know about the eclipse at all.
However, as the day went on, more visitors showed up, although by no means a crushing crowd. Sena and I were testing out our pinhole and cereal box viewers, and I practiced using the solar filter with my smartphone. While we were doing that, a woman approached us and we struck up a great conversation about the eclipse, which she was looking forward to as well.
As the time approached for the big event, others took up positions around the park. It didn’t take long for us to share stories with others. A woman shared her pinhole viewer with us. She also shared her eclipse glasses (Sena did as well) with another couple who had a NASA live feed on their large screen smartphone. They in turn shared the NASA live feed with us. The irony was the couple didn’t have eclipse glasses and couldn’t safely look up at the partial eclipse right where we were in Iowa City.
And that’s how we all got to share our experience of 4 eclipses, 3 of them total eclipses (albeit vicariously by the NASA live feed by smartphone) with Carbondale, Illinois as well as Arkansas and Texas. The videos were mesmerizing.
As the eclipse progressed, we noticed it got colder and darker. The birds stopped singing. On the NASA live feed, we heard a reporter excitedly remark that the bats were flying out of the caves because they thought it was nightfall. The Terry Trueblood Park lights turned on it got so dim; then they came back on as the eclipse reversed.
The eclipse itself was spectacular. Even more fascinating was how it brought some of us together with others to share it. It reminded me of an old term “the happening.” It was coined in the 1950s and, although I think it originally referred to artistic events, you could apply it to a lot of big and cool events—like eclipses. It was a happening.
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