Category: reflections

Thoughts on the Mason City 1884 Civil War Statue

Sena and I got to talking about Central Park in Mason City, Iowa. I remember my brother, mother and I taking a walk there occasionally. One time we saw a man who lost his legs and who got around using a small platform on wheels. Later in life, I wondered if he was a disabled war veteran.

That reminded us of the 1884 Memorial Civil War Statue in the center of the park. We looked it up and found it has a complicated history. In the late 1990s it was under repair for about 3 years in Cincinnati, Ohio. When it was finally returned, it was noticed that it had not been repaired correctly. The city decided to keep it anyway, partly because some people, including a Civil War re-enactment supporter, thought the flaws were relatively minor.

Anyway, there are relief busts of famous persons on the statue. We could identify Abraham Lincoln, Ulysses S. Grant, and a Civil War soldier. After a brief web search, we confirmed that the 4th relief bust was that of George Washington.

There are a couple of topics of interest here. One of them is the George Washington relief bust and the other is Civil War re-enactments.

The connection of the Civil War to George Washington is a little puzzling because he owned slaves. We’re aware he freed them upon his death. On the other hand, when we visited Washington D.C. in 2015, we took a tour of Mt. Vernon. It was a scenic boat trip out there. We took a picture at the dock with the dog of the guy who helped people on and off the boat. We also took pictures of the slave quarters. There were no re-enactment persons and we were told we were on our own when viewing those exhibits.

This also reminds me of the news item about a bill recently (on February 9, 2024)) introduced in the West Virginia legislature to remove the statue of former Senator Robert C. Byrd from the West Virginia State Capitol and replace it with 4 other statues: Abraham Lincoln, James Madison, Arthur I. Boreman, and George Washington. Nothing is mentioned in that news story about Senator Robert C. Byrd having been a leader in the Ku Klux Klan in the past, and filibustered against the Civil Rights Act of 1964. This is from a news story posted on the web in 2020 under a link titled “time to remove monuments to senator byrd.”

Again, I struggle a bit with suggesting that a statue of George Washington, a former slave owner, would be an appropriate substitute for that of Senator Byrd. And James Madison, despite saying that slavery was incompatible with Revolutionary principle, owned slaves and made profits on their sale. Arthur I. Boreman is described as not being an abolitionist but a unionist. However, in 1865 he signed a legislative act banning slavery in the state of West Virginia.

Maybe a nice set of abstract sculptures for the corners of the rotunda of the West Virginia State Capitol?

Turning to Civil War re-enactments, I’m ambivalent about them. I remember reading a couple of anecdotes about re-enactments in the book “Our Hidden Conversations” by Michele Norris.

One of them was about black woman re-enactor who played the role of a house slave. This was in Chapter 4, “Coins in the Couch.” The six-word Race Card (p.160) said “Why Do You “Play” A Slave?”  Nicole is a slave interpreter. She makes sure that visitors to former plantation sites portray slavery accurately to tourists. She’s a public historian by training who works at the National Center for Civil and Human Rights in Atlanta. She teaches tourists about the reality of chattel slavery, including the sale of relatives to other plantations and the ingenuity of enslaved men in improving farm implements.

The next anecdote about re-enactment in the book is in Chapter 10, “So, You Want to Talk About Lynching?” The six-word Race Card (p. 386) said “Confederate re-enactor chose intimidation as spoils.” A black man and his biracial but white looking friend were at a barbecue in Texas. Two big white guys dressed in Confederate-era uniforms were passing by and one of them placed his rifle on his knee and tried to stare down the black man. The black man stared back and this went on long enough for his friend to get nervous enough to suggest they just leave. Finally, the other re-enactor pulled the sleeve of the intimidator and they were the ones who finally left. Despite this episode, the black guy “…made a choice to accept people as I receive them.”

Apparently, there are regular Civil War re-enactments in Mason City. It looks like the most recent was from Sept 8, 2023-Sept 10, 2023. It was The Battle of Chickamauga, TN. It was held in East Park, where I used to play as a kid. Iowa soldiers in the Civil War fought on the Union side. However, I found out the battle of Chickamauga was won by the Confederates, and it had the second highest number of casualties after the Battle of Gettysburg. There was a battle demonstration and the camps were open all weekend to talk to the re-enactors. And there were food vendors.

There is a newer Mason City Veterans Monument in Central Park. It was built in 2004. It has 12 handsome black granite stones with room for the names of 4,600 veterans. We have seen pictures of it on the web. There are no relief busts.

Essay “Forget Me Not” on the Web About Leaving a Legacy

Sena found a great essay on leaving a legacy. It’s titled “Forget Me Not” written by Jonathan Clements and posted on the website HumbleDollar on February 17, 2024. I think it’s worth sharing.

The comments are still coming in. One commenter (Newsboy) wrote the one below:

“The late great author, Steven (sic) Covey, once suggested: “To live. To love. To learn. To leave a legacy – That’s what we all want.” 

How appropriate it seems that a willingness to embrace the first three items on his list (live / love / learn) typically results in the “dearly departed” achieving some meaningful degree of the last one (leave a legacy).”

This reminded me that I shared Stephen Covey’s concepts with junior residents when I was the chief resident in psychiatry. He wrote many books, including The 7 Habits of Highly Effective People.

I took the 7 Habits of Highly Effective People Signature Program many years ago. All of us who attended got the course book and the Talking Stick. Back then Covey called it the Indian Talking Stick; I guess nowadays you’d call it the Indigenous People Talking Stick. The idea was to pass the stick around and you’d have to respect the person holding it and listen carefully while they have their say until they feel understood. Only then could the stick be passed on to someone else, once again to allow them to say their piece until they are understood. There could be no interruptions.

I wonder if the Talking Stick really works. I’ve never tried it. I guess that’s the problem.

I think Covey left a legacy. I doubt that was his main goal.

More Thoughts On “Our Hidden Conversations” Book by Michele Norris

I need to correct something I got wrong in my first post about Michele Norris’s Distinguished Lecture on January 23rd. While reading her book, “Our Hidden Conversations” I ran across this race card in the chapter “Black Babies Cost Less to Adopt:”

“Vote (for) Obama! He looks like me!”

That was the 8-year-old daughter said that. The person who sent in the card was her father, Dr. Val Sheffield and he was a medical student in Iowa at the time. Once you know that, you realize why he wondered whether he should have been “…happy or dismayed by this comment.”

Anyway, I’m a little over halfway through the book, “Our Hidden Conversations.”

The title of the chapter above, “Black Babies Cost Less to Adopt” is troubling and it has a lot to say about how it was common in the past to discount the cost of adopting black babies. Foster care of non-white kids was also a subject in the chapter. Identity conflicts are common and can lead to reminiscing about things like:

“I was not Black enough.”

“I was not Asian enough.”

“I was not Hispanic enough.”

What matters is being kind enough.

Preliminary Thoughts on “Our Hidden Conversations” Book

This is a short post about my initial impressions about the book, “Our Hidden Conversation” by Michele Norris.

I’m not finished with the book yet, but I thought I would let you know that the first chapter, “Bread Crumbs” was tough to read. I had to put it down and come back to it a few times because it brought back memories.

The chapter title “Bread Crumbs” means the clues that parents, grandparents, etc. might leave for subsequent generations to find which might shed light on one’s background, explain troubling circumstances, and so on.

I have some bread crumbs left to me by my family. Some are in the form of photos, although there is no family photo of all of us together.

I remember the hair combing routine my mom had with me and my brother every Sunday morning before church when we were kids. Our father was black and my mother was white. Dad was out of the home and we lived with mom. We were the only black kids in the church. In fact, all the members were white.

Mom used a prodigious amount of hair oil while vigorously combing our curly hair back. It took many strokes and the pulling pinched a bit. The ritual took a little while. When I look back on it, I guess the goal was to straighten our hair as much as possible.

Everyone in the church always treated us kindly and I was baptized there.

If you decide to read “Our Hidden Conversations,” give yourself a break whenever you feel like you need it.

Sweethearts on a February Stroll

Yesterday, we went out for a walk because it was a pretty nice day for February. All the snow was pretty much gone. We saw a hawk who also saw us. We approached the tree it was perched in very slowly. It tolerated our attention until we got too close for comfort—and flapped off in a huff.

It was a nice enough day to walk all the way out to the Sitting Man and beyond. Others were out taking in the sun as well. It’s good to do simple things; things like walking in the sun, drinking iced coffee, eating zucchini bread, waving at UFOs.

You know how it is.

Black History Month: James Spaights Concert Pianist

I was thinking about my time as a student at Huston-Tillotson University in the 1970s (then Huston-Tillotson College) and remembered somebody who was a student there. His name is James Spaights. In honor of his stature in music as it connects to the Black History Month theme of African Americans and the Arts, I just want to make special mention that Mr. Spaights is a concert pianist. I have not found his obituary (you know already about my habit of checking the obituaries) so I’m not going to talk about him in the past tense.

When I met him, Mr. Spaights was straightforward about his life goal, which was to be a concert pianist. Little did I know that he had already achieved that by the time I met him at H-TU.

He gave a fantastic performance for the faculty and students. I’m pretty sure we gave him a standing ovation.

I found some news clippings and other items about his career (unfortunately I couldn’t find recordings of his performances), which deserves to be better known. He was a member of the Alpha Phi Alpha Fraternity and a fraternity news letter shows his photo and bio in the 1977 issue of the SPHINX:

“Brother James Spaights, pianist, whom New York critics acclaimed “a virtuoso pianist and technician of the first rank” after his New York debut at Town Hall in 1965, was presented in concert on March 20, 1977 in Carnegie Hall, New York City, by the Behre Piano Associates of New York. Spaights is a former student of Madam Edwine Behre in New York City, also Freda Rosenblatt, Bronx, N.Y. and Emma Slutsky, Brooklyn, N.Y.

For three years Spaights served as Ambassador of Goodwill for the United States’ State Department as a concert pianist touring throughout Europe, parts of Canada, and the United States.

On his most recent United States tour, Spaights was presented by the Music Department at Morgan State College in Baltimore, Maryland, and Goddard College in Montpellian, Vermont.

Spaights holds his B.A. Degree in Music from Howard University and a Master of Arts Degree in Music from Columbia University. He is a member of the Lechetisky Association of America, The Behre Piano Association of New York, and a member of Gamma Eta Lambda Chapter of Alpha Phi Alpha Fraternity in Austin, Texas.

He is presently serving a post in the Music Department of Huston-Tillotson College of Austin, Texas.” (The SPHINX, Fall 1977, Volume 63, Number 3 197706303).

I guess I misunderstood what Mr. Spaights was doing at H-TU when I was an undergraduate there. I thought he was a student! He never mentioned his career or accomplishments (at least to me) and he had a great sense of humor. I was in the presence of a music luminary and never knew it.

Ref: The SPHINX Volume 63, Number 3, October 1977.

Thoughts on the Distinguished Education Lecture by Dr. Russell Ledet MD PhD

We enjoyed the Dr. Martin Luther King, Jr. Distinguished Education (originally given on January 17, 2023) by Dr. Russell Ledet. He’s definitely a mover and a shaker and this is another recorded presentation that I wish was available for the general public.

His bio is knockdown impressive. And even more interesting to me is that he’s presently in residency toward boarding in adult psychiatry and child psychiatry as well as pediatrics.

That’s right—triple boarding.

His talk was a fascinating oral autobiography from his upbringing in poverty to his military career, to his undergraduate and graduate college career, and his achievement in organizing a very successful nonprofit, The 15 White Coats. This helps get underrepresented minority students into medicine by giving them inspiration and financial support.

His life story by itself is inspiring. It’s also exhausting. The person introducing him wondered aloud if he ever slept!

He began with a well-known quote by Dr. Martin Luther King, Jr:

“It’s all right to tell a man to lift himself by his own bootstraps, but it is a cruel jest to say to a bootless man that he ought to lift himself by his own bootstraps.”

Dr. Ledet’s story of his path from bootlessness to crowning success is compelling. You really have to hear it from him to get a clear idea of how difficult it was. It’s hard to imagine that a star like him once rummaged through dumpsters for food for the family while his mother was on the lookout to make sure he didn’t get caught.

I think a big part of what kept him going was his wife and kids. In fact, his wife, Mallory Alise, insisted that he take the path because of her fear he would die if he continued a dangerous assignment in the military.

A member of the audience who had a career similar to Dr. Ledet asked a question about what more should he do to make sure young people of color would get the kind of opportunities to succeed. Dr. Ledet had a very good answer, but that was not the most interesting part of the interaction. Firstly, the questioner didn’t sound (I know this is going to sound crass) black. He sounded more like someone who had grown up in the Northern United States—like me. But during the course of the conversation, it was clear that he was black. He just didn’t sound like Dr. Ledet. He also mentioned, almost in passing, that some people of color who succeed may develop imposter syndrome.

This sounded strange at first, but I quickly realized that I sometimes had felt like an imposter. This cuts two ways with me. One was the obvious context in which I came out of an impoverished background to finish college and medical school, and had a career as a consultation-liaison psychiatrist at a university medical center where I published and taught for many years. At times I felt like a phony.

The other situation in which imposter syndrome arose was when I went to Huston-Tillotson University (an HBCU formerly called Huston-Tillotson College) in Austin, Texas back in the 1970s. Most of the students were from the region. I had a Northerner’s accent and somebody once remarked on it, asking me “Why do you talk so hard?” I was easily identified simply because of how I spoke. I didn’t always feel comfortable, despite for the first time being not the only black guy in school. Ironically, I didn’t feel like I fit in, even in an HBCU. Even among those who looked like me, I sometimes felt like a phony. But that was not an enduring affliction.

And I think Dr. Ledet has a great deal of confidence and energy. More power to him.

Black History Month 2024 Theme is African Americans and the Arts

February is Black History Month and in 2024 the theme is African Americans and the Arts.

This reminds me of a blues artist I heard on KCCK on the Big Mo Blues Show last Friday. His name is Toronzo Cannon and his career as a blues guitarist and songwriter is skyrocketing. I heard his song “The Preacher, the Politician, and the Pimp.”

The lyrics reminded me of a character (or maybe more properly a non-character) called Rinehart in Ralph Ellison’s book, Invisible Man. I’m by no means an Ellison scholar but in chapter 23 the main narrator gets mistaken for a black guy named Rinehart who has many faces in the black community. He’s a preacher, a numbers runner, a pimp, and is also related to a political movement in the novel. Rinehart is all of them and none of them, moving between the “rind and heart” of who black people are in America. The implication is that the identity of black people is multifaceted and the similarity of the theme in Toronzo Cannon’s song is striking.

Cannon is also multifaceted. He’s a Blues guitar star and song writer and is also still a bus driver for the Chicago Transit Authority. How does he find time to do all that?

I wonder if Cannon got the idea for the song from Ellison’s novel. I guess I’ll never know.

This reminds me of an encounter I had with a black writer at Huston-Tillotson University (then Huston-Tillotson College, located in Austin, Texas) in the 1970s when I was an undergraduate in college. I’ve described this episode before in another post (“Black Psychiatrists in Iowa” 2019). The excerpt below includes a reference to a book review I wrote that was published in The American Journal of Psychiatry over 20 years ago:

“This reminds me of a book review I wrote for the American Journal of Psychiatry almost 20 years ago (Amos, J. (2000). Being Black in America Today: A multi perspective review of the problem. Am J Psychiatry, 157(5), 845-846.).”

The book was written by Norman Q Brill, M.D. It reminded me of my experience at Huston-Tillotson College (now Huston-Tillotson University, a private school, historically with largely Black enrollment) in Austin, Texas back in the 1970s. I wrote:

“Dr. Brill’s appraisal of many black leaders in chapters such as “Black Leaders in the Black Movement” and “Black Anti-Semitism” may be refreshingly frank in the opinion of some. He tailors his prose so as not to denounce openly those whom many would describe as demagogues. At the same time, it is apparent that his underlying message is that a substantial number of them are not only out of touch with mainstream black America but may even mislead black people into adopting ideological positions that impede rather than foster progress. Dr. Brill’s description of the issue reminded me of my own experience with this phenomenon as a freshman in the mid-1970s at a college of predominantly black enrollment in the southern United States. A guest lecturer (who, as I recall, had also written a book about being black in America) told us that the white man would never allow a black man to be a man in America. He had only three choices: he could be a clown, an athlete, or a noble savage. These corresponded to the prominent and often stereotyped roles that blacks typically held in entertainment, sports, and black churches.” 

I was taken aback by the speaker’s judgment and asked him what my choice should then be. He was equally taken aback, I suspect. He advised me to be a clown.

The lyrics of Cannon’s song “The Preacher, The Politician, and the Pimp,” Ellison’s Rinehart, and another writer’s characterization of the roles allowed in American society for black men all resonate together. What drives the similarity of this perception across different artistic platforms?

When I reflect on how I’ve negotiated my life’s path over they years, I guess I would have to admit that I’ve often played the clown. Anyone can see that in the way my sense of humor comes across. Is it the healthiest way to respond to racism in this country? In terms of the psychological defense mechanisms, I think it’s a relatively mature strategy. You could argue with that by asking, “But where’s the maturity in dad jokes?”

Hey, it worked for Dick Gregory:

“I’ve got to go up there as an individual first, a Negro second. I’ve got to be a colored funny man, not a funny colored man”—Dick Gregory.

Dick Gregory

Thoughts on the Passing of Artie Hicks

Yesterday, I was thinking about Artie Hicks, one of my old English teachers at Huston-Tillotson University, which was Huston-Tillotson College back in the mid-1970s when I was a student there. I looked him up on the web, just out of curiosity—and found his obituary. That seems to happen a lot lately.

Anyway, he was a gifted teacher and had a great sense of humor. He bought tickets for the whole class to see the movie Harold and Maude, a ground-breaking film in those days. He had a simple and direct approach to talking with students. He always seemed comfortable in a place where white people (including teachers) were the minority—unlike the wider world outside the campus.

He was bald and the students called him Kojak, which was the name of the bald, tough detective star (played by Telly Savalas) of the TV crime drama which aired on CBS from 1973 to 1978.

I think you could have called Artie tough as well; not bad guy tough but honest and direct.

Old Doctors vs Young Doctors

I ran across a recently published web article that originated from the Wall Street Journal (WSJ), to which I don’t have access because I’m not a subscriber. The title is “Do Younger or Older Doctors Get Better Results?” and it’s in the form of an essay by Pete Ryan.

It’s been picked up by over 130 news outlets and is actually based on an open access study published in the British Medical Journal (BMJ) in 2017, (BMJ 2017;357:j1797): Tsugawa Y, Newhouse J P, Zaslavsky A M, Blumenthal D M, Jena A B. Physician age and outcomes in elderly patients in hospital in the US: observational study BMJ 2017; 357:j1797 doi:10.1136/bmj. j1797.

I had a quick look at the rapid response comments. A couple resonated with me. One was from a retired person:

“I did not see specific patient age statistics vs physician age groupings. Wouldn’t older patients, whose risk of dying soon was higher, want to see their own older doctors? Lots of uncontrolled variables in this study… I also agree with one of the other comments that a patient who knew the end of their life was near would seek care from an older physician that would tend to be more empathetic with a patient of their own age.”

Another was from an emergency room physician, Dr. Cloyd B. Gatrell, who entered the comment on June 8, 2017. Part of it echoed my sentiments exactly:

“The authors’ own statements call their conclusion into question: “Our findings might just as likely reflect cohort effects rather than declining clinical performance associated with greater age….”

I suspect most of the web articles spawned by the study didn’t really talk about the study itself. They probably were mainly about your attitude if the doctor who entered the exam room had gray hair or not.

The study involved internal medicine hospitalists and measured mortality rates comparing physicians were in different age ranges from less than 40 years to over 60.

It got me wondering if you could do a similar study of younger and older psychiatrists. Maybe something like it has been done. I’m not sure what an appropriate outcome measure might be. If you focus on bad outcomes, completed suicides are probably too rare and can involve psychiatrists of any age. The quote that comes to mind:

“There are two kinds of psychiatrists—those who have had a patient die by suicide, and those who will.”

Robert Simon, MD, forensic psychiatrist

I doubt they would fall into any particular age category more often than any other.

Anyway, on the subject of physicians who are getting older and required to retire at a specific age, recent news revealed that Scripps Clinical Medical Group agreed to pay almost $7 million to physicians to settle an age and disability discrimination charge filed with the U.S. Equal Opportunity Commission over a policy requiring them to retire at age 75.

And this reminds me of an article in Hektoen International A Journal of Medical Humanities: Jean Astruc, the “compleat physician.” He was a doctor in the Age of Enlightenment and was a geriatrician. An excerpt from the article:

Jean Astruc had a special interest in geriatrics and in 1762 gave a series of lectures that were taken down by one of his students. He described how in old age the skin becomes thick and hard, the hair and teeth fall out, there becomes need for glasses, respiration becomes labored, urine escapes, there is insomnia, and people forget what they have done during the day but remember every detail of what they have done in the distant past. He recommended diet, some wine to help the circulation, exercise, long sleep, and “a life from bed to table and back to bed.”

I think there is a contradiction in Astruc’s recommendations.

I retired voluntarily a little over 3 years ago. It just so happens that one of the reasons was the Maintenance of Certification (MOC) program, which the BMJ study authors mentioned in the first paragraph of the introduction:

“Interest in how quality of care evolves over a physician’s career has revived in recent years, with debates over how best to structure programs for continuing medical education, including recent controversy in the US regarding maintenance of certification programs.”

That reminds me that I got an email a few days ago from Jeffrey M. Lyness, MD, the new President and CEO of the American Board of Psychiatry and Neurology (ABPN) in January of 2023, replacing Larry Faulkner, MD. It was a letter explaining how I could recertify. I decided not to renew several years ago and I’m not thinking of coming out of retirement. I have always been an opponent of the MOC.

Maybe he sent me the letter because he found the Clinical Chart Review Module on delirium that a resident and I made in 2018. As of January 24, 2024 you can still find the module on the web site just by typing in the word “delirium” in the search field. It could be the only document about delirium on the ABPN web site, although that’s difficult to believe.

On the other hand, it’s one of two modules that are labeled as approved although valid through December 31, 2023. Maybe it’s headed for retirement.