reflections – Page 21 – Go Retire Psychiatrist

Teaching an Old Dog New Tricks

While we were out for a walk yesterday, we ran into someone walking her chocolate Labrador retriever. His name is Hunter and he had a tree branch longer than him in his jaws. He looked like he was having a great time gnawing on it and swinging it around.

I didn’t envy his owner when it came time to going home and taking it away from him.

Mostly younger dogs like to chew on old sticks and some say it might be a good idea to bring a chew toy along with you when you take a dog outside for a walk. It can be tough to persuade a dog to just let the stick go.

As a retired consultation-liaison psychiatrist, I sometimes compare myself to a dog who latches on to a stick and is reluctant to let it go. I’m an old dog that way and, as I’ve mentioned before, it’s a little hard to teach an old dog new tricks.

There are examples of this issue. I rarely go grocery shopping and I still have a lot to learn. I was not good about grocery shopping and other non-work-related chores when I was a doctor for about 28 years, counting residency. Medical school kept me pretty busy too.

Anyway, I went grocery shopping yesterday and I thought I did OK although I had to wander around quite a bit to find everything on my list. Sena doesn’t need a list. She pointed out that I got the unsalted butter—which she never buys. I wondered how I managed to pick up unsalted butter. I thought I was doing good to get the Great Value brand rather than the more expensive brand.

The package was blue instead of red. You mean I have to read the package?

I got a package of chicken breasts and congratulated myself on that. Sena said they were really thin and noticed that they included rib meat—which she normally doesn’t buy. That slipped by me.

I bought a lot of items that we needed; you know, things like milk, eggs, bread, nuclear weapons, etc. But I really didn’t get anything that you could actually make a bona fide meal out of in the sense of cooking something.

Well, I did get a couple of frozen pizzas. This brought the total of frozen pizzas in our freezer to a number I’m not willing to divulge at this time.

I had to maneuver around several shoppers who were filling orders for customers who ordered their groceries on line. I tried that a very few times and it’s more difficult than I thought.

When I got up to the cashier, I just stood there while she rang up my purchases, bagged them—and then she started to put the bags in my cart. She didn’t say anything but a tiny bell in my brain rang somewhere and it occurred to me that I was supposed to put the bags in the cart. I apologized and got to work right away when I noticed. I recalled that it was probably just that mistake that led to my leaving an item at the store the last time I shopped.

Sena went to the grocery store after I got home and returned with items that could be used in menus. I think that is called meal planning.

But I did make dinner last night, meaning I reheated left-over chili and chopped up some vegetables for salads. Oh, and I got the saltines out for the bread group.

Sena is still trying to coax me to let go of the stick.

About Those Stages of Retirement

We got our new wall clock on the wall the other day. It got me to thinking about how I view time and other matters now that I’ve been retired for about two and a half years.

I actually tried to ease into retirement by getting a 3-year phased retirement contract. I thought that might help me get adjusted to not being a fire fighter as a consultation-liaison psychiatrist. I don’t know how helpful that was.

So, I looked up the stages of retirement on the web. There are slightly different versions but most of them have 5 stages:

Realization
Honeymoon
Disenchantment
Reorientation
Stability

I guess I’m somewhere at the tail end of disenchantment and the beginning of reorientation. I have to point out a few things about me and the clock on the wall to help get my point across.

When I was running around the hospital, I used to pay a lot of attention to the clock. One example is how I helped medical nurses and doctors diagnose and manage catatonia. That’s a complicated and potentially life-threatening condition linked to a lot of medical and psychiatric disorders. It can make people afflicted with it look like they have a primary mental illness and they can look and act spooky.

Most people with catatonia are mute and immobile. They could also have wild, purposeless agitation but the mute and immobile type is more common. I would recommend administering injectable medicine in the class of benzodiazepines, often lorazepam.

Often the catatonic person would wake up and start answering questions after being like a statue only minutes before the injection. I watched the clock very closely, and the nurse and I watched the vital signs even more closely.

The recovery from a catatonic state looks like a miracle, which often made me look like a hero—despite the fact I could not explain exactly the mechanism of how catatonic states begin or how injectable benzodiazepines work to reverse the state. In most situations, on the general medical and surgery wards, the cause was not infrequently a medical emergency.

That made retirement difficult. I often didn’t notice time passing when I was working. In fact, my job as a C-L psychiatrist was marked by a series of emergencies, hence the fire fighter feel the job held for me.

Somehow, interrupting my schedule (if you can call firefighting a schedule), didn’t help me very much in my adjustment to retirement.

Right from the start, I noticed I missed being a hero. By the time I got to the first stage, Realization, I was already part of the way into the Disenchantment stage. I don’t really recall the Honeymoon stage.

Time passed slowly after full retirement for me. Not even the phased retirement schedule prepared me for it. It was excruciating. I have never slept very well, but my insomnia got worse after retirement.

I had fleeting thoughts about returning to work, and that’s the surprising thing. You’d think I would have just dropped the whole retirement thing and get right back in the fire truck.

But I didn’t. Part of me knew that the job consumed me and burnout was a consequence. My focus on work did not help me be a good husband. On the other hand, retirement by itself didn’t help either.

It’s still hard, but not as difficult as it was at first. I would say that I’m somewhere between the latter part of Disenchantment and the beginning of Reorientation. I’m not anywhere near Stability.

I have replaced my schedule to some degree. Most days, I exercise and practice mindfulness meditation. I have also recently taken up juggling, as many of my readers know.

But any YouTube videos of me “cooking” are bogus. Sena takes video of me messing around making pizza and whatnot as if I know what I’m doing—but she’s giving me cues every step of the way. I’m allergic to kitchens and I probably always will be.

Anyway, I have a different relationship with the clock nowadays. I’m still hoping that I’ll evolve into somebody who knows how to manage not just retirement better, but a whole lot of things in a more adaptive way.

I sure hope so. According to some statistics, at my age I’ve got a limited time to improve. So, I need to get busy.

Terry Trueblood Outing Today or How to Find Hearts Needing a Home

We had enough of bad news on the web, so we went out to Terry Trueblood Recreation Area today. Good things are happening around here, including what we found at Trueblood. Sena ordered some items last week. One is a clock, which we’ll hang somewhere and then not look at. Another is a chair that I will put together, and which will probably give me a reason to use up at least some of the oversupply of band aids.

The best deliveries, in my humble opinion, will be a couple of brand-new sets of juggling balls. One reason for buying them is that my other juggling balls are already starting to leak their millet fillings.

Millet is bird seed. I first noticed it on my hands, and then saw it on book shelves and my chair. I practice juggling every day, and see to it that they get banged up as much as possible, even if that happens to involve impacts with my head. Many juggling balls are stuffed with something: plastic pellets, sand, dandruff from extraterrestrials—no reason to avoid millet.

The new juggling balls will be bigger and heavier: a little over 2.5 inches in diameter and around 130 grams. I’ll probably knock myself unconscious dropping them on my head. One set of 3 will be as close to Iowa Hawkeye colors as I can get: black and yellow (which is what black and gold usually look like to me). The other set will be multicolored and have 12 panels. Balls covered with leather or other material have to be sewn shut and some say that the more panels, the more the impact will be spread, possibly reducing the risk for breakage. On the other hand, I can’t help wondering if there are more seams, wouldn’t it be more likely they’d be split when (not if) I drop them?

I’ll think about that later. We had the best time today at Trueblood. In fact, a lot of people were having a great time out there. The weather was fantastic; the temperature was in the fifties. One trail walker claimed she saw 16 bald eagles! I took this with a grain of salt, but then we saw at least a half dozen, though they were flying too high to get good photos. There were plenty of shore birds.

The best sightings were the quilted hearts hung on several trees. They are from an organization called “I Found A Quilted Heart” and you can learn more about the people who got this started at their web site www.ifoundaquiltedheart.com. Volunteers place the small quilted hearts in various places, often local parks. The sole purpose is to brighten your day. That beats the daily news any time.

What we didn’t know was that we could keep the quilted hearts we found. We saw 4 of them. We’re going to let others find them and share the joy.

Thoughts on Regrets

I’ve been thinking about Dr. Moffic’s article on regret, posted on February 16, 2023 in Psychiatric Times.

I’ve dwelt on it long enough that I feel compelled to inject humor into the subject. It’s one of my many defenses.

There’s a quote from Men in Black 3 involving a short telephone conversation between Agent K and Agent J:

Agent K: Do you know the most destructive force in the universe?

Agent J: Sugar?

Agent K: Regret.

You could probably sense that joke coming. Whenever there is talk of regrets, I always recall maybe one or two remarkable episodes which led to lifelong regret. Because regret is pretty corrosive, as noted by Agent K, I need something to counter it.

My trouble is that I have many regrets. Am I so different in that regard?

Sometime in mid-career, a very important leader told me, frankly and calmly, “You’ll never be a scientist.”

Well, by then it was far too late for me to change life course. It was true; I’ve always been the rodeo clown, never the matador.

On the other hand, I know one thing I’ve never regretted and that’s my retirement. At least I think I haven’t regretted it. I have this recurring dream. It’s not every night, but often enough to make me wonder what I should do about it.

In the dream, I’m late for an exam or class and I fear I’m going to flunk. I look for the building where the exam is going to be held. I can never find it. Hallways appear and look vaguely familiar, but as I wander about looking for the bookstore or classroom or exam room, I feel like I’m in a maze, climbing stairs, almost like an Escher drawing.

That reminds me. Incidentally, several years ago, one of the medical students rotating on the psychiatry consult service drew a picture entitled “The Practical Psychosomaticist” which contained images of stairs running in different directions similar to an Escher drawing (see the featured image). It was really just her expression of how I got around the hospital. I avoided elevators and always took the stairs.

Anyway, I’m carrying several notebooks and loose papers keep falling out. I get lost in this jumble of halls and stairways, never finding my destination.

The dream is probably just me telling myself I’m failing at something in my waking life. It’s not like I need a dream to notify me.

This is a long way of saying I have many regrets, and that I may not know exactly how many. Some of them are less important than others. Take the “I’ll never be a scientist” theme. I’m not terribly broken up about it.

After all, rodeo clowns do pretty important things.

In Search of Al Martin

Today, I was thinking of a guy named Al Martin, who was one of the few African American role models for me when I was a teenager in Mason City, Iowa. I thought of him a couple of years ago, googled his name and couldn’t find him. I mentioned him anyway in a blog post at that time, “Snow Moon Reflections.” A major topic was black male role models.

Today, for some reason I thought of him again. I googled his name once more and found an obituary for a man named Allen Henry Martin. This particular Martin was a black man who was 83 years old when he died just this last November of 2022. The obituary stated that he was a talented artist, just as I recall. Despite the many decades gone by, his photograph looked familiar to me.

He was a sculptor and photographer as well as a painter. He worked several different jobs. He had a great sense of humor. He worked as a land surveyor for several years, which I connect with because I did that for a while when I was young.

I’m not absolutely certain that Allen Henry Martin is the same Al Martin who I looked up to when I was at a tender age. But for now, I’m going to assume they were one and the same.

One time, Al Martin took me to an art show where he set up many of his pictures. It was a brisk autumn day. We drank a lot of coffee, partly to keep warm. I remember how uncomfortable I felt because of my full bladder. The wind was cold.

I don’t know why I remember this, but Al one time spoke of his children and he happened to mention what he did when they felt sick to the stomach. It sounds gross, but he made the story comical and said something like, “Many a time I caught vomit in my hands!” It was disgusting—but funny at the same time, the way he told that little story. You really had to be there to get it.

As I read this, I catch myself thinking I should have something more solemn and dignified to say about Al.

But this is not an obituary. These are just my memories of Al Martin which are fading the older I get, and I’m entitled to them. Al Martin was a great guy.

Iowa State University African American Science Graduates

I was thinking about what to write for the first day of Black History Month, which starts today on February 1, 2023.

As usual, I started to reminisce about my time at Iowa State University (ISU) in Ames, Iowa. I usually don’t talk about my undergraduate days. In fact, I had a little trouble finding my diploma. It was in storage in the first place I should have looked. I graduated from ISU in 1985.

The Iowa State Daily ran a story, “Black scientists from Iowa State,” published on February 4, 2021, obviously in honor of Black History Month. Of course, it featured ISU’s most illustrious graduate, George Washington Carver, who earned his graduate degree in 1894. Carver also loved poetry and painting, which I didn’t know.

This work is in the public domain in the United States because it was published (or registered with the U.S. Copyright Office) before January 1, 1928

Carver was a scientist and put it to practical use. It fits with the ISU motto, which was short and to the point: “Science with Practice.”

I transferred credit to ISU in the mid-1970s from one of the country’s Historically Black Colleges and Universities (HBCUs), Huston-Tillotson College (now Huston-Tillotson University). I submitted a poem to the college’s annual student poetry contest sponsored by one of the English Professors, Dr. Jenny Lind Porter-Scott. My poem didn’t make the cut, but many students got their work published in the little book, Habari Gani (Swahili for “What’s Going On”), which published the best poems.

Part of the reason I went to ISU was the encouragement I got from my bosses at WHKS &Co, consulting engineers. I was a surveyor’s assistant and drafter. I was the only African-American employee working there.

The idea behind going to ISU initially was to pursue a degree in engineering. That didn’t happen because frankly, I didn’t have a head for the mathematics. On the other hand, I got interested in biology, chemistry, and zoology and finally ended up in medical school at The University of Iowa in Iowa City. The rest is history, as they say, which allows the usual cover up of a multitude of sins.

At the time Sena and moved to Ames in the early 1980s, it was a quiet little town, except during VEISHEA, an annual spring celebration on campus. The event got out of hand many times and it was finally banned in 2014.

Back in the days of George Washington Carver, African American students were not allowed to room with other students who did not have black skin on campus. By the time we moved to Ames, the most uncomfortable racial incident I can recall personally was being the butt of a “nigger” joke at a barbershop. I had to find another place to get my hair cut.

I still had a lot of science to digest at ISU after switching my major from engineering to the life sciences. I remember a chemistry professor who looked like the typical hippie who demonstrated how electrons get excited by stacking chairs on top of the counter in front of the chalkboard (which teachers were still using) and climbing to the top and nervously doing a shaky little dance showing what an excited electron he was. I think all of us collectively held our breath, waiting for him to tumble to the floor.

I really had a tough time learning organic chemistry. You had to draw diagrams showing how the molecules and atoms connected after each reaction. I will never forget an Asian Teacher’s Assistant who patiently tutored me, despite my having a very bad cold and a bad attitude to boot.

I graduated and then returned to get more credits to try getting into medical school after finding it very difficult to find employment with my Bachelor of Science degree. It took about 9 months before I finally landed a job in the clinical lab at one of the hospitals in Des Moines. The lab director worked there for a very short time while I was there, and then left to go to medical school.

That was my cue. I think it worked out for the best. By the way, the engraved crystal in the featured image is an appreciation gift from The University of Iowa for my years of service.

And I guess that’s about enough reminiscence for now.

KCCK Big Mo Blues Show Brings Back Memories

Last night on the KCCK Big Mo Blues Show I listened to something I haven’t heard since the mid-1970s. It was a radio commercial for the Green Beetle and Frank’s Liquor Store. It ran right after the song, “Memphis Women and Fried Chicken.”

I think I first heard this radio ad while I was a student at Huston-Tillotson College (now Huston-Tillotson University) in Austin, Texas in the mid-1970s.

I heard it early on in the evening in my sweltering college dorm room. Later on, I heard a stirring rendition of the opening song, “Lift Every Voice and Sing,” for another radio program, the name of which I can’t recall. I don’t know who sang it, but her voice was breathtaking. I have not heard a better version of it since.

The contrast between the “Old Crow Boogie” and “Lift Every Voice and Sing” was striking. No matter what race, culture, gender we are, we struggle to reconcile these opposites.

Exercise or Weaponize My Privilege?

Back in November 2022, while on our way to the Stanley Museum of Art, we saw the two murals on the East Burlington Street Parking Ramp. It was the first time we saw them in person although photos were available last fall. The Little Village article published an article about them on September 30, 2021. It’s the Oracles of Iowa mural project, conceived by Public Space and the Center for Afrofuturist Studies partnered with the artists, Antoine Williams and Donte K. Hayes. The artists sought to stimulate a conversation in the community about how black and white people relate to each other.

The murals are painted on parking ramp at two locations along East Burlington Street. One says “Black Joy Needs No Permission” and the other says “Weaponize Your Privilege to Save Black Bodies.”

The Little Village article points out that a survey of public perception of the murals revealed that 64 percent of white respondents supported the murals while only 40-50 percent of minority respondents supported them. The stickler for minorities was the use of the word “weaponize” and the phrase “Black bodies,” which were thought to raise impressions of “violence” and dehumanization.

Because I’m a writer, retired psychiatrist, and a writer, the word “weaponize” made me wonder what other word might have been chosen in this context. The only definition of “weaponize” that I can find which makes sense to me is from Merriam-Webster: “to adapt for use as a weapon of war.”

I’m a retired physician, so I have a perspective on the “privilege” to “save” lives, and by extension to enhance health and well-being. I’m also Black. I grew up in Iowa and I can recall getting bullied and being called a “nigger.” I can remember my psychiatry residency days, which includes a memory of a patient saying “I don’t want no nigger doctor.” I didn’t have the option to switch patients with another resident. When I saw the patient on rounds, I did my best and every time the “nigger” word erupted, I left the room. It was one of a few episodes which were marked by frank racist attitudes.

I was given the University of Iowa Graduate Medical Education Excellence in Clinical Coaching Award in 2019, one of several esteemed colleagues to be honored in this way. Many of those who nominated me were white. It was one of many joyful experiences I had before my retirement in 2020, when the pandemic and other upheavals in society occurred, including the murder of Black persons, resulting in many consequences prompting the creation of the murals.

I have other memories. I was privileged to be given a scholarship to attend one of the Historically Black Colleges and Universities (HBCU) in this country, Huston-Tillotson College (now Huston-Tillotson University). It’s one of the oldest schools and is the oldest in Austin, Texas. The scholarship was supported by one of the local churches in my home town of Mason City. I don’t think it had any black members. Although I didn’t take my undergraduate degree from H-TU, it was one of the most valuable learning experiences in my life. It was the first time I was ever not the only Black student in the class. It was marked by both joy and a struggle to learn where I belonged.

The murals did for me what the artists hoped it would do. It stimulated me to reflect on the meaning of racializing life. They stir me to seek perspective on whether joy has any color and why anyone needs permission for it. And I believe I would rather exercise my privilege to respect and care for others than to weaponize anything, including my sense of humor.

More Thoughts on Physicians Going on Strike

I noticed Dr. H. Steven Moffic, MD had written another article in Psychiatric Times asking whether it’s time for psychiatrists to consider going on strike. Often the issue triggering discussions about this is the rising prevalence of physician burnout. I’ve already given my personal opinion about physicians going on strike and the short answer is “no.”

One of my colleagues, Dr. Michael Flaum, MD, recently delivered a Grand Rounds presentation about physician burnout. The title is “Everyone Wins—The Link Between Real Patient-Centered Care and Clinician Well-Being.”

Fortunately, I and other are able to hear the substance of his talk on the forum Rounding@Iowa. During these recorded presentations (for which CME can be obtained), Dr. Gerry Clancy, MD interviews clinicians on topics that are of special interest to medical professionals, but which can be educational for general listeners as well.

I remember meeting Dr. Flaum when I was a medical student. At the time, he was very involved in schizophrenia research. He’s been a very busy clinician ever since. As he says, while he may be Professor Emeritus now, he’s definitely not “retired.” He’s still very active clinically.

Dr. Flaum identifies both systems challenges and physician characteristics as important in the physician burnout issue. Interestingly, he bluntly calls the systems challenges as virtually unchangeable and focuses on bolstering the physician response to the system as the main controllable factor. His main tool is Motivational Interviewing, which is more of an interview style than a separate kind of psychotherapy.

I think the kind of approach that Dr. Flaum recommends, which you can hear about in the Rounding@Iowa presentation, is what most psychiatrists would prefer rather than going on strike. See what you think.

My Two Cents on The Embrace Sculpture Honoring MLK Jr and Coretta Scott King

I first saw a photo of the sculpture honoring Dr. Martin Luther King Jr and Coretta Scott King, called “The Embrace” a couple of days ago. I remember my first impression being that it would have been nice to see a full sculpture of the couple rather than disembodied arms.

Sena mentioned it today because it was unveiled at Boston Commons. This was just before my mindfulness meditation, so I just told her that I saw the picture of it and said I would have to think about it some more.

As I sat in meditation, it occurred to me that “The Embrace” expressed what I think is a basic abstract idea, which is the challenge for us to embrace the notion that we’re all humans who ought to accept each other, and be kind and generous to one another.

That’s what I think the Kings did. That’s why Dr. King won the Nobel Peace Prize.

You could make a sculpture of the King as a couple embracing each other after he won the Nobel Prize. It would have been beautiful. On the other hand, you could make a sculpture which tries to do more than that. How difficult would it be to make a representation of what it might look like if all of us embraced our humanity—and each other?

It sounds too difficult. Yet the artist managed to do just that. Anyway, that’s my two cents.