Category: reflections

Thoughts on Near-Death Experiences

There is a very interesting Medscape article on Near Death Experiences (NDEs), “Young Doctor Explores Near-Death Experiences – Medscape – Jan 13, 2022.” The story was written by Stephanie Lavaud. It was a transcript of an interview with a general practitioner from, Francois Lallier, MD, PhD, from Reims University Hospital in France. He conducted a retrospective study on NDEs for his general medicine dissertation. He discussed the results in his book, Le mystere des experiences de mort imminente (translation: The Mystery of Near-Death Experiences).

It has so far collected several interesting comments. I submitted a couple.

One of them was about a teacher and colleague of mine, Dr. Russell Noyes, Jr, MD, Professor Emeritus University of Iowa. He published several articles about NDE related to traumatic accidents, mainly in the 1970s. Lallier used the Greyson Near-Death Experience Scale for his study, and this scale was based on the work of Noyes and others.

He also participated in a Iowa Public Radio Show in 2018. Dr. Noyes collected over 200 personal accounts of NDEs but declined to publish them. I don’t recall that Dr. Noyes ever discussed his interest in this area with me.

My other comment was a correction to a mistake in my first comment, in which I said no patient I saw in my career as a consult-liaison psychiatrist ever reported a Near-Death Experience to me. I remembered one later. It occurred decades ago but I had forgotten about it. I included the patient’s NDE self-report in a grand rounds presentation, which was not mainly about NDEs.

As a consultation-liaison psychiatrist, I saw many patients with severe medical illness and I can recall only one patient who described an experience of NDE. Delirium was a common syndrome in most of the patients I saw, especially those in the intensive care units.

I think it’s possible that some of the cases of NDE might be attributable to delirium. Vivid and compelling hallucinations and delusions are common symptoms of delirium. The catatonic variant of delirium, which can be caused by severe benzodiazepine withdrawal and other psychiatric disorders can lead to the rare Cotard’s syndrome, marked by the nihilistic delusion that one is dead or even paradoxically immortal, has lost one’s body, is rotting internally or is without limbs and other body parts. The line between NDEs and neuropsychiatric disease can sometimes be thin. However, I don’t categorically dismiss NDEs as mental illness.

Dr. Noyes was very familiar with delirium. He was one of my first teachers in the practice of consultation-liaison psychiatry. He taught me and countless other trainees and early career psychiatrists about anxiety, somatoform disorders, and delirium. He knew the difference between neuropsychiatric illness and NDEs.

In the National Public Radio interview, he explained that after consulting with an attorney who cautioned about the possibility of lawsuits related to breach of confidentiality (obtaining releases of information consents after so much time had passed would have been next to impossible), he decided against publishing his collection of personal accounts of NDEs.

The Medscape article author pointed out that many doctors usually take little interest in the issue of NDEs with patients. Lallier said this is because it’s not normally a part of medical school curriculum. On the other hand, one doctor pointed out in the comment section that he had been conducting NDE research for a decade and had published a series of articles in a peer-reviewed journal. Dr. John Hagan III reported that the articles were included in a medical textbook for physicians in 2017, The Science of Near-Death Experiences, copyrighted by the Missouri State Medical Association (MSMA). Dr. Hagan added that the MSMA passed a resolution which was sent to the national US medical organizations asking that all medical school curricula include education on NDEs.

Even the titles of the books I mention in this post are interesting: The Mystery of Near-Death Experiences and The Science of Near-Death Experiences. The mystery vs the science—or the mystery and the science? They seem almost analogous to bookends, or maybe the Janus head, which is fun to speculate about.

The Janus head used to be the logo for the Academy of Consultation-Liaison Psychiatry (ACLP). It was replaced by some nondescript design for reasons I don’t understand. It reminds me of waves, which could lead to seasickness.

Janus was a god in Roman mythology and is typically represented as having two heads, each facing opposite directions. Janus was the god of doors, gateways, and transitions. He held a key in one hand to open gates and a staff in the other to guide travelers. He is said to represent the middle ground between the abstract and the concrete, between life and death—and perhaps between mystery and science.

University of Iowa Health Care Black History Month Lecture: “Pursuing Health Equity—A Call to Action”

Yesterday Sena and I listened to the Zoom lecture “Pursuing Health Equity—A Call to Action,” delivered by Louis H. Hart, III, MD from noon to 1:00 PM. Dr. Hart is the inaugural Medical Director of Health Equity for Yale New Haven Health System and Assistant Professor of Pediatrics and faculty member in the Yale School of Medicine. The lecture was sponsored by the University of Iowa Office of Diversity, Equity, and Inclusion in the College of Medicine. The introductory remarks about him were that his “leadership work addresses unjust structural and societal barriers that lead to inequitable health outcomes for the patients we serve.” His lecture was intended to “focus on efforts to ingrain an equity lens into clinical operations.”

Sena and I talked a lot about Dr. Hart’s presentation, as usual in a spirited way. We don’t always agree on everything and we’re not shy about saying so to each other. The lecture was recorded. However, since I don’t know when it might be publicly available, I looked on the web, and as luck would have it, I found a YouTube (see below) of a similar lecture he gave on June 22, 2021 in New York. The message was basically the same, and included many of the same slides.

Dr. Hart is very committed and passionate about health equity. Calls to action typically, as you’d expect, are delivered with passion, which sometimes entails emphasizing the “whys” of what must be done over the “hows” regarding implementation of changes to our health care system.

He began by letting the audience know that we’d all probably be a little uncomfortable about some parts of his message. He had a little original one-liner about comfort zones, which I unfortunately can’t recall exactly, but it conveyed a message similar to the one below:

A comfort zone is a beautiful place, but nothing ever grows there.

John Assaraf

In the YouTube video below, Dr. Hart reminds me of myself in my role as a consultation-liaison psychiatrist many years ago, when I was trying to persuade our general hospital medical staff to take delirium much more seriously, stop seeing it as a psychiatric problem, and treat it as a complication of severe medical disease. I got acquainted with a famous critical care doctor, Wes Ely, MD, who recently published a fascinating book, “Every Deep Drawn Breath.” He has worked tirelessly for most of his career to teach his colleagues, nurses, and trainees, especially those in critical care, to get the point he made so succinctly in his research notebook: “Hypothesis: The lung bone is connected to the brain bone.” I wish we could keep it that simple.

I was a crusader at the time. I often took nurses and doctors and medical students out of their comfort zones, driven to ingrain in them the delirium lens that would help save patients from developing dementia and dying from the deadly syndrome of delirium.

My approach sometimes probably didn’t sit too well with my peers and my trainees. My call to action for preventing delirium likely moved a few clinicians—but just as likely alienated others.

I can see how some people might get that feeling from Dr. Hart in the video, although when I compare him with others who beat the drum loudly about structural racism in general and get pretty confrontational, I think he does a pretty fair job of moderating that approach. I get his passion and his urgency, which is for the most part balanced by his impressive ability to articulate all the “whys” about what must be done. I was reasonably confident he could collaborate with all of the people he needs to figure out the “hows.”

Now, to throw you a curve ball, I’m giving you the link to a podcast in which, if I close my eyes, I nearly don’t recognize Dr. Hart as he describes in polished detail the “hows” of his plan to improve health equity. It seemed almost miraculous. He’s just as passionate about his mission, but the crusader gives way to the thorough, confident, caring and even witty administrator presenting his very sophisticated vision of what the health care system of the future might look like. See what you think.

Happy Valentine’s Day!

Happy Valentine’s Day! Boy, are you guys lucky! I woke up yesterday morning with the crazy idea of making a video of me singing “L-O-V-E.” You know, the one Nat King Cole made famous. What do you mean, “No, what are you talking about?”

No kidding, though; I even cleared my throat a couple of times just thinking about it, getting ready to burst into my full-throated, only slightly phlegmy 60ish voice. I let that go after my first cup of coffee, thank goodness. You don’t know how close you came. My singing would kill a cat from a hundred yards.

Anyway, Sena got a kick out of my Valentine’s Day card because it had a scrabble theme. The top line actually is made of 3-dimensional Scrabble tiles. I bought that card before I found the Tile Lock Scrabble game.

By the way, I’m zero for 3 games so far. We really need a Scrabble dictionary. Sena plays the video scrabble game a lot and she played the word “Qi” twice (at right angles to each other) in our second game, claiming it’s a real word. I didn’t argue and without a dictionary, I couldn’t challenge it. But she didn’t know what it meant. “I’ve been meaning to look that up,” she says.

It turns out Qi is a variant spelling of CHI (pronounced like the first syllable of cheapo, a variant of cheapskate, as in a guy who spends the least amount of money possible on a Valentine’s Day gift for his wife). Qi is defined as the energy or life force in everything and it’s the basis of most of Chinese medicine and philosophy. It’s also the single most commonly used word in Scrabble tournaments.

We made this deal a while ago. If we buy a cribbage board in the shape of the state of Iowa with a road map and names of major cities, etc. on it, then I would agree to play Scrabble. We got the Scrabble game first. A deal’s a deal, even if it’s backwards. Sena ordered the Iowa State Map cribbage board yesterday. She wins most of the cribbage games, too. Here’s how she counts her scores: “15 for 2, a run of 3 for 19 (laugh it up you people, these are the jokes; hint, you have to know what scores are impossible in cribbage), and a flush for a total of 29; hey, I win again!”

You guys need to thank for me another thing. At first, Sena allowed me to use just one snapshot of us in this post. It’s of us at Niagara Falls in front of the helicopter we took a ride on to get a fantastic view of the falls. But we got to looking at a ton of pictures. We laughed a lot. We chose more pictures.

Have a great Valentine’s Day!

Our Impressions of University of Iowa Free Webinar Yesterday: The Stories That Define Us”

We were overall delighted with yesterday’s presentation, University of Iowa Free Webinar: “Breaking Barriers: Arts, Athletics, and Medicine (1898-1947).” It’s one in a series of 4 virtual seminars with two more scheduled this month, which you can register for at this link.

February 15: Endless Innovation: An R1 Research Institution (1948–1997)

February 22: The Next Chapter: Blazing New Trails (1998–2047)

The moderator was university archivist and storyteller, David McCartney.

Presenters include:

Yesterday’s presentation was recorded and will be uploaded to The University of Iowa Center for Advancement YouTube site at a later date.

McCartney did an excellent job as moderator, although got stumped from a question from a viewer about who was the first African American faculty member in the College of Medicine. He’s still working on tracking that down. It wasn’t me. I’m not that old and I am not risen from the dead, as far as I can tell; but to be absolutely clear, you should ask my wife, Sena. I was able to google who was the first African American graduate of the University of Iowa law school: Alexander Clark, Jr. McCartney thinks he might have been the first University of Iowa alumnus, although he couldn’t confirm that.

On the other hand, I could have been the first African American consulting psychiatrist (maybe the only African American psychiatrist ever) in the Department of Psychiatry at UIHC—but I can’t confirm that. Maybe McCartney could work on that, too.

 There are a few words about me in the department’s own history book, “Psychiatry at Iowa: The Shaping of a Discipline: A History of Service, Science, and Education by James Bass: Chapter 5, The New Path of George Winokur, 1971-1990:

“If in Iowa’s Department of Psychiatry there is an essential example of the consultation-liaison psychiatrist, it would be Dr. James Amos. A true in-the-trenches clinician and teacher, Amos’s potential was first spotted by George Winokur and then cultivated by Winokur’s successor, Bob Robinson. Robinson initially sought a research gene in Amos, but, as Amos would be the first to state, clinical work—not research—would be Amos’s true calling. With Russell Noyes, before Noyes’ retirement in 2002, Amos ran the UIHC psychiatry consultation service and then continued on, heroically serving an 811-bed hospital. In 2010 he would edit a book with Robinson entitled Psychosomatic Medicine: An Introduction to Consultation-Liaison Psychiatry.” (Bass, J. (2019). Psychiatry at Iowa: A History of Service, Science, and Education. Iowa City, Iowa, The University of Iowa Department of Psychiatry).”

And in Chapter 6 (Robert G. Robinson and the Widening of Basic Science, 1990-2011), Bass mentions my name in the context of being one of the first clinical track faculty (as distinguished from research track) in the department. In some ways, breaking ground as a clinical track faculty was probably harder than being the only African American faculty member in the department.

I had questions for Lan Samantha Chang and for Dr. Patricia Winokur (who co-staffed the UIHC Medical-Psychiatry Unit with me more years ago than I want to count.

I asked Dr. Chang what role did James Alan McPherson play in the Iowa Writers Workshop. She was finishing her presentation and had not mentioned him, so I thought I’d better bring him up. She had very warm memories of him being her teacher, the first African American to win a Pulitzer Prize for fiction, and a long-time faculty member at the Workshop.

She didn’t mention whether McPherson had ever been a director of the Workshop, though she went through the list of directors from 1897 to when she assumed leadership in 2006. You can read this on the Workshop’s History web page. I have so far read two sources (with Wikipedia repeating the Ploughshares article item) on the web indicating McPherson had been acting director between 2005-2007 after the death of Frank Conroy. One source for this was on Black Past published in 2016 shortly after his death, and the other was a Ploughshares article published in 2008. I sent an email request for clarification to the organizers of the zoom webinar to pass along to Lan Samantha Chang.

I asked Dr. Winokur about George Winokur’s contribution to the science of psychiatric medicine. Dr. George Winokur was her father and he was the Chair of the UIHC Psychiatry Department while I was there. She mentioned his focus on research in schizophrenia and other accomplishments. I’ll quote the last paragraph from Bass’s history on the George Winokur era:

“Winokur, in terms of research, was a prototype of the new empirical psychiatrist. Though his own research was primarily in the clinical realm, he was guided by the new neurobiological paradigm (perhaps in an overbalanced way) that was solidifying psychiatry with comparative quickness. New techniques in imaging and revelations of the possibilities in genetic study and neuropsychopharmacology lay ahead. George Winokur had helped the University of Iowa’s Department of Psychiatry—and American psychiatry as a whole—turn a corner away from subjectivity and irregularity of Freudian-based therapies. And once that corner had been turned there was no going back.”

George Winokur was the department chair at University of Iowa Hospitals and Clinics from 1971 to 1990 and had a unique and memorable style. George also had a rough sense of humor. He had a rolling, gravelly laugh. He had strict guidelines for how residents should behave, only slightly tongue-in-cheek. They were written in the form of 10 commandments. Who knows, maybe there are stone tablets somewhere:

Winokur’s 10 Commandments

  1. Thou shalt not sleep with any UI Psychiatry Hospital patient unless it be thy spouse.
  2. Thou shalt not accept recompense for patient care in this center outside thy salary.
  3. Thou shalt be on time for conferences and meetings.
  4. Thou shalt act toward the staff attending with courtesy.
  5. Thou shalt write progress notes even if no progress has been made.
  6. Thou shalt be prompt and on time with thy letters, admissions and discharge notes.
  7. Thou shalt not moonlight without permission under threat of excommunication.
  8. Data is thy God. No graven images will be accepted in its place.
  9. Thou shalt speak thy mind.
  10. Thou shalt comport thyself with modesty, not omniscience.

Quinn Early has a lot of energy and puts it to good use. His documentary of the sacrifices of African American sports pioneers, including “On the Shoulders of Giants” (Frank Kinney Holbrook) is impressive.

There was a good discussion of the importance of the book “Invisible Hawkeyes: African Americans at the University of Iowa during the Long Civil Rights Era”, edited by former UI faculty, Lena and Michael Hill.

Sena and I thought yesterday’s presentation was excellent. We plan to attend the two upcoming webinars as well. We encourage others to join.

Thoughts So Far on “To Kill a Mockingbird”

I am just getting started reading “To Kill a Mockingbird” by Harper Lee. As I said in a previous post, I can’t remember ever reading it, but I saw the movie (or most of it). I have seen news reports that some schoolteachers are opposed to keeping the title on required reading lists.

I just finished the 3rd chapter, the one that contains an oft quoted line from Atticus:

“You never really understand a person until you consider things from his point of view…until you climb into his skin and walk around in it.”

 I found dozens of hits on the web about this quote. There are likely a lot more. I don’t have to explain it to anyone, least of all to schoolteachers.

I can see my bookshelf from my chair where I’m reading Lee’s novel. I see my copy of a book by James Thurber, “The Thurber Carnival.” I occasionally re-read a story in it entitled “Bateman Comes Home.” I think it’s hilarious. There’s a short message ahead of the main text:

“Written after reading several recent novels about the deep south and confusing them a little—as the novelists themselves do—with “Tobacco Road” and “God’s Little Acre.”

And then I searched the web and found a web site, The Library dot org, and on a web page entitled Kids Booklists, there was the message, “If you liked ‘To Kill a Mockingbird’,” you might also enjoy…” Beneath it was a list of books, including “God’s Little Acre” by Erskine Caldwell.  

I noticed the resemblance. I’ll keep you posted.

Links to Ozymandias

Sena and I took a walk down Scott Boulevard today. The weather was practically balmy, compared to how cold it has been. Forty degrees above zero compared to 9 degrees below feels miraculous.

We walked past the Harvest Preserve entry. Across the street is what we’ve just learned is an old building that is known as the “Haunted Barn” (photo taken in August 2021).

We passed the 20-foot-tall, 110-ton Sitting Man sculpture, now on the west side of Scott Boulevard after it was moved from the east side of the road in July, 2020.

Today was the first time we trekked past the Sitting Man to Rochester Avenue and beyond. If we hadn’t, we would not have noticed a fascinating, blindingly white abstract sculpture mounted on a concrete block which we initially believed was on the Harvest Preserve property at the northwest corner of the intersection. Sena said it looked like a person, noting the head, arms, and body. I didn’t notice that.

After we got back home, I couldn’t find out anything about it on the web, no matter how much I connected the search terms to Harvest Preserve, the Sitting Man and so on. I found only one item with a photo and it was an announcement about a tour on Harvest Preserve in 2018. The impression is that the sculpture is on the property.

I sent an email inquiry to Executive Director of the Harvest Preserve Foundation, Inc., Julie Decker, whose email address is available on the website.

Ms. Decker informed me that the sculpture is technically not on Harvest Preserve property. She knew the sculpture is entitled “Family,” and the artist’s name was Eugene Anderson, who died in 2008. That’s all she knew.

It turns out that what little she knew led to an astonishing story that was even deeper and more engaging than we imagined. You can read the obituary of the Iowa City artist Eugene Anderson on legacy dot com. The highlights are that he started his career in architecture, was the University of Iowa Hospital and Clinics (UIHC) architect for 25 years, and then began creating original art work to display in the hospital to comfort patients. He later became a full-time sculptor, and was on the board of directors for “Arts Iowa City.”

I was a medical student, resident, faculty member and a consulting psychiatrist at UIHC, a career starting in 1988 and ending with my retirement in June of 2020. It’s possible I saw some of Anderson’s work while I was galloping around the hospital.

In 1994 he created the “Family Group” series of sculpture which have been displayed at Chait Galleries in Iowa City, Des Moines Art Center, and the Brunnier Art Museum in Ames, Iowa. The piece we saw might have been one of those. Unfortunately, I couldn’t find anything on the web about the series.

And what is more intriguing, Anderson also traveled extensively, even to Egypt where he cruised on the Nile and took a sunrise balloon ride over the pyramids.

How is it possible that so little of Eugene Anderson’s life and work are not better known? Come to think of it, I guess time can erase the memory of our accomplishments.

This little story reminded me of the poem “Ozymandias” by Percy Bysshe Shelley. I’ve forgotten all of my college freshman English Literature but a web search indicates that Ozymandias was based on Ramesses II, a king of ancient Egypt. Ozymandias was a great ruler of a vast empire. His sculptor built a huge monument in the desert and gave it the oft-quoted inscription, “Look on my works, ye Mighty, and despair!”

Ozymandias

Percy Bysshe Shelley-1792-1822

I met a traveller from an antique land
Who said: “Two vast and trunkless legs of stone
Stand in the desert . . . Near them, on the sand,
Half sunk, a shattered visage lies, whose frown,
And wrinkled lip, and sneer of cold command,
Tell that its sculptor well those passions read
Which yet survive, stamped on these lifeless things,
The hand that mocked them, and the heart that fed:
And on the pedestal these words appear:
‘My name is Ozymandias, king of kings:
Look on my works, ye Mighty, and despair!’
Nothing beside remains. Round the decay
Of that colossal wreck, boundless and bare
The lone and level sands stretch far away.”

Today we searched for links on the web to find out more about a mysterious sculpture. We found links of a different kind, links to a stranger and to the near and the ancient past. Anderson’s sculpture, “Family,” is still standing, tall, clean, and bright for all to see.

Return to the Sun Room

We have a sun room again. We moved into this house a little over a year and half ago. It has taken a little time to get it comfy. For the last couple of weeks, I’ve been sitting in there on Friday nights listening to the KCCK Jazz Radio ‘da Friday Blues show hosted by John Heim, aka Big Mo. I used to do that regularly but we’ve not lived in a house with a sun room for several years. The Big Mo blues show has been a favorite of mine for a long time.

I suppose I could have listened to it in another room in the other homes we’ve lived in. But it wouldn’t have felt right. I connect sun rooms with ‘da Friday Blues on KCCK 88.3.

It’s hard to believe Big Mo is still doing the show. He suffered an accidental neck injury a few years ago that left him paralyzed from the neck down. He was hospitalized at the University of Iowa and went to rehab from there. He still sounds great. He retired from teaching in 2004. He hasn’t retired from having a good time and helping others enjoy music and life. There’s a lesson in that for us all.

Anyway, we have a great sun room again. We have a nice coffee table in there, with the mandatory coffee table book. Chet Randolph really didn’t write that book, Theory of Detasseling—but he could have.

coffee table book

 Here’s a tune from tonight’s show that fits the season.

An Old Dog’s Approach to Replacing Electrical Outlets and Other Thoughts

Since retirement, I’ve been very gradually casting about for another identity now that I’ve given up my professional identity. It doesn’t come naturally. I’m definitely not a handyman, although I’ve been learning a few skills.

For some reason, a large number of our electrical outlets didn’t hold power cords tightly enough. They were either cheap or worn out or both. Appliances would stop running because the electrical plugs fell out of the outlets.

That led to Sena picking up an 85 gross of various replacement outlets, which led to losing one of my best excuses for not getting the vacuuming done. Since then, I’ve replaced a large number of outlets (see “instructional” video below). Toggle switch replacements are another item high on the list of vital electrical equipment to replace, mainly because they also get loose with age.

Funny how that doesn’t work for me. I get tighter in my joints as I age, which makes it very hard for me to sit cross-legged on the floor while replacing outlets. Standing up is even harder. That excuse doesn’t work either.

I’m pretty keen on checking outlets and the like for power before I start messing around changing them. I use a UL approved voltage tester for that—an electric can opener. Don’t let that get around. I always shut the power off at the circuit breaker to be safe.

Another skill comes to mine. Yesterday I had to install a soundbar on our TV for the first time. After Sena returned that one for a refund because it didn’t seem to improve on the TV’s audio, I installed a sound bar and subwoofer made by a different company.

I had a heck of a time getting it to work. It came with enough cords to hook it up, either by optical cable or something called HDMI ARC cable. Apparently, ARC stands for Audio Return Channel. I still don’t yet know why that makes it different from a regular HDMI cable.

What should have been a 10 to 15-minute hookup ended up taking most of an hour because neither cable worked. It was mysterious. I even hooked up both of them. The sound bar was soundless. In disgust, I yanked out the HDMI ARC—and abruptly the sound bar was loudly functional. Just prior to that I think I had moved the power plug from a power strip to a wall outlet. I figured the power strip might have just got old.

On the other hand, I had switched the sound bar plug and a CD player plug on the power strip which had been working fine and the sound bar still didn’t work. It was either aliens or luck. Sometimes it’s better to be lucky than good. I’m thinking about trying that HDMI cable again.

I have changed only in very small ways over the last 19 months (837,755 minutes; 50,265,308 seconds) since retirement. Some people say you can’t teach an old dog new tricks. I wonder if some people are just being ironic.

Retiree Musings

I’ve just discovered a web site that calculates the time that has passed since an event occurred. So, it calculated that I’ve been retired for 19 months—or 580 days, or 13,909 hours and so on. But I’m not counting.

What has been happening since then? I’ve had the usual problems with letting go of my professional identity, still having them in fact. I’ve posted a quote from another retired psychiatrist, H. Steven Moffic, MD.:

Plan for retirement, even if you don’t plan to retire. This means sound financial planning, developing other interests, and nurturing your relationships with significant others. Retire, even if you are not retired. Take enough time off periodically, and completely, with no connections to work, so that you can feel emotionally free from concerns about patients and practice. Of course, there is no reason to retire if you really love your work and relationships just as they are.

H. Steven Moffic, MD

There was also an article entitled “When Should Psychiatrists Retire?” written by Dinah Miller, MD. It was published in Clinical Psychiatry News January 2022 issue, Vol.50, No. 1 as well as Medscape on November 17, 2021. There is no consensus on the answer to the question, although there are several opinions by the commenters.

There are a lot of articles out there about what it’s like to lose your professional identity and the potential consequences of that. One thing I’m learning is that, while I may not be fully reconciled with losing my identity as a consult-liaison psychiatrist, I’m gradually starting to have more fun just being a clown sometimes, which pre-dated my becoming a doctor.

Maybe I just need to grow up, but my interests are everyday stuff I tend to make fun of.

Like dryer balls. Now, I don’t want to offend anybody who believes that dryer balls are effective at drying clothes quicker and the like—but the jury is still out on that claim.

In fact, there are many articles on the web, both pro and con about dryer balls. One of them is by somebody who did what sounds like an exhaustive study (just with his own laundry; you won’t find it published in any journal). He swears by them. Then there was the article which pretty much debunked dryer balls. It mentioned an “in-depth experiment” by an 8th grader in 2013 proving that they don’t reduce dryer time. My wife, Sena, says they don’t work. One ball got snagged in a fitted sheet pocket.

What I don’t get is why dryer balls look so much like the spiky massage balls (hint, it’s the green ball; the dryer balls also have holes in them). I think everybody just takes for granted that massage balls work. Sena says it works. She also has what she calls a massager which looks vaguely like a headless alien doing the downward dog yoga thing.

But what I find puzzling is why I can’t find any mention on line of clamshell eyeglass cases which have a steel trap-like spring-loaded hinge. You don’t want to get your fingers caught in them. They should have a safety protocol for use—so of course I came up with one.