Category: reflections

My Definitive Journey Revisited

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

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

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

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

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

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

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

El Viaje Definitivo (The Final Journey)

… and I will go away.

And the birds will stay, singing

And my garden will stay

With its green tree

And white water well.

And every afternoon the sky will be blue and peaceful

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

Peal of the bell of the high campanile.

They will die, all those who loved me

And every year the town will be revived, again

And in my circle of green white-limed flowering garden

My spirit will dwell nostalgic from tree to well.

And I will go away

And I will be lonely without my home

And without my tree with its green foliage

Without my white water well

Without the blue peaceful sky

And the birds will stay

Singing

                                –Juan Ramon Jimenez

The Park

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

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

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

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

Follow the Trail of the Woolly Bear Tale

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

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

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

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

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

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

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

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

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

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

What You See is Not Always What You Get

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

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

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

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

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

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

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

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

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

Random Thoughts on the Iowa vs Wisconsin Football Game Today

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

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

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

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

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

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

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

Moderna Booster Jab Today and Mindful Zombies

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

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

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

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

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

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

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

Congratulations to 2021 UI Physicians Clinical Awards Winners

I was so happy to see the winners of the 2021 University of Iowa Physicians Clinical Awards winners. I have a special bias for a couple of them because I worked with them for years in my capacity as psychiatric consultant in the general hospital prior to my retirement in June of 2020.

Dr. Kevin Doerschug, MD, the winner of the Excellence in Our Workplace Award, actually rotated on the psychiatry consult service when he was a trainee. He and I saw each other frequently in the Medical Intensive Care Unit (MICU). He is one of the kindest doctors I have ever met. Dr. Dilek Ince, MD, the winner of the Best Consulting Provider Award, is a thorough and tireless clinician. As consultants, our paths often crossed in the hospital.

I congratulate all the winners. Iowa is so fortunate to have you.

Can Cribbage Cultivate Congeniality?

Sena and I have been playing cribbage since late 2019. It’s a two-hander card game played on a board with pegs for keeping score. It’s been around for about 400 years and some have asked whether it’s a dying game, played mainly by codgers in retirement homes. The question is whether it can promote positive attributes like congeniality.

Actually, it’s a pretty popular game, especially for, some reason, in California where there are over 40 local cribbage clubs according to the American Cribbage Congress (ACC), the big boss organization in North America, established in 1980. Most states in the U.S. have only a few. Iowa has one in Ankeny.

If you look at the ACC website, you’ll find a section called the ACC Cribbage Club Code of Congeniality. It’s under the Clubs section. The wording is in some ways a bit ambiguous, probably because many of the members are very competitive. There are a lot of tournaments, including an annual Grand National. The most recent one was held in Sacramento in late September, just last month. Even though it’s a pretty big deal, attracting players from just about everywhere on the planet and possibly beyond, I can’t find out who the winner was from the website. Maybe that person is too congenial to brag.

Anyway, the ACC Code of Congeniality has a tone, for lack of a better word. For example, take this item:

“We pledge to not force new players to play a game in fifteen minutes. (We will, instead, be tolerant and not complain, remembering that we too, started slow.”)

Sena and I never can finish a game in 15 minutes, and we’ve been playing for going on a couple of years. That pledge as well as the others have an almost Mark Twain-like ring to them. It’s as though whoever wrote it was snickering behind her hand. Or maybe the ACC leadership got wind of a few complaints from new members who got horsewhipped for dragging the games out to 17 minutes or even longer. Actually, it’s the subtle sense of humor expressed in the Code of Congeniality that I appreciate.

The ACC also has a Code of Ethics which extols “true sportsmanship and respect for others, without rancor, animosity, or overwhelming self-interest during competition.”

The ACC publishes its tournament rules and it is to be contrasted with something called kitchen table cribbage. Except on my blog and YouTube video, you’re unlikely to find the term Kitchen Table Cribbage anywhere on the web.

There was a man named Peter Worden who traveled around the world, teaching people how to play cribbage, love it, and make new friends. His short documentary about his travels and adventures is called the Cribsionary. A photograph shows him hiding his face with his cards—I don’t know why. He says cribbage is 50% luck and 50% skill. There are those who have different opinions about that. He also says he likes the quotation:

It’s easy to agonize over such situations but quite profitless; sometimes one is faced with a scattered collection, at other times there’s an embarrassment of riches.

Peter Worden?

I could not find this quotation in its entirety anywhere on the web. Well, I found the “embarrassment of riches” part, the authorship of which seems to be in some doubt. This seems to capture how one feels about the hand one is dealt in a cribbage game—and perhaps in life. He doesn’t take credit for the quote, but I’m going to take a chance and give it to him.

Cribbage is a lot of fun and there are variety of handsome and even whimsical boards on which to score your points. The ACC prefers a special board for tournaments which makes it easier to avoid pegging mistakes.

We prefer a jumbo board (bigger numbers and pegs), but have played on one shaped like the number 29, the highest score you can make. The odds of getting that hand score are 1 in 216,580. You want to keep playing just to see if you ever get it. You’ll have a lot of fun on the quest.

It might also be a way to foster congeniality in society. We sure need it.

Stretching Our Legs on the Terry Trueblood Trail

We got out on the Terry Trueblood Trail today to stretch our legs, feel the breeze, and free our minds of the daily news, which is usually bad. It’s nice to just listen to the wind and the birds on the lake.

We see something interesting every time we walk the trail. Caterpillars were pretty busy, trying to cross the sidewalk without getting crushed by bicycle wheels. Some don’t make it. The grasshoppers are a little sluggish.

There’s a myth about woolly bear caterpillars. If they’re all black, some people say it predicts a really bad winter. The longer the brown color band, the milder the winter. We didn’t see any woolly bears today, just some nervous caterpillars trying to avoid getting smashed.

Waiting for Another Jab

I’m still waiting for my Moderna booster, which has to be blessed by the CDC Advisory Committee on Immunization Practices (ACIP). Every time I check the schedule for their next meeting on October 20, 21, I still see a draft agenda. The CDC still does not recommend heterologous boosting, although last week the FDA advisory committee discussed the preliminary results from an ongoing study about it and the data showed it was safe and resulted in impressive boosting. They had a discussion question about it, but there was no vote.  

My wife Sena, got her Pfizer booster last week. She had a sore arm for about a day and no other side effects. When I got my first Moderna shot, my left arm swelled up and got red and sore. If I had gotten another injection in the other arm, I would have looked buff.

I just remembered that when I was playing junior league baseball, I got hit with a bat in that same arm in the same spot. I think it took longer for that to heal up. I always struck out anyway. I think the pneumovax I got last month hurt more than the COVID shot.

After my second jab, I got pretty tired for about a day, but still exercised and didn’t really limit my activities beyond my usual laziness. I was still able to sprint away at top speed from Sena when she came looking for me to do some chores. She didn’t have any side effects at all from her primary series.

Before the vaccines were available about a year and a half ago and I was still working at the hospital as a psychiatric consultant, I saw patients who had COVID-19. In the general hospital, all of them were pretty sick, although at that time we were not supposed to see any ICU COVID-19 patients. I saw a patient with a catatonic-like syndrome, who didn’t respond to an intravenous benzodiazepine challenge test (see yesterday’s post about the catatonic variant of delirium). I always wore the proper Personal Protective Equipment (PPE).

Anyway, it sounds like more and more people are getting COVID-19 vaccines. I believe it’s the right thing to do. I’m not a big fan of mandates. Million-dollar lotteries didn’t seem to get the vaccination rates up very much. I don’t think scaring people is the ideal way to motivate them. I guess it’s up to you.