I want to give a shout out to Dr. George Dawson for his post today “The Autocratic Approach to Homelessness” in reference to President Trump’s most recent executive order, “Ending Crime and Disorder on America’s Streets.” As a retired psychiatrist, I look back and remember seeing the problem of the homeless mentally ill a lot. You can read my take on it from last summer’s posts:
I spend a lot of time joking around on my blog, but this is no joking matter. I think the President gets it wrong.
I just noticed something about one of my YouTube videos that I made sort of as a combination gag and educational piece about pseudobulbar affect. It needed a couple of updates—one of which is minor and which I should have noticed 10 years ago when I made it.
It’s a pseudo-rap performance (badly done, I have to agree although it was fun to make), but it’s one of my most watched productions; it has 18,000 views.
One minor update is about the word “Dex” in the so-called lyrics of this raggedy rap song (see the description by clicking on the Watch on YouTube banner in the lower left-hand corner). It stands for dextromethorphan, one of the ingredients along with quinidine in Nuedexta, the medication for pseudobulbar affect. Dextromethorphan has been known to cause dissociation when it’s abused (for example, in cough syrup).
The most important update is about Dr. Robert G. Robinson, who I joked about in the piece. He passed away December 25, 2024. He was the chair of The University of Iowa Dept. of Psychiatry from 1999-2011. He was a great teacher, mentor, and researcher. He published hundreds of research papers and books on neuropsychiatric diseases like post-stroke depression and pseudobulbar affect. He lectured around the world and was widely regarded as a brilliant leader in his field.
Early in my career in the department, I left twice to try my hand in private practice psychiatry. Both times Dr. Robinson welcomed me back—warmly. He was my co-editor of our book, Psychosomatic Medicine: An Introduction to Consultation-Liaison Psychiatry, published in 2010.
All who worked with Dr. Robinson will never forget him.
Yesterday I noticed a hummingbird hovering about the flower pots on our porch. I hurried to get my point and shoot camera and shot video, through a window as usual and it was getting a little late in the evening too, so light was low.
Can I blame the bird for always looking like a blur—or not? Anyway, the video looks similar to others I’ve managed to capture in years past, except this one was the closest I’ve ever gotten to one. I tried messing with the clip using my video editing software, but I ended up believing it best to leave it mostly unmessed around with.
On the other hand, the one I got about 6 years ago was pretty fair for an amateur backyard birder. Same camera, same software although I was closer to the birds and I’m pretty sure I was sitting outside and very patient. They were very interested in our little feeder.
I think the hummingbirds we’ve seen are ruby-throated species partly because that’s the most common in Iowa. Typically, I think it’s just the males who have ruby-colored throats; our visitor didn’t.
I guess the usual way to attract hummingbirds is with a feeder but other people say there are other reasons hummingbirds visit us. More common to the indigenous peoples, they may be thought of as the spirits of those who recently died and are visiting those they were close to.
I don’t remember the movie “The Curious Case of Benjamin Button” so well but I’ve glanced briefly at web articles which connect it with hummingbirds, which has something to do with their ability to fly backwards or in a figure 8, maybe connecting that with reverse aging or infinity. Other symbolic connections are with joy, healing, and partnership. There are so many connections they seem to blur together—sort of like the bird itself as it hovers and flits from flower to flower.
I think this hummingbird just really liked Sena’s flowers.
Well, I’ve been waiting all morning for the Big Mo Pod Show and it usually shows up long before now on Saturday morning. In spite of this, Big Mo did say on the blues show last night that the first two songs on the show would be on the pod show and I know what they are. So I’m going to go ahead and start without Big Mo and Producer Noah today.
The first one is a song by someone Big Mo mentioned last week, Monster Mike Welch, “Keep Living Til I Die.” It just happens to be related to my post yesterday on death doulas—only it’s full of raw and feisty humor in how it approaches the usual ideas about death, which can be morbid.
In the lyrics, I think there’s even a classical Greek mythology reference to the river Styx, “I pay my toll at the river…” It could be referring to the river which separates the living from the dead in Hades.
There’s nothing morbid about death in this tune. The singer doesn’t seek death, but neither does he try to run away or hide from it. He’ll just keep living till he dies.
I’m less sure what to think of the next song Big Mo would be on the pod show. It’s by Lil’ Ed & the Imperials, “Walking the Dog.” I can’t make sense of the lyrics.
That’s about as far as I can go so far without the pod show. On the other hand, there was another song on the blues show by an artist I didn’t know about until last night. “Been Here Before” is a striking song because right away I wondered if was about reincarnation. It is sort of related to the idea of what happens after we die.
In fact, the artist, Christone Kingfish Ingram speculates in an interview he might be open to the idea of his have been reincarnated. This is not that different from a few of Dr. H. Steven Moffic’s thoughts about the death, reincarnation, and the afterlife in some of his recent Psychiatric Times columns. A couple of examples are “Past Lives and Psychiatry” and “Past Lives, Death, Dying, and the Afterlife.”
And that’s the “old soul” side of the story about death.
I listened to the Rounding@Iowa podcast “End-of-Life Doulas” twice because I’m at that difficult age when I think about my personal death. I don’t think about it at great length, mind you, but when I think about it, I feel afraid. Early mornings tend to be the time I wonder how much time now until…?
There was the usual podcast format, Dr. Gerry Clancy interviews Mary Kay Kusner, who is certified death doula to get the overview and details about what death doulas are all about.
I listened to the podcast in the late afternoon and discussed it only briefly with Sena. I felt out of sorts for a few hours afterward. I was in a funk until later in the evening when my thoughts almost abruptly switched to something funny. It was about a topic I’m thinking of for another blog post which has a humorous angle to it. I even chuckled a little out loud. I didn’t force that line of thought—it just happened.
But I know why it happened.
I didn’t know what a doula was until I listened to the podcast. Because I’m a writer by inclination, I looked for the original definition, which is a female servant who helps women with birthing. That didn’t enlighten me much, obviously; I can’t remember the last time I was pregnant (see what I did there?). An end of life-or-death doula helps people come to terms with impending death, death when it happens, and with whatever comes up after death has happened.
The title of this post comes from the Mary Kay Kusner’s short anecdote near the end of the podcast. Early in her career as a chaplain, she met with a 4-year-old child in the oncology unit who had a terminal illness, evidently death was coming and asked her, “How will I get to heaven?” They talked about it and the next thing the child said was, “So it’s like another dimension?” which Kusner evidently validated in some way. It’s a really cute story.
Anyway, there was a thread running through the podcast which pointed to what is apparently an ongoing psychological disconnect medical professionals have about death because we’re so focused on cure. It’s disappointing, but there you go. Death doulas are around to fill the role of talking calmly and matter-of-factly about it with patients and families.
There are some nuts and bolts about the profession, some of which I get and others which I scratch my head about. There are a couple of doula organizations in Iowa City which Kusner mentions: Community Death Doulas and Death Collective Eastern Iowa. Mary Kay Kusner is certified as a death doula via online training through INELDA.
Interestingly some people do not believe that this is a profession which can be certified, at least without some practical clinical experience. There’s a web site in which the question-and-answer section is longer than the article itself about this. The author recommends specific courses.
Death doulas are not covered by health insurance, so the practitioners arrange for payment, often through a sliding scale hourly fee. Part of the reason for the training of and demand for death doulas is that hospice nurses have heavy caseloads.
This reminds me of the hospice where my younger brother died after his battle with cancer. He was in his forties. Before he entered hospice, I had to be one of his doctors on the medical psychiatry inpatient unit after he accidentally overdosed on his pain medication.
When my brother was in hospice, I sat at his bedside. Most of the time, he was delirious. I watched and listened as one of the hospice workers as he asked him whether he was entering the dying process. He used those words. My brother was just as delirious as he was when he had to be admitted to the medical-psychiatry unit. I don’t know how much he heard.
I sat at his bedside, determined to hold some kind of death watch vigil. This was interrupted, ironically, by some friends of his who visited. They stood opposite the bed so that I had to look at them instead—and to listen as they told me stories about how close they’d been to him and how much they loved him.
By the time they were finished and I turned back to my brother, he was gone. It took me a little while to figure out I had not missed anything I really needed.
So, I think death doulas could be vital in building a bridge between those who are dying and those who need to connect with them. That’s the main thing.
Just like a few days ago, yesterday evening while we were playing cribbage, Sena spied a slim indigo bunting. This one flew right up to our window! It was probably not the same one we first saw. That guy was buff, likely because he’d been branch pressing in the gym.
This character was slim and trim and looked like a lot of other birds we saw charging at their reflections in our windows last month. He really wanted to tell that other bunting where to fly off. I think he should work out more if he’s going to strut like that.
If we’d been sitting by the window all day long with camera at the ready, we’d have been unlikely to ever catch Slim Indigo peering and posing like he was on the bird walk.
It’s a random surprise when lucky breaks like that happen. It can take your breath away. I’m not sure why we’ve been lucky enough to catch a look at Slim, especially after over 20 years since seeing the last one. One answer to that might be here. Sometimes it’s better to be lucky than good. By the way, that reminds me; Sena won the cribbage game—this time.
The one thing I couldn’t get by shooting video through a window is Slim’s voice. Clearly, you can see he was chirping at one point. So, here’s a link for that.
I don’t get out often to the mall to do mall walking, but I did today. I put on a little over 2.5 miles on my step counter. Mall walking is OK for exercise although I have to drive over there. Right next door to the entrance to the mall is the outdoor entrance to Planet Fitness, which is kind of ironic. But you have to pay a membership fee to use the facilities there. You can just walk through the mall for free and it opens an hour before the other shops just to accommodate mall walkers.
I think mall walking does wonders for my lower back. I see a lot of older people who look like they make mall walking regular exercise. They’re my age or older. Some of them have physical challenges that may be the reasons why they mall walk, that is, for conditioning. Their physicians might have even recommended it.
A minority of mall walkers I see are young, so this isn’t just for the elderly. Occasionally I’ll see a group who are challenged in various ways. Today it looked like the guy who was blind and using a cane was right out in front, actually leading the group.
Mall walking has advantages over, say, walking downtown. It beats getting clobbered by an exploding manhole lid, bit by a dog, or mugged.
There are some studies about mall walking, but the authors of a 2015 review mainly noted that there’s a need for more rigorous studies. Their conclusion sounds a little grumpy:
“We found the potential for mall walking programs to be implemented in various communities as a health promotion measure. However, the research on mall walking programs is limited and has weak study designs. More rigorous research is needed to define best practices for mall walking programs’ reach, effectiveness, adoption, implementation, and maintenance.”
Farren L, Belza B, Allen P, Brolliar S, Brown DR, Cormier ML, Janicek S, Jones DL, King DK, Marquez DX, Rosenberg DE. Mall Walking Program Environments, Features, and Participants: A Scoping Review. Prev Chronic Dis. 2015 Aug 13;12:E129. doi: 10.5888/pcd12.150027. PMID: 26270743; PMCID: PMC4552141.
Maybe the authors need to go for a walk.
It’s inspiring to see some of the mall walkers out there despite having major disability of one kind or another. I often see a lady who uses a wheeled walker and cannot hold her head up straight. When she sits down for a break, it looks like she’s collapsed. But she just gets up and at it again a few minutes later.
Mall walking may be understudied—but it’s also underestimated as a sign of resilience in anyone young or old.
I caught the Big Mo Pod Show today, “Music of the People” and of course, I listened to his Friday Blues show last night.
Big Mo is a bottomless pit of blues music knowledge (as well as other genres) and that takes me back to my wasted youth when I had a short conversation with one of my former bosses when I worked for Wallace Holland Kastler Schmitz & Co., a consulting engineer firm in Mason City, Iowa.
Ages ago, Ralph Wallace and I got into a short conversation one day about blues music, believe it or not. I can’t recall what actually got that short chat started but it was kind of surreal. He asked me about what I liked about the blues and I brought him up short by telling him I didn’t know anything about it.
I think Ralph thought I would know about the blues just because I was black. I didn’t. He even tried to prompt me by asking about different kinds of blues music, for example 12 bar blues and so on. I’ll never forget his facial expression when he realized I barely knew it existed. He looked puzzled and incredulous. He was a white man and knew more about it than I did. I think it stunned him that a black guy was completely ignorant of the blues.
I could dismiss the interaction simply as a mild form of racism, but I think it was more complicated than that. He was the boss of the company who gave me my very first real job but really didn’t know anything about my background. I was the child of a black man and white woman and my father left home when I was just a little kid. I went to an all-white church. I went to all-white schools, that is, until I was persuaded by a white woman and the black pastor and professor of religion and philosophy to enter Huston-Tillotson College (now Huston-Tillotson University), one of the HBCUs in America located in Austin, Texas. I first heard gospel music there and it raised the hair up on the back of my neck.
It’s a little ironic but I also think of John Heim (aka Big Mo) as another white man who knows more than I’ll ever know about the blues. And I’ve been learning from him for years, which is great.
So, the point is that the theme of the Big Mo Pod Show today is “Music of the People.” The blues is music for all people and the songs can have broad appeal.
One example is the song “Artificial” by Walter Trout. It’s a modern rant against the many synthetic artifacts in modern society and that includes something I rail against—Artificial Intelligence (AI). I can relate to it.
One song that didn’t make it to the list of 5 on the pod show but which was on the blues show last night was “Room on the Porch” by Taj Mahal and Keb’ Mo’ (featuring Ruby Amanfu). I got a surreal feeling about it because it’s about being openly welcoming to everyone. I hear a note of irony in it related to the current conflicts in America and around the world which highlight the opposite of openness and welcome. They’re not new.
On the other hand, I don’t think either Taj Mahal or Keb’ Mo’ intended for the song to be ironic. Maybe I just hear it because of all the background noise that has to be called reality because that’s what’s out there.
What if they’re not being ironic? What if they believe it and they’re trying to say there’s a good reason we should think of the blues as the music of the people—all the people? Where could we go from there?
Big Mo said it last night, “The blues can heal you, if you let it.”
Yesterday we took our usual walk on the Terry Trueblood Trail. It’s customary as the seasons evolve for us to make sure everything is progressing as it should. It helps to make believe we’re in charge.
It’s still spring and flowers are still blooming and birds are still nesting and nurturing new life. There are lots of plants we don’t know much about except they make the land more beautiful.
So, the Big Mo Pod Show was on just now and I listened to it because I heard the Big Mo Blues Show last night.
I just want to mention that I heard Big Mo do an extended version of his comedy bit on Mayree’s hand-battered catfish last night too. I never know when he’s going to do the long version of it and I nearly always regret not having some way to record it. It’s kooky and complicated with twists and turns like a long hairy dog story with punchlines scattered like land mines all over it.
Anyway, the pod show was pretty interesting. I think the Beth Hart song “Can’t Let Go” could be about more than a busted relationship, a frequent subject of a lot of blues songs. There’s a lot of baggage that we can’t let go of in life. The other notable feature of that song is Sonny Landreth cutting all the way loose with guitar licks spinning out beyond every nearby galaxy.
What was strange during last night’s blues show was I could have sworn I heard the lyrics of “Stand by Me” but it’s not on the list of songs. Songs sometimes don’t get on the list. Anyway, it reminded me of the Playing for Change version that starts with Roger Ridley and goes around the world, released 16 years ago.
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