Politics on the Brain

I just discovered the news item about 5 Minnesota Senate Republicans who introduced a bill this month seeking to classify “Trump Derangement Syndrome” (TDS) as a mental illness. This is not a new idea, I think, and it targets Democrats as having the syndrome. There’s a big Wikipedia article about the history of the origin of it.

It reminded me of a Dr. Henry Nasrallah’s editorials about “neuropolitics” a term he used in an effort to understand how much politics can affect the human brain. He published a series of 3 articles in the journal Current Psychiatry. The one published in the October 2018 issue is entitled “Neuropolitics in the age of extremism: Brain regions involved in hatred.”

Dr. Nasrallah is a neuropsychiatrist who has an entertaining and thought-provoking writing style. I met him briefly when I was interviewing for psychiatry residency at the University of Cincinnati.

The political situation now is difficult and it makes me wonder even more if there is a problem with the human brain when it comes to politics.

Dr. Nasrallah article 1

Dr. Nasrallah article 2

Dr. Nasrallah article 3

The Zamboni Effect

I was walking around the mall today doing ordinary old guy things: watching the Zamboni machine resurface the ice rink, which I’ve never seen before, by the way. The surface was pretty dull before the Zamboni team started. There were two kids in the seat, one young lady driving and the other young man pointing out spots she missed. They went around and around getting the thin layer of water on the whole rink while eager skaters waited to get out there. They rejuvenated the rink, got it shining like crystal and skaters spun, twirled, and had a great time. It was the Zamboni Effect.

After that, I got up and did my usual thing, looked at books in Barnes & Noble, got a bite to eat, wondered why the mall security guy was walking by the bench so often where I was sitting. After his third pass, I got up and did my best to look like a solid citizen who is aware that loitering might look sinister to some mall security guys.

And when I wandered back to the tables next to the ice rink, I sat down again because the mall security guy was nowhere in sight. While I was just zoning out watching people pass by, one of them stopped and made a funny face at me. For a half-second, he didn’t register in my memory and then he called me by name. I suddenly recognized him as a former resident in the Medical-Psychiatry training program at University of Iowa Health Care (UIHC). It was Ravneet, one of the best trainees I have ever had the pleasure to work with.

It was kind of a shock. He had left for a great position with a health care organization out in Arizona many years ago and is very successful. He and his wife and daughter were on vacation and were walking through the mall. His son is also a high-level performer in science but he was not with them today. Ravneet takes time out every so often to travel like that. I’m sure it helps rejuvenate him—kind of like how the Zamboni machine rejuvenates the ice rink–the Zamboni Effect.

We exchanged pleasantries, he took a selfie with me, and I forgot to ask him to send me a copy, probably because I was so flabbergasted at running into him at the mall. It really brightened my day. Again—the Zamboni Effect. I really felt rejuvenated.

Every now and then, we all need the Zamboni Effect. Maybe it could even help the mall security guy.

Noteworthy Black Psychiatrists on the Last Day of Black History Month

I wanted to give a shout-out to Dr. H. Steven Moffic, MD for his article highlighting the career of a notable black psychiatrist, Dr. Alvin F. Poussaint, MD, who sadly died on February 24, 2025. I’m mortified that I hadn’t heard of him before now.

It reminded me of the time I mentioned another black psychiatrist I had never heard of either, Dr. Chester Middlebrook Pierce, MD, in a post about the book “Our Hidden Conversations” about a year ago.

I wondered if Dr. Pierce and Dr. Poussaint ever met. I looked this up but couldn’t find a definite link.

Dr. Moffic’s essay, in which he mentions antisemitism. also reminded me of an essay also published in Psychiatric Times in 2020 by Dr. Robert M. Kaplan, MD. The title is “Alois Maria Ott: I was Hitler’s Psychologist.”

It gives even more texture to Dr. Poussaint’s views on whether or when extreme racism should or should not be classified as a mental illness. My own residency training experience was marked by being assigned to a patient said to have schizophrenia—who angrily shouted when he saw me, “I don’t want no nigger doctor!” My faculty supervisor didn’t think I should be reassigned to an alternate patient, a decision I’m still ambivalent about.

Bluebirds Fly on the Terry Trueblood Trail

We got out today on the Terry Trueblood Trail because it was sunny and 60 degrees. It felt like early spring, although Punxsutawney Phil put the kibosh on that.

The ice was giving way on Sand Lake. The birds were waking up and hungry. And I can’t remember the last time we saw bluebirds at all, let alone the many we saw out in the open grassland today.

It was the kind of day you forget what’s in the news and just celebrate the coming of spring. Just watch the bluebirds fly.

Old School

We were reminiscing about our elementary school days following a discussion of news article about what some educators want to do with the school day schedule. Apparently, kids are pretty sleepy in class and teachers think it’s because they’re sleep deprived. Apparently, they’re not getting enough sleep at night and the proposal is that the school day schedule ought to be pushed ahead, the day starting at 9 AM instead of 8 AM.

Maybe the kids should be off their electronic devices a little earlier in the evening.

I guess there have been studies supporting this idea for years, but of course I hadn’t heard of it. Nobody seems to be in a hurry to change the system.

What we remembered were the consequences imposed by teachers and principals when we didn’t perform up to expectations in class, or misbehaved in class or on the playground.

Sena had a little trouble with remembering the vowels, a e i o u and sometimes y. She had so much trouble with it that she had to stay after school to write that out over and over on two big blackboards. It took quite a while. That was back in the days when blackboards were big and covered one entire wall of the classroom. There was always more chalk available if she ran out. Sometimes the penalty for her not paying attention was a few sharp raps on the top of her head with a No.2 pencil. Most often it was for talking out of turn or not paying attention.

I got caught a couple of times for throwing snowballs on the playground. I think it was at least a couple of times. The consequence for this infraction was to sit in the principal’s office drawing little circles resembling snowballs on a sheet of paper. They had to be small so that it took you a long time to fill up the paper. If you made them too big, the principal made you flip the sheet over and do it again. I think if you got writer’s cramp, you had to switch hands.

My brother and I had to walk to and from school. We had to get up early and sometimes the snow was up to our knees. It was about a half-mile walk to school. One winter day, I was walking home and found a dog frozen stiff as a statue next to the sidewalk.

I spent most of time after lunch looking at the clock, wishing the hands would move faster to 3 PM, when school let out. I would walk home and because I was a latchkey kid, I just let myself in the house.

I guess moving the time up so that kids can be more awake during the morning wouldn’t hurt anything. Maybe the curriculum will be simplified a little bit too. Things like geography could be easier. You could change the name of the Gulf of Mexico (or is it the Gulf of America now?) to something that makes more sense—like the Gulf of Water.

If you can’t learn that, maybe you need to have your head rapped with a No.2 pencil.

Rife vs Ripe: Which is Right?

I noticed a couple of things about one of the President’s many new Executive Orders, which was “ESTABLISHING THE PRESIDENT’S MAKE AMERICA HEALTHY AGAIN COMMISSION,” or MAHA for short. It was posted on February 13, 2025. One thing it reminded me of is the tax filing season, which is upon us (everything reminds me of the tax filing season around this time of year). The other thing was a short article about the IRS, which is cutting staff sharply in response, probably as a response to the federal government workforce layoffs generally. One sentence in the article read:

“The IRS layoffs, first reported by the New York Times, come as part of a broader effort by President Donald Trump and Elon Musk’s overhaul of the federal government, which they argue is too bloated and inefficient, and ripe with waste and fraud.”

I put the word “ripe” in bold-face type because I sensed that the writer probably meant “rife” instead. I looked up the definitions of both just to make sure: Rife means abundant and ripe means mature (possibly overly mature as in smelly and ready for the garbage can).

I wonder if “rife” or “ripe” could apply to MAHA. I’m all for making us healthy. I agree with promoting health. I’m not sure what is meant by “assess the prevalence of and threat posed by the prescription of selective serotonin reuptake inhibitors, antipsychotics, mood stabilizers, stimulants, and weight-loss drugs.” It sounds like a shot across the bow for psychiatrists and primary care physicians.

Some of the content may be either “rife” (or is it “ripe”?) with potentially misleading innuendo, implying that health care professionals are not doing all we can already to promote health. I agree with promoting research into the “root causes” for mental illness. However, some people need psychiatric medications for “just managing disease.” Reducing the suffering of those who are tortured by depression and delusions and hallucinations makes sense because that’s the humane thing to do.

This reminds me of a very interesting article about what some scientists think about how life began on this planet and how it might start elsewhere in the universe. Some think life evolves mainly by chance, by a cosmic accident. Others think it’s inevitable and occurs when planetary conditions are right. So that might mean there’s a good chance there are extraterrestrials are out there. If they are, what would they think of us?

And this reminds me of a quote from the movie, Men in Black. Agent K is showing Edwards a universal translator, one of the many wonders in the extraterrestrial technology room, which gives us a perspective on how humans rank in the universe:

Agent K: We’re not even supposed to have it. I’ll tell you why. Human thought is so primitive it’s looked upon as an infectious disease in some of the better galaxies.

So is the universe “rife” with life—or is it “ripe”?

All Jokes Aside, What Do I think About the Book “Caste: The Origins of Our Discontents?”

I just finished reading Isabel Wilkerson’s book, “Caste: The Origins of Our Discontents.” It was a painful read because it talks about racism in America, which is a part of my lived experience. Wilkerson’s compares it to the Nazi persecution of the Jews and the caste organization in India. The chapter on the pillars of caste make sense to me.

When I reached the last section (not at all “final” by any means), which is called “Awakening,” I was not surprised that there were no prescriptions or outlines or action plans for how to eliminate caste in any culture. It turns out that we’re all responsible for becoming aware of how we all are complicit in some way with maintaining caste divisions in society. And the word Wilkerson used for how to begin is “empathy,” or somehow becoming conscious of that tendency and to replace it with understanding.

As Wilkerson emphasizes, empathy isn’t sympathy or pity. Empathy is walking a mile in someone else’s shoes, as the song goes. But she goes a step further and uses the term “radical empathy.” It’s difficult to define concretely. It goes beyond trying to imagine how another person feels, going the extra mile and learning about what the other person’s experience. It’s not about my perspective; it’s about yours. It’s not clear exactly how to make that deep connection. She uses terms like “spirit” which may or may not resonate with a reader searching for a recipe or a cure.

Politics turns up in the book. How could it not? I’m going to just admit that I wanted to make this post humorous somehow, especially after I saw Dr. H. Steven Moffic’s article in Psychiatric Times about whether psychiatrists are to act in the role of “bystanders” or “upstanders” in the present era of political and social turmoil. He specifically mentioned the Goldwater Rule, which is the American Psychiatric Association Ethics Annotation barring psychiatrists from making public statements of a diagnostic opinion about any individual (often a politician) absent a formal examination or authorization to make any statements. The allusion to a specific person is unmistakable.

But, as a retired psychiatrist, I’m aware that my sense of humor could be deployed as a defense mechanism and it would certainly backfire in today’s highly charged political context. I’m not sure whether I’m a bystander or an upstander.

Sena and I had a spirited debate about whether America has a caste system or not. I think it’s self-evident and is nothing new to me. I suspect that calling racism (which certainly exists in the United States) a form of casteism would not be altogether wrong. Wilkerson mentions a psychiatrist, Sushrut Jadhav, who is mentioned in the Acknowledgments section of her book. Jadhav is a survivor of the caste system in India. I found some of insights on caste and racism in web article, “Caste, culture and clinic” which is the text of an interview with him.

His answers to two questions were interesting. On the question of whether there is a difference between the experience of racism and caste humiliation, he said “None on the surface” but added that more research was needed to answer the question adequately. And to the question of whether it’s possible to forget caste, he said you have to truly remember it before you can forget it—and it’s important to consider who might be asking you to forget it.

This reminded me of the speech in the movie “Guess Who’s Coming to Dinner,” said by John Prentice (played by Sidney Poitier) to his father:

“You’ve said what you had to say. You listen to me. You say you don’t want to tell me how to live my life? So, what do you think you’ve been doing? You tell me what rights I’ve got or haven’t got, and what I owe to you for what you’ve done for me. Let me tell you something. I owe you nothing! If you carried that bag a million miles, you did what you were supposed to do because you brought me into this world, and from that day you owed me everything you could ever do for me, like I will owe my son if I ever have another. But you don’t own me! You can’t tell me when or where I’m out of line, or try to get me to live my life according to your rules. You don’t even know what I am, Dad. You don’t know who I am. You don’t know how I feel, what I think. And if I tried to explain it the rest of your life, you will never understand. You are 30 years older than I am. You and your whole lousy generation believes the way it was for you is the way it’s got to be. And not until your whole generation has lain down and died will the deadweight of you be off our backs! You understand? You’ve got to get off my back! Dad. Dad. You’re my father. I’m your son. I love you. I always have and I always will. But you think of yourself as a colored man. I think of myself as a man. Hmm? Now, I’ve got a decision to make, hmm? And I’ve got to make it alone. And I gotta make it in a hurry. So, would you go out there and see after my mother?”

 And there was this dialogue that Sena found on the web, which was similar to that of John Prentice. It was a YouTube fragment of a 60 minutes interview in 2005 between actor Morgan Freeman and Mike Wallace. Wallace asked Freeman what he thought about Black History Month. Freeman’s answer stunned a lot of people because he said he didn’t want Black History Month and said black history is American history. He said the way to get rid of racism was to simply stop talking about it. His replies to questions about racism implied he thought everyone should be color blind. John Prentice’s remarks to his father are in the same vein.

I grew up thinking of myself as a black person. I don’t think there was any part of my world that encouraged me to think I was anything different. I think Wilkerson’s book is saying that society can’t be colorblind, but that people can try to walk a mile in each other’s shoes.

Black History Month 2025 ASALH Theme

This is Black History Month and the Association for the Study of African American Life and History (ASALH) theme this year is African Americans & Labor.

When I look back on my youth, I think of my time learning on the job to be a survey crew technician and drafter for a consulting engineer company in Mason City, Iowa, Wallace Holland Kastler Schmitz & Co. (WHKS & Co.).

I was probably not the first black person to work for WHKS & Co. One other black person who was one of very few role models for African Americans was a guy named Al Martin, who I’ve posted about before.

My time there was in the 1970s and there were not many job opportunities open to minorities. I learned more than just the skills specific to the job. I learned that I could succeed in life, which was valuable later on. I developed the confidence to seek other opportunities which included going to medical school and becoming a physician.

Although racism was not absent at WHKS & Co., there was just enough open-mindedness to support my ambition to move forward in life despite the barriers to success in society that existed.

I think the ASALH theme for Black History Month in 2025 is vital to reflect on in the present day. People from all walks of life can relate to this.

Carter G. Woodson is considered the father of Black history and was the founder of Black History Month.

Keep Hope Alive

Just a reminder, Isabel Wilkerson will be giving her presentation, ” “Caste: How the hierarchy we have inherited restricts our humanity” from noon to 1 p.m. Wednesday, Feb. 5, in Prem Sahai Auditorium (room 1110) in the Medical Education and Research Facility.

I’m about halfway through her book, “Caste: The Origins of Our Discontents.” It’s a very difficult read, as I anticipated. It’s full of horrendous descriptions of what those in lower castes suffered, whether from the time of the Nazis, India, or America. I can read it only for a short while and then I have to put the book down and take a break. I get so I feel like I need an inspirational lift.

And it just happened the other night. I heard a poem on TV I’ve heard before, “I am Somebody.” Although it was written in the 1950s by Reverend William Holmes Borders, a civil rights activist and senior pastor at Wheat Street Baptist Church, it was recited by Reverend Jesse Jackson in 1963.

I remember seeing Reverend Jackson cry the night Barack Obama was elected President in 2008. I never heard the original speech Reverend Jackson gave in 1988, during the second time he was running for President himself.

I think it was probably because I was focused on starting medical school at The University of Iowa. I began my studies in August of 1988 in what was then the summer enrichment program for minority students.

One of Reverend Jackson’s speeches contained the other memorable cry, “Keep hope alive!” You can hear it and read the transcript.

You must not surrender! You may or may not get there but just know that you’re qualified! And you hold on and hold out! We must never surrender!! America will get better and better.

Keep hope alive. Keep hope alive! Keep hope alive! On tomorrow night and beyond, keep hope alive! I love you very much. I love you very much. —Rev. Jesse Jackson, 1988.