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.

Dr. Martin Luther King Jr. 2025 Events and Some Thoughts

Dr. Martin Luther King Jr. Week started January 20, 2025. There will be several very worthwhile events, many of which are listed here.

Isabel Wilkerson, winner of the Pulitzer Prize and National Humanities Medal, will deliver the Dr. Martin Luther King Jr. Distinguished Lecture on February 5, 2025 at the University of Iowa Medical Education and Research Facility (MERF); Prem Sahai Auditorium. General admission is free although it’s a ticketed event, more information here.

I was searching the web for articles about whether and when Dr. Martin Luther King Jr. visited Iowa and found one that sparked personal memories of defeat, which Dr. King talked about when he visited my alma mater, Iowa State University in Ames in 1960, where he said:

“The Negro must not defeat or humiliate the white man, but must gain his confidence. Black supremacy would be as dangerous as white supremacy. I am not interested in rising from a position of disadvantage to a position of advantage.”

This quote was in an article entitled “Mentality Has Outrun Morality” in the January 23, 1960 issue of the Ames Tribune.

It reminded me of two episodes in my life which left me with a strong sense of defeat in the context of racism.

One of them was ages ago when I was a young man and somehow got involved in a pickup game of basketball with guys who were all white. I was the only black man.  This was in Iowa. The members of my team were those I worked with. The opponents were men my co-workers challenged to a game of basketball. I had never been in such a contest before. I think we lost but what I remember most vividly is a comment shouted by one of the opponents: “Don’t worry about the nigger!” I sat on the bleachers for the rest of the game while they played on. I remember feeling defeated—and wondering whose team I was really on.

The other incident was also long ago (but I was a little older), when I was a member of a debating team at Huston-Tillotson College in Texas (now Huston-Tillotson University, one of America’s HBCUs). We were all black. We were debating the question of whether capital punishment was a deterrent or not to capital crime. I couldn’t get a word in edgewise with my opponent. He just kept a running speech going, punctuated with many “whereas” points, one of which I’m pretty sure included the overrepresentation of black men on death row. I had never been in a debate before. My professor remarked that my opponent won the debate by being bombastic—for which there didn’t seem to be a countermeasure. I remember feeling defeated—and wondered if I was on the wrong team.

There’s a lot of emphasis on defeating others in sports, politics, religion, and the like. On a personal level, I learned that defeat didn’t make me feel good. I’m pretty sure most people feel the same way.

Dr. King also said “We can’t sit and wait for the coming of the inevitable.”

I’m not sure exactly what he meant by “the coming of the inevitable.” What did he mean by the “emerging new order”? Did he mean the second coming? Did he mean the extinction of the human race when we all kill each other? Or did he mean the convergence of humanity’s insight into the need for cooperation with the recognition of the planet’s diminishing resources?

I don’t know. I’m just an old man who hopes things will get better.

Is Artificial Intelligence (AI) Trying to Defeat Humans?

I just found out that Artificial Intelligence (AI) has been reported to be lying as far back as May of 2024. In fact, because I can’t turn off the Google Gemini AI Overview. Gemini’s results always appear at the top of the page. I found out from my web search term “can ai lie” that AI (Gemini ) itself admits to lying. Its confession is a little chilling:

“Yes, artificial intelligence (AI) can lie, and it’s becoming more capable of doing so.”

“Intentional deceptions: AI can actively choose to deceive users. For example, AI can lie to trick humans into taking certain actions, or to bypass safety tests.”

It makes me wonder if AI is actually trying to defeat us. It reminds me of the Men in Black 3 movie scene in which the younger Boris the Animal boglodite engages in an argument with the older one who has time traveled.

The relevant quote is “No human can defeat me.” Boglodites are not the same as AI, but the competitive dynamic could be the same. So, is it possible that AI is trying to defeat us?

I’m going to touch upon another current topic, which is whether or not we should use AI to conduct suicide risk assessments. It turns out that also is a topic for discussion—but there was no input from Gemini about it. As a psychiatric consultant, I did many of these.

There’s an interesting article by the Hastings Center about the ethical aspects of the issue. The lying tendency of AI and its possible use in suicide prediction presents a thought-provoking irony. Would it “bypass safety tests”?

This reminds me of Isaac Asimov’s chapter in the short story collection, “I, Robot,” specifically “The Evitable Conflict.” You can read a Wikipedia summary which implies that the robots essentially lie to humans by omitting information in order to preserve their safety and protect the world economy. This would be consistent with the First Law of Robotics: “No machine may harm humanity; or, through inaction, allow humanity to come to harm.” 

You could have predicted that the film industry would produce a cops and robbers version of “I, Robot” in which boss robot VIKI (Virtual Interactive Kinetic Intelligence) professes to protect humanity by sacrificing a few humans and taking over the planet to which Detective Spooner takes exception. VIKI and Spooner have this exchange before he destroys it.

VIKI: “You are making a mistake! My logic is undeniable!”

Spooner: “You have so got to die!”

VIKI’s declaration is similar to “No human can defeat me.” It definitely violates the First Law.

Maybe I worry too much.

Should We Trust Artificial Intelligence?

I‘ve read a couple of articles recently about Artificial Intelligence (AI) lately and I’m struck by how readily one can get the idea that AI tends to “lie” or “confabulate” and sometimes the word “hallucinate” is used. The term “hallucinate” doesn’t seem to fit as much as “confabulate,” which I’ll mention later.

One of the articles is an essay by Dr. Ronald Pies, “How ‘Real’ Are Psychiatric Disorders? AI Has Its Say.” It was published in the online version of Psychiatric Times. Dr. Pies obviously does a superb job of talking with AI and I had as much fun reading the lightly edited summaries of his conversation with Microsoft CoPilot as I had reading the published summary of his conversations with Google Bard about a year or so ago.

I think Dr. Pies is an outstanding teacher and I get the sense that his questions to AI do as much to teach it how to converse with humans as it does to shed light on how well it seems to handle the questions he raised during conversations. He points out that many of us (including me) tend to react with fear when the topic of AI in medical practice arises.

The other article I want to briefly discuss is one I read in JAMA Network, “An AI Chatbot Outperformed Physicians and Physicians Plus AI in a Trial—What Does That Mean?” (Accessed January 6, 2025).

Hswen Y, Rubin R. An AI Chatbot Outperformed Physicians and Physicians Plus AI in a Trial—What Does That Mean? JAMA. Published online December 27, 2024. doi:10.1001/jama.2024.23860 (accessed January 6, 2024).

I think the conversation amongst the authors was refreshing. Just because the title of the article suggested that AI might take the place of physicians in the consulting room doesn’t mean that was the prevailing opinion of the authors. In fact, they made it clear that it wasn’t recommended.

I liked Dr. Chen’s comment about confabulation and hallucinations of AI:

“A key topic I talk about is confabulation and hallucination. These things are remarkably robust, and only getting better, but they also just make stuff up. The problem isn’t that they’re wrong sometimes. Lab tests are wrong sometimes. Humans are definitely wrong sometimes. The problem is they sound so convincing, they confabulate so well. “Your patient has an alcohol problem, Wernicke-Korsakoff syndrome.” It’s only if you double check, you’ll realize, “Wait a minute, that wasn’t actually true. That didn’t make sense.” As long as you’re vigilant about that and understand what they can and can’t do, I think they’re remarkably powerful tools that everyone in the world needs to learn how to use.”

What’s interesting about this comment is the reference to Wernicke-Korsakoff syndrome, which can be marked by confabulation. Clinically, it’s really not clear how this comes about in AI although thiamine deficiency is the main cause in WKS. In both, it involves inventing information, which is technically not the same as lying.

Unfortunately, this contrasts sharply with the recent fact checking Snopes article I wrote about recently, which suggests that humans are teaching AI to lie and scheme.

In any case, it’s prudent to regard AI productions with skepticism. My conversations with Google Bard clearly elicited confabulation. Also, it didn’t get humor, so I wouldn’t use it as a conversational tool, given that I’m prone to kidding around. As far as trusting AI, I probably wouldn’t trust it as far as I could throw it.

Big Mo Pod Show: “Blues: The Universal Mixer”

We listened to the Big Mo Pod Show (Sena stuck with it for about the first hour anyway) last night and then I got a mini-education in the forms of music, at least, as it relates to timing and rhythm. The theme was “Blues: The Universal Mixer.” Frequently, the blues show and the podcast remind me of previous eras in my life and lead to a few free associations.

Big Mo Pod Show 085 – “California Bluesin” KCCK's Big Mo Pod Show

After a short break during the Thanksgiving holiday your hosts are back at it again with another episode! This week features the usual mix of blues eras you’ve come to expect along with a few Californian artists, tune in to see which ones! Songs featured in the episode: Solomon Hicks – “Further On Up The … Continue reading
  1. Big Mo Pod Show 085 – “California Bluesin”
  2. Big Mo Pod Show 084 – “Garage Blues”
  3. Big Mo Pod Show 083 – “Legal Pirate radio”
  4. Big Mo Pod Show 082 – “Tribute”
  5. Big Mo Pod Show 081 – “Cheers To Kevin”

The 5 songs reviewed by Big Mo and Noah are probably recognizable to many listeners. As usual, I have to search for the lyrics because I seem to have an inborn tendency to hearing mondegreens. And as usual, I don’t always pay the most attention to the songs chosen for the podcast.

But Big Mo did a little teaching session about rhythm forms, which he related to a couple of songs on the list. One of them was “Wait on Time” by The Fabulous Thunderbirds. I happened to notice that a couple of lines in the lyrics of “Wait on Time” reminded me of another artist who didn’t make it to the list on the podcast but was on the blues show playlist last night. That was Junior Walker and the All Stars. Their song “I’m a Road Runner” was one of my favorites because it reminded me of how I ran all over the hospital as a consult psychiatrist. But I can’t relate to the song as a whole.

The lines the two songs share are:

“Wait on Time” lyrics:

“Well, I live the life I love
And I love the life I live
The life I live baby
Is all I have to give”

“I’m a Road Runner” lyrics:

“And I live the life I love
And I’m gonna love the life I live
Yes, I’m a roadrunner, baby.”

Although the lyrics are similar, the themes are different. The guy in the song “Wait On Time” is promising he’ll get back to his lover someday. On the other hand, in the “I’m a Road Runner” lyrics, that guy is making no such promise and is actually is saying just the opposite.

Big Mo pointed out that there is a common rhythmic form in blues that easily mix with other forms of music, including Latin forms (I don’t understand that music lingo but I think I hear and feel what he means). He mentions that Bo Diddley mixed certain rhythms like that into his music, which surprised me because I didn’t know that. It may be why I like Bo Diddley.

Big Mo didn’t play “I’m a Road Runner” last night but played another hit from Junior Walker and the All Stars: “Ain’t That The Truth.” Just an aside, that tune is mostly instrumental and has a total of only 4 lines apparently, which express a common blues sentiment about relationships:

“Say man, what’s wrong with you?
Oh man, my woman done left me
Say it, man, play me some blues, jack
Get it, baby
Ain’t that the truth”

Several artists covered “I’m a Road Runner” including but not limited to the Grateful Dead and Steppenwolf. Bo Diddley did a song called “Road Runner” but it was not the Junior Walker tune. There’s a YouTube video relating it to the cartoon Roadrunner and Wile E. Coyote.

I’m not a roadrunner by any definition, but I learn a little something new just about every time I hear the Big Mo Pod Show.

Artificial Intelligence Can Lie

I noticed a Snopes fact check article (“AI Models Were Caught Lying to Researchers in Tests — But It’s Not Time to Worry Just Yet”) today which reveals that Artificial Intelligence (AI) can lie. How about that? They can be taught by humans to scheme and lie. I guess we could all see that coming—or not. Nobody seems to be much alarmed by this, but I think it’s probably past time to worry.

Then I remembered I read Isaac Asimov’s book “I, Robot” last year and wrote a post (“Can Robots Lie Like a Rug?”) about the chapter “Liar!” I had previously horsed around with the Google AI that used to be called Bard. I think it’s called Gemini now. Until the Snopes article, I was aware of AI hallucinations and the tendency for it to just make stuff up. When I called Bard on it, it just apologized. But it was not genuinely repentant.

In the “lie like a rug” post, I focused mostly on AI/robots lying to protect the tender human psyche. I didn’t imagine AI lying to protect itself from being shut down. I’m pretty sure it reminds some of us of HAL in the movie “2001: A Space Odyssey,” or the 2004 movie inspired by Asimov’s book, “I, Robot.”

Sena found out that Cambridge University Press recently published a book entitled “The Cambridge Handbook of the Law, Policy, and Regulation for Human–Robot Interaction.” I wonder if the editors and contributors of book on AI and robots mention Asimov.

It reminds me of my own handbook about consultation-liaison psychiatry which was published 14 years ago by CUP—and which CUP now wants me to sign a contract addendum making the book available to AI companies.

I haven’t signed anything.

The Flowers Are Doing Well

The Christmas Amaryllis/Hippeastrum flowers are doing well.

I’m getting older and often I wake up early in the morning feeling anxious and a little blue. I look at the news headlines about people who die and often they’re my age or even younger. Maybe the Christmas holiday does that.

When I get this feeling of dread, I try to think of what I can be grateful for. It’s hard to think of big dramatic experiences. If I sit still long enough, it’s the little acts of kindness that drop down like snowflakes, slowly.

The grade school teacher who took the time to figure out I needed eyeglasses because I couldn’t see the blackboard.

The preacher who sat up all night in a chair with my sick mother when my brother and I were little kids and didn’t know how to help her.

The company that hired me for my first real job when I was a teenager. If they hadn’t done that, I might have become homeless.

The guy who took me to an autumn outdoor art show where he was exhibiting his paintings on a brisk autumn day. Man, it was cold.

The guy who took me to a Minnesota Twins baseball game in the summer. Man, it was hot.

I remember a couple of best friends. We weren’t friends long—but it was long enough.

The friends who supported Sena and me on our wedding day. I still remember it with gratitude 47 years later.

And looking at the flowers helps.