science – Go Retire Psychiatrist

Groundhog Day Finally Explained

Well, by now everybody has heard the official news about what Punxsutawney Phil saw this morning since it’s Groundhog Day. On the other hand, the unofficial news is this: for some reason he saw extraterrestrials instead of his shadow. I know about it only because a drunken official calling me from the Pentagon spilled the beans to me and abruptly hung up just before he passed out.

Apparently, they were looking for a decent rib joint, which they’re always on the lookout for after traveling halfway across the galaxy.

You have to question the ETs preference for using so much fuel and creating missing time and hallucinations for thousands of people gathered for this time-honored and totally bogus event which the editors of The Old Farmer’s Almanac repeatedly try to debunk in a futile attempt to educate us about the seasons.

What almost nobody knows is that recently declassified government documents obtained by Brer Rabbit has led to the discovery of yet another conspiracy to hoodwink the American people about the ETs preoccupation with finding the best BBQ rib joint in the galaxy, which is genetically linked to their inability to distinguish humans from woodland creatures whose only real purpose in life is to dig holes in the ground so they can secretly write books circulated only amongst groundhogs about how silly it is for humans to call them ridiculous names like “whistle pigs.”

The truth is groundhogs know perfectly well how the seasons change and it has nothing to do with them—it’s all about the tooth fairy. But…ETs can’t handle the truth, as Col. Jessup has repeatedly pointed out in countless memes and gifs over the years.

We can only hope this deplorable state of affairs will be rectified when scientists eventually back engineer and reverse the polarities of the device (which is, trust me, stored in a cardboard box in a garage in Area 51) ETs use to hypnotize the criminals amongst their own kind into endlessly flying around in their souped up Tic-Tac UFOs in the absolutely pointless search for the perfect rib joint—all because the ET leaders can’t come up with a better solution to close the gaps in their worthless criminal justice system.

I hope I have made all this clear. Happy Groundhog Day!

Verdict on Kale Salad

Well, Sena served the cranberry kale salad today, along with a hearty vegetable soup. If I had not known that the kale was in the salad, I would not have noticed anything unusual about it.

In fact, the salad was pretty good, although truth be known, the kale was mixed together with so many other veggies and Dijon salad dressing, I wouldn’t have known it was in there.

So, I’m obligated to share the article about kale I read yesterday when I was complaining about kale salad. It’s chock full of vitamins but has hardly any calories.

And it doesn’t turn you into an extraterrestrial.

Another Silly Bill in the Iowa Legislature

I saw a story in the Iowa Capital Dispatch by Robin Opsahl today that there’s a bill in the Iowa legislature which seeks to make the drugs ivermectin and hydroxychloroquine over-the-counter (OTC) in Iowa. It doesn’t actually specify the reason why but it’s probably because some Iowans want the drugs available to treat Covid-19. I think the motivation sounds similar to the bills introduced in March of 2025 which were designed to make it illegal to get mRNA vaccines for Covid-19 in Iowa. They both died in funnel week last year.

The bill was discussed yesterday and, while there were 3 commenters in favor of it, there are several reasons to be suspicious of whether it would be a good thing for Iowans. Both ivermectin and hydroxychloroquine were studied for evidence of efficacy for Covid-19 and the studies failed to show that.

The FDA has made it clear that it doesn’t recommend either ivermectin or hydroxychloroquine for treatment of Covid-19.

However, the Iowa bill HF 2056 seeks to make both available OTC and require pharmacies not only make it available but protect the pharmacist from legal or criminal liability for any harms that might result from its use.

While you can find news stories saying simply that 4 states (Tennessee, Idaho, Arkansas, and Idaho) have adopted similar laws, there is at least one recent follow up news story indicating that the pharmacists still have some reservations.

A Boise, Idaho pharmacist says he’ll dispense ivermectin to callers—as long as they have a doctor’s note. Most callers don’t have a parasitic infection. The pharmacist points out that, while the Idaho law says he can dispense ivermectin without a prescription, the FDA hasn’t approved it to be used this way. “It’s not designed or packaged for retail sale,” according to the pharmacist. It’s not made for OTC use.

There’s also a hitch when it comes to health insurance coverage for OTC drugs, implying you might have to pay out of pocket. Arkansas and Tennessee pharmacists say that, despite the law change allowing OTC sale of ivermectin in their states, they won’t sell it that way.

I hope their example will be followed by the other states who seem to be going the same way as Iowa. On the other hand, I’m pretty sure there might be plenty of conscientious objectors in Iowa who might slow down the legal push to get either hydroxychloroquine or ivermectin OTC.

Just because lawmakers put in a lot of language in a bill in an effort to persuade pharmacists that they won’t get sued or go to jail if they always give the customers what they want doesn’t mean they’ll obey a law based on misinformation and which makes them disobey their principles. I don’t understand how the legislative machinery works but I’m hoping the fate for this bill will be the same as what happened to those from last year.

Thoughts on Martin Luther King, Jr. Day

Today being Martin Luther King Day, I’m reminiscing a little about my short time as a student at Huston-Tillotson College (one of this country’s HBCUs, Huston-Tillotson University since 2005) in Austin, Texas. It’s always a good idea to thank your teachers. I never took a degree there, choosing to transfer credit to Iowa State University toward my Bachelor’s, later earning my medical degree at The University of Iowa.

However, I was a reporter for the college newspaper, The Ramshorn Journal. That’s where the featured image comes from.

Although I didn’t come of age at HT, I can see that a few of my most enduring habits of thought and my goals spring from those two years at this small, mostly African-American enrollment college. I learned about tenacity to principle and practice from a visiting professor, Dr Melvin P. Sikes, in Sociology (from the University of Texas) who paced back and forth across the Agard-Lovinggood auditorium stage in a lemon-yellow leisure suit as he ranted about the importance of bringing about change.

He was a scholar yet decried the pursuit of the mere trappings of scholarship, exhorting us to work directly for change where it was needed most. He didn’t assign term papers, but sent me and another freshman to the Austin Police Department. The goal evidently was to make them nervous by our requests for the uniform police report, which our professor suspected might reveal a tendency to arrest blacks more frequently than whites.

He wasn’t satisfied with merely studying society’s institutions; he worked to change them for the better. Although I was probably just as nervous as the cops were, the lesson about the importance of applying principles of change directly to society eventually stuck. I remembered it every time I encountered push-back from change-resistant hospital administrations.

As a clinician-educator I have a passion for both science and humanistic approaches in the practice of psychiatry. Dr. James Means struggled to teach us mathematics, the language of science. He was a dyspeptic man, who once observed that he treated us better than we treated ourselves. Looking back on it, I can see he was right.

Dr. Lamar Kirven (or Major Kirven because he was in the military) also modeled passion. He taught black history and he was always excited about it. When he scrawled something on the blackboard, you couldn’t read it but you knew what he meant.

And there was Dr. Hector Grant, chaplain and professor of religious studies, and devoted to his native Jamaica. He once said to me, “Not everyone can be a Baptist preacher.” He tried to explain that my loss of a debate to someone who won simply by not allowing me a word in edgewise was sometimes an unavoidable result of competing with an opponent who is simply bombastic.

Dr. Porter taught English Literature and writing. She also tried to teach me about Rosicrucian philosophy for which she held a singular passion. Not everyone can be a Rosicrucian philosopher. But it prepared the way for me to accept the importance of spirituality in medicine.

I didn’t know it back in the seventies, but my teachers at HT would be my heroes. We need heroes like that in our medical schools, guiding the next generation of doctors. We need them in a variety of leadership roles in our society. Most of my former HT heroes are not living in the world now. But I can still hear their voices.

Paranormal Productions: The Skunk Ape

Last night, I watched what I thought was a brand-new episode of Josh Gates’ series, Expedition X. It was titled “Beast of the Everglades” and it was about the skunk ape in the Florida everglades. Turns out the show originally aired in 2024, so I’m a little behind. You might want to watch it first before reading this post, because I’m going spill the lima beans about it.

Expedition X is all about chasing cryptids and in this episode the quarry is the skunk ape in the Florida. The skunk ape is a Bigfoot which desperately needs deodorant because it stinks to high heaven. Right from the beginning of the show, I thought of Dave Barry’s book, Best State Ever. A Florida Man Defends His Homeland. It was published in 2016. I used to have nearly every nonfiction book he published up until several years ago.

The aptly named relevant chapter in Barry’s book is “The Skunk Ape.” The book and the TV show intersect in the guy who sort of invented the story of the skunk ape, Dave Shealy, because his video of the cryptid is shown on the show and is widely available on the internet. He has a bit part in the show. He and the co-star Heather Amaro talk about the skunk ape briefly and he does have a piercing gaze, just as Barry describes in his book. Barry’s photo of Shealy in the book shows him wearing a pair of high boots—and he wore the same boots on the show. He didn’t talk about using lima beans as bait to attract the skunk ape on the show but he told Dave Barry about having used the vegetable.

That reminds me of the highly evolved and fancy technology that the stars, Phil Torres and Heather Amaro used in the show. Phil used a really cool, high-tech slingshot to shoot scent balls infused with the stink of 3 different animals (skunk, wild boar, and bear) into the brush to attract the skunk ape. It’s a lot more impressive than tossing out lima beans.

They also used a very expensive looking drone with a camera and caught video of something which looked to them like it was hustling across the marshes on two legs. I thought it looked like it was on four legs, but what do I know about drone video footage?

On the show, Phil and Heather found a few stinky nests which they suspected or at least wondered whether the skunk ape built and sat in. One or two of them I think were in tree tops although the trees were not that tall. I wondered about the relatively small size of the nests, given that the large size of the skunk ape—about 7 feet tall and over 400 lbs. (so, about the size of a typical NFL lineman), if I remember correctly (if that matters). It looked like the nest was about the size of a baby’s car seat.

There were small skeletons in it and one of them Phil identified as a baby alligator gar. That’s a prehistoric-looking animal resembling an alligator. They can grow to massive size. The little one was probably a snack which the skunk ape munched on while watching reruns of My Favorite Martian on the little portable TV, which was on the fritz at the time Phil checked. There were no lima beans in the nest, which means the creature cleaned its plate, which was neatly stacked with others in the tiny dishwasher.

Primates will eat stuff like that, according to a local animal expert on the show. But he politely speculated that the animal bounding across the everglades in Shealy’s video moved more like a person than an ape.

Phil got a few hairs from the grass out in the swamp, which was tested for DNA. It came back human. But since humans and apes share more than 98% of their DNA, that means the skunk ape legend remains intact.

Replace Sycophantic AI with Marvin the Paranoid Android?

I found the perfect JAMA article explaining that sycophancy is programmed into Artificial Intelligence (AI) therapy chatbots.

This reminded me of Marvin the paranoid android (“Life! Don’t talk to me about life!”) in the book series “The Hitchhiker’s Guide to the Galaxy” by Douglas Adams. Marvin is an incredibly depressed robot who would never make a good psychotherapist.

There’s even a Facebook page listing someone posts of questions to ChatGPT about non-inspirational quotes from Marvin.

If programmers can make sycophantic AI therapists, there should be a way to make them less sycophantic. For more specific information, you can check out this relatively recent article published in Psychiatric Times by Dr. Allen Francis, MD and Justin Angel, a tech expert. I would probably substitute the term “confabulation” for “hallucinations” in most places where you read the latter.

Saw a Banded Red-tailed Hawk in Our Back Yard!

I got a picture of a banded Red-tailed Hawk today in our back yard. It was pretty exciting. I can’t remember ever seeing one banded. I’ve gotten pictures of them occasionally, most recently before this in July, 2025. That one wasn’t banded.

I checked on the web for any reports of who might be tagging Red-tailed Hawks in Iowa. In recent months there have been a few sightings posted on social media sites. Other birds are being banded as well. There are people who are licensed by the United States Geological Survey (USGS) to tag birds.

The Hitchcock Nature Center in Pottawattamie County is located in Honey Creek, Iowa, which is near Council Bluffs.

The Iowa Raptor Project is involved in conservation, education, and rehabilitation of birds of prey.

OK, until I saw this video, I admit I thought the snipe was an imaginary bird, an idea I got from the movie “Up.”

Confabulation in Artificial Intelligence

I saw an excellent post on Artificial Intelligence (AI) in Dr. George Dawson’s post today, “The Problems With AI Are More Readily Apparent.” He mentions AI producing confabulations which are sometimes called hallucinations in AI. I distinguish hallucinations from confabulations because the former are sensory or perceptual problems while confabulations are making things up. In dementia, confabulations are often described as attempts to fill in gaps in knowledge or memory without any intention to deceive.

I sometimes read that AI is being sycophantic in its interactions with humans, which sounds a little strange to me. The definition of sycophancy is more about trying to please someone else by being obsequiously flattering. It’s puzzling but I have gotten that impression from AI, yet it’s a machine and I don’t know how anyone would program AI to be sycophantic because it’s a human trait.

On the other hand, I got a comically sycophantic reply from AI to my question inquiring about the definition of Calvinball Cribbage. It’s just a made-up term and, to be fair, I’ve also gotten bluntly frank denials from AI that there is any such thing as Calvinball Cribbage.

As a reminder, Calvinball is a term that arose from a comic strip called Calvin and Hobbes. In the strip, the characters invent a game called Calvinball and the only rule is making up the rules as you go along, although there is a goal of capturing your opponent’s flag. But you can’t play it the same way twice.

The most recent hilarious AI confabulation I’ve previously posted about was when Sena and I played our game of 11-card cribbage. There are cribbage players out there who make fun of such variations from standard 6-card cribbage and the name for it from one such player was “Calvinball crib.” My simple question was as usual, “What is Calvinball Cribbage?” The reply is copied below:

“Calvinball Cribbage is a humorous mashup of the chaotic, rule-free game from Calvin & Hobbes with traditional Cribbage, often involving themed boards or rule modifications, where the core idea is applying Calvinball’s fluid, make-it-up-as-you-go spirit to Cribbage’s scoring and play, adding wild, non-sensical rules like using mallets, changing hand values, or scoring points for silly actions, making each round unique and unpredictable, not a single defined game but a creative approach to Cribbage.

What it is (The Calvinball Aspect):

No Fixed Rules: Just like original Calvinball, there’s no single set of rules; the players invent them as they go.
Rule Changes: A key rule is that rules can’t be repeated, and players constantly invent new scoring, actions, or penalties.
Props & Actions: You might use mallets, balls, trees, or make up actions like “scoring three points for pointing at a cloud” or “losing a turn for looking left”.

How it Applies to Cribbage:

Themed Boards: You can find or make custom cribbage boards featuring Calvin & Hobbes, adding visual flair.
Modified Scoring: Instead of just points for pairs and runs, you might add a “Hobbes Bonus” for a specific card or penalize for “too much logic”.
Strategic Chaos: Players still play cribbage (cards, pegs, crib), but the gameplay is constantly disrupted by invented rules, turning strategic plays into potential jokes or absurd victories.

Example Calvinball Cribbage “Rules”:

“If you play a 7, you must hop on one foot until your next turn”.
“The crib gets 5 points if it contains a card with a face on it” (referencing Calvin’s drawings).
“A ‘skunk’ is achieved by making your opponent laugh out loud”.

In essence, Calvinball Cribbage is about injecting unpredictable fun and silliness into the structured world of cribbage, making it a game of spontaneous creativity rather than strict strategy. “

This could be an example of sycophantic confabulation because almost all of it was probably cooked up by AI from scanning my blog posts about the subject. What’s a little eerie about it is that I never published any specific rules or strategies about the fictional game of Calvinball crib. You can actually find and purchase a Calvin and Hobbes cribbage board from a shop in Canada.

While this is an example of the occasional comicality of AI, that shouldn’t lead us to deny that it can do scary things, some of which Dr. Dawson describes. My early experiences a couple of years ago with what used to be called Google Bard were somewhat alarming because it confabulated then. And it still does.

Connections Between Psychiatry, Artificiality and Blues Music?

I heard a song on the KCCK Big Mo Blues Show that I first heard in June of 2025. The song is “Artificial” by Walter Trout.

At first blush, I agree with what I think is the point of the song, which is basically a protest against artificiality which could manifest in a range of ways from superficiality and dishonesty in communications, attitudes, style of clothing, relationships, and all the way to Artificial Intelligence (AI).

The other connection I make is to the artist himself. Walter Trout developed Hepatitis C (eventually leading to liver transplant) according to a Wikipedia article which connected his lifestyle to contracting the disease. In my role as a consultation-liaison psychiatrist, I saw many patients with Hepatitis C who were referred to psychiatry from gastroenterology.

I was the main psychiatrist who evaluated them for treatment with Interferon-alpha. At the time it was the only treatment for Hepatitis C and was frequently associated with many side effects including depression. I was also one of the psychiatrists consulted as part of liver transplant evaluations.

Trout got very sick from Hepatitis C and made a remarkable (even miraculous) recovery after his liver transplant. Interferon is no longer used to treat Hepatitis C. It has been replaced by direct-acting antiviral (DAA) agents. They’re much better-tolerated and more effective.

The other aspect relevant to Trout’s song is ironic. The newest scientific literature supports the idea that AI can be helpful for diagnosing Hepatitis C, predicting its progression and response to treatment.

That doesn’t mean I’m completely sold on AI.

Aside from that, there’s interesting research suggesting that there may be a link between schizophrenia and bipolar disorder and Hepatitis C infection (which could be hiding deep in the brain’s choroid plexus lining the cerebral ventricles). In other words, some people might have mental illness because of the liver disease itself.

If you think about the dictionary definition of the word “artificial,” you can hardly dismiss this kind of research as insincere.

Exercise to Relieve Depression?

I’m sure you’ve seen the recently published articles on the web encouraging people to try exercising to treat depression. The articles rely on a new systematic review by the Cochrane Database, which you need to carefully interpret—not necessarily the whole paper; you could just skip to the bottom line in the Authors’ Conclusions:

“Authors’ conclusions: Exercise may be moderately more effective than a control intervention for reducing symptoms of depression. Exercise appears to be no more or less effective than psychological or pharmacological treatments, though this conclusion is based on a few small trials. Long-term follow-up was rare. The addition of 35 RCTs (at least 2526 participants) to this update has had very little effect on the estimate of the benefit of exercise on symptoms of depression. If further research is to take place, it should focus on improving trial quality, assessing which characteristics of exercise are effective for different people, and exploring health equity.”

Clegg AJ, Hill JE, Mullin DS, Harris C, Smith CJ, Lightbody CE, Dwan K, Cooney GM, Mead GE, Watkins CL. Exercise for depression. Cochrane Database Syst Rev. 2026 Jan 8;1(1):CD004366. doi: 10.1002/14651858.CD004366.pub7. PMID: 41500513; PMCID: PMC12779368.

As usual, though, several science news web sites talk it up as though it were a big deal. They usually do that at the top and then gradually toward the end of the story they slowly start to confess the truth about the limitations of the review.

I think this type of story could be called filler. It’s content that doesn’t really tell you anything new or earthshaking and most of the time it’s just to fill space left over from the bigger stories.

It’s almost like snake oil. Initially it sounds really good but you know the old saying: If it sounds too good to be true, it probably isn’t true.

This reminds me of my early career as an assistant professor of psychiatry at The University of Iowa. My superiors thought it was a great idea for me to give a major presentation (and it might have even been an Internal Medicine Grand Rounds) about adjustment disorders. I admit I was a new guy and somebody had to talk about something that non-psychiatrists might misdiagnose as a major mood or anxiety disorder.

There’s really not a whole lot to say about how to treat adjustment disorders, but it’s important to distinguish them from other major mood and anxiety disorders. That’s not to say adjustment disorders are unimportant. They can cause considerable distress and even some impairment. By and large, clinicians don’t often recommend treating adjustment disorders with medication, although there are exceptions. The diagnostic criteria are pretty clear. Psychotherapy is often the preferred intervention.

On the other hand, exercise could be one way to address the discomfort of some of those who struggle with adjustment disorders.