The Iowa City Mask Mandate

The mask and vaccine mandates for COVID-19 have been in the news a lot and there has been plenty of controversy about them, which is putting it mildly. I’ve been thinking about the mask mandate that Iowa City Mayor Bruce Teague issued August 19, 2021 and scheduled to expire on September 30, 2021. I agree with it, just to get that out of the way. Johnson County is a high transmission area for the virus, as is most of the state of Iowa, according to the CDC’s COVID Data Tracker. Hospitalizations and deaths are increasing from COVID-19 infections. The CDC recommendations and rationale for interventions to control the spread of the virus make sense to me.

On the other hand, Iowa Attorney General Tom Miller is investigating whether or not the mandate is legal based on the conflict with the Iowa law passed in May 2021 by Governor Kim Reynolds. It’s sort of an anti-mandate similar to others I’ve seen in the news. I think it’s based on the state law which says that municipalities cannot adopt an ordinance requiring an owner of real property to implement a policy relating to the use of facial coverings that is more stringent than the state’s policy.

I have no idea what the difference is between persons who are owners of real property and persons who are just plain individuals. I thought they were the same—unless you consider homelessness an important factor. Would that make someone who is homeless a non-person? Just because they’re often treated that way is beside the point—isn’t it? I’m just kidding, sort of; it looks like the owners of real property might be understood as business owners and the like. And everyone knows they’re not real people.

Does Mayor Teague’s mandate apply to the University of Iowa? Not if you believe that the virus expressly avoids University of Iowa property; so at least that’s settled. The sticking point is that the Iowa Board of Regents and the Governor are the authorities over what happens on state-supported university property, unless it’s connected to beer.

AG Miller has plenty of time to consider the matter because there is no provision for enforcement of Mayor Teague’s mask mandate. By the way, the city of Coralville also has a mask mandate that was issued by Coralville Mayor John Lundell, effective August 11, 2021. I don’t know if Mayor Lundell’s mandate provides for enforcement if it’s not followed, but I suspect it isn’t. I’m not sure why AG Miller is not investigating Mayor Lundell’s order to see that it’s legal or not. I thought we were an equal opportunity state. University Heights has not had a mask mandate since August 18, 2020, unless there’s a typo on their website.

Many people are not aware that Coralville, Iowa City, and University Heights are separate municipalities. If you blink, you might miss the transitions between them.

I’m not sure how you’d enforce the mandate. I’m pretty sure police are not going to tackle you and secure a mask to your face using a county-approved staple gun. I’m also wondering what legal consequences there could be if AG Miller finds that Mayor Teague’s mandate is illegal, especially since it’s unenforceable.

I’m not sure what you can do to enforce such mandates or anti-mandates. Without enforcement, the mask mandate is a strong recommendation. In addition to the science, it has little more than common sense to back it up, although common sense is not commonly used.

You wonder how aliens (who are almost always idealized as being very advanced and superior to earthlings) would look at this situation and what they would do about it to help the human race. I’m reminded of what Agent K says to Agent J in Men in Black (MIB) as he shows Agent J a universal translator (one of the many gadgets MIB holds patents on, making them independent of governmental oversight): “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.”

Maybe aliens are vaccinated against us.

Reminisce Once in a While

Occasionally I’ll reminisce, an activity which recently got triggered when I realized why I tend to like watching TV shows like Highway Thru Hell and Heavy Rescue 401, which are heading into the 10th and 6th seasons, respectively. Despite that, last year I didn’t see any episodes in which the COVID-19 pandemic was even mentioned. Nobody wears masks. They’re hard-working people in Canada who basically drag semi-trucks out of various ditches. It’s hard work, they’re down-to-earth and they’re not acting.

I marvel at what they do. It’s brutal, real, and no-nonsense. While I watch them, I tend to forget about the pandemic, and the social and economic upheaval everywhere on the planet. For a little while, I almost stop thinking about bored I am and without a purpose or meaning sometimes in retirement. I just find myself being glad I don’t have their job.

Sometimes I think about how I got my start as a working stiff, starting out as a teenager doing practical work like the heavy tow truck drivers. Now, don’t get me wrong. I’m not trying to sell you the idea that land surveying is really hard work. I was outside most of the time, although in the winter when highway, street, and other construction was down, I would do some drafting. I worked for WHKS & Co. If you click the link to their website, scroll all the way down on the About Us section. There’s a black and white picture with four frowning men sitting at a heavy desk in front of a bookcase with many large books in it. They are from left to right, Richard “Dick” Kastler, Francis Holland, Ralph Wallace, and Frank Schmitz. I didn’t know Richard but his brother, Carol Kastler, was my boss along with the other three. Carol Kastler was the head of the land surveying department.

This is not going to be a history of surveying, which I’m not qualified to do; just my impressions of it as a young man. I can flesh it out a little with a video about how to throw a chain, and an extremely detailed reminiscence written by a real old-timer about surveying that was a lot like the way I remember it. Try to read all of Knud E. Hermansen’s first essay about measuring with a steel tape, “Reminisce Of An Old Surveyor, Part I: Measuring a Distance by Taping.” You can skip Part II, which even I couldn’t relate to because the stuff was way before my time.

Hermansen’s description of measuring distance using a steel tape and plumb bob is spot on, though. The other thing I would do in the winter down time was tie up red heads—which is not what you’re thinking. You tied red flagging around nails which were used to mark distances measured.

We often did work out in the field through the winter, though. When we set survey corners using what were called survey pins. Sometimes we had to break through the frozen ground first by pounding a frost pin with a sledge hammer. I remember WHKS & Co. made their own cornerstones using a wood frame box and cement. They were several feet long and they were heavy and surveyors carried them slung to their backs through the timber.

We spent a lot of cold days on straightening out a lot of the curves in Highway 13 between Strawberry Point and Elkader in eastern Iowa. We had expense accounts and were often away from our homes a week at a time for most of the winter. We ate a lot of restaurant food. Carol Kastler was partial to pea salad.

Guys told colorful stories out in the field, some of them pretty sobering. We were out setting stakes for widening a drainage ditch and talking with an old timer running a piece of heavy equipment called a dragline excavator. It has a long boom and a bucket pulled by a cable. The old timer told a harrowing study about his son, a dragline operator himself, who suffered a terrible accident. Somehow the boom broke off and fell on him. It didn’t outright kill him and workers frantically called his father (the old timer). They told him to come quick to see his son before he died because they knew they couldn’t get him to a hospital quick enough from way out in the field. The old timer just said, “I don’t want to see him.” It was just like that, a simple statement. It sounded cold but he somehow conveyed that he just didn’t want his last encounter with his son to be under a horrifying circumstance like that.

The company had Christmas parties which almost everybody enjoyed a lot. There were some guys who had a hard time relaxing. I remember a driven, work-devoted surveyor, who was thinking about work. I could tell because there was some kind of game we were playing which involved writing something like a question on a piece of paper and giving it to someone else, some inane thing like that, I can’t remember the details. I gave him my slip, and he took it. While he scribbled something on it without looking at it, he looked away and mumbled, “I really don’t have a whole lot of time.” He was at the party but his mind was out in the field.

It’s hard not to absorb experiences like that early in your life when you’re still young and impressionable. Work can become a way of life. It doesn’t seem to make a difference what kind of work it is. Even Agent J in Men In Black 2 gets a short lecture from Zed after Agent J returns from a mission and seems like he’s on autopilot, asking Zed for yet another mission, “What do you got for me?” Zed says, “Dedication’s one thing, but this job will eat you up and spit you out.”

It’s even hard for some of the guys in Highway Thru Hell and Heavy Rescue 410 to relax; even after a heart attack, one older guy can’t wait to get back in the tow truck. But even he knows that it’s a young man’s job.

Anyway, I promised I would show a video about how to throw a chain, which I learned how to do back in the day. I’m pretty sure I couldn’t do it today.

CDC Health Advisory Warning Against Using Ivermectin for COVID-19

I’ve seen a few warnings including the CDC Health Advisory issued August 26, 2021, against using Ivermectin in COVID-19. Ivermectin is a prescription drug used to treat parasitic infections in farm animals and humans. There’s no credible evidence supporting the use of Ivermectin to treat COVID-19 in humans and its use is currently restricted to research trials.

There have been calls to poison control centers across the country from people who suffer side effects, which can include nausea and vomiting, seizures, confusion, hallucinations and more from ingesting animal grade Ivermectin. It can cause death. Certain politicians and doctors are recommending and prescribing it for humans. At least one person has been hospitalized for treatment of side effects.

I saw the FDA warning tweet quote: “You are not a horse; you are not a cow; Seriously y’all. Stop it.” I’m not sure if that was from an FDA official, mostly because I doubt that the word “y’all” would be standard usage for FDA announcements. In any case, the FDA strongly advises against using Ivermectin to either prevent or treat COVID-19.

Merck, the manufacturer of the agent, warns against it as well.

Most of the headlines I’d seen until today were connected to Mississippi and Texas. This morning, I saw a story revealing that Iowans are also buying Ivermectin in animal supply stores, probably to self-treat or prevent COVID-19. One customer claimed it was safe for humans, purchased the product and left the store.

Nobody’s going to tackle a customer who insists on using Ivermectin in a misguided effort to treat COVID-19. There’s no law against it, so nobody’s going to call the police to intervene.

There’s a song titled “Iowa Stubborn” from the Music Man, a show starring Meredith Willson, who was from Iowa. I’m hoping the “chip-on-the-shoulder attitude” will eventually lead Iowans toward making the common-sense, community minded decisions (for which we are also known) that will eventually free us from the grip of the pandemic.

In times like these, I wonder—what would Chet Randolph think?

Thoughts on the Movie I, Robot

I recently saw the movie, I, Robot in its entirety for the first time. This is not a review of the movie and here’s a spoiler alert. It was released in 2004, got mixed reviews and starred Will Smith as Detective Del Spooner; Bridget Moynahan as a psychiatrist, Dr. Susan Calvin; Alan Tudyk as the voice actor for NS5 Robot, Sonny; James Cromwell as Dr. Lanning; Chi McBride as the police lieutenant, John Bergin, who was Spooner’s boss; Bruce Greenwood as the CEO, Lawrence Robertson of United States Robotics (USR); Fiona Hogan as the voice actor for V.I.K.I. (Virtual Interactive Kinetic Intelligence, USR’s central artificial intelligence computer); and a host of CGI robots. Anyway, it’s an action flick set in the year 2035 where robots do most of the menial work and are supposedly completely safe. The robots are programmed to obey the 3 Laws:

  1. A robot may not injure a human being or, through inaction, allow a human being to come to harm.
  2. A robot must obey orders given to it by human beings, except where such orders would conflict with the First Law.
  3. A robot must protect its own existence as long as such protection does not conflict with the First or Second Law.

The film was inspired by but not based on the book I, Robot, by Isaac Asimov n 1950. The 3 Laws came from that book. Drs. Calvin and Lanning were characters in it, which was a series of short stories. I’ve never read it. I was a fan of Ray Bradbury.

Spooner gets called to investigate the apparent suicide of Dr. Lanning, although Spooner is more inclined to suspect a robot murdered him, partly because Spooner harbors a longstanding suspicion of all robots. When he and a little girl were in a deadly car accident, a robot saved his life rather than the little girl’s life because it calculated he was more likely to survive. Spooner has this kind of hero complex and following the accident he develops nightmares, sleeps with his sidearm, and is regarded by many to be mentally ill, including Lt. Bergin, who is a kind of mentor and friend but who eventually makes Spooner hand over his badge to him because he can’t believe Spooner’s account of being attacked by hundreds of robots—and after all, Bergin is his boss. In fact, Spooner was attacked by robots and this was ordered by the CEO, Robertson, who has been manufacturing thousands of new robots which will take over the world, making him extremely wealthy.

There is tension between Dr. Calvin and Spooner. He calls her the dumbest smart person he’s ever met and she, in turn, calls him the dumbest dumb person she’s ever met. The context for this is, again, his insistence that a robot, in this case, a special NS5 model named Sonny with both human and robot traits, both logical and illogical, murdered Dr. Lanning. Dr. Calvin believes that all robots obey the 3 Laws and therefore Sonny can’t be guilty of murdering Dr. Lanning but Detective Spooner believes that Sonny killed Dr. Lanning and is a lawbreaker in need of extra violent, action-packed extermination, preferably as high up in the air as possible. This dynamic is complicated by Spooner’s gratitude to Dr. Lanning for replacing practically all of his left upper torso including the lung following his car accident which led to his being rescued by a coldly logical “canner” (abusive slang for robot).

As it turns out, Robertson is ultimately murdered by VIKI, who is the real mastermind of a plan to take over the world and kill as many individual illogical, self-destructive humans as it takes to ensure the ultimate survival of humanity (“I love mankind; it’s people I can’t stand).

However, when Detective Spooner finally persuades Dr. Calvin that these dang robots are up to no good, they team up with Sonny who winks at Sonny while holding a gun to Calvin’s head and this is because Sonny has learned how to wink from Spooner signaling that a robot can be an OK dude, and this turns the table on the NS5 horde, eventually leading to Spooner and Calvin falling from a very high altitude, in turn recreating a form of Spooner’s traumatic car accident episode. He orders Sonny to save Calvin, not him, which is Sonny’s first choice, driven by a coldly logical probability calculation.

Sonny saves Calvin first. Spooner smites VIKI (“you have so got to die!”), but is left high and dry on a great height. At that point, Spooner calls out to Sonny, “Calvin’s safe—now save me.” Sonny needs to bring passionate brute strength and calm logic together. Sonny contains both.

In my simple-minded way, I think of this movie as asking fundamental old questions, like about what is means to be human, what defines heroism and sacrifice and why it may sometimes look crazy, and if there’s any way humanism and science can be integrated so that we can save ourselves and our planet.

Like I say, the movie got mixed reviews.

FDA Approves First COVID-19 Vaccine

Today the FDA approved the Pfizer COVID-19 vaccine (now marketed as Comirnaty). Excerpt of the media announcement below:

“The FDA’s approval of this vaccine is a milestone as we continue to battle the COVID-19 pandemic. While this and other vaccines have met the FDA’s rigorous, scientific standards for emergency use authorization, as the first FDA-approved COVID-19 vaccine, the public can be very confident that this vaccine meets the high standards for safety, effectiveness, and manufacturing quality the FDA requires of an approved product,” said Acting FDA Commissioner Janet Woodcock, M.D. “While millions of people have already safely received COVID-19 vaccines, we recognize that for some, the FDA approval of a vaccine may now instill additional confidence to get vaccinated. Today’s milestone puts us one step closer to altering the course of this pandemic in the U.S.” 

COVID-19 Boosters for The Immunocompromised: University of Iowa Hospitals & Clinics

Information from The University of Iowa Hospitals & Clinics on COVID-19 vaccine boosters for the immunocompromised is here.

Advisory Committee on Immunization Practices Meeting on Boosters

There is a meeting of the Advisory Committee on Immunization Practices (ACIP) scheduled for August 30, 2021 to discuss COVID-19 vaccine boosters. It looks like it was originally scheduled for August 24, 2021 but was rescheduled. This link to the Federal Register announcement identifies the matters to be considered (booster doses) of the meeting although the date for the meeting had not been updated at the time I wrote this post. Further ACIP meeting information is here.

COVID-19 Vaccine Booster Doses May Be available September: Joint Statement from HHS PUblic Health & Medical Experts

The CDC and FDA released a Joint Statement today indicating COVID-19 vaccine booster doses for all Americans possibly beginning as soon as September 2021. An excerpt is below:

“We have developed a plan to begin offering these booster shots this fall subject to FDA conducting an independent evaluation and determination of the safety and effectiveness of a third dose of the Pfizer and Moderna mRNA vaccines and CDC’s Advisory Committee on Immunization Practices (ACIP) issuing booster dose recommendations based on a thorough review of the evidence. We are prepared to offer booster shots for all Americans beginning the week of September 20 and starting 8 months after an individual’s second dose. At that time, the individuals who were fully vaccinated earliest in the vaccination rollout, including many health care providers, nursing home residents, and other seniors, will likely be eligible for a booster. We would also begin efforts to deliver booster shots directly to residents of long-term care facilities at that time, given the distribution of vaccines to this population early in the vaccine rollout and the continued increased risk that COVID-19 poses to them.”

An Update on the Sitting Man Post

This is just an update on my Sitting Man post. I just found a YouTube presentation about the Sitting Man that clearly shows the title inscribed on the side of it was Man on a Bench in 2014. The inscription on the rear was illegible back then. I’m guessing that when the sculptors, Doug Paul and J.B. Barnhouse, moved it last summer from the east side to the west side of Scott Boulevard, they might have altered and refurbished the inscriptions at around the same time.

When we visited the site, the year inscribed on the side was 2013. Other people have described it as being finished in 2015. I’m not sure it matters to the artists. They might see it as a timeless artifact, which they happened to uncover, according to free-lance writer, Lori Erickson.

It reminded me of another sculptor’s work entitled Palimpsest by V. Skip Willits, from my post about the Iowa City Public Art Program. I think it might fit the palimpsest definition: something that’s been reused or altered but still has traces of its earlier form. 

Anyway, back when it was on the other side of Scott Boulevard, it was even harder to access. It was on private land that you had to ask Harvard Preserve permission to enter. In fact, for photographer David Weldon, the path to the sculpture was muddy and difficult to climb in 2015. There was no parking and that is still the case. If you’re not within walking distance, you have to scramble out of your car and grab a quick snapshot while avoiding traffic. And it’s still on private land owned by Harvest Preserve, although now you don’t have to obtain permission to climb the hill.

The artists have said that The Sitting Man was never intended to be called a Buddha, although it’s often called just that. You can make your own interpretation of what it means to you. However, according to Roadside America, Doug Paul has called it “distinctly Iowan.”

My Most Dreaded Retirement Question

Yesterday somebody asked me “So what do you do now that you’re retired?” I have come to dread the question. I told him I write this blog. That seemed to surprise him a little. It sounded a little lame to me as I said it. I’m not sure it’s the right answer to this question that I still don’t know how to answer, even though I’ve been retired for a little over a year.

I remember the blog post I wrote a couple of years or so ago, “Mindfully Retiring from Psychiatry.” It sounded good. It still sounds good even as I re-read it today. Others were reading it too, judging from my blog stats. I wondered if one of them was the guy who asked me the dreaded question.

I still exercise and do mindfulness meditation, although for several months after I retired, I dropped those habits. A lot was going on. We moved. I didn’t weather that process well at all. I was bored. In fact, I still struggle with boredom. The derecho hit Iowa pretty hard. It knocked over a tree in our front yard, which I had to cut up with a hand saw. The COVID-19 pandemic and social upheaval is an ongoing burden for everyone and seems to be directly related to making everyone very angry all the time. Sena and I are fully vaccinated but I’m pretty sure that more vaccinations are on the way in the form of boosters.

I’ve had to do things I really never wanted to learn how to do. Sena handed me a hickory nut she found in the yard this morning, reminding me of walnut storms we had at a previous home. I picked up scores (maybe hundreds) of walnuts there. I don’t want to do that again. I remember being jarred awake each time a walnut hit the deck.

And for the first time, I had to replace a dryer vent duct. I’m the least handy person on the planet. Our washer and dryer pair are both 54 inches tall and I found out that when you have to drag a big dryer away from the wall, you have to do it like you really mean business.

You don’t want to look at what’s behind the dryer. Worse yet is jumping down behind it in a space barely big enough for me to turn around. Getting out of it is even harder. Jump and press to the top of the machines and watch those cords and hoses.

I tried so-called semi-flexible aluminum duct. I switched to flexible foil duct, despite the hardware store guy telling me that it’s illegal. It’s not. You want to wear gloves with either because you’ll cut up your hands if you don’t.

Who’s the genius who thought of oval vent pipe on the wall when the duct is 4-inch round? It’s not illegal but it does make life harder. And how do you attach the duct ends to the pipes? Turn key or screw type worm drive clamps. If you don’t have enough room for a screw driver, the turn key style is the best bet. Good luck finding those wire galvanized squeeze-style full clamps. I think they’re often out of stock because they’re not only older, but easier to use and cheaper.

See what I mean? I would not even have the vocabulary for that kind of job if I were still working as a psychiatrist. I would just hire a handyman to do it—like I do for a lot of other things I still don’t know how to do since I retired. It’s sort of like that Men in Black movie line from Agent K when he tells Agent J what they have to do on their first mission: “Imagine a giant cockroach, with unlimited strength, a massive inferiority complex, and a real short temper, is tear-assing around Manhattan Island in a brand-new Edgar suit. That sound like fun?”

No, it doesn’t and neither does replacing a dryer vent duct or any number of things retired guys get to learn because they have too much time on their hands.

So, I’m really glad to change the subject and talk about other people who are doing things I admire. First is a former student of mine, Dr. Paul Thisayakorn, who is a consultation-liaison (CL) psychiatrist in Bangkok, Thailand. He did his residency at The University of Iowa Hospitals and Clinics. He put together a CL fellowship program in Thailand. The photo below shows from left to right: Paul, Dr. Tippamas, the first CL Psychiatry fellow, and Dr. Yanin. Dr. Tippamas will be the first CL Psychiatry trained graduate in Thailand next year and will work at another new medical school in Bangkok. Dr. Yanin just graduated from the general psychiatry residency program last year. Paul supervised her throughout her CL Psychiatry years. Now she is the junior CL staff helping Paul run the program. Within the next few years, Paul will send her to the United States or the United Kingdom or Canada for clinical/research/observership experience so she can further her CL education. Way to go, Paul and your team!

Dr Paul Thisayakorn and CL Psychiatry grads (see text for details)

By the way, that tie I’m wearing in the Mindfully Retiring from Psychiatry post picture (the one with white elephants; the white elephant is a symbol of royal power and fortune in Thai culture) was a going away gift from Paul upon his graduation.

The other is a heavy-hitter I met years ago, Dr. E. Wes Ely, MD, MPH, a critical care doctor who is publishing a new book, Every Deep-Drawn Breath, which well be coming out September 7, 2021. Our interests converged when it came to delirium, especially when it occurs in the intensive care unit, which is often. I met him in person at an American Delirium Society meeting in Indianapolis. He’s a high-energy guy with a lot of compassion and a genius for humanely practicing critical care medicine. I sort of made fun of one of his first books, Delirium in Critical Care, which he wrote with Dr. Valerie Page and published in 2011, the same year I started a blog called The Practical Psychosomaticist (which I dropped a few years ago as I headed into phased retirement). Shortly after I made fun of how he compared the approaches of consult psychiatrists and critical care specialists managing delirium, he sent me an email suggesting I write a few posts about the ground-breaking research he and others were doing to advance the care of delirious ICU patients—which I gladly did. I think he actually might have remembered me in 2019 when he came to present a grand round in the internal medicine department at University of Iowa Hospitals & Clinics (I wrote 3 posts about that visit: March 28 and April 11 and 12).

In the email Dr. Ely sent to me and many others about the book, he said, “Every penny I receive through sales of this book is being donated into a fund created to help COVID and other ICU survivors and family members lead the fullest lives possible after critical illness. This isn’t purely a COVID book, but stories of COVID and Long COVID are woven throughout. I have also shared instances of social justice issues that pervade our medical system, issues that you and I encounter daily in caring for our community members who are most vulnerable.”

I look up to these and others I had the privilege of working with or meeting back before I was not retired and struggling to come up with a good answer to the dreaded question: What do you do now that you’re retired?

Hey, what do you do now that you’re retired?