Go Retire Psychiatrist

Music and Change Go Together

We listened to the Big Mo Blues Show last night on KCCK radio 88.3. It was recorded and we noticed that he sounded younger for some reason. Once he remarked that things were difficult because of having to “shelter in place.” The format of the show was different from usual.

That made me wonder if the show was recorded sometime during the Covid pandemic. I’ve been listening to Big Mo for a long time. John Heim, aka Big Mo, been doing the Friday Blues show since about 2005, according to one news story. Another KCCK legend, Bob DeForest, has been doing the Saturday night blues show for over 30 years now.

John Heim, aka Big Mo is still going strong. I think I’ve been listening to his show for about as long as he’s been doing it. He has come back strong since an accidental fall in 2018 in which he sustained a neck injury which led to a long rehab stint. But he’s back.

There have been interesting additions over time, like the Shout-Outs, the Concert Calendar, the Bodega Bay Weather Report, the Big Mo Pod Show in which he and producer Noah on Saturday discuss the music selections he made on Friday. The comedy bits have also been interesting, like MayRee’s hand-battered catfish (It’s better because it’s battered!).

Last night, we heard a couple of songs which we both liked. One of them was “She Don’t Live Around Here” by Samantha Fish. I heard it for the first time on the Big Mo Blues Show and just about every time I hear it, the hair on the back of my neck stands up. I’ve read that music will do that sometimes, although I can’t remember getting that sensation before.

We both liked Delbert McClinton’s rendition of “I’ve Got Dreams to Remember.” He’s had a huge career. Sena asked me if he’s still alive and I foolishly guessed that he died. Nope, he’s 84 years old and evidently still going strong.

I have a personal top ten songs, most of which I’ve heard on the Big Mo Blues Show. They’re not in any particular order. A few of them I like mainly because of the artist’s voice, like Samantha Fish and James Carr.

“She Don’t Live Around Here” Samantha Fish

“The Dark End of the Street” James Carr

“Everyday Will Be Like a Holiday” William Bell or Eric Clapton

“Lean On Me” Bill Withers or Keb Mo

“Mockingbird” Larkin Poe

“I’ve Got Dreams to Remember” Delbert McClinton (written by Otis Redding)

“You Were Never Mine” Delbert McClinton or Janiva Magness

“A Change is Gonna Come” Sam Cooke

“Over The Rainbow and What a Wonderful World” medley Israel Kamakawiwo’ole

“You Can’t Teach An Old Dog New Tricks” Seasick Steve

Lately, Big Mo has played Larkin Poe’s “Mockingbird” a fair number of times. I think one interpretation of it is that people’s sense of their identity tends to evolve over time. At different times in your life, you’ll take on a new voice, so to speak, which fits with the idea of the many songs the imitative Mockingbird sings.

Some songs I like because of the message, like “Lean On Me,” or “A Change is Gonna Come.” And I like the song “You Can’t Teach An Old Dog New Tricks” just because I identify with it. I realized that runs counter to the theme of many songs, which are often about change: people change, the times they are a’changing, and the like. So, my top ten song list will probably change, too.

Certification of Old Fart Status by Iowa House of Representatives

Well, thank you very much, State Representative Adam Zabner, for recognizing me as an old fart as you prefer to call it, which is fine with me.

I received a similar honor several years ago, from State Representative Dave Jacoby, who was much more prolix in his remarks on my certificate.

A long time ago, I kept a blog when I was a consulting psychiatrist in the University of Iowa Health Care Dept of Psychiatry. I used to mention occasionally that someday those who recognized my greatness would raise a statue of playdoh to me in the Quad.

Funny thing is I don’t know if the Quad even exists anymore. I supposed the statue could be raised (and perhaps later razed when people finally catch on) somewhere else, in a place much more prominent given my eminence, possibly at the state house in Des Moines or outside Pagliai’s Pizza here in Iowa City at least.

I’ll admit frankly, age does bring with it some of the usual markers: deepening wrinkles, receding hairline, fading memory and the like. There are some advantages, such as the tendency to joke and tell little stories of the distant past (chariot races and so on). This helps to bore younger persons enough for them to move out of line at the ice cream shop so that I can move up.

And I still exercise vigorously, lifting the salt and pepper shakers, crossing and uncrossing my legs on the ottoman, walking back and forth between the chair and the fridge, and power napping.

Seriously, I’m still juggling, which I took up about two and a half years ago. I exercise but not too much. A while ago I had an issue with my quads getting so big they were flopping over my knees so I had to cut back a little.

I don’t know that I’ll get many more certificates of senility from the Iowa House of Representatives. That makes it even more important for somebody to get to work with all possible speed on my playdoh statue.

Why Did China Tell President Trump His Tariff Strategy is a Joke?

The title of this post, which is admittedly the lead-in to a lame joke, is inspired partly by the news headlines today and partly by an essay, “Laughter: Better Than a Sharp Stick in Your Eye,” I found on The University of Iowa’s Well-Being at Iowa website. The author, Megan Gogerty, MFA, BA has some pretty sharp opinions about laughter being the best medicine. It’s not always the best.

Anyway, Reuters carried the story “China raises duties on US goods to 125%, calls Trump tariff hikes a ‘joke’,” by Joe Cash and Yukun Zhang, accessed April 11, 2025.

China is pretty upset. So, why did China tell President Trump his tariff strategy is a joke? Because they don’t get it.

Just half-kidding there; actually, I think that might be President Trump’s reply, but I really don’t understand tariffs. That’s probably why I also had trouble with the economist joke below:

Why did the Keynesian psychiatrist get fired? He told his patients to spend their way out of depression.

I found this joke on a YouTube by Jacob Clifford, an economics teacher. I didn’t get the joke, so I repeatedly replayed it because I couldn’t understand the first part. That’s because I didn’t know anything about Keynesian economics. It turns out that it’s based on the belief that proactive actions from the government (like spending) are the only way to control the economy. Get it? Neither do I but it was the only economy joke I could find that included a psychiatrist on a quick internet search.

Here’s twenty economics jokes from Jacob Clifford. They’re pretty lame, but then so is most of the political news.

How About That Goldwater Rule?

I’ve been looking over some of the web articles on the Goldwater Rule, which is the APA Ethics Committee guideline enjoining any psychiatrist from making public psychiatric armchair diagnoses of public or political figures without a formal evaluation or permission to conduct one. It was originally made in 1973, years after Fact Magazine in 1964 sent out a questionnaire to psychiatrists asking for their public opinions about the mental stability of then candidate Barry Goldwater who was running for President against Lyndon B. Johnson. Many thought he was psychotic, although there was no evidence for that. Goldwater won a lawsuit against Fact Magazine, which led to the publisher going out of business. It was a big embarrassment for psychiatrists, which contributed to the creation of the Goldwater Rule.

Over the last few years and currently, many psychiatrists question whether the Goldwater Rule should be revised and abolished, making it permissible for psychiatrists who believe they have a duty to warn the public about political leaders they think might be a threat to national security, specifically President Donald Trump.

I’ve found a few articles on the web which helped me think about my own position about this. McLoughlin says the Goldwater Rule should change, but doesn’t tell us how. Glass calls the Goldwater Rule a “gag rule” and tells us why it should change. He resigned from the APA in protest. Ghaemi and others don’t agree on whether the Goldwater Rule should change, and one discussant says the rule only applies if you’re a member of the APA. Blotcky et al tell us how it could change, using sample conversations between reporters and psychiatrists.

I lean toward Blotcky et al. In fact, the final paragraph gives psychiatrists another way to express their opinions to the public. They can give them as private citizens without calling them professional judgments—which is their right.

On the other hand, if you want to know about my psychiatric interview of President Trump, you can see it below.

Mr. President, you have signed an affidavit allowing me to conduct a thorough psychiatric assessment today.

Yes, Dr. Amos, that’s correct.

Can you tell me why an Autopen was used to sign it?

I decline to answer that question on the grounds it may incriminate me.

Have you ever undergone a psychiatric assessment before?

Yes, but I had to fire her when she started asking questions about tariffs.

Very well, then. Can you tell me a little about your childhood?

It was perfect—as long as the other kids paid their tariffs.

Oh. Was there ever a time in your life marked by any problems with having access to the basic necessities of life?

Well, there was one thing. Water pressure was sometimes low, which is why I just wrote an Executive Order ensuring that low water pressure in faucets and showerheads will never again in my lifetime or yours be a problem. Make American Faucets Gush Again (MAFGA).

Thanks, I’m sure. Tell me, how would you typically go about solving an interpersonal conflict between you and others?

Raise tariffs by 300%.

I see. How about talking to people with whom you disagree?

I would say, “You’re fired.”

Would you try anything else first?

I would try tariffs.

Well, I think we’re done here. Thank you for your time, Mr. President.

Of course, this was satire.

References:

McLoughlin A. The Goldwater Rule: a bastion of a bygone era? Hist Psychiatry. 2022 Mar;33(1):87-94. doi: 10.1177/0957154X211062513. Epub 2021 Dec 20. PMID: 34930051; PMCID: PMC8886301.

Nassir Ghaemi, MD MPH.The Goldwater Rule and Presidential Mental Health: Pros and Cons – Medscape – Jun 07, 2017.

Glass, Leonard A. The Goldwater rule is broken. Here’s how to fix it. Stat News. June 28, 2018.

Blotcky, Alan D., PhD; Ronald W. Pies, MD; Moffic, H. Steven, MD. The Goldwater Rule Is Fine, if Refined. Here’s How to Do it. Psychiatric Times. January 6, 2022. Vol. 39, Issue 1

University of Iowa Will Lead NASA Space Mission to Learn the Music of the Spheres

The big news for University of Iowa will be a NASA satellite mission to investigate how solar wind interacts with Earth’s magnetosphere. You can read the whole fascinating story in this issue of Iowa Magazine.

According to the story, “twin spacecraft known as TRACERS—Tandem Reconnection and Cusp Electrodynamics Reconnaissance Satellites—will begin their journey to study Earth’s mysterious magnetic interactions with the sun. The satellites will be packed with scientific instruments along with two small, but meaningful, tokens.”

The two small tokens happen to be purple guitar picks that belonged to University of Iowa physicist, Craig Kletzing, who died from cancer in 2023. Kletzing and colleagues got a $115 million contract from NASA for TRACERS. It’s the largest research award in University of Iowa history.

Kletzing played guitar in a few bands, and one them was named Bipolar—which is the only connection to psychiatry that I could see. He was dedicated to work in basic science, and he was often heard to ask “How can we make this simpler?” referring to chunking big scientific challenges into manageable goals. He was a rare person in that he was both a brilliant scientist and a great teacher. One example of his work ethic was that he skipped a meeting with NASA’s top brass in order to deliver a morning lecture on introductory physics to 275 students.

The members of the UI TRACERS team call the project “Craig’s mission.” I’m pretty sure he would have called it a team effort “… to help scientists better understand the powerful forces harmonizing throughout the universe—something the ancient Greeks described as the music of the spheres.”

And that’s what the purple guitar picks represent.

Members of the Human Club

I just read Dr. Moffic’s column, “Join This Club for Mental Health” in which he described the Clubhouse movement which got started in the 1940s to help those with mental health challenges to cope with their illness and, more importantly, to recover, grow, and achieve success in life.

It made wonder if there are any chapters of the Clubhouse model in Iowa. It turns out there is and it’s Carol House in Davenport, Iowa. It’s connected with the Vera French Mental Health Center. Its namesake is Carol Lujack, who was a member when the center was called “The Frontier Community Outreach Program” in the 1980s in downtown Davenport.

I was looking at the Carol Center website where you can find many interesting features of the people and activities that go on there. The April newsletter is fascinating and funny. You can find out in the April Newsletter about a few of the current members, April holidays (there’s a slew of them), and famous quotes. One of the quotes is familiar and it’s by F. Scott Fitzgerald,

“Vitality shows not only in the ability to persist, but in the ability to start over,” The quote is worded in various ways, but I remember it because I used it as an inspirational quote when The University of Iowa honored me and several of my colleagues with a Feather in Your Cap award back in 2011.

This was shortly after I returned to Iowa after an unsuccessful stab at trying private practice psychiatry in Wisconsin. And it was the second time I did that—the first time was in Illinois.

Did you know that April is National Humor Month? And have you heard the joke “What kind of candy is never on time?” Choco-Late.

One April holiday is not mentioned and that’s Arbor Day, which varies according to what part of the world you’re in as planting times differ. Sena planted a couple of new trees in the back yard.

Starting new chapters of Clubhouse is a little like planting new trees. They need watering.

SAINT Therapy for Treatment Resistant Depression at The University of Iowa

First of all, if you looked up Saint therapy for depression, you might have accidentally found information on Saint Dymphna, the Catholic patron saint of those living with mental illness.

Actually, SAINT stands for Stanford accelerated intelligent neuromodulation therapy. It’s a personalized protocol for using transcranial magnetic stimulation (TMS) to treat severe depression. The University of Iowa is the first academic center to offer it in the Midwest.

This is a big step forward from the days many years ago when we were starting use right unilateral electrode placement for applying electroconvulsive therapy (ECT) to treat depression because it was thought to lead to fewer cognitive problems post-treatment.

SAINT is a game changer according to Dr. Nicholas Trapp, MD, assistant professor of psychiatry, who describes it as a method to pinpoint the best location in each patient’s brain to target with TMS to treat major depressive disorder. The procedure is quick and recovery from depression can be sustained for months.

Kudos to The University of Iowa. And maybe thanks to Saint Dymphna.

The Goldwater Rule and The Golden Rule

I read Dr. Moffic’s column today about the challenge in finding a rational solution to the objections many psychiatrists have to diagnosing President Donald Trump with a psychiatric disorder, despite the Goldwater Rule against doing that in any public forum.

Dr. Moffic points out that the high emotions aroused on both sides of the political aisle by the president has resulted in proposed legislation by Minnesota republican lawmakers to create a novel psychiatric diagnosis, Trump Derangement Syndrome (TDS), which may justify revising the Goldwater Rule, allowing psychiatrists to go public with diagnoses of President Trump.

I suspect that the TDS law was provoked by the conflict between democrats and republicans about the president. In fact, one of the Minnesota lawmakers has basically admitted that the bill was a prank by calling it “…tongue in cheek…” On the other hand, if this is just frustration between politicians, then I would expect that the whole thing might have been dropped a couple of weeks ago.

Yet, the bill still stands, albeit without any movement forward to committee. One of the authors, Senator Glenn Gruenhagen, has posted a comment on Facebook on March 17, 2025 (the day the bill was introduced), indicating that he knows democrats “…will never allow this bill to pass anyway, so take a breath and calm down.”

Can we do that, please? A good start might be to withdraw the bill.

I also saw a news story posted by The Guardian on March 26, 2025, quoting a New York City Child Psychiatrist, Leon Hoffman, MD, suggesting that the Goldwater Rule is too often broken, and, in response to the TDS gambit, that it might be preferable “…to develop a comparable national rule prohibiting political personnel, both elected and appointed, from creating psychiatric diagnoses as a tool against their political opponents.” Would anyone like to second that emotion?

You can’t just legislate restraint, respect and kindness in public or private discourse. Policies and laws can lay the groundwork for the eventual development of tolerance and maybe even acceptance of others. The Goldwater Rule is too often broken. The Golden Rule is too often broken as well.

Thoughts on the X-Files Episode “Humbug”

So, I was watching the X-Files episode, “Humbug” last night and it got me wondering about the meaning of the word “nature.” The character, Dr. Blockhead says “Nature abhors normality.” Of course that reminded me of a similar quote attributed to Aristotle, “Nature abhors a vacuum.”

You can read the short Wikipedia summary of “Humbug” and comments about how Otherness philosophy (perceiving oneself as distinct from others in order to form one’s own identity) figures into the story contrasting sideshow freaks with the conventional FBI agents Mulder and Scully. The episode is funny, which is one reason why I like it. It sheds a little light on the way humans treat each other (and potentially, extraterrestrials?) in terms of their genetic, cultural and other differences.

I found another connection to “Humbug” in, of all places, a WordPress blog post from 2017 entitled “Fiji Mermaid,” written by an artist who relocated to America from Scotland many years ago. The Fiji Mermaid was featured in “Humbug.” It was a humbug (fake mermaid) made up of the head and torso of a monkey stitched to the tail of a fish. Commenters actually mention that it reminded them of the X-Files episode, which the artist enjoyed, partly because she’s interested in the history of sideshows and freaks.

I also read an interesting news item about the definition of nature in terms of the relationship between humans and the rest of the natural world. That led me to check on the definition of the word.

Until recently, the word “nature” was defined in the Oxford English Dictionary (OED) as “The phenomena of the physical world collectively; esp. plants, animals, and other features and products of the earth itself, as opposed to humans and human creations.”

The updated OED has additional definition, which is “More widely: the whole natural world, including human beings.”

I think one of the points of “Humbug” is that humans are a part of nature and we are hard at work mutating it. One of the characters, Dr. Blockhead, criticizes it:

“Twenty-first century genetic engineering will not only eliminate the siamese twins and the alligator-skin people, but you’re gonna be hard-pressed to find a slight overbite, or a not-so-high cheekbone. You see, I’ve seen the future, and the future looks just like him! (points to Mulder).”

“Nature abhors normality. It can’t go for long without creating a mutant.”

You can understand the word “nature” to refer to both humans and the natural world outside of us, possibly to other galaxies. It also makes me wonder who defines what is normal. That leads to social and political factors which complicate everything. I guess that could be why Dr. Blockhead says the reason why nature abhors normality is a mystery—and should remain so.

On the other hand, if it weren’t for the natural human drive to ask questions and explore, the mystery of the cause of polio would have remained a mystery and the iron lung would still be in use.

But Will Black Garlic Ward Off Vampires?

Sena got some black garlic, which many people are enthusiastic about and call a superfood. There is a very long Wikipedia article with over 180 references about its beneficial health effects. The authors are very enthusiastic about it. Like many superfoods, it has a lot of support from many people.

There’s a slew of claims about what black garlic can do for you, from supporting immunity to preventing cancers and dementia.

There are some caveats. It can thin your blood, so those already taking anticoagulants should use caution about eating a lot of it.

Ahmed T, Wang CK. Black Garlic and Its Bioactive Compounds on Human Health Diseases: A Review. Molecules. 2021 Aug 19;26(16):5028. doi: 10.3390/molecules26165028. PMID: 34443625; PMCID: PMC8401630.

It’s been used for hundreds of years in Asia although it sounds like a brand-new food. It’s fermented over several weeks, which gives it the dark color.

It’s black and the taste is on the sweet side. If you just found it on the sidewalk, you’d step around it because it looks like animal poop. It has a gummy bear texture.

I didn’t see any testimonials mentioning how black garlic does in preventing vampire attacks.

It’s good in chili.