aging – Go Retire Psychiatrist

Hearing an Old Song

I have to admit that I’ve been mis-hearing some of the lyrics of one of my favorite songs, “Lean on Me” for the past fifty-odd years since Bill Withers wrote it. It stayed on the top of the charts for more than 3 weeks back in 1972. That was a special time in my life; and not an easy one.

Back then, you couldn’t just look up song lyrics or anything else for that matter on the world wide web. It didn’t exist yet. I’ve always been prone to mondegreens and I finally found out that I was hearing something different in the verse:

“Please swallow your pride

if I have things (faith?) you need to borrow

For no one can fill

those of your needs

That you won’t let show”

Just to let you know, I found lyrics in one YouTube that substituted the word “faith” for “things”. Think about that one. I don’t know how to settle it, so if anybody knows which word is right, please comment. Anyway, it’s a little embarrassing and revelatory that I heard “…if I have pain…” instead of “…if I have things (or faith)…” And I never really heard “…That you won’t let show.”

Yet I lived it.

Years later, after I’d finished college, medical school, residency in psychiatry, and had taught residents and medical students at the University of Iowa for a number of years, one of my colleagues, Scott, a brilliant psychologist and writer, stopped by my office one day. This was years ago.

His name is Scott and he suggested that it would be nice to get together sometime soon to catch up. I deferred and I remembered he replied while looking off down the hallway, “I’m 70.” I wonder if he meant he didn’t know how much more time he had left.

Scott and I had taken similar paths in the middle of our careers at Iowa. I wanted to try private practice and left for Madison, Wisconsin. Scott got the same idea and left for a position in Hershey, Pennsylvania. We both regretted it and soon after returned to Iowa. I swallowed my pride and came back because I loved teaching. I think he returned for the same reason. We were both grateful that the UIHC Psychiatry Dept. Chair, Bob Robinson, welcomed both us of back.

I touched base with Scott a little while ago. We’re both retired. I was trying to find out how to contact Bob about messages I was getting from the publisher of our consult psychiatry handbook. Neither Scott or I could find out what was going on with Bob, who retired several years ago and moved back East. It turned out he had died. Sometimes we all have sorrow.

Scott is my friend, and I leaned on him a long time ago. I’m unsure if I let it show. I’m 70 and I’m grateful to him.

On that note, I’m finding out that I can’t walk all the way to the mall and back anymore. On the other hand, I can walk about half that distance. It’s about a mile and a half out to the Clear Creek Trail and back. There’s a lot of uphill and downhill stretches along the way. I can manage that.

And Sena bought me a couple of pairs of new shoes that I’m breaking in that will probably be easier on my feet and my calves. They’re Skecher slip-ons, not to be confused with the no hands slip-ins. I’m used to slip-ons. I tried one pair out today, in fact. Before I left, I took a few pictures of Sena’s new garden. As usual, she’s planting new flowers. The dogwood tree looks great. She’s even excited about the wild phlox. I can’t keep track of everything else out there. She makes the beauty out there.

And I lean on her for that.

Coping with Old Farthood By Teaching Patience to Others

I get notices from the Iowa legislators about how great it is that I’m getting to be an old fart. An Iowa senator even reminded me: “Check your driver’s license to see if it’s time to renew!”

That’s one of the few things I’m up to “speed” on—see what I did there?

Other things remind me that I’m getting older. I walk slower. I can make several miles by walking out to the mall, walking up and down inside, and walking back. I made 5 miles yesterday.

Here’s the thing; I don’t powerwalk and, for the first time, I made a couple of stops along the way to rest. I’ve never done that before. Part of the reason is that, early this spring I had a bout of painful shin splints and calf cramps which took me a week to recover from. I wrote a very long blog post about that.

This time, before I set out for home, I was sitting inside and watching people outside. The bench I sat on faces the parking lot and a street runs along just outside of it. There’s a crosswalk visible from my bench.

As I gazed out at the parking lot, I saw one blue SUV with the two doors on the driver’s side wide open, making it impossible for anyone to park in the lane next to it. One elderly gentleman wearing a cap sat shotgun and appeared to be napping. A few minutes later, a woman with an unsteady gait made her way out to the car. She moved slowly and a few times I though she might topple over. She didn’t look very old, and she might have been younger than me, but not by much. She got in the back seat behind the napping man. The two side doors remained open.

A few minutes later, an old man with a wheeled walker came out of the mall and started to cross the street. He would push the walker forward a couple of inches at a time and then sort of drag his legs a couple of steps forward. He pushed the walker forward a couple of inches, and shuffled a couple of steps behind it; that’s the way he went. As I watched him, I wondered if I was going to have to hurry out there to help because I thought he might fall any second.

I actually took my eyes off him for a few minutes and when I looked back, I couldn’t see him in the crosswalk anymore. I figured he made it across, but then I noticed that the SUV was still sitting there and both driver’s side doors were still open. I peered around the crosswalk—and he was still scraping along, inching forward a few inches at a time. Drivers would have to either wait or back up and find another route.

He just kept creeping along. I think it took him all of 15 minutes just to get to the SUV, a distance that could have been measured linearly as not much more than 20 yards or so.

I remember wondering where and who the driver was. There were two seats left and I thought “No way is he the driver!” The driver must have still been in the mall somewhere.

As I sat there, the old man inched over to the SUV and finally made it. I almost could have taken a nap during the whole journey, but I’m not quite that old yet.

Then he opened the driver’s side back side door—and shoved his walker in the back seat! There was now only the driver’s seat open, and still no driver in sight.

And finally—the old guy got in the driver’s seat! He pulled up his trousers, started the SUV, backed carefully out of the parking lane and cruised smoothly out of the parking lot and away to who knows where, maybe a dance hall.

After I recovered from incredulity, I walked back home. I sat down to rest once before trying to across the street where, a month ago I had a sudden attack of calf cramps which nearly stopped me in the middle of the crossing. At that time, I had to hobble over to a bench and massage the cramps before heading the rest of the way home.

This time, as cars waited for me to get across, I could feel the cramps starting again but I slowed down instead of trying to trot across. I thought, “They’ll just have to wait.” No cramps this time.

Maybe that’s one of the reasons the state legislators send out cards and certificates to seniors. We help teach patience to others. You’re welcome.

One Legged Clowning Again

I noticed the other day that I was having trouble doing the one leg stand. It has been getting harder to sustain it past 10 seconds even. It’s not like I’ve been laying off exercising, including the one leg stand. Hey, I can even do a one leg sit to stand (barely). I posted about the one leg stand, including a video, about 2 years ago.

I found another news item and study about old farts like me and it included a new recommendation about the one leg stand. According to this study, if you can’t do a one leg stand for more than 5 seconds, you’ve got one leg in the grave. If you can do 30 seconds, then you’re all good.

So, I practiced a little more and I even tried the one leg juggling trick, which I also tried two years ago—and clearly faked on a video. Well, one leg clowning is back—and this time it’s for real. I think the Latin quote Ars Longa, Vita Brevis fits for this activity. This one leg stand thing is a skill and you have to work at it, even as you age and your life grows shorter.

I still don’t know if this would be called aging gracefully?

References:

Rezaei A, Bhat SG, Cheng CH, Pignolo RJ, Lu L, Kaufman KR. Age-related changes in gait, balance, and strength parameters: A cross-sectional study. PLoS One. 2024 Oct 23;19(10):e0310764. doi: 10.1371/journal.pone.0310764. PMID: 39441815; PMCID: PMC11498712.

Araujo CG, de Souza E Silva CG, Laukkanen JA, Fiatarone Singh M, Kunutsor SK, Myers J, Franca JF, Castro CL. Successful 10-second one-legged stance performance predicts survival in middle-aged and older individuals. Br J Sports Med. 2022 Sep;56(17):975-980. doi: 10.1136/bjsports-2021-105360. Epub 2022 Jun 21. PMID: 35728834.

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.

Feisty and So On

There’s this dialogue in Men in Black II between Serleena and Zed:

Serleena: Zed, look at you, 25 years and you’re still just such a looker.

Zed: Cut out the meat dairy. And you, still a pile of squirmy crap in a different wrapper.

Serleena: So feisty.

I’m becoming more aware of the use of the word “feisty” in reference to so-called “older” persons. That’s because I’m getting older.

I noticed an article on the use of patronizing words for older persons. A couple of other such words are “spry” and “sharp.”

“Sharp” as in sharp as a tack (for his age, of course). Also, as in sharp enough to know today’s date.

“Spry” as in he is spry enough to get into and out of a chair.

I’m also spry enough on most days to do under the leg and behind the back juggling tricks.

I’m still sharp enough to know the difference between respectful and patronizing.

I guess that makes me feisty.

All About the Potato Salad

I recently got a checkup for my retinal tear surgery about 4 months ago. My surgeon was pleased with the outcome. Partly based on my good outcome, he shared that he was guiding his trainees on the wisdom of not necessarily always going with the new surgical procedures for the disorder, which happens not infrequently in those over the age of 50.

In fact, the trend seems to be to do more than just the oldest operation, which is the scleral buckle, in favor of adding vitrectomy as well—a relatively newer approach. I got the scleral buckle.

Progress is good. But just because something is old doesn’t mean it’s outmoded.

We saw the Iowa State Fair episode on old farm machinery the other night. It showed how much progress has been made in farming over many years. However, those old machines replaced a lot of hard labor, so they were definite improvements back in the day.

You can learn something new and valuable by considering what is old. We saw a short film called The Foursome. On the surface, it’s about 4 old guys who have played golf together at an annual tournament for 50 years in Waukon, Iowa. Waukon is in the Northwest part of the state, close to the Mississippi River, which borders the eastern side of the state.

The show is not really about golf, of course. But before it came on, I almost decided not to watch it because of that misconception. The description gives it away, saying that it’s about friendship, small towns, golf—and potato salad.

I think it’s also about getting older. Not everybody ages gracefully and I’m including myself as a pretty good example. I’m not so sure about my memory or my hearing these days. I can stand on one leg for 20 seconds. But one day not too long ago I cracked an egg and instead of emptying the contents into the poaching pan, I dumped them on a paper towel on the countertop. I was mortified.

Sena covered for me and brushed it off, saying it was because we had been talking about the finer points of poaching eggs and I just got distracted, and some hogwash about how she’s done that too. Maybe.

In the film, one of the Foursome was showing some of the artwork he has on the walls at his home. He stopped at one and seemed to fall into some kind of reverie. The camera operator had to sort of whisper to the guy that he needed to move on.

Let’s change the subject and talk about potato salad. They filmed the wife of one of the guys making this potato salad, the recipe for which you can get for free on the web. She used Miracle Whip instead of Mayonnaise. I pointed this out to Sena, who said nothing. Miracle Whip has been around since the 1930s and I grew up eating it on sandwiches at home. I favored it over Mayonnaise.

There has not been a jar of Miracle Whip in our house in almost 45 years—which is how long we’ve been married. I have learned to like Mayonnaise.

This reminds me of one segment on the film showing the wife of one of the other guys shopping for food (including burgers, chips, and whatnot as well as potato salad fixings) for the cookout, a part of the annual golf outing for the four guys. She said it really didn’t matter what she got because “They’ll eat anything you put in front of them.”

Some of them will eat nothing but the potato salad.

There is something poignant about the irascibility alternating with poignancy in the film. Their friendship is deep enough to move one of the four guys to tears. At least that’s what it looked like.

They have the usual flaws men have, including the tendency to be stoic in the face of oncoming frailty and the specter of death.

I don’t know if I’ll age as well as they do. But I do know I will never take up the game of golf. And I wonder if you can substitute Mayonnaise for Miracle Whip in that potato salad.

One thing I’m sure of, Sena is my best friend.

Countdown to Hot Water Heater Replacement

Well, even though our hot water heater was temporarily fixed, there is no guarantee that it won’t fail again between now and later this week. That’s when we’re scheduled to have the new water heater installed

That will cost approximately 10 billion dollars. This item will be the major selling point for our house because we’ll have to sell it immediately in order to move to the poor house.

We have insurance of course. We know what our deductible will be, although we’re not exactly sure how much the insurance company will pay. Maybe they’ll want to know whether we tried to “fix” the water heater first.

Technically, we did that although it could go out again during a shower. That could mean a trip to the emergency room for treatment of rapid hypothermia including surgical removal of icicles from various bodily orifices.

There may be an upside to that. Flash freezing could mean we could preserve ourselves for the future when scientists figure out how to slow down or even stop the aging process.

In fact, that reminds me; Sena saw a news item indicating that there may be a class of medications called “senolytics” that could allow humans to live up to 200 years.

The article doesn’t say what kind of shape you’d be in around that age. What are the implications for retirement age? Would that have to be postponed until you’re over a century old? What would it be like to be that old? Maybe we could ask certain entertainers who are making a living in Branson, Missouri.

How much would senolytics cost at the pharmacy? Probably about 10 billion dollars per pill.

How about extending the working life of water heaters?

Hey, How About Them Nielsen Surveys?

Hey, how ‘bout them Nielsen’s surveys? I can’t remember getting any Nielsen media rating surveys before I retired and I’ve gotten two of them since then. They send you a crisp, new dollar bill in the mail to entice participation. More likely, it elicits guilt. You’d return the dollar bill but not in the mail, would you? Is this some kind of rite of passage or what?

Technically, you’re not supposed to talk about whether or not you participated in the survey, but I saw one blogger’s post about his radio diary survey. Is there a penalty for admitting you’re a part of “Nielsen Family”? Are there Nielsen Enforcers who come to your house and break your kneecaps while listening to the Godfather soundtrack through their earbuds if you don’t obey the rule?

One white commenter thought Nielsen just targets old white guys for some reason. Then a black commenter pointed out that Nielsen mails the surveys to old black guys too, so it didn’t have anything to do with skin color—and he did it with a sense of humor. He speculated that Nielsen might just target grouchy old retired guys with strong opinions because we remember what the value of a dollar bill was back in the day.

It reminded me of what I used to listen to on the radio in my younger days. Back then, the radio was what you had to use to listen to music. Well, there was a TV music show called American Bandstand, hosted by Dick Clark. The format was pretty much young couples dancing to the latest tunes while the camera panned over the dancers randomly. I remember watching it one day and noticing the camera was moving a lot less randomly and kept focusing on a young blonde woman in the crowd in the middle of the dance floor. That is, it did until she made a very lewd gesture which immediately led to a return to very random camera meandering—and possibly higher Nielsen ratings.

I listened to the radio a lot when I was a kid. One of the local radio stations was KRIB, which the announcer always pronounced “K-OW-I-B because he talked so fast. Many of the songs were bad, so bad that a humorist named Dave Barry published a book about it in 1997, Dave Barry’s Book of Bad Songs. He’s a Miami Herald newspaper columnist who has written a lot of funny books. I had nearly all of them at one time, including the bad songs book. I have only a few now, including an autographed copy of one about getting older, Lessons from Lucy (2019).

One of the worst songs in my opinion was a 1976 tune “Blinded by the Light” by Manfred Mann’s Earth Band. It’s actually a cover of a song by Bruce Springsteen. I kept hearing a lyric I definitely thought was “wrapped up like a douche,” which I swear I never shared with anybody nor looked up on the web (or as Dave Barry would say, “I swear I am not making this up.”) until just today to discover I’m far from the only person to hear that. I also found out that kind of error is called a “mondegreen” (a mishearing of a phrase in a way that gives it a new meaning). The actual lyric was “revved up like a deuce.” That was the kind of bad song Dave Barry wrote about—although I don’t remember that specific song being in his book.

Nowadays I listen to KCCK (88.3 FM) for blues and jazz. Years ago, I used to listen to Da Friday Blues show starting at 6:00 p.m. every Friday. It was hosted by John Heim, who is still doing the show, even after a devastating accidental neck injury which left him paralyzed from the neck down a few years ago. He was hospitalized at The University of Iowa and his family and friends donated a lot of money to help him get to a rehab center in Omaha, Nebraska. John actually retired from teaching in 2004, but has been a DJ at KCCK for years because music means so much to him. He’s a brilliant example to retirees everywhere.

There’s a lot more to radio than Nielsen ratings, no disrespect to Nielsen Families everywhere—and just a reminder, I have no kneecaps worth breaking.

Spring

I’m coming up on my last 3 days for the academic year and reflecting now that my favorite season is upon us. Spring does that to me, especially now that I’ve been in the phased retirement contract for the last 2 years. I’ll be going into the 3^rd and final year as of July.

I just found out that next week I’ll be among those faculty members selected to receive the Excellence in Clinical Coaching Award from the Gradual Medical Education Office at the Leadership Symposium.

I’ve received teaching awards from the residents at graduation time (another sign of spring!) over the years and I’m always grateful for their recognition. The Excellence in Clinical Coaching Award is recognition from my department as a whole, the members of which put together a nomination package including letters from department leaders as well as trainees.

I’m also humbled by it because I’ve learned a lot from everyone with whom I’ve had the privilege of working, but my favorites are the trainees, including medical students. In fact, I learned from them again in the last week or so. Three talented medical students gave outstanding presentations about issues relevant to all physicians, not just psychiatrists.

They will be excellent physicians. They will teach others. They will lead and it’s a good thing—medicine needs them.

I like the coach idea. I know one of the internal medicine residents thought of me as a mentor. I’m aware of the differences between mentors and coaches as well as the similarities.

Coaches spend relatively less time with learners and the focus of the relationship is usually a set of specific skills which needs to be passed on. Mentors tend to develop longer term relationships and guide learners in broader ways in terms of career goals and more.

However, both mentors and coaches serve as role models, something all teachers do—including trainees.

That’s partly why I feel less troubled about retiring as my time to leave draws nearer. I trust the next generation of doctors and, just like the Supremes song says, “You better make way for the young folks.” It’s my time to leave. It’s their time to live.

Even the birds know that.

Patience is a Virtue Redux

This transition to retirement has me looking back at times to an earlier transition in my life—college. I wrote a blog post 8 years or so ago about a few of my experiences at Huston-Tillotson College (now Huston-Tillotson University, a private, historically African American school) in Austin, Texas. We called it H-T for short. The post was entitled “Patience is a Virtue.”

You have to remember, this was in the ‘70s. A lot has changed, including me. The blog post is going to be different now.

I’m not what you’d call a patient person by nature although I’m much older and patience comes easier nowadays. Patience is arguably the physician’s most valuable asset, so it was worthwhile for me to work at cultivating it. We’ve all heard that doctors start yapping almost before patients are through talking.

I’m still learning to be patient. I think I first realized that people thought I was impatient when I was a freshman at H-T. They were right; I just didn’t know it then.

I remember a day when I was pretty annoyed about some remarks a peer made during a class in Black History (we were still “black” in those days). After class, I vented about it with the teacher, Dr. Lamar Kirven, who was also a Major in the military. We called him Major Kirven.

We loved Major Kirven. He had a wonderful sense of humor and laughed along with us when we had to tell him we just could not read his indecipherable scrawls on the blackboard. We didn’t have PowerPoint—and I don’t think it would have helped him.

Anyway, Major Kirven listened without saying a word during my long diatribe. I’ll never remember what that nonsense was all about; it doesn’t matter now.

He listened deeply and, at the time it didn’t occur to me to be surprised about that. I was too busy liking the sound of my own opinions. Several times he could have interrupted and justifiably corrected me.

He didn’t. He waited until I was finished.

And then, very gently he said, “Brother Amos, patience is a virtue”. It suddenly struck me that he had been very patiently listening to a very impatient young man’s philippic about the shortcomings of everyone but himself for almost a half hour before he made that brief observation.

I’ve been trying to be more patient. Along the way, I’ve discovered and rediscovered the truth of a statement that has often been attributed to Stephen Covey,

“With people, if you want to save time, don’t be efficient. Slow is fast and fast is slow.”
Stephen Covey

There’s a lot that goes into being an effective psychiatric consultant, not the least of which is the skill of transforming “That’s all I can do” into “I will do all I can.” That’s usually a lot easier if I listen patiently to what my colleagues, my trainees, and my patients want.