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.
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 ‘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.
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 3rd 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.
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.
I suppose you’re wondering why I’ve been saying that my wife has got me this or that item, like the pink dumbbells and whatnot. She also got me an extra yoga mat.
Part of the explanation is that I’ve recently had a birthday, which reminds me of the importance of time in my life–mainly because I have a shrinking supply of it. After all, I’m heading into the sunset of my journey on Earth.
Sunset
Occasionally, I wonder what I ought to be trying to accomplish, if anything.
To achieve great things, two things are needed:
A plan and not quite enough time.
Leonard Bernstein
Bernstein’s quote is encouraging in a way. Hey, I’ve already got half of it–I don’t have enough time. Now all I have to do is achieve some great things.
I could go on the road to promote my idea for a hit song, “Put your hand in the hand of the man with a plan to get a tan, lead a band, roam the land, avoid the bladder scan, zippity do dah shazam.”
All I have to do is come up with lyrics…and a melody…and an agent…and a band…and a voice coach…and some talent.
Now, if I’m going to accomplish something great, it would make sense to keep working on building a more harmonious balance in my everyday life. I’m doing some of that, including regular exercise, mindfulness practice, and healthy eating.
That reminds me, the birthday cake was excellent, especially topped with white chocolate vanilla ice cream.
Every so often, my former mindfulness teacher sends out an email message about the upcoming mindfulness classes. She always includes an inspirational quote, like the one below:
Be a person here. Stand by the river, invoke the owls. Invoke winter, then spring. Let any season that wants to come here make its own call. After that sound goes away, wait.
A slow bubble rises through the earth and begins to include sky, stars, all space, Even the outracing, expanding thought. Come back and hear the little sound again.
Suddenly this dream you are having matches everyone’s dream, and the result is the world. If a different call came there wouldn’t be any world, or you, or the river, or the owls calling.
How you stand here is important. How you listen for the next things to happen. How you breathe.
William Stafford – “Being a Person”
There was also a couple of suggestions for yoga and meditation techniques specifically to help you sleep. I recognized one of them as the body scan. The body scan is one of the first things they teach you in Mindfulness Based Stress Reduction (MBSR).
The body scan invariably put me to sleep, which made me feel like I wasn’t doing it right. Early on in the course, that was not exactly the “goal” of the body scan. Except mindfulness is not exactly a goal-oriented activity.
That’s hard to conceptualize. And so, the other class that is offered to those who make mindfulness practice a regular part of their lives are follow-up groups. It helps reaffirm the regular commitment to practice mindfulness.
I noticed one of the follow-up groups is entitled “Embracing the Paradoxes of Mindfulness.” The description of the course makes the point that mindfulness really isn’t about reaching a goal or achieving great things. It’s about being rather than doing. It’s hard for me to get my head around that after getting into and through medical school, residency, and practicing psychiatry for umpteen years. And now I’m making a transition to retirement.
One of my biggest fears about making and sticking to a mindfulness practice was that I often didn’t think I would have enough time for it. My teacher just advised me that I would simply have to make time.
Maybe I could accept the time I do have left and just be the geezer I am.
Go Retire Psychiatrist 