Attack of the Giant Fried Rubber Chicken Livers!

Have you ever wondered if anyone ever made a movie about an attack on planet earth by fried rubber chicken livers? Boy, am I glad I’m not the only one. I suppose I could check the MeTV channel to if any such film was ever aired by Svengoolie.

What do you mean you never heard of Svengoolie?

I used to watch Svengoolie a long time ago. It’s this guy called Svengoolie, played by Rich Koz, who hosts really awful horror movies. I could watch them for about 10 minutes before I had to switch to something which wouldn’t bore me or make me gag—which I realize often can’t be done nowadays.

Svengoolie would make corny jokes and get rubber chickens thrown at him. That was actually the best part of the show.

Part of what made me think about this was reminiscing about the early 1970s when I lived at the YMCA and worked for a consulting engineer company called WHKS & Co.

You got a single sleeping room at the YMCA and there was no kitchen. Frankly, it was for old guys who had no place else to go and for young guys trying to find out how to go somewhere else.

I ate in cafes a lot. I also picked up a lot of Kentucky Fried Chicken take out. I realize it’s called KFC nowadays. But back in the 1970s you could openly buy a box of fried chicken livers as a side dish at KFC. I think I began eating them because they’re actually a pretty healthy food item if you prepare them right. You could get a generous serving of them. They were occasionally a little tough to chew—a little on the rubbery side.

You can’t get any franchise owners to admit they sell them now. You’ll see web articles that mention you can still get them at what they call certain “regional” stores. You can also maybe still get KFC chicken gizzards. Neither is on any official menu.

The connection here is fried tough chicken livers and bad old horror movies hosted by Svengoolie who makes corny jokes and dodges rubber chickens. I can easily imagine somebody making a throwback classic B Horror movie called “Attack of the Giant Fried Rubber Chicken Livers.”

Wouldn’t that be great?

Try watching Svengoolie sometime. You might not like the movie, but you’ll get a big kick out of Svengoolie.

Maybe We Need a Dose of Humor

Sena and I were listening to the Mike Waters morning radio show (KOKZ 105.7) this morning and his invitation to listeners was to call in and quote their favorite dumb question. One of the callers recited something which was actually a George Carlin joke. Neither one of us thought we heard it right, but it’s the same framework as the joke I found on the web (only the numbers were changed):

“If you’ve got 24 odds and ends on the table and 23 of them fall off, what’ve you got? An odd or an end?”

This is an example of his wordplay humor.

Carlin’s humor was also marked by satire on American culture and politics, the latter of which has gotten pretty rough. You’ll also find references on the web to Carlin’s past history of substance use, which reportedly included psychedelics.

That reminds me of an opinion piece published in the September issue of Current Psychiatry, by the journal’s editor, Henry A. Nasrallah, MD (From neuroplasticity to psychoplasticity: Psilocybin may reverse personality disorders and political fanaticism. Current Psychiatry. 2022 September, 21(9): 4-6 | doi: 10.12788/cp.0283).

I was a little surprised at Dr. Nasrallah’s enthusiastic endorsement of psilocybin for treatment of personality disorders and political extremism. He acknowledges the lack of any studies on the issue. In the last paragraph of his essay is a sweeping endorsement:

In the current political zeitgeist, could psychedelics such as psilocybin reduce or even eliminate political extremism and visceral hatred on all sides? It would be remarkable research to carry out to heal a politically divided populace. The dogma of untreatable personality disorders or hopelessly entrenched political extremism is on the chopping block, and psychedelics offer hope to splinter those beliefs by concurrently remodeling brain tissue (neuroplasticity) and rectifying the mindset (psychoplasticity).

While I’m not so sure about how effective psilocybin would be for this, I’m all for trying something to reduce the “visceral hatred on all sides.”

Maybe humor could be part of the solution. It doesn’t have to be exactly like that of George Carlin. Both parody and satire have been used by many writers for this.

I like the distinction between parody and satire in one article I found on the web. One recent example of satire (or parody; the distinction is sometimes hard to make since the story was listed as “Iowa Parodies”) was in the news and it apparently fooled at least a few people. It was about the Iowa football coaching staff. The title was “Brian Ferentz Promoted to University President To Avoid Having to Fire Him (Satire): The move was deemed ‘a way easier conversation than having him fired’ by the athletic director. It was written by Creighton M, posted September 5, 2022.

I think the story was originally printed without the word “Satire” in the title. I can’t recall seeing the heading “Iowa Parodies” either. A later version of the story added the word “Satire.”

The story might have been about nepotism in the hiring of Brian Ferentz (he’s the son of head coach Kirk Ferentz) as offensive coach. On the other hand, under Iowa law, it was not illegal to hire Brian Ferentz, who in any case reports to athletic director Gary Barta, not Kirk Ferentz.

I suspect the joke had more to do with negative public attitudes about the performance of the Iowa football offense early in the season.

Is it funny? I guess it depends on your perspective. The Iowa football coaching staff probably didn’t chuckle over it. But it more or less fits the definition of satire. It uses humor to expose flaws in the way we behave. And it avoids direct and nasty confrontation, which usually triggers antagonism rather than collaboration. Will it change the Iowa football program? I doubt it. They’re actually doing pretty good so far.

But satire as a strategy to inform and maybe change the public opinion will endure. The Hitchhiker’s Guide to the Galaxy by Douglas Adams is one of my favorite books and it satirizes governments and the foolishness of people. I first learned about The Onion newspaper while we were in the process of relocating to Wisconsin (a short adventure). It satirizes the Associated Press news style.

One of the most uproarious examples of parody is a TV show which is no longer available on cable television but still offered on a streaming service (I think), Mountain Monsters. It’s a hilarious sendup of all the Bigfoot hunter shows.

The added benefit of parody and satire and other such forms of humor is that they are safer than psychedelics—unless your target was born without a funny bone.

Computer Crisis Progress Report

The title of this post is supposedly about progress toward fixing my Dell computer, the one with a mini-helicopter noise in the tower. The Tech drove to my house yesterday from Ouad Cities. He had the parts the Agents ordered for fixing the noise in my PC tower.

The parts were wrong. He drove an hour to get here and was done in about 15 minutes. He looked and listened to the noise before and after removing the case cover. He knew right away it was not a software problem. He ordered the right part and now the next step is for him or another Tech to return on Monday to do the job.

There are Agents and Techs working for Dell. For 2-3 days, Agents pestered me with software shenanigans, even to the point of insisting I reset my PC. Agents never looked at my machine. I sent them the video of the PC and its racket. I’m not sure they listened to it.

I think the Dell Company pays Techs more money than it pays the Agents. That’s probably why Agents spend more time with customers, maybe distracting us with chores like PC resets.

But I’m trying to look on the bright side. The Agents are polite and trying to be helpful. They evidently know a lot about software, which can create problems for which they have a long list of suggestions. The Techs know how computers actually work as machines.

It’s a little like the difference between a couple of the reality TV shows (though the analogy is not exact). Compare the heavy wrecker operators (the tow truck guys) on the shows Highway Thru Hell and Heavy Rescue 401 to the Bigfoot researchers on the show Expedition Bigfoot.

The tow truck guys focus on getting the Canadian highways open and do it with their hands, hooks, chains, and heavy trucks. They have to know something about the physics of the job. It looks real.

The Bigfoot researchers know a lot about Bigfoot lore and what little science there is about it. The only Bigfoot you’ll ever see on the show is a doll the size of GI Joe pinned on a researcher’s backpack.

Keep looking up. You don’t want Bigfoot to drop out of a tree on you.

Our Impressions of University of Iowa Free Webinar Yesterday: The Stories That Define Us”

We were overall delighted with yesterday’s presentation, University of Iowa Free Webinar: “Breaking Barriers: Arts, Athletics, and Medicine (1898-1947).” It’s one in a series of 4 virtual seminars with two more scheduled this month, which you can register for at this link.

February 15: Endless Innovation: An R1 Research Institution (1948–1997)

February 22: The Next Chapter: Blazing New Trails (1998–2047)

The moderator was university archivist and storyteller, David McCartney.

Presenters include:

Yesterday’s presentation was recorded and will be uploaded to The University of Iowa Center for Advancement YouTube site at a later date.

McCartney did an excellent job as moderator, although got stumped from a question from a viewer about who was the first African American faculty member in the College of Medicine. He’s still working on tracking that down. It wasn’t me. I’m not that old and I am not risen from the dead, as far as I can tell; but to be absolutely clear, you should ask my wife, Sena. I was able to google who was the first African American graduate of the University of Iowa law school: Alexander Clark, Jr. McCartney thinks he might have been the first University of Iowa alumnus, although he couldn’t confirm that.

On the other hand, I could have been the first African American consulting psychiatrist (maybe the only African American psychiatrist ever) in the Department of Psychiatry at UIHC—but I can’t confirm that. Maybe McCartney could work on that, too.

 There are a few words about me in the department’s own history book, “Psychiatry at Iowa: The Shaping of a Discipline: A History of Service, Science, and Education by James Bass: Chapter 5, The New Path of George Winokur, 1971-1990:

“If in Iowa’s Department of Psychiatry there is an essential example of the consultation-liaison psychiatrist, it would be Dr. James Amos. A true in-the-trenches clinician and teacher, Amos’s potential was first spotted by George Winokur and then cultivated by Winokur’s successor, Bob Robinson. Robinson initially sought a research gene in Amos, but, as Amos would be the first to state, clinical work—not research—would be Amos’s true calling. With Russell Noyes, before Noyes’ retirement in 2002, Amos ran the UIHC psychiatry consultation service and then continued on, heroically serving an 811-bed hospital. In 2010 he would edit a book with Robinson entitled Psychosomatic Medicine: An Introduction to Consultation-Liaison Psychiatry.” (Bass, J. (2019). Psychiatry at Iowa: A History of Service, Science, and Education. Iowa City, Iowa, The University of Iowa Department of Psychiatry).”

And in Chapter 6 (Robert G. Robinson and the Widening of Basic Science, 1990-2011), Bass mentions my name in the context of being one of the first clinical track faculty (as distinguished from research track) in the department. In some ways, breaking ground as a clinical track faculty was probably harder than being the only African American faculty member in the department.

I had questions for Lan Samantha Chang and for Dr. Patricia Winokur (who co-staffed the UIHC Medical-Psychiatry Unit with me more years ago than I want to count.

I asked Dr. Chang what role did James Alan McPherson play in the Iowa Writers Workshop. She was finishing her presentation and had not mentioned him, so I thought I’d better bring him up. She had very warm memories of him being her teacher, the first African American to win a Pulitzer Prize for fiction, and a long-time faculty member at the Workshop.

She didn’t mention whether McPherson had ever been a director of the Workshop, though she went through the list of directors from 1897 to when she assumed leadership in 2006. You can read this on the Workshop’s History web page. I have so far read two sources (with Wikipedia repeating the Ploughshares article item) on the web indicating McPherson had been acting director between 2005-2007 after the death of Frank Conroy. One source for this was on Black Past published in 2016 shortly after his death, and the other was a Ploughshares article published in 2008. I sent an email request for clarification to the organizers of the zoom webinar to pass along to Lan Samantha Chang.

I asked Dr. Winokur about George Winokur’s contribution to the science of psychiatric medicine. Dr. George Winokur was her father and he was the Chair of the UIHC Psychiatry Department while I was there. She mentioned his focus on research in schizophrenia and other accomplishments. I’ll quote the last paragraph from Bass’s history on the George Winokur era:

“Winokur, in terms of research, was a prototype of the new empirical psychiatrist. Though his own research was primarily in the clinical realm, he was guided by the new neurobiological paradigm (perhaps in an overbalanced way) that was solidifying psychiatry with comparative quickness. New techniques in imaging and revelations of the possibilities in genetic study and neuropsychopharmacology lay ahead. George Winokur had helped the University of Iowa’s Department of Psychiatry—and American psychiatry as a whole—turn a corner away from subjectivity and irregularity of Freudian-based therapies. And once that corner had been turned there was no going back.”

George Winokur was the department chair at University of Iowa Hospitals and Clinics from 1971 to 1990 and had a unique and memorable style. George also had a rough sense of humor. He had a rolling, gravelly laugh. He had strict guidelines for how residents should behave, only slightly tongue-in-cheek. They were written in the form of 10 commandments. Who knows, maybe there are stone tablets somewhere:

Winokur’s 10 Commandments

  1. Thou shalt not sleep with any UI Psychiatry Hospital patient unless it be thy spouse.
  2. Thou shalt not accept recompense for patient care in this center outside thy salary.
  3. Thou shalt be on time for conferences and meetings.
  4. Thou shalt act toward the staff attending with courtesy.
  5. Thou shalt write progress notes even if no progress has been made.
  6. Thou shalt be prompt and on time with thy letters, admissions and discharge notes.
  7. Thou shalt not moonlight without permission under threat of excommunication.
  8. Data is thy God. No graven images will be accepted in its place.
  9. Thou shalt speak thy mind.
  10. Thou shalt comport thyself with modesty, not omniscience.

Quinn Early has a lot of energy and puts it to good use. His documentary of the sacrifices of African American sports pioneers, including “On the Shoulders of Giants” (Frank Kinney Holbrook) is impressive.

There was a good discussion of the importance of the book “Invisible Hawkeyes: African Americans at the University of Iowa during the Long Civil Rights Era”, edited by former UI faculty, Lena and Michael Hill.

Sena and I thought yesterday’s presentation was excellent. We plan to attend the two upcoming webinars as well. We encourage others to join.

Retiree Musings

I’ve just discovered a web site that calculates the time that has passed since an event occurred. So, it calculated that I’ve been retired for 19 months—or 580 days, or 13,909 hours and so on. But I’m not counting.

What has been happening since then? I’ve had the usual problems with letting go of my professional identity, still having them in fact. I’ve posted a quote from another retired psychiatrist, H. Steven Moffic, MD.:

Plan for retirement, even if you don’t plan to retire. This means sound financial planning, developing other interests, and nurturing your relationships with significant others. Retire, even if you are not retired. Take enough time off periodically, and completely, with no connections to work, so that you can feel emotionally free from concerns about patients and practice. Of course, there is no reason to retire if you really love your work and relationships just as they are.

H. Steven Moffic, MD

There was also an article entitled “When Should Psychiatrists Retire?” written by Dinah Miller, MD. It was published in Clinical Psychiatry News January 2022 issue, Vol.50, No. 1 as well as Medscape on November 17, 2021. There is no consensus on the answer to the question, although there are several opinions by the commenters.

There are a lot of articles out there about what it’s like to lose your professional identity and the potential consequences of that. One thing I’m learning is that, while I may not be fully reconciled with losing my identity as a consult-liaison psychiatrist, I’m gradually starting to have more fun just being a clown sometimes, which pre-dated my becoming a doctor.

Maybe I just need to grow up, but my interests are everyday stuff I tend to make fun of.

Like dryer balls. Now, I don’t want to offend anybody who believes that dryer balls are effective at drying clothes quicker and the like—but the jury is still out on that claim.

In fact, there are many articles on the web, both pro and con about dryer balls. One of them is by somebody who did what sounds like an exhaustive study (just with his own laundry; you won’t find it published in any journal). He swears by them. Then there was the article which pretty much debunked dryer balls. It mentioned an “in-depth experiment” by an 8th grader in 2013 proving that they don’t reduce dryer time. My wife, Sena, says they don’t work. One ball got snagged in a fitted sheet pocket.

What I don’t get is why dryer balls look so much like the spiky massage balls (hint, it’s the green ball; the dryer balls also have holes in them). I think everybody just takes for granted that massage balls work. Sena says it works. She also has what she calls a massager which looks vaguely like a headless alien doing the downward dog yoga thing.

But what I find puzzling is why I can’t find any mention on line of clamshell eyeglass cases which have a steel trap-like spring-loaded hinge. You don’t want to get your fingers caught in them. They should have a safety protocol for use—so of course I came up with one.

Be Kind and View Our Chicago Cribbage Antics Video

It’s a mystery why our Chicago Cribbage Antics video is not getting thousands of views on YouTube. It ranks right up there with the other Top 10 great mysteries:

  1. Bigfoot sightings are everywhere, including your backyard; yet there is a shortage of Bigfoot Personal Trainers.
  2. UFOs sightings are also on the rise, and they frequently crash; yet we don’t see UFO body shop repair businesses springing up at all.
  3. How come there is no Save the Chupacabra Society?
  4. What’s the delay on opening the Loch Ness Monster petting station?
  5. Is there any explanation for the pitifully small number of Taco Bell restaurants on Mars?
  6. Will there be an upcoming investigation into why the male Weather Channel meteorologists are required to wear pants that pool around the ankles?
  7. Everywhere you look there is a crisis of men’s shirt pocket puckering—yet there is no federal investigation forthcoming.
  8. Just who is in charge of installing signs to properly identify dangerous worm hole vortex entrances?
  9. Will we ever get anything but lame excuses for the existence of isosceles triangles?
  10. Why does shredded coconut have the texture of cellophane, making it impossible to swallow for some people, like me?

Anyway, as far as we know, there is no other video about Chicago Cribbage besides ours. It deserves around 3 million views, preferably by tomorrow. We appreciate your kind attention to this matter; thank you for your time.

Big Foot Bought Shoes!

You’ve heard of the 1938 “War of the Worlds” radio broadcast by Orson Welles on The Mercury Theatre on the Air? Some people thought it caused a panic but it was introduced as just part of the radio program way ahead of time.

Well, I’m announcing way ahead of time that this post about Bigfoot’s purchase of a pair of Oxfords is just fiction so you don’t rush the shoe stores with your video equipment and lord knows what else.

You should also not storm the Terry Trueblood Trail looking for the cryptid’s footprints, although I think you might still be able to see them. They weren’t just footprints when I filmed them. It was as though someone or something extremely big and heavy, wearing shoes, had sunk into the concrete sidewalk with each step. That part is non-fiction.

We’ve walked the trail a half-dozen times over the past few years but we never noticed the footprints until just recently. I don’t think the sidewalk is newly poured, but it’s more likely than Bigfoot going for a walk on the trail. Then again, I’m used to seeing animal prints in sidewalks. They’re not shy about walking in wet cement—but things which wear shoes usually are.

It just so happens there have been reports of sightings of Bigfoot in Iowa, believe it or not. Nobody has ever captured one or even seen any dead ones. Some people think they’re not animals per se, and may be able to escape detection by jumping between space-time dimensions. Maybe that’s why the footprints abruptly stop on the trail. I wonder if it hurts to do that.

I can’t explain Bigfoot at all, much less why it would buy a pair of shoes—or where it would buy them. There would be a lot of excitement if it bought the shoes. People would faint in the aisles and the checkout person would be skeptical of an intergalactic credit card.

Maybe Bigfoot is an expert shoplifter, especially if all it has to do is leap between dimensions to escape the proper authorities. It could be that the reason why they knock on trees is to tell each other where the laziest shoe store security officers work.

When you figure all this out, let me know.

A Little Too Exuberant

I think a sense of humor is a wonderful thing. I was the class clown in my youth. I remember my English teacher, Miss Piggott, wrote in my report card that I was “A little too exuberant.”

Actually, I was a great deal too exuberant. My sense of humor tends to fall into the broad category of what author Dave Barry would call “booger jokes.” By the way, I just finished his latest book, Lessons from Lucy: The Simple Joys of an Old, Happy Dog. I highly recommend it. He mixes a little wisdom in with the booger jokes.

Dave Barry can do more than booger jokes.

As a psychiatrist, I’ve learned to look for a sense of humor, exuberant or not, in the patients I’ve met. I point it out to them when I think I detect it. They usually like hearing that. Only a very few are nonplussed.

One of my teachers was George Winokur, MD, who everyone knows was a giant in psychiatric research.  Dr. Winokur was the department chair at University of Iowa Hospitals and Clinics from 1971 to 1990 and had a unique and memorable style. I thought he had a fair amount of exuberance. He had a rolling, sort of gravelly laugh, especially during rounds when he would sometimes make a point of reminding trainees like me that we had a lot to learn, “You all don’t know how to diagnose Somatization Disorder!” I made sure I learned how.

When Winokur was department chair, he created a set of “commandments” regarding personal behavior and comportment that have stood the test of time. I don’t know if anyone else has tried to ensure that Winokur’s 10 Commandments be remembered, maybe even cast in a pair of stone tablets. Read them and follow them.

Winokur’s 10 Commandments

  1. Thou shalt not sleep with any UI Psychiatry Hospital patient unless it be thy spouse.
  2. Thou shalt not accept recompense for patient care in this center outside thy salary.
  3. Thou shalt be on time for conferences and meetings.
  4. Thou shalt act toward the staff attending with courtesy.
  5. Thou shalt write progress notes even if no progress has been made.
  6. Thou shalt be prompt and on time with thy letters, admissions and discharge notes.
  7. Thou shalt not moonlight without permission under threat of excommunication.
  8. Data is thy God. No graven images will be accepted in its place.
  9. Thou shalt speak thy mind.
  10. Thou shalt comport thyself with modesty, not omniscience.

More evidence that a sense of humor is prevalent amongst psychiatrists is the work some residents put into making a video (in two parts) about managing violent patients. I realize that the recent news stories about health care professionals often being the victims of violence from patients might make some think this is nothing to joke about. They were not joking. The video makes a good case for a method to manage the violent patient. It just makes it with an exuberant sense of humor.

Violent behavior by patients in the general hospital is often caused by delirium. The proxy for delirium in the form of violence could be what is called the “Code Green” here at our hospital.

The Code Green team at our hospital consists of a group of people specially trained to use non-violent measures to help patients who are violent get under control in order to minimize the risk of injury to themselves and others. These events are often intense encounters in patient’s rooms, hallways, lobbies, and other places in the hospital where patients who are confused and out of control can wander. First and foremost, we try to contain the patient to maintain everyone’s safety, and then ascertain why the patient is confused and at risk for imminent violence or already perpetrating acts of violent behavior toward themselves and others. This has to be done quickly so as to minimize injury.

One mnemonic, described in my chapter in our book, Psychosomatic Medicine: An Introduction to Consultation-Liaison Psychiatry is [1]:

1.         Amos, J.J., M.D., Assessment and management of the violent patient, in Psychosomatic Medicine: An Introduction to Consultation-Liaison Psychiatry, J.J. Amos, M.D., and R.G. Robinson, M.D., Editors. 2010, Cambridge University Press: New York. p. 58-63.

Containment before

Assessment before

Non-violent

Intervention before

Take down

Shameless plug…

The so-called CAN IT mnemonic is a reference mainly to containment before all else in order to protect everyone involved in a Code Green situation. An excerpt from the chapter on the importance of containment is:

“Containment refers to ensuring that you and the patient both feel relatively safe in the assessment area. Preferably, both of you should have easy access to the door for escape if necessary. At first, it may seem odd to recommend letting the patient escape from the room, but the point is not to force the patient to run over you to get to the door.

Another issue of containment is to ensure that the patient gives up any weapons before you agree to do the evaluation. Sometimes, offering food or drink (not hot enough to injure if hurled in your face) will help set a non-threatening atmosphere. It’s helpful to avoid making intense or prolonged eye contact with the patient, because this may be viewed as threatening.

Always make sure that plenty of other people are available to help you if a take-down situation develops.

Containment under these conditions sometimes is achievable by simply being honest with the patient who is still able to hear you by admitting that he/she is saying or doing things that make you afraid. This may seem counter-intuitive. But, provided it’s delivered calmly as a statement followed by reassurance that you and everyone else involved are committed to maintaining the safety of all persons present (including the patient), this may capitalize on the patient’s own fear of losing control by assuring that you’ll do everything in your power to keep the lid on the situation.”

You can see the exuberant YouTube videos below, illustrating these principles made by talented trainees in our psychiatry residency program in 2008.

In 2009, Dr. David Mair, MD was the producer and director of the video. I see he’s now with Innovative Psychological Consultants (IPC) in Maple Grove, MN (they get a lot of snow up there!). Below is his introduction to the videos:

Early in my training, I didn’t quite know how to react with potentially violent patients.  No amount of knowledge of medicine, physiology, or the DSM provided me the skills to address these situations.  Though we had excellent training during orientation, I really learned by observing skilled clinicians, and through my own encounters, both good and bad.  This was exemplified during my rotation in consultation-liaison psychiatry, when working with Dr. Amos, to learn his logical, step-wise approach, see him in these problematic scenarios, and to practice what I had learned. 

In making this educational video, I wanted to give incoming residents a quick way to make these observations, and present it to them in a way that was both useful and entertaining. It helped that I had a cadre of multi-talented peers and a faculty supervisor who recognized the utility of such a project.  Though managing these patients will be an eternal source of anxiety for all psychiatrists, my hope is that with this video, they will feel just a little better prepared. —David Mair, MD.

Well said, Dr. Mair. You were all very exuberant.

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