Iowa – Page 4 – Go Retire Psychiatrist

Fluoride in Your Precious Bodily Fluids

Yesterday, Sena and I talked about a recent news article indicating that a federal judge ordered the Environmental Protection Agency (EPA) to review the allowed level of fluoride in community water supplies. The acceptable level may not be low enough, in the opinion of the advocacy groups who discussed the issue with the judge, according to the author of the article.

A few other news items accented the role of politicians on this issue. This seems to come up every few years. One thing leads to another and I noticed a few other web stories about the divided opinions about fluoride in “your precious bodily fluids.” One of them is a comprehensive review published in 2015 outlining the complicated path of scientific research about this topic. There are passionate advocates on both sides of whether or not to allow fluoride in city water. The title of the paper is, “Debating Water Fluoridation Before Dr. Strangelove” (Carstairs C. Debating Water Fluoridation Before Dr. Strangelove. Am J Public Health. 2015 Aug;105(8):1559-69. doi: 10.2105/AJPH.2015.302660. Epub 2015 Jun 11. PMID: 26066938; PMCID: PMC4504307.)

This of course led to our realizing that we’ve never seen the film “Dr. Strangelove Or: How I Learned to Stop Worrying And Love the Bomb,” a satire on the Cold War. We watched the entire movie on the Internet Archive yesterday afternoon. The clip below shows one of the funniest scenes, a dialogue between General Jack Ripper and RAF officer Lionel Mandrake about water and fluoridation.

During my web search on the fluoridation topic, one thing I noticed about the Artificial Intelligence (AI) entry on the web was the first line of its summary of the film’s plot: “In the movie Dr. Strangelove, the character Dr. Cox suggests adding fluoride to drinking water to improve oral health.” Funny, I don’t remember a character named Dr. Cox in the film nor the recommendation about adding fluoride to drinking water to improve oral health. Peter Sellers played 3 characters, none of them named Cox.

I guess you can’t believe everything AI says, can you? That’s called “hallucinating” when it comes to debating the trustworthiness of AI. I’m not sure what you call it when politicians say things you can’t immediately check the veracity of.

Anyway, one Iowa expert who regularly gets tapped by reporters about it is Dr. Steven Levy, a professor of preventive and community dentistry at the University of Iowa. He’s the leader of the Iowa Fluoride Study, which has been going on over the last several years. In short, Dr. Levy says fluoride in water supplies is safe and effective for preventing tooth decay in as long as the level is adjusted within safe margins.

On the other hand, others say fluoride can be hazardous and could cause neurodevelopmental disorders.

I learned that, even in Iowa there’s disagreement about the health merits vs risks of fluoridated water. Decisions about whether or not city water supplies are fluoridated are generally left to the local communities. Hawaii is the only state in the union which mandates a statewide ban on fluoride. About 90 per cent of Iowa’s cities fluoridate the water. Tama, Iowa stopped fluoridating the water in 2021. Then after a brief period of public education about it, Tama restarted fluoridating its water only six months later.

We use a fluoridated dentifrice and oral rinse every day. We drink fluoridated water, which we offer to the extraterrestrials who occasionally abduct us, but they politely decline because of concern about their precious bodily fluids.

Thoughts on the Big Mo Pod Show 034: Laughing in the Face of Death

I heard the Big Mo Blues Show just (Halloween theme) this last Friday night and was not surprised to see that one of the songs discussed on the Big Mo Pod Show on Saturday was Peetie Wheatstraw’s “Devil’s Son-in-Law.”

When I first heard it, it got me chuckling because I didn’t understand hardly a single word until the last line. It was babbling. I can remember googling the term “Peetie Wheatstraw and unintelligible,” which revealed I’m not the only one who thinks he’s unintelligible. It’s a mondegreen mine field. It’s a good thing the lyrics are available.

I want to hastily point out that he’s not always unintelligible—but William Bunch aka Peetie Wheatstraw is speaking in tongues on that song. For comparison I listened to another song, “Sweet Home Blues” and I could understand just about every word in the lyrics.

That led me down the rabbit hole about the artist in a web search that seemed to have no end. I should probably say Brer Rabbit hole since most of my searches pointed in the direction of a character called Peter Wheatstraw, Petey Wheatstraw, as well as Peetie Wheatstraw who had variations in their identities, most often in the context of African American folklore.

I’m not going to attempt a summary of my web search on Peetie Wheatstraw; there’s too many twists and turns. You can start with the Wikipedia article. But from there, you can get trapped in Brer Rabbit’s little tunnels, which can run in different directions.

William Bunch was a blues artist in the 1930s who adopted the moniker “Peetie Wheatstraw.” While Big Mo says it’s sort of another name for Satan, I found confusing references by writers who claim that the Peter Wheatstraw character comes from Black folklore. There are those who believe that novelist Ralph Ellison wrote about a character in his book “Invisible Man” named Peter Wheatstraw and said it was the only character in the novel that was based on a live person—William Bunch.

Is that true? And did Ellison ever meet Peetie Wheatstraw (William Bunch)? I can’t tell from the web articles.

I was prompted to get my copy of “Invisible Man” out after reading a scholarly online essay mentioning the Peter Wheatstraw character, “Re-visioning Ralph Ellison’s Invisible Man for a Class of Urban Immigrant Youth” by Camille Goodison, CUNY New York City College of Technology. I couldn’t remember Wheatstraw at first, but there he was in Chapter 9.

Goodison reveals there is a lot more texture to the Wheatstraw character then just as a moniker adopted by William Bunch. Wheatstraw is probably more complex than the devil. He has many sides to him and could be helpful—but mostly in an indirect way. His guidance is full of riddles and there doesn’t seem to be a solid way to cut through the metaphorical morass. As Emily Dickinson advised, Wheatstraw may tell the truth—but tells it slant.

I still don’t know why he mumbles the song.

University of Iowa Psychiatrists Publish Huntington Disease Study Results

I ran across a fascinating story about a study on Huntington’s disease published by members of the University of Iowa Health Care. The study examined how the Huntington’s disease gene might enhance brain development and function early in life prior to the onset of the devastating disease. It was published in The Annals of Neurology:

I also found an abstract for a paper about Woody Guthrie, a famous American musician and activist who was very creative in his early life, but sadly succumbed to the ravages of Huntington’s disease when he was 55 years old. I couldn’t access the full article without paying for it but the abstract was intriguing because I wondered whether the author suspected something similar to the premise of the study:

Ringman JM. The Huntington disease of woody guthrie: another man done gone. Cogn Behav Neurol. 2007 Dec;20(4):238-43. doi: 10.1097/WNN.0b013e31815cfee4. PMID: 18091075. Abstract: Woody Guthrie was an American songwriter, musician, writer, and political activist who died with Huntington disease (HD) in 1967 at age 55. His relatively brief creative life was incredibly productive with countless songs and a tremendous volume of letters to his name. His personal life was similarly driven with Woody having had 3 wives and at least 9 children and an insatiable appetite for traveling the United States. In this essay, I explore Guthrie’s art in relation to the development of the overt behavioral changes and chorea that characterized his illness. Woody’s most productive time artistically was in the 5 years immediately preceding the onset of overt symptoms of HD. I hypothesize that subclinical HD may have been an important driving force behind Woody Guthrie’s creativity.

If anybody knows, please comment.

Woody Guthrie was certainly an important figure in the American history of activism as well as music.

Usually, I would share the music of some of the artists I mention on this blog. On the other hand, one of the co-authors of the University of Iowa paper mentioned above is Doug Langbehn, my former colleague, who’s an accomplished musician and statistician. So instead, I thought I’d share the talent of Doug and his band.

U.S. News & World Report Ranks Iowa City Hospital in 9 Specialties

The University of Iowa Stead Family Childrens Hospital in Iowa City has ranked in 9 pediatric specialties, including pediatric behavioral health by U.S. News & World Report!

Hit Them Back with Love

I didn’t get to listen to the Friday blues with Big Mo last Friday because my little Sony Dream Machine radio audio kept cutting out.

But on the Friday blues of August 9, 2024, I heard a tune I liked. It was “Hit ‘Em Back” by Kenny Wayne Shepherd and Shemekia Copeland.

Some blues songs can be gritty and dark, but the title “Hit ‘Em Back” isn’t what it makes you think. The song is really about turning the other cheek, emphasizing the growing importance of getting along with each other.

Getting along with each other is hard to do. I know to most old people (including me) that used to be a lot easier. Old people say that, like saying “What happened to the good old days?”

Well, when I reflect on the past just from my perspective, I have trouble remembering the so-called good old days. In general, we all struggle to get along with each other.

I think the song “Hit ‘Em Back” is a novel way of expressing how relationships between people and nations usually go, but also suggest we “hit” them with love. We mostly hit each other back-in a bad way. The lyrics send an apparently paradoxical message which gets your attention.

And then you get it. Let’s not hit each other. Let’s listen to each other instead.

Thoughts on the Homeless Mentally Ill

The homeless man who lives on the sidewalk outside our hotel reminds me of a couple of things. One is Dr. Gerard Clancy, MD who is University of Iowa Health Care Professor of Psychiatry, Professor of Emergency Medicine, and Senior Associate Dean of External Affairs.

I remember Gerry, who was in the department of psychiatry when I was a resident. I saw his picture in the newspaper and hearing about him riding a bicycle around Iowa City doing a sort of outreach to the homeless mentally ill.

I found an archived article mentioning him published in 1995 in the Daily Iowan. The story starts on the bottom of the front page, entitled “I.C. opens new doors for area’s mentally ill.” It continues on page 9A.

The story mentions Dr. Clancy and what was called then the Clinical Outreach Services and the Emergency Housing Program (EHP). The challenges then sound a lot like what they are now: long waiting lists for psychiatric evaluation and treatment, a lack of funding for the treatment of mental illness, and a lack of preventive care. The most common mental illnesses in the homeless mentally ill are chronic schizophrenia, schizoaffective disorder, and bipolar disorder. The idea of reaching out to them “on their own turf” as Clancy was quoted, was to help them feel more comfortable talking about their mental illness.

The housing situation for this population of those struggling with mental illness was dismal then and it’s still dismal.

The homeless guy I’ve been calling Bob lives on the sidewalk next to a busy street. It’s just my opinion that he’s mentally ill based on my observations of his behavior. I’ve never tried to talk to him. However, Bob gets visits from people who obviously have differing views about the way he lives.

Some of them do talk to him and, although I can’t hear their conversations, the actions tell me important things. Some bring him what I call “care packages,” often food, water, and other items. They may start by acting kind, although may get impatient with him. Others try to clean up his sidewalk, and may criticize him. The police occasionally visit and have so far not taken him into custody.

It looks like things have not changed much since 1995 regarding the homeless mentally ill based on what I write here about my observations. In fact, it’s easy to find current news stories that say things are getting worse.

At the beginning of this post, I said I found a couple of things. The other thing was a very thorough teaching presentation about the current state of formal outreach to this population. It’s available on the web as a power point presentation by another University of Iowa faculty, Dr. Victoria Tann, MD, entitled “Assertive Community Treatment 101.”

Dr. Tann is currently an IMPACT Team psychiatrist. It’s an excellent source of background on the history of this effort at outreach to the homeless mentally ill. It also summarizes what’s happening with the program now.

Historic Rock Island Line Depot in Iowa City

Last week while on our way to the Stanley Museum of Art, we saw the Rock Island depot at 115 Wright St in Iowa City. We’ve lived here 36 years and never visited this historic landmark before. It has interesting architecture and there is even a passenger bench inside. It was built in 1898 and was converted to law offices in the early 1980s. There used to be a waiting room which was removed when it was remodeled. You can see it in the featured image.

The depot has a rich history which you can read here.

Be sure to see the YouTube presentation by local historian Irving Weber.

You’ll notice that Mr. Weber opens his talk about the Rock Island depot by singing a line from a popular song about it: “Rock Island Line is a mighty fine line…”

When we looked on the web for the song, we couldn’t find a rendition with that exact line. Every version we listened to was slightly different but that line was always “Rock Island Line is a mighty good road…” There is an original version recorded in 1934 by John Lomax. We like the one by Lead Belly.

Iowa City Sculptors Showcase 2024

Right on time, the Iowa City Sculptors Showcase is out in the parks. The featured pieces all have a plate on the showcase pad with a QR Code you can scan to learn more about the works. They’ll be up for two years.

Tim Adams: “Exuberance” at Mercer Park, Bradford Dr; “Poppy” at Scott Park on Scott Blvd

Hilde DeBruyne: “Gaia” and “Life Leaf” at Terry Trueblood Recreation Area, McCollister Blvd

V. Skip Willits: “Writing Figure” at Iowa River Trail; “Flight of Butterflies” at Riverfront Crossings Park

Kristin Garnant: “Mechanics of Grace” at Riverfront Crossings Park

Johnathan Goupell: “Pillars [1]” at Riverfront Crossings Park

Thoughts on Hobos and Homelessness

We can see the man from our hotel window. We assume he’s homeless. He has a small area where he sits on the curb next to the street. He does this most of the day. He has a blanket and a few other loose items which sometimes are strewn on the sidewalk or the grass.

Even in 90-plus heat, he’s out there, sometimes standing beneath a small tree, presumably for shade although it’s inadequate. He waves his arms around in what looks like a futile attempt to cool himself. He might just be restless. Other times he sits on his blanket. Occasionally, people stop their cars and seem to be trying to communicate with him. He most often ignores them.

One of the hotel residents approaches him sometimes. It looked like he gives him something (probably a cigarette). Once, the homeless man left his station by the street and walked over to the front of the hotel, waving his arms, seemingly because the hotel resident was speaking to him. We couldn’t see what happened after that, but when he returned to the street, he lit a cigarette. We also saw he accepted fluid, maybe a can of soda.

Later, some people in a car gave him something they bought in a nearby drive-up fast-food joint. He threw out the ice from his drink, which he didn’t consume and sprinkled the fluid on his arms. The people left and returned later with several items they gave him. Some of it looked like more water, which he again poured on his arms. There was a backpack or something like it. He didn’t seem to know what to do with it.

He couldn’t ignore them when they try to help him (water, food, etc.). One person tried to help him clean up his little camp by picking up his trash. The police came out to check on him. We couldn’t hear the short conversation. After she left, he continued to toss his water bottles and other items into the parking lot. He sleeps on the pavement.

This reminded me of a couple of times when I’ve seen hobos. I don’t see the homeless man as a hobo. The term “hobo” is not synonymous with homeless, vagrant, or tramp. Hobos prefer not to have a home, travel around to find work, may still ride the rails to get around, and don’t see themselves as tramps.

As a young man, I worked for consulting engineers as a draftsman and survey crew worker in Mason City. This was in the 1970s. We traveled to outlying cities. One day, we went to Britt for a job. It was during the Britt Hobo Days Convention. It was not the first time I ever heard of it.

Funny thing, I thought I recognized one of the hobos in the café where we got coffee. He was wolfing down a big breakfast. When he was finished, he left in a hurry. I just assumed he was a hobo in town for the festivities. But he looked so familiar.

And suddenly it dawned on me. He had been a kindergarten classmate of mine. I couldn’t recall his name, but it was him.

Another memory that occurred to me was much later in my life, when I was a psychiatrist and co-attending on the medical-psychiatry unit in University Hospital in Iowa City. We admitted a patient who had been found walking around and around in a circle in the street, and seemed confused. Evidently the patient had an acute medical problem and no diagnosable psychiatric illness.

The patient identified as a hobo and was proud of it. The person was polite, grateful, and cooperative. The person refused any help from us beyond help for the acute medical problem. We discharged the person to the street.

Hobo life is different nowadays, I gather. Many have cars and phones. If you look carefully at their photos on the Britt Hobo Days web site, they don’t make me think of homelessness or mental illness. They have made a choice.

On the other hand, homelessness is often not a choice and severe mental illness is not uncommon. There is a homeless shelter in Iowa City, and the resources include a supportive community living program for those who struggle with mental illness. One member of the board of directors is a psychiatrist. Not every homeless person wants to go there. The University of Iowa Health Care has an Integrated Multidisciplinary Program of Assertive Community Treatment (IMPACT).

Thoughts as Train Cars Visualization in Mindfulness Meditation

The Iowa Interstate Railroad train rumbles past our hotel a few times a day and it reminds me of the Mindfulness Based Stress Reduction (MBSR) course I took 10 years ago. One of the exercises the instructor mentioned was the train visualization mindfulness exercise. I don’t know if I remember what our instructor actually said about it, probably something like what the instructor says in a mindfulness video.

One thing I do remember is that it’s OK to notice my thoughts as train cars running through my head. The other thing is the train cars can sort of hijack me and off I go on a tangent, like a hobo hopping a freight car. And, what if also I notice the spaces between the train cars? What would that be like?

The side of my nose itches.

My left eye is tearing up.

What can I do about anything?

Are we all alone in the universe?

Why is David Attenborough’s voice so calming?

Why do I joke around so much?

Even after 10 years of mindfulness practice, I still notice my thoughts jumping around. I’m still hopping from box car to box car.