My Updated Easy Exercises

Okay, so I’m nobody’s personal trainer, but I have an update on my exercise routine, which I’m doing daily for the most part. I spend about a half hour on the “workout” which starts with a floor yoga warm up. I get on the exercise bike for 5 minutes. Then I do 3 sets of body weight squats, dumbbells, and planks. I finish off with another 5 minutes on the bike.

Obviously, my goal is not to be ripped. I just want to keep my bowels moving, to sleep OK, and stay reasonably fit for a geezer. I also do daily mindfulness meditation.

I still have a lot of work to do on being more well-rounded. And I mean a lot.

About Me Page Revisited

I’ve been looking at my About Me page and see that it needs revising. I’m way past the stage of being in phased retirement and I’m pretty sure I can’t do without this blog—or at least some way to keep writing. I notice I said that I was not sure how long I’d keep blogging.

I recently updated my YouTube trailer. It’s my first attempt at an elevator pitch in years. It’s a 48 second video, probably the shortest video I’ve ever done. According to some experts, it’s 3 seconds too long. If you want to read the long version, it’s on this blog, “Elevator Pitch for a Very Slow Elevator.”

Anyway, I’ve been retired from psychiatry since June 30, 2020 (there was a minor clerical glitch in the exact date). My wife, Sena and I have gotten all of our Covid-19 vaccines—until they come up with more. We have made Iowa City our home for over thirty years.

We play cribbage. One of the most fun cribbage games we played was the game on the Iowa state map board. That was a blast. The video of it was over 10 times longer than most YouTube videos I make. That’s because the main reason for the game was to talk up Iowa. You really ought to visit, maybe even move here. You can get used to snow. I keep reading articles on the web telling me I’ve got to stop shoveling at my age. I’ll think it over.

We also like going for walks. One of our favorite places to walk is on the Terry Trueblood Trail. Sometimes you can see Bald Eagles out there.

I have not yet mentioned Consultation-Liaison Psychiatry, even once. That’s a big difference from the old About Me page. It was the first thing I mentioned then, because it was just about the most important role I had in life.

It took a long time before I began to question that once I retired—about a year or so. It was a lot like being a firefighter. In fact, my pager was the bell, and I even had a firefighter’s helmet, a gift from a family medicine resident who rotated through the psychiatry consult service. I didn’t wear it when I interviewed patients. It would have alarmed them.

I also carried around a little camp stool. It was because there were never enough chairs in patient rooms to accommodate me, the trainees, and visiting family. Often, I sent a medical student to find me a chair from out in the hall—until I got the stool. I slung it over my shoulder and away I went. I was sort of like the guy on that old Have Gun—Will Travel (paladin) TV show (a 1950s-1960s relic with a gunslinger called Paladin). Have Stool—Will Travel. A surgeon, who also doubled as a palliative care medicine consultant, gave me the little chair as a gift. I passed it on to a resident who took it with good grace.

I miss work a lot less now than I did when I left. I think I must have loved my work. Maybe I loved it too much, because leaving it was hard. There are different kinds of love. I love writing. I love long walks and watching the birds. And most of all I love Sena.

Love

I’m gradually replacing work with something else I love, which is writing. Mindfulness meditation and exercise also help. And let’s not forget, I change electrical outlets. I think I’ve changed just about every outlet (and many toggle switches) in the house. They ought to do away with those bargain bin plugs. Just because they’re cheap doesn’t mean they’re any good.

I’m not sure yet how I’ll edit the About Me page. Maybe I’ll just call the first one Chapter One and this one Chapter Two.

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.

Moderna Booster Jab Today and Mindful Zombies

I got my Moderna Covid-19 booster jab this morning. That was quick. A guy (probably about my age, I’m not sure) waiting for his booster behind me chuckled and asked, “Did she even let you sit down for it?” I was in and out that fast. It’s the same as the primary series, only half-dose. Sena and I are now both fully vaccinated and boosted.

According to the FDA and CDC guidelines, I could have gotten a heterologous booster, but I stuck with what I got for my primary series. There was no problem with vaccine supply; it was already on the shelf, so the only thing different was the smaller dose. Since there’s not much else to say about it, we’ll move on to other more exciting news.

Sena ordered the Zombie cribbage game I just had to have. It won’t get here by Halloween, but that’s OK. I know the board is a folding plastic affair and there’s only enough peg holes for what would be half a full game (61 instead of 121). The pegs are zombie figures—which may or may not fit in the holes.

But it’s zombies! This is what happens to you in retirement, people. My gratitude to Sena for getting Zombie cribbage will be to play Scrabble with her.

That reminds me of a cribbage story I read on the web about a game between a couple of old guys in a senior community in Minnesota. One of them, Harry, was 108 years old and the other, Don, was 105. They were long time cribbage players, but they’d never played each other. The young guy won. As soon as he did, he got back on his walker, saying, “Just another game,” and left. In fact, neither player got as excited about the affair as everyone else including spectators, family, and staff, talking it up like it was a championship boxing match. Don’s family said that his attitude about the win was probably part of the reason for his longevity.

I liked Don’s reaction to winning the game. I don’t know if Don’s approach to cribbage is the same as it is to life in general. Maybe it’s about living in the present. When something is over, it’s in the past and it’s time to move on. There’s probably no point in worrying about the future either, especially when you get pretty old. There’s not much of it left.

Maybe this mean that retirees should be more like zombies—we should just play cribbage, eat brains mindfully, and forget about tomorrow. You’re welcome.

My Most Dreaded Retirement Question

Yesterday somebody asked me “So what do you do now that you’re retired?” I have come to dread the question. I told him I write this blog. That seemed to surprise him a little. It sounded a little lame to me as I said it. I’m not sure it’s the right answer to this question that I still don’t know how to answer, even though I’ve been retired for a little over a year.

I remember the blog post I wrote a couple of years or so ago, “Mindfully Retiring from Psychiatry.” It sounded good. It still sounds good even as I re-read it today. Others were reading it too, judging from my blog stats. I wondered if one of them was the guy who asked me the dreaded question.

I still exercise and do mindfulness meditation, although for several months after I retired, I dropped those habits. A lot was going on. We moved. I didn’t weather that process well at all. I was bored. In fact, I still struggle with boredom. The derecho hit Iowa pretty hard. It knocked over a tree in our front yard, which I had to cut up with a hand saw. The COVID-19 pandemic and social upheaval is an ongoing burden for everyone and seems to be directly related to making everyone very angry all the time. Sena and I are fully vaccinated but I’m pretty sure that more vaccinations are on the way in the form of boosters.

I’ve had to do things I really never wanted to learn how to do. Sena handed me a hickory nut she found in the yard this morning, reminding me of walnut storms we had at a previous home. I picked up scores (maybe hundreds) of walnuts there. I don’t want to do that again. I remember being jarred awake each time a walnut hit the deck.

And for the first time, I had to replace a dryer vent duct. I’m the least handy person on the planet. Our washer and dryer pair are both 54 inches tall and I found out that when you have to drag a big dryer away from the wall, you have to do it like you really mean business.

You don’t want to look at what’s behind the dryer. Worse yet is jumping down behind it in a space barely big enough for me to turn around. Getting out of it is even harder. Jump and press to the top of the machines and watch those cords and hoses.

I tried so-called semi-flexible aluminum duct. I switched to flexible foil duct, despite the hardware store guy telling me that it’s illegal. It’s not. You want to wear gloves with either because you’ll cut up your hands if you don’t.

Who’s the genius who thought of oval vent pipe on the wall when the duct is 4-inch round? It’s not illegal but it does make life harder. And how do you attach the duct ends to the pipes? Turn key or screw type worm drive clamps. If you don’t have enough room for a screw driver, the turn key style is the best bet. Good luck finding those wire galvanized squeeze-style full clamps. I think they’re often out of stock because they’re not only older, but easier to use and cheaper.

See what I mean? I would not even have the vocabulary for that kind of job if I were still working as a psychiatrist. I would just hire a handyman to do it—like I do for a lot of other things I still don’t know how to do since I retired. It’s sort of like that Men in Black movie line from Agent K when he tells Agent J what they have to do on their first mission: “Imagine a giant cockroach, with unlimited strength, a massive inferiority complex, and a real short temper, is tear-assing around Manhattan Island in a brand-new Edgar suit. That sound like fun?”

No, it doesn’t and neither does replacing a dryer vent duct or any number of things retired guys get to learn because they have too much time on their hands.

So, I’m really glad to change the subject and talk about other people who are doing things I admire. First is a former student of mine, Dr. Paul Thisayakorn, who is a consultation-liaison (CL) psychiatrist in Bangkok, Thailand. He did his residency at The University of Iowa Hospitals and Clinics. He put together a CL fellowship program in Thailand. The photo below shows from left to right: Paul, Dr. Tippamas, the first CL Psychiatry fellow, and Dr. Yanin. Dr. Tippamas will be the first CL Psychiatry trained graduate in Thailand next year and will work at another new medical school in Bangkok. Dr. Yanin just graduated from the general psychiatry residency program last year. Paul supervised her throughout her CL Psychiatry years. Now she is the junior CL staff helping Paul run the program. Within the next few years, Paul will send her to the United States or the United Kingdom or Canada for clinical/research/observership experience so she can further her CL education. Way to go, Paul and your team!

Dr Paul Thisayakorn and CL Psychiatry grads (see text for details)

By the way, that tie I’m wearing in the Mindfully Retiring from Psychiatry post picture (the one with white elephants; the white elephant is a symbol of royal power and fortune in Thai culture) was a going away gift from Paul upon his graduation.

The other is a heavy-hitter I met years ago, Dr. E. Wes Ely, MD, MPH, a critical care doctor who is publishing a new book, Every Deep-Drawn Breath, which well be coming out September 7, 2021. Our interests converged when it came to delirium, especially when it occurs in the intensive care unit, which is often. I met him in person at an American Delirium Society meeting in Indianapolis. He’s a high-energy guy with a lot of compassion and a genius for humanely practicing critical care medicine. I sort of made fun of one of his first books, Delirium in Critical Care, which he wrote with Dr. Valerie Page and published in 2011, the same year I started a blog called The Practical Psychosomaticist (which I dropped a few years ago as I headed into phased retirement). Shortly after I made fun of how he compared the approaches of consult psychiatrists and critical care specialists managing delirium, he sent me an email suggesting I write a few posts about the ground-breaking research he and others were doing to advance the care of delirious ICU patients—which I gladly did. I think he actually might have remembered me in 2019 when he came to present a grand round in the internal medicine department at University of Iowa Hospitals & Clinics (I wrote 3 posts about that visit: March 28 and April 11 and 12).

In the email Dr. Ely sent to me and many others about the book, he said, “Every penny I receive through sales of this book is being donated into a fund created to help COVID and other ICU survivors and family members lead the fullest lives possible after critical illness. This isn’t purely a COVID book, but stories of COVID and Long COVID are woven throughout. I have also shared instances of social justice issues that pervade our medical system, issues that you and I encounter daily in caring for our community members who are most vulnerable.”

I look up to these and others I had the privilege of working with or meeting back before I was not retired and struggling to come up with a good answer to the dreaded question: What do you do now that you’re retired?

Hey, what do you do now that you’re retired?

Busy as a Beaver

I’m probably busy as a beaver, especially now that I’ve read a short description of how a beaver builds a dam. The article is short on references; in fact, there are none to back up the unidentified author’s remarks. In fact, I suspect the article is fact-free, the only apparent purpose to create test questions for grade-school children.

The author says that, while beavers are busy when engaged in tree felling and dam building, they are disorganized, poor at planning the activities and often mess them up—even accidentally getting killed by falling timber.

By analogy then, since I retired last year, I’ve been about as busy as a beaver. When my frame of reference was working at the hospital as a consulting psychiatrist, I was extremely busy. I put on 3 to 4 miles and about 30 floors a day chasing consults all over an 800-bed hospital with 8 floors.

Now my typical day is very different. Staying physically fit is challenging. I exercise daily, but it’s hardly as demanding as when I was working. I start off with floor yoga to warm up. I hop on the stationary bike, which is not a Peloton or anything like it. There’s nobody in the display exhorting me to crush that Peloton. The digital mileage counter display doesn’t even work.

Next, I do bodyweight squats. My ankle and knee joints crackle and pop loudly, but as long as they don’t hurt, I imagine I’m fine. Next, I do curl and press exercises with a pair of 10-pound dumbbells. Then I do planks. After 3 sets of squats, etc., I get back on the bike. Following the exercises, I sit for mindfulness meditation. That whole business takes about an hour.

As far as beaver busyness, the only time I felled any timber was last summer, when I flirted with danger using a power pole saw trying to clear dead tree limbs left over from the derecho. That actually was a poorly planned activity and was certainly dangerous. I guess I was busy as a beaver then.

Is there such as a thing as being mentally busy as a beaver? Apparently not. Sena and I play cribbage now and then. Other than that, there’s always TV. I listen to music on the Music Choice Channel on TV. I like the Easy Listening and Light Classical stations. Each musical artist featured has several short biographical notes appear while the music plays. I practice doing mental subtractions when the artist’s birthdate appears. It’s the old borrowing method of subtraction you learn in grade school—unless nobody teaches that anymore. There are usually several grammatical and usage problems (worse than mine) with the information about artists and I practice recasting sentences. Sometimes they’ll mention a musician’s nickname, such as BullyboysquatlowjoocedewdliosityBrahms. Several of the classical musicians composed symphonies before they were potty-trained.

On the practical side, I watch the Weather Channel, following which are shows like Highway Thru Hell and Heavy Rescue 401. Those guys are really busy, dragging semi-trucks out of ditches in snowstorms in British Columbia. They operate 75-ton wreckers with rotating booms and winches which regularly spit their cables at anyone nearby.

I alternate the heavy wrecker shows with the Men in Black (MIB) movies, which poke fun at the UFO and alien themes (a welcome counterpoint to Ancient Aliens which takes itself too seriously). I was sure I was watching MIB movies way too much until I found all of the fans’ contributions to websites which list the many errors in the movies. Just google “MIB goofs.” You’ll see the triumphant announcement from those who somehow know what color scheme New York City streets signs had in 1969 and point out how wrong the movie is. On the other hand, I know what kinds of pies young Agent K and Agent J had in MIB 3 (apple with a “nasty piece of cheddar” and strawberry rhubarb, respectively).

I guess all this makes me busy as a beaver.

Stumped

Ever since the derecho last month, we’ve been stumped by stumps—tree stumps. It has been a lesson in the value of persistence. The tree in our front yard got knocked over almost right at ground level. I cut it up with a 20-inch hand saw. But the stump has me stumped so far. You can google “stump removal” and get an idea of what your options are.

One method is to use chemicals, involving drilling holes into the stump, into which the chemical is poured along with water and waiting patiently a few years. One guy’s review of a product revealed what appeared to be a basic misunderstanding of the procedure. It involved mixing the chemical with peanut butter, applying it to the stump which he then set on fire to make a smoke signal which could allow lost hikers to be more easily rescued. And by the way, it also hastened the rotting of a tree. The reviewer even included a photo of the heavily smoking concoction. I suspect the manufacturer published the review mainly for entertainment.

We took a half-hearted stab at chemical rotting. I mainly used a bow saw, believe it or not. That didn’t get the stump low enough below ground level to assure grass would grow above it.

Manual labor methods usually include recommendations for using a chain, a truck with 4-wheel drive, a wrecking bar, shovel, mattock, axe, and a few sticks of dynamite.

Manual labor has been the main method so far. There was a wire wrapped around the stump and three steel T-bar fence posts, which were probably placed when the tree was first planted several years ago. We got two of the T-bars out but couldn’t get the last one loose (only breaking it in half) until I got a hatchet and a pry bar. Thick roots were wrapped every which way around it and meandered off in all directions. I chopped and pried for hours until I could finally yank it out with vise grips. We hacked a softball-sized chunk of root out of the tangle, and managed to amputate several others away from the main stump. That is why I’m not a big fan of the manual labor method.

And then there’s a guy named Frank, half of a duo owning a stump grinding service. I called him and he came over the following day, shortly after I had removed the T-bar—which probably would not be the best thing for the 21-inch blade on his giant stump remover. He plans to grind it sometime in the next week.

I knew I could rent a stump grinder, but I would never do a thing like that. I’m not the handiest guy in the world, putting it mildly. I’m lucky I didn’t amputate a digit (along with a root) with the hatchet.

We talked with Frank in the front yard as he examined the stump. He said, “Oh, that’s nothing.” He quoted a fair price, which was far less than how much I would have had to pay to rent a stump grinder—and to cover the costs of emergency room charges, damage to the machine, the house and the neighborhood from a runaway grinder.

Frank is pretty busy and we speculated about what the main reasons might be, naturally one being the derecho. Frank thought the coronavirus pandemic might be another one. People sit at home either in self-isolation or quarantine and they have more time to stare at longstanding problems around the house and in the yard.

Having time on your hands can lead to boredom and brooding, which can happen to retirees like me. There are times when I would rather hack at a tree stump than read the daily news. I have to keep focused on where I’m aiming the hatchet or how I’m holding the power pole saw, which occupies me, makes time go by faster, and makes me tired and sore at the end of the day. I feel like I accomplished something. Frank retired several years ago and only later set up the stump grinding business.

We’ll see what happens next week with the stump. Frank’s business card has a picture of his giant machine. He can operate it by remote control. You can see what that looks like in a couple of videos at the website which markets the grinder he uses.

Jumbo Cribbage Board Antics

Well, Sena and I played the official inaugural cribbage game on our new Jumbo Crib board from Ontario. That was a belated Valentine Day’s gift for us which Sena is only too happy to remind me about; but that’s OK, I deserve a little ribbing. You can get a sample of that from watching the video.

We have to stretch a bit more to reach across the table and the 8-inch-wide board. That’s good exercise. The 2-inch-tall pegs have a pleasing heft to them.

Making the video for our cribbage games is a big challenge. I think one of the best reasons for doing it is that we learn from our mistakes by watching them. We’re still rookies. It took us all day just to shoot a decent video—although it was fun to play. I’m pretty sure players out there will spot errors. Let us know what they are!

I just happened to come across an old newspaper article about a guy named Frank Lake who was a Grand Champion level player years ago. When the journalist interviewed him, he was around 83 years old—that was in 2005. Frank said that cribbage is “85% luck and 15% smarts.”

We think there has got to be more skill involved than that. Somebody once said that cribbage is a game which takes a few minutes to learn but a lifetime to master. At my rate, it’ll take more years than I have left in my lifetime just to learn.

Each game is different. In a two-hander, each player gets only 6 cards. The non-dealer ends up with only 4 after dropping two into the dealer’s crib. We take about 30 minutes to play a game, which is about half the time we took when we first started playing. I’ve read that you really can’t expect to play at the tournament level unless you can finish a game in 15 minutes. I doubt we’ll ever get there.

The Jumbo is the fourth cribbage board in our small collection. Frank Lake accumulated quite a few cribbage boards in his career, some of them trophies. I think he owned a collection of around twenty of them. One of them was in the shape of the state of Oregon. Hmmm…

The Geezer is Redeemed

Well, as far as this tardy Valentine’s Day gift is concerned, the Geezer is redeemed. The answer to the riddle in the 2/18/2020 post “I’m Late for Valentine’s Day” is a new Jumbo cribbage board (the Jumbo Crib).

This is the gift I forgot to order for our Valentine’s Day, which was a Canadian Hard Maple cribbage board. It arrived today from Ontario. It was shipped only this past Tuesday, so we were pleasantly surprised (almost shocked) that it arrived so quickly. It’s really big compared to our other cribbage boards.

The clues in the post a couple of days included a picture of us in rain gear at Niagara Falls, taken about 5 years ago. The picture of a bed of flowers in the shape of a Maple leaf with a bunch of falling Maple leaves was taken in Canada, just across the border.

Sena keeps telling me that she told me to order the board, but I honestly don’t remember her telling me that.

The board is made by Michaud Toys, a small, family-owned craft shop in Ontario not that far from the Niagara area. They are well-known for making excellent wooden toys, games, and puzzle boxes. They believe in family game night, which for me and Sena is almost every night.

I ordered it on Valentine’s Day, which was just last Friday. It shipped the very next Tuesday and we got it this morning.

It came with a nice storage bag, some metal pegs (2 inches long), a deck of cards, and a set of very accurate rules. It’s 27 ½” long and 8” wide. It’s great fun to play on.

Wow!

It has a handy little cubby on the board which can hold the card deck, pegs, and rule booklet. This is covered by a cap which fits snugly over the hole and is secured by “powerful rare earth magnets.” They work. I can turn the board upside down and shake it—nothing pops out.

Jumbo Crib stuff

The rare earth magnets remind me of the 1970s soul music band, Rare Earth. I went to one of their concerts when I was a teenager and it was so loud that I think I suffered some mild but permanent hearing loss.

Maybe that’s why I didn’t hear Sena when she told me to order the cribbage board. Anyway, we’re celebrating!

I’m Late for Valentine’s Day

I’m a little late for Valentine’s Day, but you could give me a break because I’ve been a little busy being retired. Don’t throw things at me because I’m getting too old to duck. And I did get my wife a card, flowers, and some candy on time.

It was something else I forgot. It’ll take a few days before I can tell you what it was.

We made a Valentine’s Day wish by breaking a chicken wishbone the other day. I believe that was before Valentine’s Day. In fact, it was about a week prior.

I don’t know if there are any rules about how to you’re supposed to hold the wishbone. Some will probably say our technique was poor when they see the video.

I think if you talk about what you wish for, you’re liable to break the spell and you won’t get what you wish for. I believe you’re allowed to hint, though. Pay close attention to the video.

Happy late Valentine’s Day!

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