Just an Introduction

Hello again

Well, it has been about 3 months since I opened this blog. My YouTube channel needed an updated channel trailer, so I’m posting it here as well. Why not?

I was surprised at how long a minute and a half channel trailer took to make, even with the aid of video editing software (maybe because of it, partly).

In my situation, a channel trailer is sort of a mini biography. It’s hard to compress a career into a short clip that takes about 5 minutes to upload to YouTube–after a few hours of what was essentially cut and paste.

As you can gather, my path is changing. Over the next 12 months, I’ll be half off and half on the consultation-liaison psychiatry service. That’s according to the terms of my phased retirement contract.

This is really a re-introduction, of course. I’m slowly evolving–not in any big way. I’m still a geezer.

On the other hand, I have found that I’m much more comfortable being on some kind of schedule. I still get up early, only by about an hour later. I generally arise between 5:30 and 6:00 a.m. That may seem very early to some.

I eat less when I’m off service (which I’ll call “retired” for simplicity). That’s probably why my trousers fit more loosely.

I need to have something to do. I exercise daily, for about 20 minutes. I do mindfulness meditation and yoga. I blog. I photograph and film, mainly birds, which I post to YouTube.

The only reason I ‘m not a disaster in the kitchen is because you generally can’t get me within 10 yards of it unless I need a snack I can immediately eat (like an apple). I still don’t cook–not really. It’s embarrassing.

I trim the lawn and by that, I mean just around the walkway edges and some of the garden margins. I don’t mow the lawn because my wife does a much better job, by mutual agreement.

I’m not a gardener. I’m a garden appreciation expert. That means I watch gardening that is done by others.

I suppose a lot of this adds up to laziness.

More Reset Woes

It can take a while longer than you expect when you do a system reset of your computer. I’m still trying to get my software reinstalled. You know, it’s not very funny when you get the message that all of your apps are going to be expunged and the long list you see on the screen is followed by the promise that (not to worry) this list will be available on your desktop after the reset, so you don’t have to remember it or try to copy it down.

That’s a bald-faced lie; don’t believe it.

The best example today is my quest to track down the software for my Webcam. Since it got wiped during the reset, I navigated to Logitech’s web support page thinking I would just re-download it from there.

Wrong. The only software listed were updates that either didn’t work, were not applicable for what I wanted to do with them, or were incompatible with my video editing software. No kidding, one of the apps recorded audio but the video editing software could not play the video.

Now I knew that the software for my particular version of the Webcam was old but it worked with Windows 10. None of the other new apps did, which was ironic.

I couldn’t find the old app on Logitech’s site at first. In a roundabout way, by googling and sitting through a YouTube that displayed one of Logitech’s web pages, which was not really obvious at first–I eventually blundered onto Logitech’s web page where I could download the old rickety software. It was at the bottom of a long list of apps only a couple of which were compatible with Windows 10.

But it worked with my video editing software and, unlike the new software, didn’t give me annoying messages in big red letters suggesting that my nearly new computer didn’t have the resources to run it.

I like the Webcam part of making videos because it allows me to do things like put my talking head into a PowerPoint presentation, like the one below:

I realize that’s work-related and I’m supposed to be retiring. However, just before I did all that hunting for the old Webcam software, I had been out in the yard with my wife, me trimming the edges of the lawn while she mowed. I also applied grub control granules with a drop spreader. That’s actually about just as much exercise as a moderate jog around the block.

Finally, the explanation for the picture of the hummingbird feeder above. Today we retired it, which fits the theme of my life in a way. For one thing, it’s a pain to fill that thing with sugar water (which I have to mix each and every time, 4:1 water to sugar).

The other problem are the pesky carpenter ants which climb all over it. I know there are ways to prevent that–sort of. On the other hand, hummingbirds have to deal with them all the time in nature, don’t they?

How do hummingbirds usually defend themselves against ants, anyway? Maybe they need to take martial arts classes. They could also use their brains, which proportionally are larger than ours, by the way. They’re smart enough to come up with a clever argument to persuade ants to scram: “It has been documented in numerous scientific studies that sugar water makes ants explode.”

Our hummingbird feeder is now just another decorative object in the garden.

So long, it’s been good to know ya…

Coming to Terms with Retirement

I’m in the off phase of phased retirement right now. It reminds me of the consuming question, “What are you going to do when you’re retired.” Coming to terms with retirement is not a one-step thing.

It’s probably easier to think of things I’m not going to do. I can think of at least a couple of books I’m probably not going to finish reading: “The Social Transformation of American Medicine” by Paul Starr and another title I rather not type but the picture of which I’m not squeamish about showing.

I’ve already read a new book by Dave Barry, “Lessons from Lucy,” which is about coming to terms with getting older. And I’m going to reread a book I read years ago, “The Ultimate Hitchhiker’s Guide to the Galaxy” by Douglas Adams.

I read the Hitchhiker’s Guide and lost it in one of our many moves. I bought a new hardback copy a few days ago and just restarted it.

I can’t remember when I got The Ultimate Hitchhiker’s Guide. It was published in 1986. Around that time, I had graduated from Iowa State University and could not find employment for about a year. It was a difficult time. Anyone who has been through something like that might understand how hard it could be to retire.

I’m not going to write another work-related book. Editing a multi-author book was too much like herding cats. And as one of my friends put it, once you’ve done that, you ask, “Now what?”

I’m still checking my office email every day. You never know. It’s FOMO, I realize; on the other hand, there are still legitimate work-related things I need to do and some have deadlines.

This makes me think of my YouTube video, “A Day in the Life of a C-L Psychiatrist.” It’s a little tough to come up with something like “A Day in the Life of a Retired C-L Psychiatrist.” Of course, there would be nothing connected with psychiatry in it.

My day in the life after C-L Psychiatry?

I’m reminded of an exchange between Men in Black agents J and K (2nd sequel) after K is deneuralized out of “retirement” to return to the active job of defending this little green planet from aliens.

Agent J: “So what was it like on the outside, not doing this every day?”

Agent K: “It was nice; Sleep late on the weekends, watch the Weather Channel.”

My life is more or less like that, except every day is a weekend day…sort of. And the Weather Channel has gotten way too political for me.

I watch Men in Black reruns. I wait for the garbage truck. How does that guy know exactly where to brake in order to operate the automated side load mechanical arm grabber? I carry my POS camera on my belt. You just never know when an opportunity for great snapshots might arise. I trim and edge the lawn boundaries. I vacuum. I fold the fitted sheets, Hondo. I really don’t cook; I stick frozen pizzas in the oven and make microwave popcorn—not very often, Slick. I exercise and do mindfulness meditation and yoga. I take clothes out of the dryer and put away. I dry the dishes and put away. No, we do not use the dishwasher, pal. It’s about coordination and timing.

I realize that I might sound like Agent K. But I’m more like Agent J—still a rookie around the house and in the yard. This is going to take a while.

My Perspective on FOMO

I just saw a great post on Fear of Missing Out (FOMO) on Bob Lowry’s blog, Satisfying Retirement. The link is on my home page and it’s a great read, along with many of his other posts.

FOMO for me is different because I’m not actually retired yet. Bob has been retired for a long time and knows what he’s talking about. I’m still just trying to get used to the idea of being retired for now.

Even though I’ve been in phased retirement for over two years now and this coming year is my last before full retirement (see my countdown!), I’m still coping with FOMO.

I check my email several times a day, even when I’m not on service. My position will likely be filled with my replacement well before the year is out. Occasionally I’ll find a trainee evaluation that is time sensitive that I have to complete. I updated the guide to the psychiatry consultation service and notified others about that just yesterday.

What am I going to do when I’m retired? That’s what so many ask me and which I sometimes ask myself. I’m actually having a pretty good time now that I’m finally adjusting to phased retirement. According to the 2018 Report on U.S. Physicians’ Financial Preparedness: Retired Physicians Segment, one suggestion is that physicians try to retire gradually rather than abruptly.

I agree with that and the phased retirement program I’m in has felt right for me. It hasn’t stopped me from FOMO so far, but I’m gradually getting more and more enjoyment from doing things that are not work-related—even though FOMO makes me check my email and the electronic medical record every day.

My wife and I started saving very early on in my medical training and we were fortunate enough to eliminate educational debt early. We’ve always lived simply and don’t need a lot of expensive toys.

Feed me!

I find ways to build a schedule into my day. I exercise and meditate.

I’m not much for yard work, but I try. I get a big kick out of hobbies I’ve rediscovered such as bird-watching.

I like to make silly videos as some of my medical students have noticed. One of them learned how to fold a fitted sheet from one of my YouTube videos. I really enjoy blogging and combining that with my mostly short YouTube movies. You’ll notice I do have some work-related videos, though, some of them fairly recent.

Hey, here’s how to fold a fitted sheet!

The featured image for this post was actually partly a creation of one the residents a few years ago, who by some miracle found a way to combine my photo with a picture of a smartphone. I added a little more to it to make the point about FOMO.

My FOMO nightmare, once upon a time.

I actually didn’t have a smartphone until about 4 years ago. And I still mainly use it just as a phone. I check the step counter when I’m staffing the psychiatry consultation service, but I’ll quit doing that.

In fact, the residents persuaded me to get a smartphone. I had a flip phone for a few years prior to that mainly because a snowstorm caught my wife out on the road while she was driving to the hospital to pick me up from work. I had no way of knowing where she was and was worried out of my mind. That convinced me we needed more than land lines.

I may go back to the flip phone after I fully retire.

I still use a desk phone at work. For the first time in my career, last weekend it just quit working. You can’t imagine how happy I was.

Whenever I drop my pager, I always say out loud to the trainees, “Oh my gosh, I hope it’s broken!” I’m only half-joking.

I won’t miss pagers when I retire.

I dropped most of my social media accounts over a year ago, including Facebook, LinkedIn, Twitter, and even Doximity believe it or not. I don’t miss them.

I’ll keep you posted on how my struggle with FOMO goes.

Kalona Adventure

Man, it was hot yesterday—par for the course for this time of year. Sometimes it seems like we skip spring and just start with summer. It was in the 90’s and muggy.

So Sena and I decided to head to Kalona to do some outdoor shopping at the Maple Avenue Greenhouse. Sena is the gardener and I mostly stood by the cart to make sure the surface temperature maintained a steady first degree burn level.

Sena found the Jacob’s Ladder plants and I found the martins houses near the entrance to the greenhouse property. I looked up Jacob’s Ladder later and found out that the name comes from how the plant’s pinnate leaves grow up the stem like the steps on the Biblical ladder of Jacob’s dream.

Jacob’s Ladder

I also found out that Jacob’s Ladder prefers shady and cooler temperatures. Did I mention that the temperature was 90 degrees out in the sun?

We passed the Kalona Creamery on the way out to the greenhouse. After purchasing the Jacob’s Ladder plants, we suddenly got a craving for something cold and creamy.

The Kalona Creamery was established in 2015 and does a pretty good business. It’s bigger than it looks from the outside. Don’t let the cow sculpture scare you. Kalona cows are what this extra sweet creamery is all about.

And in turn, cheese curds and fancy, hand-rolled butter (3rd place at the  2018 Iowa State Fair) is what humans are all about.

Hand-Rolled Butter…and curds.

And don’t forget the ice cream. I have a lot of imagination and cosmopolitan, discriminating tastes—so I got the “Plain ol’ Vanilla.” Sena got the Kalona Crunch—with pecans. You get a chocolate cow with any selection. It brought back memories of hand-churned ice cream in grade school. Man, that’s good.

Plain ol’ Vanilla

And the people were sure friendly in Kalona—even in 90 degree heat.

Hold on for the Kalona Adventure!

Walking the Terry Trueblood Trail in May

We took a walk on the Terry Trueblood Trail yesterday and saw quite a few birds even though it’s early in the season. We caught sight of Orchard Orioles and got a snapshot for the first time of a bird that can fool you into thinking it’s a robin.

There are a lot of Tree Swallows nesting out there. It’s too soon for babies. Sena got a couple of great shots of a sassy Red-Winged Blackbird. I got my first good shot of a Gray Catbird.

Red-Wing Blackbird on the Terry Trueblood Trail
Gray Catbird

It’s very peaceful out there—except when the bugs fly up your nose.

When we got home, we noticed the House Finches flitting around the juniper tree where the giant crow stole all their chicks the other day. It looks like they’re planning to rebuild. Foolhardy.

The robins may have abandoned their nest under the deck but they’ve built a regular Hoorah’s Nest in our front yard crabapple tree. It still needs a proper floor.

Terry Trueblood Trail video

The Bird Saga

The bird saga continues and it has been a little rocky. The cardinals are having an up and down course with their young. They lost a chick. One egg was laid a bit late and so the two chicks remaining are vastly different in size.

Big brother and little brother

The house finches are hatching. So far there were two hatchlings we could see. Out of the five eggs it was hard to tell what happened to the other three. I could see only two; one of them was the brown egg.

My wife took a shine to one of the house finch nestlings. She calls it her “little alien.” Funny, I always thought I was her little alien. Both of the babies look like they have Mohawk haircuts.

The robins probably have abandoned their carefully built nest under our deck. It has been a few days now since the nest was completed and no eggs are in it.

Now we’re starting to see Baltimore Orioles flitting around our garden. There were three of them (all males) and I could barely get snapshots of two. I doubt we’ll see nests. They build pretty high up in the trees.

The Groundhog Effect

Last year, we noticed a groundhog waking up and bulldozing our back yard, even though snow was forecast that day. It’s pretty good at just putting its head down and pushing through almost anything in its path including leaves, sticks, small rocks, flowers, and so on.

Their single-minded digging has helped uncover bones and pottery of old civilizations and aided medical researchers study a lot of things including the role of viral hepatitis in liver cancer.

I can compare them to those who bury themselves in the single-minded study of medicine in the transformative path to medical practice. I can recall my medical school classmates and their clicker pens taking notes in class. They weren’t called “gunners” for nothing. Call it the Groundhog Effect.

Even if you weren’t a gunner, you had to apply yourself just like a groundhog to your studies. It could lead to another characteristic common among these creatures. They tend to be loners.

The analogy is far from perfect, of course. Groundhogs aren’t lonely. People can be, which is why medical students and residents are often advised to always remember H.A.L.T.

H.A.L.T. refers to trying to avoid letting oneself get too hungry, angry, lonely, or tired. It’s probably a warning about incipient burnout, a problem that affects at least half of physicians and which is the hot topic these days.

I’m always a little puzzled that so many physician wellness programs and meetings seem to devote a lot of time trying to teach doctors how to improve their resilience. It’s as though we’re somehow to blame for getting burned out.

I’m not saying learning things like mindfulness are not important for promoting physician wellness. I have my own daily mindfulness practice and it is certainly helpful.

It would also be nice to spend more time addressing the systems issues contributing to physician burnout, such as very full clinic schedules, overly complicated electronic health records requiring hours of data input that create the need for “pajama time,” which is bringing your job home with you, board certification busywork, managed care rules that marginalize physicians, and so on.

This is a continuation of the hassle factors that can lead to physicians just learning to put their heads down and dig through the mess—sort of like the groundhog, and often in isolation from each other.

Transformative processes can also occur at the end of a physician’s career. I’ve spent a long time learning to be a physician and now that I’m in phased retirement, I’m finding out how hard that can be. It would be helpful to know that others are passing through this stage as well, and that I’m not alone.

Could it be that one way to counter the Groundhog Effect is to come together and share this retirement experience? There will always be those who work well into their nineties and that’s great. Statistically, though, most of us will retire in our mid-sixties.

The graying out of the psychiatrist population is contributing to the shortage, to be sure. But we could still be useful to the next generation of doctors acting as role models for how to navigate the other transformative process—reflecting on the task of becoming somebody other than a physician. I think it would be easier if several doctors did this.

Animals do this. I saw this several years ago when we owned a house with a fountain, which was frequented by more than a couple of species of birds, including Bluebirds. They gradually arrived but were at first tentative about immediately diving in. One would perch on the rim. Another would come along and do the same, maybe drink a little water while watching the other.

Eventually, one would dip its tail feathers in just for a moment. Pretty soon, they would make like ducks.

I guess you could call it the Bathing Bluebird Effect.

What’s Up with the Birds?

Since my last post about our birds, we’ve had some new developments. The robins actually have a pretty fine nest now under our deck. I managed to get a blurry snapshot of mama robin actually sitting in the nest. I’ve also caught sight of a portly male cavorting with her on our porch rail. Early this morning the nest was empty.

There’s an odd, brownish egg amongst the house finch clutch. I’m not sure what that means, if anything. Maybe it’s the same as brown or white chicken eggs. E.B. White wrote an essay entitled “Riposte,” (in White, E. B. (1999). Essays of E.B. White. New York, HarperPerennial), which treated the difference in some detail. The general idea was that brown eggs are more “natural” than white ones because they are suggestive of the country. However, the last paragraph of the essay mentions a farmer who planned to promote green eggs and who knew of a hen who could lay them.

See that brown egg?

That reminds me. Later today, I noticed some pretty large green eggs, not just in the robin’s nest, but in a few other places too. Robins don’t lay eggs as big as my head and they generally are not green; they’re robin’s egg blue as the saying goes. As for who laid them, I think I spotted the culprit out in the garden.

There are still just 3 cardinal eggs. Mama cardinal lets me get pretty close to the nest these days before she thunders off. She tries to hide behind leaf and junk. And papa is stand-offish as usual.

My wife is pretty busy in the garden and pointed out that I don’t have any shots of the pansies. They’re a sure sign of spring, along with the daffodils and tulips—and cavorting birds leading to many eggs.

Pansies; a sure sign of spring!

Spring

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

Even the birds know that.