Don’t Wait for the World to Change

I’m not waiting for the world to change. The Geezer has enough to do just working on changing himself. On the other hand, it’s pretty obvious that I don’t blog just for the heck of it, although it is a lot of fun. I can remember it was almost a year ago that the facilitator of a committee for improving delirium detection and management told me that it’s generally better to try to do one thing at a time. That meant trying to implement a practical delirium early detection and prevention project and not trying to end world hunger at the same time.

A year later, I’m still trying to improve the way our hospital culture perceives delirium and how health care providers react to it, trying to reframe that response to anticipating it instead…and cheering on the movement for world peace. I’m incorrigible.

I say the same things over and over about the importance of preventing delirium. I think I’m lucky to be in an academic environment, where there are young people who may still be teachable. Still, I roll the rock up the hill, day after day after day…and it rolls back down. Internists and surgeons still would rather call a psychiatrist first rather than try to evaluate and manage delirium themselves first (have a look at short link Patients who are not in alcohol withdrawal are loaded with sedatives in well-intentioned but misguided attempts to prevent or treat imagined delirium tremens–and suffer intoxication delirium (see short link . Or worse, they are given beer in a vain attempt to do the same thing (see short link

So I keep preaching and hoping. And I’m not waiting on the world to change.


Author: Jim Amos

Dr. James J. Amos is Clinical Professor of Psychiatry in the UI Carver College of Medicine at The University of Iowa in Iowa City, Iowa. Dr. Amos received a B. S. degree in Distributed Studies (Zoology, Chemistry, and Microbiology) in 1985 from Iowa State University and an M.D. from The University of Iowa in Iowa City, Iowa in 1992. He completed his psychiatry residency, including a year as Chief Resident, in 1996 at the Department of Psychiatry at The University of Iowa. He has co-edited a practical book about consultation psychiatry with Dr. Robert G. Robinson entitled Psychosomatic Medicine: An Introduction to Consultation-Liaison Psychiatry. As a clinician educator, among Dr. Amos’s most treasured achievements is the Leonard Tow Humanism in Medicine Award.