Firemen, Foot Soldiers, And Fixers

The blog has been pretty quiet lately. One reason is that the psychiatry consult service has been pretty busy. I also am in phased retirement and away from the hospital more often. However, I do have a new office, which I plan to keep as neat as possible for the next occupant, whoever that might be. It won’t be long.

Speaking of retirement, my wife, Sena, and I attended a seminar on preparing for retirement a few days ago. It was a marathon that went all afternoon downtown.

There’s a great deal to know about Medicare and Social Security. A lot of current events in the news bear on what life might be like for us in retirement. People joked about Social Security going away.

Maybe “joked” is not the right word. Some members of the audience didn’t want to be there. Others talked enthusiastically about travel plans around the world.

This might be hard to believe, but I didn’t think about the hospital while I was there. I even took notes:

  • Budgeting for retirement
  • Annuitizing
  • Medicare Parts A, B, C, D and other letters of the alphabet
  • Medigap
  • The 4% rule
  • Minimum distribution
  • Taxes
  • The Break Dancing Koala Bear Deduction

Maybe some people wonder whether I’ll be able to retire from the action. As the months go by, I wonder less and less.

One of the best parts of the seminar was the introduction to the University of Iowa Retiree Association (UIRA). The motto on the brochure was “Stay Connected. “ Inside the brochure was a picture of Dr. Arthur Canter, PhD, Professor Emeritus, who founded UIRA back in 1995 and who was the first President. That was shortly before I became an Assistant Professor in the Psychiatry Department. UIRA had 665 members as of April of 2017.

Dr. Canter was a regular attendee at the Psychiatry Department Grand Rounds. I remember him participating in post-presentation discussions. He may still be going. I wouldn’t know because I don’t have time to attend, usually because I’m too busy putting out fires all over the hospital.

There will always be a need for the firemen, foot soldiers, and fixers in the world. When I fall, many will march over me.

By the way, the residents are doing a wonderful job on coming up with an improvement in how we encourage our colleagues to ask clearer consult questions.  You might recall the main impetus for the project was a paper published in 1990 by Dr. J. R. Zigun, who was a psychiatry resident at the time (The consultation checklist: A structured form to improve the clarity of psychiatric consultation requests. General Hospital Psychiatry, 12(1), 36-44).  He outlined a structured checklist called The Psychiatric Consultation Checklist (PCC). The PCC was designed to:

“Assist in clarifying consultation in the clinical setting,

Provide teaching as an “expert” like questioning system,

Establish a database for research regarding consultation phenomena

Be user friendly (i.e., checklist oriented, and

Take less than 5 minutes to complete”

Zigun’s checklist is pretty long and our efforts are producing a similar product. Some complicated and vexing mathematics problems have been given memorable names. Maybe we could call this problem the Zigun Checklist Conjecture. I’m trying to stay out of the way, but I suspect that the trainees will solve the Zigun Checklist Conjecture pretty soon with a process most physicians will find helpful to them.

I’m developing a different checklist at this stage of my life. It’ll include what kind of meals I’ll learn how to cook without burning them to a crisp. Maybe hormone-free sway back nematodes garnished with free range nachos and a finely chopped cheerios side? Full of fiber.

I saw a list of old products that have outlived their usefulness. They included things like the personal digital assistant (remember the palm pilot? I thought not), the calculator, desk phones, pagers (then why do I still wear at least one to three every day?), and so on. Vinyl records were on the list but more because they just don’t go away; some people love to collect them. I still have the first smartphone I ever bought a couple of years ago. I use it as a phone.

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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.