Pain

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This is not an altered Shakespearean quote, in case you couldn’t tell

Hello and good morning.  It’s Thursday, and for the first time in quite a while, this is my weekly blog post, the way I used to do things.

I’ve not been very well lately, even by my standards.  By which I do not mean that I haven’t been writing.  Monday morning I wrote just under 1400 words on Extra Body, which I guess is a good thing.

Then, Tuesday I did not go into the office.

I’ve had a particularly bad time lately regarding my insomnia.  Since Friday night, I haven’t had a single night with as much as four hours of sleep, and many of the nights have seen significantly less.  On Tuesday morning, I just stayed home and took some Benadryl, which only made me doze off for about two hours.  Then, Tuesday night I got another few hours, and went to work Wednesday.  I felt a little loopy during the day yesterday, to be honest, and occasionally I even acted a bit silly.  I suppose everyone at the office thought I was feeling better.

But even my pain has been worse than usual, too, probably largely because of the sleep deprivation.  I don’t think that the causality works in the other direction, because it’s usually not pain that wakes me up; it’s the semi-panicked feeling that I must have overslept by hours and hours, even though it’s only been about five minutes or so since I dropped off.

In any case, I have some kind of feeling of anxiety or vulnerability while I’m asleep.  You’d think I was a Vietnam veteran or something, except I was born in 1969, so I would have been very young indeed to serve.  Whatever it is, I don’t feel safe, or at least secure, when I’m asleep.

Still, it’s not as though I’m safe when I’m awake.  The thing is, no one is safe, not entirely, and no one ever has been (as evidence, note that almost all people who have ever lived are currently dead).  And I frankly find life mostly painful and stressful and exhausting and lonely and dreary, so I don’t know what exactly I’m afraid of such that I’d feel worried about having anything taken away from me.  It’s weird.

Anyway, I didn’t even bring the little laptop computer with me on Monday when I left the office, so I didn’t have it when I was on my way to the office (extremely early) on Wednesday morning.  Instead, I decided to use the Word app, which I’ve mentioned before, and I started to write the beginning of HELIOS.  I did not plan to go far, and I didn’t, writing just over five hundred words‒just beginning to introduce the setting, really.  Then I got to the office and wrote a bit over 800 words on Extra Body, bringing my total new words that day up to nearly the same as on Monday.

On Monday morning, I even strummed the guitar just a little bit.

Unfortunately, there has been no joy in writing fiction‒nor in playing guitar, come to think of it‒since I’ve restarted doing it.  I don’t blame the fiction, of course.  Nor do I blame the guitar.  The problem is my own faulty hardware and/or software, my operating system or particular programs or I don’t know what.  To quote C3PO, “He’s faulty!  Malfunctioning!”

I wish I could get some kind of system update that would fix some of the bugs.  Or at the very least, I wish I could reboot from time to time‒in other words, that I could just get a restful night’s sleep.  I feel that if I could get just a good night’s sleep, it might be almost like a little resurrection.  I still recall how good it felt on that day in the nineties when I had my last (or at least my most recent) good night of sleep, from which I awoke refreshed and rested the next day.  I don’t recall what I did that day, but I felt amazing.

I don’t know how I could accomplish that, though.  I’ve tried medications of various kinds, but they’ve tended just to make things worse.  I can force myself unconscious with Benadryl, for instance, but I awaken feeling groggy and confused and more out of it than when I went to sleep.  I’ve tried getting massages of various kinds, from real massage therapists and so on, but I guess I can’t really relax with a stranger.  And massage chairs, unfortunately, just don’t do it.

So it sucks, and I’m tired, and I’m in pain, and I see no light at the end of the tunnel, not even a glimmer, not even a glint.  All I see is a vague sort of swamp-light haze, a sort of sickly phosphorescence.  There’s just enough light to be able to take in the dreariness of my surroundings.

Blackness would be better, honestly.  Black, silent, empty oblivion seems quite preferable to my life, in which the only joys I know are the guilty (and steadily diminishing) reward of food, and‒as Steve Martin said‒a dishwashing liquid.

I need just to opt out.  I need just to work up my nerve.  That’s the hard part.  Fighting against those ingrained drives to stay alive even though it’s not merely utterly pointless but almost entirely without joy (yet almost never without pain, both physical and psychological).

It’s been getting old for a long time.  I’m sure you’ll all agree.  From within, I feel about a thousand years old, or a million, or a billion‒but I’m not an organism built to live that long.  So, again, I’m faulty and malfunctioning, held together by gaffer tape and twine and mud and twigs and clothes-hanger wire and paper clips, with modeling clay stuck in some of the holes to keep the damp from getting in.

Anyway, that’s my status for now, which is nothing new, just more (and gradually worse) of the same.  I hope you’re all feeling much better than I am.  At the very least, you deserve it for being patient enough to read my blog.  That’s a definite trial by ordeal.

I will do my best to keep writing fiction tomorrow, and I plan to do next week what I planned to do this week, though hopefully with at least a little bit more sleep.  By which I mean, I want to try to write fiction every day but Thursday.

If you see a post go up on some other day, it means I lost my resolve for that plan, at least temporarily.

If you don’t see a blog post at all, not even next Thursday, then either I’ve gotten sick, or I’m dead.  The longer time passes with no posts, the more likely it is to be the latter.  We can always hope, right?  I don’t know, maybe you think it would be a negative thing for me to die.  I’ll even admit that I am afraid of dying, by which I mean the process.  I don’t so much want to die as I want, most days, to be dead.

Silence.  Oblivion.  These things so often seem so much better than the noise and stress and tension and pain of awareness.  If I could just become “comfortably numb” it would be a vast improvement.  But that’s not likely.

TTFN

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“I can see you’re out of aces”

Well, it’s Saturday morning and I’m on my way to the office in the back seat of an Uber, against my better judgment, for various reasons, into some of which I may (or may not) get during this post.

The day has not started auspiciously.  I got up and got ready to shower, selecting my clothes for matched colors* and all that, and then turned the shower on…and the shower head popped right off, and water shot all over the place.  I tried an impromptu fix, but there’s cracked plastic in the portion that grips the actual shower head in place, and I’m going to need to provide a stronger repair for that.  I have some things in mind, but in the meantime, I had to wash my hair in the sink and write an IOU to my body in the form of antiperspirant and aftershave.

Of course, I could either get in touch with the owner/landlord or my former housemate to get it fixed (or replaced), but that would entail having one of them come into my room at some point, and I’d rather avoid that if I can.  I think I’ll watch some videos about how to put in a new shower head and/or go to wikiHow for an eventual fuller fix.

That’s if I don’t just die before it becomes relevant, which doesn’t necessarily seem like the worst option.

I had abdominal pain yesterday during the day similar to what I had on Wednesday, which I think I wrote about here.  It may be because I’ve been trying to institute a form of daily exercise that I used to do, but which I haven’t done in a long time, and it’s putting strain on my mesentery or something.

I suppose it could be an abdominal aortic aneurysm that’s getting close to rupturing, but that seems unlikely‒I’ve had MRIs and such of the area in the past and there’s never been any sign of such a thing, and they don’t just happen overnight.  It’s kind of a shame in a way; if one of those ruptures and you’re not in very close proximity to an operating room, you’re in for a probable quick death.

That wouldn’t be too bad.

It’s also very unlikely to be appendicitis; although it is similar in character to the initial stages of that disease, if it were that, it would have progressed by now.  Appendicitis doesn’t come and go.  At least, I have never heard of a case in which it does 

It’s probably just a combination of something I have been eating and my attempt to do new exercise.

Anyway, it doesn’t matter.  It’s just one more of the numerous forms of pain, both literal and figurative, that one can experience in life.  I’ve also been getting some threatening esophageal spasm, something I know and recognize from doleful experience, and that is a very unpleasant sensation.

I guess I shouldn’t restart that exercise, after all.  I had tried it as an alternative to walking because of the irritation of my left knee, but I guess I’ll have to find some way simply to adapt and ease that knee’s trouble.  It would be nice to use my bike, but I’ve had trouble with that due to my back.  Still, maybe if I commit to it, I can make biking something to which my body will adapt.

Sorry, I know all this is probably incredibly boring.  It’s also probably just silly fantasizing, since I don’t think I’m ever going to get back into any kind of good shape.  I want to lose weight, because I find myself disgusting, but I keep falling back into bad dietary habits, or developing new bad dietary habits.

It might be easier if I could think of any good purpose for getting healthier other than just living longer in the profoundly unsatisfactory state in which I currently live**.  Pink Floyd may be right when they say that hanging on in quiet desperation is the English way, but though I revere much of their work, I am not, in fact, English, so I don’t want to do it.

If I have any English blood, it’s very dilute, so to speak (though I am an anglophile nevertheless).  Most of my ancestry is Irish, with some Scottish here and there, unless I am very mistaken.  I never did the “23 and Me” thing, but others in my family have, and though there were little surprises here and there, as far as I know I have few direct genetic connections to the Angles (or, presumably, the Saxons).  Mainly it’s the Celts.

That was another weird little tangent, or digression, or however else you might prefer to refer to such deferrals of main ideas.  I don’t really have much more to say today, anyway.  Don’t expect a blog post on Monday or on Tuesday or on Wednesday.  I may succumb and write a post on any or all of those days, but my intention remains to do fiction writing on those mornings.  I also intend to go back to taking the bus at least on the way back to the house, unless or until I can get used to walking without causing too much exacerbation of my left knee, or to biking without exacerbating my back.

Of course, we could all get lucky and I could have something fairly severe going on in my belly, and I might never write any blog posts or fiction again.  If not now, something like it will happen eventually.  “The losing card I’ll someday lay,” as the song says.  In the end‒as it was so beautifully put in the Kenny Rogers song, The Gambler‒we all break even.

In the meantime, for those of you who celebrate it, please have a Happy Easter tomorrow.  I hope you get a chance to enjoy some time with friends and/or family, and that you all feel at least a little bit personally resurrected.

*That’s a minor joke; I only wear one “color”, top to bottom, inside and out.  It makes everything less stressful.

**I don’t mean Florida, though that would make for a reasonably funny joke.  I mean “state” in one of its other standard uses:  the specific condition that someone or something is in at a given time.

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Be sure to warm up before kipling

Here I am at the train station, to which I arrived quite a bit later than I ought to have done, because Uber switched drivers on me twice, meaning I was assigned to 3 different people, resetting the waiting clock each time.  Then the last driver didn’t follow the route recommended by his own company’s app, apparently thinking that taking the interstate would be faster.  Long experience with the area leaves me with the knowledge that the route that the app recommended really is the fastest route, especially at this time of day.  I was very tempted to give the driver a low tip and a low rating, but since I recognized that some of my animosity is due to matters outside his control‒specifically, the changed drivers‒I would not let him bear the brunt of the consequences.

I need to quit taking Uber.  I’ve curtailed my morning walk for now‒working on a different form of exercise‒because it’s been causing my left knee to act up with greater and greater severity.  But taking the bus to the other train station adds nearly an hour to my commute, or at least it makes me get to the office an hour later.  It’s very frustrating.

Obviously, I’m not writing any fiction today.  I’m not really doing much of anything that matters at all to me today (except, perhaps to a small extent, this blog).  I don’t think I’ll write fiction or play guitar or sing or study any interesting subject today.  By yesterday already, I was too drained and distracted to be able to consider focusing on studying any mathematics or physics or whatever, even just by watching videos.  Ear plugs and hearing protectors don’t help noticeably.

Today, I think I’m going to use double ear plugs in each ear.  They’re the little squishy, compressible, throw-away earplugs, so they can be rolled down to small enough size to insert even when doubled, I’ll wager.  I’m not terribly fond of having crap stuck in my ear canals, but it’s better than being exposed to all the loud voices and noises.  At least, I suspect it is.

You’re probably wondering why I keep going to the office and back and all that.  It’s a fair question, but the answer is neither profound nor very interesting:  it’s just all I have.  I can’t see myself trying to find a different job.  At least I know the people at this job, and I even like most of them.  And I’m at least used to the place where I live.  It’s decent.

I am frustrated about the fiction writing thing, though.  I haven’t even bothered taking the laptop computer back with me at the end of the day so far this week.  I know I’m not going to use it.

I sometimes wish I’d never started doing this daily blog, but it seems I don’t want not to do it.  It’s my pathetic little scent-marking on the world, I guess, though it’s probably not very interesting most of the time.  For instance, I doubt many people enjoyed my weird asides about cosmology yesterday.

It’s hard to remember writing much of Son of Man on my tiny old smartphone back in the day, but I know I did.  I think I didn’t do indenting, but instead just did double line breaks for paragraphs and then corrected the layout after the draft was done.  I suppose, in principle, I could do that here also, but I fiddled with it last week at one point using the Word mobile app, and found it very unsatisfying.

Of course, I did not use Word to write the initial part of Son of Man.  I used the notepad function on my smartphone at the time, which is reasonably impressive, even to me.  But it would seem a shame not to use my laptop computer, now that I have it.  I suppose I could bring it with me and write fiction in the morning before even leaving the house, and take the southbound bus to catch the northbound train‒that bus route doesn’t begin until far too late for the early trains.  I hate the idea of arriving so late, though, especially since I’m awake anyway in the very early morning, no matter how much trouble I have falling and staying asleep.

I really hate my life, to be honest.  I’m sure you picked that up by now; it’s not as though I’m being particularly subtle.  I’m just so tired.  I’ve lost almost everything that ever mattered to me.  What is it Kipling wrote, “If you can bear to hear the truths you’ve spoken / twisted by knaves to make a trap for fools / or watch the things you gave your life to, broken / and stoop build ’em up with worn-out tools…”?

If so, then…well, you’re probably just a stubborn idiot, I don’t know.  Don’t get me wrong, it’s a nice poem, very stirring and well-written, and obviously quite memorable.  But at the end, your big reward for all the listed attributes is, “you’ll be a man, my son”.  That’s it?  You get to be “a man” according to the criteria set by Rudyard Kipling?  Well, bully for you, I guess.  I don’t even feel human, let alone that I’m a man according to a nineteenth century author and poet’s* judgment.  I frankly feel dishonest when I have to check the Captcha box that says I’m not a robot, for crying out loud.

Anyway, that’s enough of my shit for today.  Unless we’re all lucky and something kills me or severely injures me between now and then, I guess I’ll write another blog post tomorrow, and I’ll probably be no closer to solving my difficulty with fiction writing than I am today.

I hope you’re all doing as well as you can do.

*He was a good one, though.  Gunga Din, The Jungle Book, all that kind of stuff was not half bad.

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Won’t you spring into silence with me?

Hello and good morning.  It’s Thursday, the day of my old, traditional blog posts.  It’s also my second and the planned last blog post for this week.

In the morning, I entertained trying to write a post in the afternoon yesterday, and I even thought about it in the afternoon for a bit.  But there was just too much noise and irritation, and I couldn’t summon the concentration.  This is a bit similar to what often happens with my thoughts about studying during slow time at the office.  I consider it often, and in the morning, while I’m walking, if I’m listening to some science-oriented book, I think with truly eager anticipation about cracking open one of the texts I have at the office.

But the overhead noise and the people being late and saying silly things and all that just wears down my concentration.  I have to use all my energy just not to go berserk and/or leave the office.  Even when I am the one who chooses the overhead music playlist, as was the case on Monday and Tuesday, it’s not enough.  The only playlist I want is the original sound of silence, and I don’t mean the song by Simon and Garfunkel.  I mean silence, like that abyss between the stars I mentioned a few days ago.

There’s a reason Sailor Saturn is my favorite Sailor Senshi.  She’s the sailor of silence, the bringer of total destruction (and also rebirth, but no one’s perfect).

Anyway…

I walked to the train yesterday.  It was a good day for it, since it was relatively cool down here.  I also wrote a little over a thousand words on Extra Body, and that’s also good, of course.  I really find it tempting to want to write some on it every day, but I fear that I would lose my motivation if I did.  Also, as I’ve said before, this blog is my only frequent contact with the “outside world”, and my only personal “cry for help”, though that last part isn’t doing so well at its purpose‒which makes it pretty typical for things that I try, come to think of it.

The whole thing highlights one of the big problems with the various forms of serious mental illness:  The very nature of the problem significantly hinders the ability of the sufferer to seek or ask for, let alone to obtain, help.  If no outside person actually does anything, no assistance arrives, except perhaps after some true catastrophe, by which time it is often too late.

I suppose part of my problem in using this blog for that purpose is that I leave readers subject to the bystander effect.  Read about it.  It’s quite disheartening, and is yet another way the world sucks.  Basically, a person is more likely to help someone in need if he or she is the only one who can help.  When there are more people around, not only is each individual less likely to provide assistance, but the overall chance of anyone helping the person in need is less than if there was just one person to help.  At least, that’s if I recall the overall data about the effect well.

The most famous case of it turns out not to have been as clear-cut an instance as is often believed, so I won’t describe or link it here.  But there is some data demonstrating that people are less likely to offer aid to those in immediate need if there are other people around.

There’s at least a fair chance that someone will catch any events surrounding someone crashing and burning on their smartphone, though, and will share the video to social media.  If anyone ever wonders why I often express the sentiment that the human race ought to be destroyed, it’s these sorts of things that engender such a sentiment.

I don’t really know what else to write about today.  I’d love to discuss psychology and physics and math and economics and biology and philosophy, not to mention writing, but I’m frankly just exhausted.  I had a terrible night’s sleep last night, and I feel less well-rested after getting up than I did when I went to bed.  This is not unusual.

Also, the arthrosis in the base of my thumbs is getting worse, and I have not yet figured out any adequate therapeutic intervention.   Even doing the small amount of note-taking by hand that is required by my job is quite uncomfortable.

Don’t get me wrong, it’s not horrific pain or anything like that.  I’ve had and continue to have far worse.  It’s just yet another straw laid across the dromedary’s hump, which would be fine if there were a good reason to keep carrying the load, but I have no such reason; I merely have the habit.

Life, for me, may be merely that:  a bad habit that I need to break.

Anyway, that’s enough for today, and for this week, and so on.  I hope you’re having a good first few days of Spring in the northern hemisphere; I hadn’t realized on Tuesday that the equinox was that day, slightly earlier (from a Gregorian calendrical point of view) than is typical, and by the time I did, the post had already been published.  Oh, well.  I’m probably the only one who cares, anyway.

TTFN

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“What hears with their ear? The abyss between the stars.”

It’s Friday, and presumably I’m not working tomorrow.  I don’t think I will work even if it turns out I am working, if you take my meaning.  I’m too tired.  My coworker was out sick yesterday, and so were some other people.  Unfortunately, I’m not sick, apart from the chronic, sick-in-the-head sort of sickness with which you all are no doubt familiar.

I’m writing this on my phone, though I brought my laptop computer with me yesterday.  I had thought to whip out a draft of a blog post on it then write a page of Extra Body before editing the blog post, but now I’m having to wait so long for an Uber that I decided just to take one into the office, anyway.

I hate how Uber always tries to get you to do the “share a ride” thing.  I wish they would stop suggesting it to me, or that there was some setting in the app that would let me tell them never to offer me a shared ride.  In the unlikely event that I want to share a ride, I’ll select that option from the start.  Stop “nudging” me.  It’s unpleasant enough for me to have to deal with the fact of the driver; I don’t want to share the back seat with some other stranger.

Actually, if I’m going to “share a ride” I’ll just take the flipping bus and pay pennies on the dollar, as the saying goes.  I really should just do that, anyway.  Uber and Lyft are bad habits, and not cheap ones.  In fact, I ought just to be walking to and from the train in the mornings, since riding the bike makes my back and hips absolutely scream with pain afterwards (which is very disheartening).

I took half a Benadryl again to try to help me sleep last night.  I don’t think it actually helped me rest, but I do feel groggy and incoherent this morning, so it’s had some effect, subjectively speaking.  I don’t know if you readers can tell, though.  It may well be that, from your point of view, I’m always more or less equally incoherent.

I feel that I’m becoming more and more decoherent with every day.  I wonder if my wave function is collapsing.  Can the Born Rule be applied to a human…or to whatever I am, for that matter?

I’m being silly, I know.

In a sense I suppose the Born Rule could apply to an individual if that individual makes a decision based on a quantum measurement.  There is, apparently, an app that allows you to do just that; it’s connected to a beam splitter in some lab somewhere, through which one photon at a time is being sent, and it tells you which direction a given photon ends up being measured.  Thus, you can make a truly random decision if you so desire‒as far as physics can currently tell, a fundamentally random decision.

A coin flip or a die roll is not fundamentally random, though for practical purposes it may as well be.  We don’t have access to enough information to predict a given outcome on a fair coin or die, but in principle it is possible.  Whereas with a photon going through a beam splitter, we have a completely, in-principle, unpredictable process.  The Nobel Prize was recently awarded to Aspect et al for their experiments that tested and confirmed the Bell inequalities, thus disproving anything but the most esoteric forms of “hidden variables” descriptions of quantum mechanics.

Sorry.  That was one of my weird tangents.  I’m a bit too mentally fatigued to restrain myself very well.

This sort of thing happens in real life, too.  Yesterday, I was talking about something to do with some song that came on the playlist to my boss, and I went off on some esoteric tangents about music and stuff, and I could finally just see his eyes start glazing over, so I pulled up short.  Then I caught myself looking up to see if I could find someone else in the office with whom to share some of my trivia and my thoughts about songs and various other things.

I caught myself in time, though, and retreated to my desk.  Then someone asked to change the music playlist to some pathetic new artist and related crap that wasn’t nearly as interesting.  I briefly put in my earphones and listened to some of the Feynman lectures on physics to block out the noise.  That didn’t work for long, though, because I kept having to do office stuff that required interaction with living humans.  And then, of course, I had to work through lunch, because three people got sales all at once, just as lunch arrived.

I hate my life.  I really do.  It’s not just work that I hate‒at least that involves some purpose, however unfulfilling.  I also hate my time “off”, my lack of friends, my apparent inability to be a friend, and my inability to be able to fucking sleep, along with many other things.

I’m so tired of it all.  I’m tired of writing this blog, but I feel stressed at the prospect of not writing it.  I don’t get tired of writing fiction so much as feel it’s an exercise in futility, and so I generally don’t get started anymore.

Then again, everything in the universe, ever, is just an exercise in futility.  As Charles Halloway said*, “Where do you come from?  The dust.  Where do you go to?  The grave.”  The same could be said of every planet and star and cluster and galaxy and every bit of the observable universe and everything else that may be beyond it‒metaphorically speaking, anyway.  Dust is something within the universe, as are graves, so it seems unlikely that the universe could come from dust.  But I think you get my point.

It’s that there is no point.

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This is the way the whirled Ns knot…

Hello and good morning.

It’s Thursday morning, which long-time readers will be able to tell from the opening line of this blog post, even if they don’t happen to have the day of the week displayed on their computers.  Does that actually happen, anymore?  Are there people who have smartphones and tablets and laptop computers and desktop computers where the computer‒they are all computers‒does not keep them informed of the day and date?

Based on some of the things I see at the office, you would imagine it to be thus, but I think that’s mainly a function of people not paying attention.

Speaking of people not being as sharp as they might be, I was a serious mess yesterday.  I’m not at all sure that my blog post was coherent, but I know that at work I struggled to be sensible.  Numerous times while I was there I lost track of what I was doing, and had to shake myself into focus.  It’s a good thing I prepare for the payroll ahead of time and that the boss looks at the results before I send the numbers in.  Also, it’s good that I do it every week, so it doesn’t require as much concentration as it would if I were doing it for the first time.

I did not write any on Extra Body yesterday, despite my hopeful intentions.  I left the office after lunch, with my boss’s blessing (so to speak) because he and everyone else could tell that I was really a mess.  If I were someone with a drug problem, they would probably think I was using.

I wish I could say that I had been able to get back to the house and go to sleep and sleep until time to get up.  Well, I did get back to the house, of course; that much is true.  But it took me a long time to be able to get to sleep, despite half a Benadryl.  I also started waking up at a little after 11pm (!).  I didn’t get up then, of course, but I kept going through my frequent awakening more or less from then on, until I finally got up five minutes before my alarm.

I feel more rested than yesterday, but that’s not saying very much.  It’s like beating your personal best on the 100 meter dash when your personal best was 5 minutes.  My chronic pain doesn’t help any of this.

I’m sorry, I wish I could write about more interesting things, or even that I knew what readers would like to read.  It seems that unpleasant things are all that’s ever on my mind.

I know a fair amount about various science topics and obviously about medical matters, and some mathematics and some philosophy and psychology and (ugh) politics and whatnot.  But it’s very difficult for me to find the energy to do anything interesting because I’m always tired, I’m always stressed, I’m always in pain, and I never get enough sleep.

I don’t know if I’m going to keep doing this much longer.  I didn’t even bring my computer back with me last night; I’m writing this post on my smartphone.  I’m tempted to go back to doing at most once a week blog posts, and trying to do fiction on the other mornings.  But I feel this blog is the only strong connection I have with the wider world out there, other than my sister.  This is my only means of reaching more than one person.  It’s also my only good means of sending out my distress call, my cry for help to the world.  At least, it’s the only one I seem capable of using.

It’s not very good at that, though.  There just aren’t all that many people who read it, and though I get some encouraging words from time to time, that’s only going to have a limited effect.  If you’re trying not to drown, it can be nice for someone to shout for you to keep swimming, that you can do it, that you just have to keep treading water…but only if more concrete help is on the way, and you just need to stay above water until it arrives.  If there is no actual boat or floaty ring or rope or lifeguard coming, then at best you just become a spectacle, where onlookers perhaps try to guess just how long you’ll be able to keep afloat before you finally go under for the last time.

At least I guess I’ve been able to offer that bit of entertainment.  I wonder if anyone has been making bets on length of time and specific outcomes for me.  If anyone has, let me know‒I think I would find it funny.  Don’t tell me what you bet on, whether it be how long until I die or by what means I will die or what have you; I don’t want to be unfairly biased either in your favor or against you.  But it would be funny to learn that there were spectators who were willing to admit that they’re morbidly curious just to see if I’ll actually die, and when.

That’s enough of that for today.  I don’t know what I’ll do from here on out.  It was tempting just to drop onto the tracks in front of the train as it was arriving, and sometimes I feel like I don’t give a shit if I inconvenience all the passengers.  But of course, I do give a shit about that, at least so far.  I don’t want to screw up everybody’s day.  The world is hard enough as it is.

Also, it would be a frightening way to die, and I’m not sure I’m bold enough for it.  You have to overcome really powerful instincts to do something like that, which is no doubt why many suicides are associated with drugs and alcohol.

I don’t know.  I might go back to writing fiction every day except Thursdays.  Or I may stop writing at all.  Or I may just collapse and fall apart and give up, I don’t know.  I’m so very very very very tired and uncomfortable.  And I have no real reason to expect it to get any better.

TTFN

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Below average night, average post

I had a horribly interrupted and just generally bad sleep last night.  One might imagine, after decades of insomnia, one would be relatively inured to the paucity of sleep one gets, and that the relative worsening of a single night would make little difference, but it doesn’t appear to be so.

Of course, it’s possible that something else is making me feel particularly horrible, and it has nothing to do with my exceptionally fractured night’s sleep.  It’s also even possible that the two facts are causally linked but in the other direction, and that whatever is making me feel bad is what made my sleep worse than usual, not the other way around.  It’s difficult to tell without more information.

It’s also possible—thought extremely unlikely—that everything I’ve experienced since early August of 1988 has been a dream, and soon I will awaken in the recovery room after my open heart surgery, thinking, “Damn it, I survived,” which is roughly what I thought when I first woke up from that surgery.  It was not a pleasant awakening; I was cortically blind for about a day (though I didn’t realize it at the time), I was (obviously) in quite a lot of pain, I had three chest tubes and a couple of central lines and an endotracheal tube inserted into me, and my hands were strapped to the bed rails.  I probably looked vaguely like something out of an H. R. Giger painting.

Anyway, the point is I feel really worn down this morning.  I almost wish that I hadn’t brought my laptop computer with me, because my backpack feels like it weighs twice as much as usual.  That’s an illusion, of course, but the experience is salient even if misleading.

I resaved this original file for yesterday’s blog post with a new name—not overwriting the original draft of yesterday’s post—in order to avoid having to start a new post with that (cr)Aptos font and change it to Calibri.  I wonder how many people like the new default font, how many people really don’t care, how many people, like me, dislike the new font, and how many people don’t mind it so much but don’t appreciate the whole “change for the sake of change” nonsense that motivates so much of the computer industry these days.

“All improvement is change, but not all change is an improvement,” as Eliezer Yudkowsky has said.  I could not agree more if I tried with both hands (which I am doing, at least while typing).  This is one of the reasons I hate political and related slogans in movements that simply talk about making “change”.  Change in general is easy enough to make.  If you ignite some thermite and napalm in the middle of a house, that will change the house.  For that matter, so will hitting the house with a tornado, or a large asteroid.

Does any environmental organization say, “Let’s work together to make real climate change”?  It would be slightly humorous, I suppose, but it would miss the point.

As an aside, the southbound train just pulled into the station across the way, and my computer automatically logged into its Wi-Fi and saved the draft of this post to my OneDrive, because apparently I’ve logged into that train’s Wi-Fi in the past and saved the link.  That’s pretty nifty, when you think about it.  Now it’s pulling out and soon I will lose that connection.

The ease of such things, and their automaticity, is quite remarkable and useful, though of course, it entails certain vulnerabilities as well.  Still, it’s fascinating just how well the nature of such codes as used in Wi-Fi signals allows them to transmit useful information with barely any connectivity.  This is the real difference between digital and analog signaling, and it’s one of the things that makes me want to study Information Theory more deeply.

I have an audio textbook (very basic) on information theory, but I don’t tend to listen to my audio books except during long walks, and I’ve fallen off that wagon a bit.  But still, Information Theory is really very cool.

If I were able to get good nights’ sleeps, if I were able to rest, I think I would be able to console myself with nothing more than learning about more of these really interesting subjects and having my own thoughts about them*.  As it is, though, I’m so tired and in pain and worn out that most days I just fantasize about going to sleep and never waking up.  It would be nice to have a better future than that, but there’s no good reason for me to expect it.

Meantime, I’ll keep writing this and, as I did yesterday, also write about a page a day of my new story until it’s done.  I hope each of you—and all of you collectively on average—feels better than I do today.  Come to think of it, if each of you feels better than I do, then your average, perforce, will be better than my level.  That’s trivial mathematics**.

*They’re not necessarily banal or unoriginal thoughts, either.  I predicted the tech stock bubble burst in the late nineties well in advance, I recognized an issue with LLMs and the like quite some time ago that was discussed in a Sabina Hossenfelder video yesterday, and I even had some ideas about the reversibility of time and the possibility of the big bang happening in both “directions” that I’ve discovered is similar to some real ideas from real physicists.  I’m not saying I had unique or remarkable or singular insights, but I don’t just passively take in stuff.  I build mental models—I don’t necessarily learn quickly, but I do learn deeply—and they can be useful, at least when I believe in myself.  In the nineties, I did not have the courage of my convictions, and I let a bank talk me into investing in a tech fund, despite my misgivings…and before very long, the fund had lost half its value.  Humility can be a false virtue sometimes.

** Incidentally, it’s possible in principle for 90% of people to be above average, but not for 90% of people to be above the median.  The median is defined, mathematically, as the midway point along an ordered list of ascending values in a group, so literally 50% of the members are at or above the median and 50% are at or below.  With the average—which usually refers to the arithmetic mean, in which one sums all the numbers of a group then divides the sum by the number of members of that group—one can have rare situations such as 90 of a hundred people getting a 51% on an exam and the remaining 10 getting 10%, which would give a mean score of 46, so that indeed, 90% of the test-takers would be above average.

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I should take a flying Leap Day

Hello and good morning.

Happy February 29th.  This is a date that only comes approximately once every four years.  I say “approximately” because as I’ve noted before, on three of every four turns of centuries, there is no leap day.  This is because the length of a year is ever so slightly less than 365.25 days…though I don’t recall if that’s measured in solar days or sidereal days.

Anyway, I’ve gone over this ground often enough already‒too often, probably.  I won’t bore you with more of it for now.  Probably I’m the only one who really finds it interesting, anyway.

Yesterday was a miserable day overall, though I did start off somewhat productively, typing all of what I’d written so far of Extra Body into the laptop computer.  It was almost five handwritten pages, which turned out to be just shy of 1400 words.  That’s roughly how much I used to write on any given day when producing a draft of a new work of fiction.  Anyway, I didn’t write anything new after that yesterday , but at least it’s primed and hopefully I’ll do a page of new writing today, once I’m done with this.  I’m heading to the office early‒even for me‒to try to make sure I have plenty of time to get that started.

I ended up leaving the office really late last night, because now it turns out that even the two people I like most there are getting to be part of the group who is willing to roll over the guy who’s not capable of just shutting out and walking away from work and saying to Hell with people who don’t worry about how what they do affects others.

I was already really depressed and frazzled to start the day.  I even put ear plugs in and then wore my airport-style hearing protector muffs to block out the noise of the music and the people saying silly things.  Neither of the two measures works adequately on its own, but together they do a decent job.  However, the ear muffs give me a headache after a while, because they squeeze my head.

I should just sabotage the stupid sound system; unfortunately, it is both fixable and replaceable.

Sometimes I feel almost as if a collection of a few people in the office‒among them people I thought were my friends‒are trying to drive me to quit, or to kill myself, or perhaps just to lose it in some other way.  I know it’s pretty silly to think such things, but in some ways, it’s emotionally less horrible to think that people are deliberately out to cause me harm than to think that people about whom I care, and who I thought cared about me, are willing to cause me distress and pain just out of thoughtlessness and inconsideration.

I’m probably being oversensitive.  I’m probably actually just on the verge of seriously losing my mind.  That probably wouldn’t surprise anyone.

Anyway, I ended up getting back to the house quite late, and then‒because commuting is not inherently relaxing‒I was a bit wound up and had trouble getting to sleep, so I watched several videos of people “reacting” to songs that I know.  This can be kind of fun, to a limited degree, because it feels almost like listening to a song (or similarly, to watching a movie or show) with a friend who hasn’t seen it before, though there is no actual give and take.

It also doesn’t give you the experience of watching some new thing (or listening to some new song) that you yourself have never seen with a friend, because the YouTube videos can’t really embed an entire show or movie, without being taken down due to copyright.  One has to join Patreon groups to watch things like that, and I’m really only following two people on Patreon.

I joined one of the two to see reactions to Doctor Who, but they are now all caught up, and there won’t be new Doctor Who episodes until May, I think.  They react to other shows, most of which I haven’t watched, but unfortunately, most of those shows are ones in which I am not interested.

I might be interested in them if I truly, literally had someone with whom to watch them; I watched many shows with my (now-ex) wife that I probably wouldn’t have watched on my own, because she was interested in them, and it made me happy to enjoy them with her.  Also, of course, we had similar tastes in many things; there was, after all, a reason we got married.  Or, well, there was a whole set of reasons.  Just one probably wouldn’t have been an adequate incentive for either of us.

But I’m a tiresome person, even to people who honestly love me.  I can sympathize, since I find myself tiresome.  Maybe people at the office really would prefer me to be gone, but are too kind to allow themselves to think such thoughts in their conscious minds, but end up acting on them nevertheless.  I couldn’t blame them, really, for such a thing.  How can someone be blamed for their subconscious thoughts?

I should just take myself out of everybody’s way.  I don’t make other people happy in any kind of reliable sense, but I do make many other people unhappy, though I would prefer not to do so.  Since I’m a net negative on the world, any personal return to zero on my part would be a net gain for the world at large.  And after that, it wouldn’t be my problem anymore.

Time will tell, I guess.  I’ll try to screw my courage to the sticking point and see if I can eventually succeed.  Well, actually, I will only see if I fail.  Only others will be able to see if I succeed.  That’s the nature of the thing, as far as I can tell, and is one of the most potent arguments against it, given I would be causing problems for which I could provide no possible assistance.

But since other people seem sanguine about inconveniencing me‒and it seems to be a general tendency among humans‒I shouldn’t let it be an absolute barrier to my choices, though I still think it should be a relative one.

Anyway, that’s that.  I hope to get a page written on Extra Body today, if I can.  I suppose, if you’re unlucky enough for me to be still around tomorrow and writing my blog, I’ll let you know.

TTFN

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My poisonous (or poisoned) thoughts

I’m disappointed to have to tell you all that I did not write any fiction yesterday.  I didn’t write any in the morning, having written a longish blog post.  Then, by relatively early in the workday, I had become mentally exhausted.

The “music” in the office doesn’t help, since it’s loud and basically unrelated to anything about what we do‒it’s just there for background noise, to dampen the sounds of other people on their phones, or to camouflage it, to break up its signature.  But also, it was just maddening to see again how slipshod and unreliable people are, how little they care about how what they do affects other people (or themselves).

Early in the day, a few minutes after our official starting time, I looked out at the office‒as the person who keeps track of who’s there and who isn’t and when people arrive and leave‒and could see that perhaps only half of the people in the office were there yet.  I noted this to my coworker, who grimly nodded with obvious resigned disapproval.  I told him, as if realizing it for the first time, that it really bothered me.  And it really does.  It’s both contemptuous and contemptible.

We long ago moved our starting time back an hour, nominally to make sure people could get to work on time more easily, since traffic in south Florida really can be terrible.  However, that did not change people’s lateness at all.  It made no discernible difference.

Unfortunately, people suffer no consequences for being late, so there is no incentive for anyone to do otherwise.  They are also not penalized for working over into lunchtime or past the official end of the day (it is often the people who arrive late who also stay late).  So, basically, I never get an adequate break time, since there’s no sensible way for me to go anywhere outside the office during lunch, and those who started break on time restart work on time, and so need support people to be available.

Anyway, it’s appalling that already, by Tuesday, I was simply mentally (and emotionally) exhausted.  And I know it’s not just the specifics of this job that wear me out.  If I were to do any job I’ve ever had in the past, I think I would be similarly worn out; the exact time until it happens might vary slightly, but I don’t think it would do so by all that much.

Even as early as high school, I used to get into these states in which I felt just completely empty, and would have been “happy” to stop, to end right there.  They didn’t happen as often, and I lasted longer between them‒that’s redundant, isn’t it‒and I think I recovered more quickly and easily.  But it went on into college and med school and residency and practice and all that has come after.

The medical work, though harder, was somewhat less enervating, because there were intellectual challenges and the ability to make a real difference for people, and there was a degree of respect.  Also, one was working with professionals at all levels, and that’s reassuring.

I was labeled with depression (then later also, and more generally, with dysthymia) fairly early, and certainly started having these feelings of wanting to die, and more specifically wanting to kill myself, at a young age.  Obviously, there’s some inherent degree of “typical” depression here, but I wonder how much of it might be due to undiagnosed autism spectrum disorder‒assuming that even applies to me, which I think it probably does.

I have no real capacity to seek out diagnosis or help for it or for anything else, frankly, so it’s hard to get any kind of “official” feedback.  Between a kind of learned helplessness from chronic internalized stress (and chronic pain), and my own social dysfunction and my ever-present self-hatred and self-destructive urges, it’s hard even to begin to take care of myself.

Actually, I don’t know if it’s the case that, fundamentally, I hate myself so much as that I hate my experience, my moment to moment interaction with reality.  It’s so often so very unpleasant.  At the very least, there is no single day that I can recall that didn’t include some significant moments of what one might call “spiritual revulsion”, a kind of nausea and stress about how unrational and unsane the world is, at least from my point of view‒and ultimately I have no other viewpoint from which to gaze upon reality.

I think my self hatred is a kind of rationalized conclusion combined with a sort of “halo effect”*.  If the world is so anathema to me, so much of the time, then I must just not be suited for this world.  So, I’m defective, or at least, I’m not the right organism for the job.

Also, since so much of life is persistently unpleasant, and since the single common variable in all aspects of that unpleasantness is me, then I cannot help but have residual disgust and hatred stain my image of myself; it accumulates over time until it’s thicker than a rhino’s hide and as disgusting as the slime of a hagfish.

I don’t know what I can do about it, unfortunately, other than either declare myself the enemy of the world and act accordingly or destroy myself.  Or, I suppose, I could do both.  No matter what, I don’t think I can go on much longer.  Then again, I’ve felt that way off and on for quite a long time.  But it’s becoming more frequent and more persistent‒the pulses are longer and closer together.

My reserves may be deeper than I would ever have expected them to be, but they cannot be infinite.  Certainly on the scale of the duration of the world, I must either lose my mind or destroy myself (or both) before much longer.

In the meantime, I’m going to have to do my fiction writing in some other way, if I do it.  I’ll need to do it earlier in the day, before the troglodytes start arriving and making their noise.  I may give up and use the laptop computer, because the handwriting is really exacerbating the soreness at the base of my thumb.  Maybe I’ll do it in the mornings after my blog post, or instead of it on some days.

I did fiddle with my guitar a little yesterday, so to speak, but that’s far less fruitful than writing, so maybe I’ll just give up on that.

Ultimately, I should probably just give up…period.  Until I do, I guess I’ll keep poisoning the Internet with these, my gloomy thoughts.  Enjoy!

*Perhaps “horns effect” might be a better term in this case.

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Late-arriving, futile “justice” and reminders of a life that has been all but annihilated

I read the news yesterday, oh boy.  And yes, it was about a lucky man‒luckier than I am, anyway, at least in some ways.

There was a doctor in the heartland of America somewhere, I don’t recall where, who had been convicted of, apparently, inappropriately prescribing very large amounts of pain meds, the report quoting the number 500,000* (It seems unlikely that there were 500,000 prescriptions**, so it probably was that number of pills).

Anyway, his conviction was overturned on appeal, because apparently, in 2022, the SCOTUS handed down a ruling that the prosecution had to prove in such cases that there was “intentional or knowing” inappropriate prescription for it to rise to the level of a crime, and the jury hadn’t been appropriately instructed regarding that fact.

I looked up the case, and I’ve even downloaded the PDF of the case.  Although I haven’t read through it yet, the summaries make it clear that, yes indeed, this is a new and specific requirement.

Silly me, I had always thought that mens rea was a crucial requirement for nearly any criminal case, certainly one that rises to the level of a felony charge.  I brought that up with my (public) defense attorney, trying to point out that I shouldn’t be convicted of a crime since I literally had never intended to do anything but treat patients who had chronic pain‒which I did because I had chronic pain, and it had already severely harmed my life.  I knew how hard it was for even a physician, who at the time had good health insurance, to be able to get adequate treatment and even to get his prescriptions filled by often-judgmental pharmacists who looked at him as if he were a criminal just because he wanted to try to mitigate his pain with the most effective medicine that was available.

But no, apparently, according to my attorney, the prosecutor didn’t have to prove any such thing specifically; it could just be inferred.  And apparently I’m not exactly the sort of person to elicit sympathy from a jury in south Florida, because my voice tends to be monotone and my face tends to be expressionless and I don’t look like someone who is frankly worthy of sympathy.

All the charges against me were created by the PBSO, who sent in undercover people with (evidently) faked MRIs and fake complaints, who complained of chronic, severe pain and said they were in pain when I examined them***, and whose own secret recordings and records showed that there were often only one or two other patients in the whole office when they were there‒hardly what one would call a “pill mill” I should think.

Anyway, I was offered a plea bargain and I took it, because unless you’ve got a lot of money or you literally have nothing to lose, you will take a plea bargain in the right circumstances, even though you know you’re innocent.  I’ve written a blog post about how the plea bargain system is an extortionate game slanted against especially the underprivileged.

The statutes involved in my charges were designed by that <sarcasm> bastion of intelligentsia and morality, the Florida State Legislature </sarcasm>, to give judges no leeway, and to grind away maximally at anyone charged with “trafficking”.   If a jury decided that they should convict on at least one charge, since the state had created so many charges against me (each prescription being a charge, and twenty something having been conned out of me by various lying police officers over time) and the number seems impressive, I still could have faced a minimum of fifteen years in prison.

In retrospect, I think I would have been little worse off if I had, given the mockery and shambles my life has become.  But at the time, I hoped to see my kids again, perhaps sometime before they were adults.  Three years was better than fifteen (or potentially the rest of my life), and I had no one else to help me with a legal fight, and certainly no reservoir of money, so I took the deal.

The way things are now, though, I might not have been charged, or might have been offered some misdemeanor plea deal.  Or I might have gone to trial and won with relative ease, since the fact that I never knowingly or intentionally mis-prescribed medicine was a fact I knew for certain, at a Cartesian, cogito ergo sum sort of level, since it was a fact about my own mental state.

I may be naïve, and I often do not understand humans.  I am often easily misled and manipulated and used and misused and probably abused, because I am socially and emotionally very clueless and believe in giving other people the benefit of the doubt (to hold them innocent until proven guilty, in other words).  But I have never been greedy or unscrupulously opportunistic, and I took the practice of medicine and my duty and goal to relieve suffering very seriously.  I was never into making a lot of money, though it was good to be able to buy books I wanted and to take care of my kids.  I lived in a one-bedroom apartment and drove a ten-year-old Toyota Sienna.

Before yesterday, it had been a long time since I’d bothered thinking about what my life might have been like if things had not gone the way they did.  There didn’t seem to be any point.  I was a lost cause and that was that.  But this has made me feel acutely once again the cut of all the lost time with my kids and my lost ability to practice medicine, and all the other losses I’ve experienced as part of this debacle of a life.

What’s more, there’s been salt and vinegar rubbed into the wound by the fact that it took a Supreme Court dominated by many justices who’d been appointed by The Donald to require courts to require prosecutors to prove something that was supposed to be a necessary element of almost any serious criminal charge:  actual criminal intent.

That’s all leaving aside the un-ethics and illogic of the government of the “Land of the Free” dictating what people can put into their own bodies when it doesn’t directly harm other people in the first place.  I won’t get into that because it had no bearing on my medical practice‒I was not in the business of dealing in euphoriants, I was trying to relieve actual suffering.

One cannot really apply new jurisprudence to old cases in which a sentence has already been carried out and finished, and when the consequences thereof are already irrevocable.  I cannot regain the time I have lost with my children or the time I have lost when I could have been practicing medicine, or the time I spent at FSP West or in the Palm Beach County Main Detention Center, where even the people who worked there frequently asked why the hell I was there, or still there (I spent 8 months in the place, on the mental health floor, because I couldn’t make bail, but finally my former girlfriend’s mother helped secure it‒at least she got all her own back after I was sentenced, and I appreciate her very much, though I might as well just have stayed in jail, since at least the whole sentence would have ended earlier given “time served” and I was basically homeless when out on bail, having lost everything I owned and relying on the generosity and kindness of friends/former coworkers).

So I am stuck with a ruined life and a twisted mockery of myself.  The fruits of a considerable number of years of time and effort and thought and creativity on my part**** were all taken away by the mindless grinding of a huge stupid machine of “criminal justice” that has little to nothing to do with the latter part of the term.  I don’t claim not to be stupid or foolish or not to have ever made mistakes in the whole situation.  I make many mistakes.  But it is maddening to see how misapplied the law can be and to experience it for oneself, especially when one is now by oneself, partly thanks to that misapplication, and then to learn that now the law is changed (or correctly applied) such that I could have been in a better situation had that change come sooner.

I often consider the possibility of going to the Palm Beach courthouse, dousing myself in various flammable liquids, and turning myself into a “bonfire of the unsanities and inanities”, to bring attention to some of the costs of misapplied “justice” and to bring an end to my own mis-called life.  I even have two gallons of paraffin lamp oil and six liters of charcoal lighter fluid and a big enough backpack to carry them all, in case I decide to do it.

Death by fire is intimidating, though‒I am no Buddhist monk by any means.  And I also dislike causing inconvenience to other people, even those involved in an institution that had no qualms about recklessly “judging” me and ruining my life.  But it is tempting, and I feel right now even more than usual the utter pointlessness of continuing, even while stupidity in the office in which I work grinds away at me further (though, to give him credit, my boss tries hard to keep things as sane as he can).

I feel rotten enough and alien enough even at baseline, and all this doesn’t help.  I have lost almost all that mattered to me, and I live alone in a stupid one-room (plus bathroom) “in-law” suite that is smaller than many hotel rooms.  All my previous friends are far away, and most are doing much better with their lives than I am and don’t really have much in common with me anymore.  In any case, I don’t really talk or otherwise communicate with them, though it would be nice.

There are also plain few people where I am now who have anything in common with me.  Very few people have much in common with me:  a disgraced physician unable to practice, with a love of math and physics and biology and of Shakespeare and horror fiction and science fiction/fantasy (reading and writing it) and of science and rationality-oriented podcasts and books and videos, who wants to learn or relearn more about modern physics at a deep level and whose brain doesn’t seem to run the same operating system as most of the people around him‒a Linux in a world of iOS, or worse.

So, I don’t know what I’m going to do.  Knowing me, I’ll probably just grind along until I’m worn to a nub and then tumble into the trash can, unmarked and largely unlamented.

I know that I won’t be sorry‒not about that.

*This sounds like an awful lot of pills, but it’s deliberately chosen to sound that way in a manipulative, rhetorical tactic as used by reporters and prosecutors alike.  Let’s run the numbers, as I am wont to do, to see how impressive they really are.

Now, if there were one patient, taking one pill per day‒perhaps the person only takes one prescription, say an antidepressant or a cholesterol med or a long-acting antihypertensive‒it would take nearly 1400 years to use that many pills.  Plain few patients live that long (see my recent blog post), and most pills would long since have expired and become inactive before the end of that time.

Still, the average physician is responsible for the care of 2,000 to 3,000 patients (see here and here), meaning that if, on average, their patients each only took one prescribed pill a day, they would go through 500,000 pills in 6 to 9 months.  But many prescriptions call for more than one pill per day, and uninsured patients cannot tend to afford the long-acting pain meds that claim to allow for steadier doses and thus slightly less risk of rebounds and escalations and all the horrors involved in that.

Now, presently, I take three to nine aspirin a day, sometimes more, and I also take two naproxen and some supplemental Tylenol as well, all of which are more directly toxic to the body than opioids, but are nonetheless over the counter (as they should be).  If I averaged ten total pills a day, then it would take me only 137 years or so to take 500,000 total pills.  That’s longer than I’m likely to be taking pills, but I’m only one person (that, as Dave Barry said, is the law).  An average practice of patients who took only six pills a day would go through 500,000 pills in one to one and a half months.  Many ordinary, non-pain-specific patients, especially those middle-aged and older, take that many and even more prescription meds a day.

In any case, an ordinary general practitioner with a light patient load of two thousand patients, each taking only an average of two pills a day, would prescribe 500,000 pills in 3 to 5 months.  So don’t be too impressed by the carefully curated numbers that prosecutors and media choose to elicit your alarm and disgust.

**Even 500,000 prescriptions, in a modest 2000 patient practice, would require only 250 prescriptions total per patient.  That would certainly take quite a bit longer than 500,000 pills would take, but given an average of only one prescription per patient per month (counting refills) it would only take a bit over 20 years, a decently short length of practice.  Many doctors see more than 2000 total patients and many patients get more than one prescription per month.  And, of course, one cannot even apply refills on “controlled substances”, they have to be literally re-written every month, and patients have to come to the doctor’s office to get them, assuming they can even get them filled.  Monthly doctor’s visits can be hard for someone trying to work a regular job while dealing with chronic pain.  Thus, the whole “mill” part of the “pill mill” trope is created by the law itself, leading to greater costs in time and fees for the patients who are trying to survive after job-related and other injuries or conditions that have caused them chronic pain and make it difficult for them to find consistent, gainful employment or to sustain health insurance.

***Pain is a symptom, not a sign, in medical terms.  We have no reliable ways of testing it, beyond patient report.  We try to find physical correlations when we can, often to see if we can find some treatable cause, but even Harrison’s Principles of Internal Medicine (I think it was on page 80 or 81 of the 14th or 15th edition, whichever one I had at the time) has clearly stated that, for instance, back pain does not correlate well even with specific injuries noted on MRIs and the like.  As large a number of people without pain will have nerve root impingements and bulging discs and the like seen on spinal MRIs as do have pain.  NO ONE KNOWS all the wherefores of this situation, but there is no serious doubt that such pain is quite real.

****It did not all happen during medical school or residency‒one does not coast along from K-12 and undergraduate college and only then start to work hard in med school, especially if one grew up in a blue-collar, factory town outside Detroit.