chronic-illness

by

“Well…I’m back.”

First off, I apologize for not writing a post yesterday.  I did not go to work because I was not feeling at all well.  And, of course, the office was not open on Saturday, so I didn’t do a post then.  I ought to have been well rested, at least, but I wasn’t.  Being alone at the house is not conducive to restfulness and recharging for me, though it’s better than not getting days off.  But I have only my own company, and I hate that guy, so it’s not pleasant.

One of my main weaknesses in the realm of the physical is my GI tract, and that was the main problem over the past few days.  I’ve taken a lot of meds for my chronic pain‒aspirin, acetaminophen, ibuprofen, naproxen, all that stuff‒over the last 20+ years (and more, day per day, over the past 10 years or so), so there are no doubt chronic toxic effects on my stomach and even intestines (and possibly liver and kidneys).

Also, I have to take proton pump inhibitors or at least H2 blockers to prevent myself from getting gastritis and ulcers from all the NSAIDs I take.  That’s probably interfering with the absorption of at least some nutrients, such as perhaps calcium and iron, for instance.  I try to counter that with supplements, but it only can go so far.  Also, they tend to cause their own troubles.

Why do I do it?  Well, chronic pain really sucks, I can tell you.  I actually have told you, many a time and oft, probably to the point of making you feel nauseated*.  So I have to make choices about what I value more at any given moment.  And future selves of me don’t always agree with the past selves about these things‒that’s how brains/minds work, I’m afraid.

So, there’s the added frustration of trying to tell myself not to overdo it on aspirin, say, and to cut back on the omeprazole and maybe replace it with famotidine, but failing and becoming physically ill when pain is too much and then stomach upset is too much.  But nothing is ever just right.  And pain is never-ending but not constant, in the sense that it waxes and wanes at least a bit, and some days it is harder to keep to a manageable level than others.

Sometimes it helps if I do things that hurt myself, deliberately, to distract me at least a bit.  That’s difficult to grasp, maybe, for someone who hasn’t experienced such things, but it’s the way it is.  Also, hurting oneself physically can help distract from psychological pain, and give one a sense of at least some control of one’s pain.

Unfortunately, and perhaps strangely, chronic pain does not distract from psychological pain; it makes it worse.  No wonder Darth Vader was always so grumpy‒he was in chronic pain that must have been horrible (which he brought upon himself, of course).  Mind you, the “dark side” of the Force probably didn’t help.

I often think it’s very strange for something like the Force to have a “light side” and a “dark side”.  It feels very much that the sentient beings are projecting their own values onto something that is, finally, a natural phenomenon.  Also, I don’t get why someone would pick a part of the Force to “use” or to follow, but try to avoid the other “side”, if one is truly trying to discern and follow the “will” of the Force.

Oh, well, the metaphysics and metaethics of fictional universes can sometimes be entertaining, I guess, but this is not one such time.

In some ways, it’s just as well that I didn’t write a post yesterday, since it was the 45th “anniversary”** of the murder of John Lennon.  I might have dwelt on that a bit much, since it’s a horrible event that still grinds away at my sense of whether the human race has any net value whatsoever.

John Lennon has now been dead for five years longer than he lived, while his murderer turned 70 this year, alive and at least somewhat healthy.  Well, that little purulent exudate can at least count himself lucky that he has not found himself in my power in the time since 1980.  I would use all my knowledge and all of my quite active and very dark imagination to keep him alive and begging for death as long as I possibly could.  The Spanish Inquisition were pussies.

Anyway, that’s enough of that.

In closing, I just want to share a notion and question that came to me (and has done so on and off):  I wonder if I would get more, or at least second-level, response to my words if I did a sort of vlog in which I read out loud some of my prior posts.  What do my readers think?  Would it be worth it?

Anyway, try to have a good day.  Remember, “do” or “do not” is never fully in your control; there is only “try”.  Or as the Japanese say, you are responsible for the effort, not the outcome.

Yoda’s a moron.

*Ad nauseam, in other words.

**It seems almost disgusting to use that word here, since often anniversaries are celebrated, and this is not something worthy of celebration, but I had a hard time coming up with another word that worked.  And etymologically, the word “anniversary” doesn’t carry value judgments, it just means something that comes every year.

by

Black Friday Sun, won’t you come?

Well, it’s officially “Black Friday” here in the US at least‒an ironic name that referred to the fact that the day after Thanksgiving was, at least traditionally, the busiest shopping day of the year, so going holiday shopping (mainly for Christmas) was always considered an ordeal.  And therefore…well, therefore everyone went and did it.  It doesn’t make a lot of sense if you look at it that way.  But that’s the way humans are, isn’t it?  Think of the hoarding of toilet paper that led to self-fulfilling prophecies of shortages during early COVID-19 days.

So, anyway, I’m going to the office today, because we’re open.  We’re also planning to be open tomorrow.

I wish I were sick.  I mean, I’m sick in the head (ask just about anybody, if they’re being honest) and I have chronic pain and all the fun associated with that, but I am not acutely ill, let alone ill enough that I could mentally excuse myself from going to work.

I wonder what would happen if I just decided not to go.  I wonder what would happen if I just didn’t go to work, didn’t write my blog, shut my phone off or put it on airplane mode, and just vegetated until I wilted and became compost.  Not very much, I suspect.

I mean, people at work would try to figure out where I was, because it’s work, and if I’m not there, someone will have to pick up the slack.  And I think my sister would try to figure out what had happened to me.  But that’s most of it.

A few people would worry, but that would only be for a while, and then even all passing thought of me would taper down, asymptotically approaching zero, but in the fashion of a quantum event‒more episodic and sporadic in measurable character than a seemingly smooth decay, but nevertheless getting closer and closer to zero all the time.

I’m tired.  Also, frankly, I’m uninterested.  The two things may be related.

None of the things I do for entertainment‒for distraction really‒are working very well anymore.  I am particularly bored of being in pain, of course.  That gets old very quickly, especially when it’s chronic, and mine has been there for decades now.  It’s not a warning of some life-threatening process happening, it’s just a set of alarms that are broken so they’re stuck in the “on” position.

Of course, my main problem(s) is/are me.  I’m a piece of merchandise that’s defective in many ways and in more than one system.  Believe me, if you got me as a present, you would hope whoever bought me had kept the receipt.

Anyway, I hope you all had a nice Thanksgiving yesterday if you celebrated the holiday.  I ate a bit of junk food at the house, but it wasn’t very good, and it seemed to give me some gastrointestinal trouble, so that wasn’t a lot of fun.  There was nothing good on TV, unfortunately; I started to watch the Lions game (American football), but got bored very quickly.

I watched some videos on YouTube, but I’m running out of things there that are interesting.  The best thing I saw was a couple reacting to Rogue One, but that’s still very much a simulated, twice removed illusion of watching a movie with friends, so it’s a bit lame.

Obviously‒I hope it’s obvious‒I’m giving you my viewpoint on these things, not claiming to have some definitive, objective take on them.  If people enjoy something and it does no harm, then it’s a positive and “good” thing, so I mean no disparagement.

I am not a good measure for how good things might be, because I tend to see things in a less than optimistic and upbeat fashion.

That’s enough for now.  I guess I’ll be writing a post tomorrow, barring the unforeseen, though it’s difficult to see why.  Maybe some catastrophe will befall me and become a blessing to you all (and to me) by finishing everything for me.  In any case, I hope you all have a good weekend.

by

“Don’t ask for favors. Don’t talk to strangers. Don’t axe me why.”

I’m going to try to keep this brief today.  I had a particularly bad night’s sleep, even for me, and I am in a significant amount of pain even after taking what I have for it (without massively overdosing).  Thankfully‒so far‒my thumbs aren’t acting up too much as I write this.

It certainly does get old, this chronic pain bit.  I don’t know if anyone out there is considering trying it as a way of being, but I can tell you that, after more than twenty years, I’ve decided it’s not a good lifestyle choice.  So please, if you’re considering it, then reconsider.

I know, I know, no one‒as far as I’m aware‒chooses to have chronic pain, not as such, anyway.  I suppose one might say that anyone who becomes a professional football player (American football, I mean, though all competitive sports have at least some tendency in the same direction) is in a sense choosing a life of chronic pain.

But at least there are compensations, and one receives them more or less up front.  The bill, however, almost inevitably comes due for those who play any kind of serious competitive sports.  Don’t get me wrong; I’m glad they do what they do.  I enjoy watching football, and to a lesser degree several other sports.  But even golf (which I also enjoy watching the pros play) gives its practitioners accumulated damage.

Is there any sport that does not exact a toll on those who take part in it seriously?  I don’t know.  Maybe free solo rock climbing doesn’t tend to give people quite the same kind of chronic, post-high-impact injury problems, because high impacts in that sport tend to be fatal.  Other than those, though, it appears to be a practice associated with great care and deliberation.  There is little to no tackling involved (they don’t even use other kinds of tackle, thus the “free solo” part).

I don’t know why I’m going into such things.  I was just speaking tongue in cheek about the idea of people actually choosing to have chronic pain, which was an absurd notion.  Then I realized that, in a way, people often do choose things that will almost inescapably lead to chronic pain.  But, of course, they aren’t consciously choosing the pain, and many of them probably don’t seriously think it’s something that can happen to them, not when they’re young and feel unstoppable.

Then, by the time they’ve come to recognize their own susceptibility, their own mortality and morbidity, it’s too late.

I suspect that chronic pain was much less common for our ancestors, at least if you go back far enough.  This is not because they were hardier or healthier than we are necessarily, though they probably had less occasion to be indolent.  But we are exposed to injuries they might not have been‒even minor traffic accidents can cause damage that accumulates and persists‒and also, we survive many things that would simply have killed them, thanks to modern science and technology.

Just because we survive them doesn’t mean they are harmless, though.  As Billy Joel sang, “You are still the victim of the accidents you leave.”  That which does not kill you can still leave damage; it does not necessarily make you stronger, any more than syphilis made Nietzsche healthier.

On that cheery note, I think I will wrap up this week and put it in the fridge for leftovers, where it will eventually go bad and will have to be thrown out anyway.  I know, that particular metaphor doesn’t really make sense.  I didn’t have anything in mind when I wrote it, I was just following the automatic thought that was initiated by the words “wrap up”.  If any of you have a good potential meaning for the metaphor that I just frivolously threw out there, please, feel free to share it with us.

Also, please have a good day and a good weekend if you can.

by

I have no title today (other than “doctor”)

I don’t think I’ll probably write very much today‒though I’ve been wrong about that many times before, so I guess I’ll have to wait and see.  I feel particularly tired already this morning, but that didn’t let me sleep uninterrupted for more than a few hours.  So far today I’m not in as much pain as I was the previous two days, but then again, on neither of those two days was my pain as prominent in the morning as it became during the day, so I cannot be too optimistic.

I am, of course, trying all my various adjustments and interventions and so on to try to improve things, and they have limited and temporary success in general.  But I will keep trying, until the day that I finally give up and/or die.  I suppose, of course, that I might even get better.  It’s physically possible.  But I’m not going to hold my breath, because I’ve tried many, many things to improve my pain, and they have not had much success.

With that in mind, unless you have something truly esoteric that you think I, a physician with a broadly curious mind and with chronic pain, will not have encountered or considered, I don’t encourage recommending or suggesting pain treatments to me.  You can of course, and I truly appreciate the sentiments involved in such offers, but they are often frustrating.  Also, when people recommend things that I know are just woo, it’s additionally frustrating to have to remind myself not to respond impolitely.  Good intentions aren’t enough to make good things actually happen, but they are worth taking into consideration and appreciating.  You shouldn’t be rude to people who are trying to help, even if they aren’t succeeding.

Anyway, my new thing that I mentioned yesterday did not arrive; it’s supposed to arrive today, now, having been delayed.  I won’t get into it yet, but I maintain my stupid pseudo-optimism, which I cannot explain nor justify, except to say that I’m stubborn.  But I have my limits.

It’s been a string of rather frustrating days, lately, and though none of the frustrations are catastrophic, in some ways that makes them more pernicious.  With major setbacks, one is allowed and expected to need a real recovery process, a bit of time, a bit of rest, or maybe just some sympathy.  One gets a break.  With more minor setbacks, one gets no respite, but they can nonetheless pile up, especially if one has chronic issues already.  But one will gain little ease from others with respect to them.

For instance, when I mentioned to a coworker that I was having a lot of frustrating things happen over the past several days, I got a reply that everyone was having a rough time‒based on what data, I don’t know.  His rough times apparently have to do with taking his daughter to the doctor for a thankfully not too severe issue and his wife being sick and so on.  I would give almost anything possible to have such “problems” again, or just to be able to be with my children in a significant way again.

Anyway, I was not terribly pleased, and in response to his statement about the claimed recent local preponderance of irritations, I said, “Well, that makes everything all right, then, doesn’t it?”

It wasn’t the cleverest of replies, but at least I was channeling the Toymaker a bit.

Anyway, I’m sure few or none of you readers are particularly sympathetic, either.  Why would you be?  I’m no one and nothing, just a weird little “voice” on the internet/web.  I’m a wisp of marsh gas, a flicker of movement in the corner of your vision, an occasionally annoying afterthought, like the water that gets on your shirt at the waist from doing the dishes, but that you don’t notice until you’re done.  I’m a tiny little grain of rock that gets on the bottom of your foot inside your shoe; it’s not quite bad enough to force you to stop, take off your shoe, and clear it out, but it’s there all the while, and you end up with a blister and other aches at the end of the day, from changing the way you walk.

So, yeah, that’s me.  That’s how I feel today.  I know, it doesn’t matter to anyone, but there it is.  Maybe today will be better than yesterday.

I wish I could say it couldn’t be worse, but that’s never true.  Reality has no lowest level.  Things can always deteriorate.

by

Lost then found thoughts about lost connections

While I was getting ready to go this morning, I thought about writing this blog post.  I thought about my usual starting point of saying something like, “Well, it’s Wednesday morning again,” or some other such inanity.  But then, as I was thinking about that, another, more interesting beginning and an actual, rather interesting, topic occurred to me.

Then, by the time I got ready to start writing—i.e., now—I had completely forgotten what I meant to write.

That’s terribly frustrating, but it is par for the course.

Oh, wait!  Maybe what I was going to write was about my realization regarding the effects of having a very uncomfortable crisis, but one that is inherently finite*.  It’s probably pretty obvious to you that what made me think of this was my recent adventure with a kidney stone.

Of course, while it was happening, it drowned out everything else, especially in the acute stages.  If that had been something without an endpoint, and if there were not sufficient medication to control the pain, then death would have been the only feasible alternative.  Even later, with the stent in place and the literal, constant, burning feeling that I needed to urinate for two weeks, things were pretty harsh.  But though it did not truly drown out my depression, and it was thoroughly exhausting, it did rather overshadow much of my chronic pain.

The day the stent was taken out I felt a fair amount of relief, of course.  But before long my usual existence asserted itself, with all its emptiness, and of course, with all its chronic pain.  And I remembered that, really, I have nothing going on in my life at all, nothing to which I look forward in any kind of long-term sense, and I have no further clue about or hope for my future.

It’s a bit reminiscent, on a shorter time scale, of what happened when I was a “guest” of the Florida Department of Corrections.  Though I was/am innocent of the charges that were created against me, I took a plea bargain for three years (toward which time served applied) because it was tolerably short and I didn’t want to risk the possibility of the much longer sentence with which the prosecution threatened to try to get, risking the outcome on the potential of a jury of my peers to see past my (apparently) not terribly endearing personality and the simple fact that I was a doctor and thus, to those who might be in a typical jury, a generally hated “elite”**.

I think it was the best available choice at the time.  And while I was “up the road” I was able to console myself with looking forward to seeing my children again once I got out—and to see them before they were adults, which would not have been the case otherwise—and that gave me the optimism to write first Mark Red and then The Chasm and the Collision and then Paradox City while I was at FSP West.

But then, of course, once I got out, it turned out that my kids didn’t really want the discombobulation of me having visitation or anything of that sort.  While I was heartbroken, I didn’t feel that I had a right forcibly to disrupt their lives when I had already fucked everything up, first with my personal health problems, then with my misguided attempts to help other people with chronic pain that led me to be arrested.

So, I bit the bullet and kept on writing at least, on my own, though I think my stories grew steadily bleaker and darker over time.  And I learned to play guitar and wrote and recorded a few songs, and did some covers and everything.  But I still didn’t see my kids, and haven’t even communicated with my son other than to receive his email stating that he didn’t really want to have a relationship with me (“right now”).

At least I got to see my youngest when I was visited in the hospital with my kidney stone.  That was a gift that was well worth even that much pain.  But now I’m back to my nosferatu existence, and like Vermithrax***, though I don’t feel pain as severe as the kidney stone, I still feel constant pain.

There may be people who can have chronic pain without getting depressed about it, and indeed, without losing their zest for life, but I fear I’m only left with the squeezed dry pulp of mine.  It seems to be just the way I’m built neurologically.

I suspect that most people who keep their spirits up despite chronic pain and disability do so because they are surrounded by a local support system of some sort****, and they probably do better at connecting with and getting along with other people than I do.

I’ve only ever really been close to specific, core groups of people, and with ones nearby, that I saw nearly every day.  I’ve never been good at connecting over long distances, and I have a hard time even picturing people when they’re far away.  I mean, I can “picture” them in the sense that I know what they look like, and I will be able to interact with them if and when I see them, but I cannot in any intuitive sense “model” their existence elsewhere.  I cannot really get a feel for what they might be doing and certainly not for what they might be thinking.

When even the people I love are far away from me, they really exist more as concepts than as people whose reality I can feel.  They are missing in a bleak and rather horrible way.  I feel terrible about that fact, and I hope it doesn’t come across as insulting—though it has probably hurt the feelings of people about whom I care on more than one occasion—but it seems to be just the way my brain works.  It’s also probably related to the fact that I never have for an instant imagined wanting to be someone other than myself, even though I hate myself; I just cannot even conceive of what that would mean, let alone wish for it.

Oh well, whatever, never mind.  I’m back on the train, yeah, and here I go again, on my own…alone again, naturally.

(I do like to quote things, don’t I?)

I hope you have a good day.

*Of course, as far as we can tell, pretty much everything is inherently finite, but some things are much more constrained and contained in time than others.

**This is based on what my attorney, and my attorney’s supervisor, said to me.  I don’t think they were trying to be unkind, and though their judgement was and is fallible, it was likely better than mine would have been.

***I know, I’m mixing fantasy metaphors and similes.  That’s okay; I like them.

****And most of them are probably not “ex-cons”.

by

Please eschew sour grapes, or at least don’t chew them…they’re sour.

I don’t really remember what I wrote yesterday; I remember that I was angry, but it wasn’t really about anything solid or sharp, more just a general sense of frustration and despair.  I really felt and feel at a loss, with no sense of meaning or purpose or deep value.

I can’t claim to think that feeling is unreasonable; the world provides plenty of evidence for the pointlessness of all things.  I suspect that most people just try to avoid thinking about it.  They distract themselves with religions and other ideologies and with social interactions, whiling away their time until everything finally breaks down and they die.

Some surely die in a state of bewilderment and fear, never having accepted or even having truly contemplated their own mortality.  Some probably find comfort in the aforementioned religious ideas or just in community.  Having the love of family and friends, especially if such people are with them near the end, must help relieve at least some of the dread and pain as things wind down.

It must be at least some comfort if, when one is dying, one has loved ones nearby, helping to provide reassurance or at least just company.  If one has loved ones who willingly and lovingly attend to them while they are dying, or even just want to be there with them, one must at least be able to think that one has done something right in life.

Anyway, I’m on my way into the office, still rather sick but definitely improving.  I’m coughing, but not as badly, and the goo I’m bringing up is thinning out and looking less like some weird, opaque resin made from peas.  I’m still far from optimal, but then, I only started getting sick about six days ago.  If I’m substantially over it by, say, Friday, well that will have been a decently circumscribed illness, especially considering just how badly I’ve been feeling.

Somewhat ironically, my illness at least distracted me‒temporarily‒from the degree of my back, hip, ankle, and shoulder/arm pains, and those are becoming more prominent again as the illness recedes.  This leads me to wonder to what degree interferons or “tumor necrosis factors” and other aspects of the immune response can have beneficial effects on chronic pain, or if indeed they can do so at all.

It might be interesting to do a retrospective study involving, say, people who were treated with strong doses of interferon (with ribavirin) for Hepatitis C, or even for cancers such as melanomas, and who came out the other end healthy, then to try to learn whether any of them had chronic pain before starting treatment, and how the pain responded to the treatment.  We could compare them to age (and otherwise) matched cohorts who did not receive any such interferon treatments but who had similar amounts of chronic pain and see if their courses differed in a statistically significant way.

Of course, those high-dose interferon treatments for Hep C had their own serious complications and side-effects.  For instance, they could trigger serious depression even in people with no previously known disposition to have mood disorders.  These outcomes were generally worth the risk, if one could thereby eliminate chronic Hepatitis C, which is associated with significant morbidities and pathologies, not the least of which are potential liver cancer and sclerosis.

Still, if I could go through, say, a six week course of such treatment and thereby reduce (or eliminate) my chronic pain, I think it would probably be worth it.  I’m depressed and suicidal anyway.

Of course, we’re a long way from such a study outcome, even if we had unlimited funding and could start the study tomorrow.  Money can help make a lot of things easier to do, but as Kansas pointed out in Dust in the Wind, money has no effect on time*, and some things just take time.

I don’t expect to see such a study done, let alone to be able to benefit from the results, and honestly, I don’t have a high credence that it would show clinically useful effects.  After all, my own pain is not diminished now as I’m getting over my illness; it’s just changing back to baseline.  And, unfortunately, taking a vacation from one pain to another only to come back to the original one is probably not something anyone would really seek out***.

That’s enough for today.  I hope you all have a decent one‒do please try, at least.  Someone should, and it would be nice if most such people were reader-types who like blogs rather than wealthy assholes who don’t give much of a shit about anyone else, though those are the people who seem most likely to have happy days most often.

Not that wealth means someone is undeserving of happiness; that’s a non sequitur, really‒sour grapes projected onto the world by those who resent and envy the wealthy (sometimes with good reason, sometimes without).

Do your best.

*Okay, if you had enough money, all in one place**, you might form a massive enough object that it would measurably slow the local passage of time.  Heck, you could make a “money black hole” if you could get enough of it together and compress it enough, and at the event horizon, time would stop (to an outside observer, anyway).  Of course, according to GR, a black hole is a black hole is a black hole, with only mass, angular momentum, and charge differentiating one from another, so it wouldn’t matter if the black hole was made out of money.  Quantum mechanics demands otherwise, though, and thus we have the famous “black hole information paradox”, which isn’t really a paradox, anymore than is the “Fermi paradox” (When you come to an apparent paradox or contradiction, that’s just an alert, saying “something you’re doing here is incorrect or incomplete.”)

**Even if you’re just storing that money as information, with no bills or coins, there is still energy associated with the information, always.  So enough information about enough money could still have gravitational effects.

***Then again, there is the phenomenon of deliberate self-harm, and I can tell you from experience, it is sometimes a way of diverting oneself from a pre-existing, chronic pain to another pain, one deliberately and personally chosen.  Does that count as a pain vacation?

by

Why would mice and men plan things together? Small wonder such plans go awry.

It’s Friday, as you know if you’re reading this on the day it’s posted.  I’m writing this on my smartphone because I didn’t feel like bringing my laptop computer with me when I left the office yesterday, but I’m beginning to regret it slightly.  My thumbs have still not completely recovered from their inflammation.  Perhaps they will never fully recover.  Who knows?  But it’s certainly the case that writing on the computer is much easier and more “natural” for me.

I will be working tomorrow if the office is open, and if so I will probably write a blog post.  For the past two weekends the office has not been open, since we had so few people willing to come in.  But maybe this weekend will be different, though we still have a lot of people out of the office.

As for anything else, well…I haven’t backslid on what to eat so far, in that I am following a path that should be good or at least useful.  I must say, though, there were times yesterday‒there are such times many days‒when I thought that maybe what I ought to do is just lock myself in the house and eat ice cream and cookies in huge quantities until it kills me.

Unfortunately, it takes a very long time to kill oneself that way, I’ll wager.  The body has a very high capacity to store calories before it completely breaks down and falls apart.  Individual mileage will vary, of course, but the mileage is long.  Such a course might be enough to make me stop liking ice cream and/or cookies, but that’s not the specific goal.

Yesterday I was also contemplating, both to myself and with my coworker, what I might be like if I had not had my back injury a little over 20 years ago.  I think I said something like, “You should see what I would be like if I didn’t have chronic pain.  You have no idea.”

I don’t have specific ideas myself either, but I do know that I used to be someone who‒when not suffering from too much chronic depression and apparently autistic burnout‒could do just about anything to which I put my mind.  For instance, I decided to apply to medical school more or less as an afterthought, but I never doubted that I could get in or that I could become a doctor.

It’s not that I was cocky.  Self-confidence of that sort has been something I occasionally pretended to have, but it’s not my natural state.  I just considered medical school an eminently soluble problem and proceeded to solve it.

Medical school does not involve a mentally super-challenging curriculum.  There’s a lot of information to internalize, of course, but none of it involves dealing with any counterintuitive notions.  There are rarely any complex numbers or linear algebra or calculus or differential geometry involved in medicine!  Quantum mechanics essentially never comes into play, except perhaps in describing vaguely how MRIs and PET scans work.

Anyway, things being so stochastic, it’s very difficult to imagine what I or my life would be like if I had never developed my chronic pain and back problem.  I might still be working in Winter Park as a doctor; I might still be married; and I would be much more likely to be with my kids, or at least to be able to see and interact with them.  I would also probably be much less grumpy than I am.  I don’t know how my autism itself would change its presentation.  Maybe I never would have sought out or even considered the diagnosis.

I guess it’s pointless to contemplate these things.  We cannot change the past.  Still, one of the big strengths of the human brain (or a pseudo-human brain) is the ability to contemplate counterfactuals as simulations so one can make decisions based on assessment of potential outcomes, colored by past experience and knowledge, rather than having to do everything trial-and-error, with death weeding out the worst local failures.

Still, all I can see stretching before me if I cannot reduce my pain and try to get better sleep at the least is loneliness (which is what I deserve, I guess) and pain and never-ending fatigue, with intermittent forced distraction.  That’s not worth the risk, especially since, in that scenario, an accidental or medical death would be one of the better outcomes.

Anyway, my resolve hasn’t changed since I discussed it earlier this week.  In the meantime, I hope you have a good day.  If I work tomorrow, I will probably write another post.  If not, I won’t.

by

Well, here we go again

It’s Monday morning, again, and I’m starting another week writing a blog post in the morning instead of doing something productive or creative or whatever.  Or, I suppose one could also say I am doing this instead of sleeping, though it’s not as though I really had a choice about that.

Oh, and the reason I didn’t post on Saturday was because the office didn’t open on Saturday, since everyone kind of needed a break.  It wasn’t because I died sometime after my Friday morning post, unfortunately.

Anyone who thinks that dying would be the unfortunate thing clearly hasn’t wrestled with and internalized the fact that everyone is going to die anyway, and that chronic pain makes the process of being alive a form of slow torture.  And as some famous person from the time of the inquisition said, if anyone has not confessed themselves a witch or a heretic, it is merely because they have not been subject to torture.

He was commenting on the fact that, unless there is truly some greater purpose motivating someone, torture works on essentially everyone, eventually.  Now, I don’t know if it’s melodramatic of me or if I exaggerate in calling 20+ years of chronic pain (while still trying to live a gainfully employed, productive life) a form of torture.  Maybe I’m just a wimp.  I do know that I do not have that greater purpose, that goal on which to keep my gaze fixed.

I used to have something or some things like that.  One of the thoughts that helped me get through prison was that I could look forward to seeing my kids again when I got out.  The whole point of accepting a plea bargain, even though I consider myself innocent, was that I didn’t want to take the chance of being in prison any longer than I had to, because I wanted to see my children again as soon as I could.

Of course, that turned out not to happen, because they didn’t actually want to see me.  It turned out that their lives were at least simpler when I wasn’t around, just like their mother’s was, just like pretty much everyone else’s life is simpler when I’m not around.

That was about 10 years ago, and I still haven’t seen either of them since.  I ask you, what’s the point of enduring anything in that situation?

I have a lot of endurance, I think‒mentally, anyway.  I can put up with a surprising amount of stuff just out of general pig-headedness.  But after a while it all gets annoying.

And lest anyone be under the mistaken impression that I am someone who has not sought help or not allowed people to help me when they tried:  I have gone through years of therapy at various times and of various kinds, I have taken various types and brands of antidepressants and related medications, I have called the suicide crisis line more than once and have very briefly been hospitalized because of it.  I have taken various kinds of medications and have tried numerous interventions including surgery to address my chronic pain.  I don’t easily let problems go.  I don’t tend to give up easily, at least not at things that matter to me.

But I am tired and I am in pain and I am alone.  Also, it turns out I am autistic.  That would, of course, be nothing new, just newly discovered, but it does make it very hard to make new friends or new connections with people, especially now that I am no longer in an environment where there are people around who are interested in at least some of the things in which I am truly interested or who have shared backgrounds.

I would like to do good in and for the world in some fashion.  I would at least like to bring original creations into the world that make some people happy, at least for a little while.

I know we’re all just animals, muddling our way from the womb to the tomb, acting in ways shaped by natural selection’s effects on our ancestors.  There need be no deeper point to life than that to keep everything rolling.  But it’s not very interesting after a while.

I don’t know.  Everything is getting boring.  It’s hard to bother keeping oneself alive when everything is either dull or irritating or painful.  There is such a thing as learned helplessness, even for the very stubborn.  All creatures have their limits.

I don’t know what I’m trying to say or do here.  I don’t know what the point is.  Probably there is no point.  I know that I am pointless, at the very least.  So I’ll draw this to a close again, and start yet another pointless, unpleasant, idiotic day.  I’m stupid that way.  But maybe I’ll get smarter someday.

by

I could a blog unfold whose lightest word would harrow up thy soul

Hello and good morning.  It’s Thursday, of course‒Valentine’s Eve, if you will.  I don’t mean to imply that every Thursday is Valentine’s Eve (which would imply that every Friday is Valentine’s Day).  No, no.  For the sake of any future archaeologists who might be trying to piece together tattered bits of our civilization, among which is this blog post*, I’ll point out that Valentine’s Day falls on February 14th (every year, without even any breaks!), and today is February 13th.  I’ll also point out that I am probably the only one who would think of it as Valentine’s Eve.

As you may be able to tell, I have nothing about which to write, today.  Don’t worry (as if you would), that won’t stop me from writing.  But I am distracted by mental exhaustion and rather severe pain that’s been bothering me and exacerbating my depression all week.  I know that my depression is not dependant on or caused by my chronic pain‒I know this because it predates it by a good twenty years‒but Batman knows it doesn’t help.

I mean, think about it:  you have dysthymia (aka chronic depression, with dips into full-on major depression), probable undiagnosed ASD with all its associated difficulties, you had a congenital heart defect (also called an ASD!) requiring open-heart surgery at 18, and now you have chronic back pain from a disk rupture/tear and “failed back surgery syndrome” for about 20 years (so every day for 20 years has been dominated by pain), and your career is wrecked, you’ve been to prison, you have no social life, no friends (outside of work), no romantic attachments for more than a dozen years (after having been divorced after your marriage of 15 years and then having only one, short and ultimately rather catastrophic, relationship after that) and you strive for self-improvement‒which you stubbornly keep trying to do, because you’re stupid that way‒but each time run into the barriers and obstacles and quicksand of your mood disorder, chronic pain, and probable “neurodivergence”, sending you what feels like three steps backward for every one you took forward.  Why would you not want to give up?

What, other than foolhardy stubbornness (and literally mindless biological forces), could drive someone to keep going and keep trying when there is no point, no goal, no reward, no aspirations, and no significant amount of even transient joy (though there is some)?

Whatever it is, it’s associated with such a high degree of tension that I cannot even sleep at night without waking frequently and early as if I were a soldier in the jungles of wartime Vietnam or something.  It’s really stupid.  I’m very irritated by and with myself.

But I have not yet been able to find effective solutions.  This doesn’t necessarily mean that there aren’t any‒the potential solution space might just be very large, and the subspace of workable solutions much smaller‒but it also doesn’t give any reason to be convinced that there are effective solutions.  There may be no answers, there may be no “right” way to go.

Oh, well.  What was I writing about…or, rather, what was it about which I was writing?  I don’t know.  Valentine’s Day, future archeologists (perhaps virtual beings?) trying to find clues to the attributes of our civilization, the pointlessness of continuing to live without connection or companionship or activities, no full escape from pain (ever), no good nights’ sleeps, all these weird things were matters about which I wrote above.

Enough.  I’m annoyed by myself; I can’t even imagine how annoyed you readers must be.  Really, I can’t.  My apologies.  I don’t know what I’m trying to accomplish.  Nothing, really, and possibly nothingness***.  But I have nothing else to write right now.  I hope you all have a good day.

TTFN

*This, of course, raises the question of how future archaeologists would even be able to see my blog without having already understood much of our civilization.  After all, unlike paper artifacts such as books and magazines, every written thing on the internet and web requires functioning computer systems, including processors, storage, internet protocols, languages from html to Java, C+, Python, Pascal, Fortran, Cobol, I don’t know what, as well as all the necessary hardware.  This is something people who say stupid things like “online is forever” don’t seem to grasp:  if we lose electrical power or some other process interferes with electronics, all the data on the internet is useless.  Hard copy books can decay of course, but that is much slower; they are much more self-contained stores of information, much less contingent.  That’s something about which to think, as the world approaches the brink**.

**Yes, I did that on purpose.

***That was a deliberate sentence fragment, used to convey a sense of drama and intensity.  I don’t know if it worked.

by

…sore labor’s bath, balm of hurt minds…

It’s Friday, but I work tomorrow, so the fact that it’s the last regular workday of the week means little to me.  I hope all of you (or y’all) are looking forward to the weekend.

Thanks for the kind words about my taking the day off from doing any writing or speaking yesterday.  I had a weird Wednesday afternoon to Thursday morning, so I was not really up to trying to write anything other than my note about how I wasn’t going to write anything.

I felt a strange surge of somewhat reckless energy on Wednesday afternoon‒possibly because I had finished payroll, possibly for some other reason‒and decided that it might be neat to try to walk all the way back from the office to the house.  It’s 30 miles, so I didn’t expect to be able to make it the whole distance, but I figured I’d get as far as I could and then Uber the rest of the way.  I really meant to do it.

Then, late in the afternoon, my sort of subacute-bordering-on-chronic lower GI discomfort came to a head, and I had to use the head several times in quick succession.  I realized that this would not be a good time to attempt my feat of endurance; I had no wish to be “caught short” on the streets of south Florida…or in some poor Uber driver’s car, for that matter.

So, instead, I waited at the office even after everyone left‒the train also not being a good place for GI emergencies‒and took some Imodium.  By the time everything settled, it was quite late, and so I just slept at the office.

Oddly enough, I slept better there than I usually do, and I half hoped that I might feel pretty good for the day.  That didn’t really pan out, and as you know, I didn’t even feel enough energy to write a post or do a voice recording.  I know I had already said that I’m not sure I’m going to continue this blog at all, but since I have been tending at least to post something on these days, I figured it would be polite to give notice.

It all just seems quite futile, though.  Of course it seems futile.  Everything seems‒and it may turn out to be feels‒that it will undoubtedly looks‒futile.  I don’t see any point in my continued life whatsoever.  I still haven’t gotten or even seriously investigated health insurance, partly because of the very severe tension and anxiety I have about initiating the process, but also because of my lack of desire to protect my health.

I really didn’t expect to be alive to see this year‒I didn’t plan to be alive, anyway.  Several times in the relatively recent past, I made plans to enact the end of my life, but one thing after another has gotten in the way.

I suspect there will be people who will say that I let things get in the way because I didn’t really want to die, and of course, at some level that was true.  I didn’t so much want to die as I wanted to be dead, but since there’s no quantum tunneling-style option, the one has to lead to the other.

I’ve often pointed out that the biological drive to survive can be absurd but is doggedly persistent, and it is very difficult to overcome via conscious thought.  I’ve tried.  I threw away a bunch of things I owned, I gave away some other things, and just in general attempted to put my house in order, so to speak.  I even wrote a draft of a will, of sorts, which I’ve updated a few times since.  But many things got in the way, not least the simple wish not to make things too inconvenient for other people.

And there’s the fact that, as I noted earlier, rather than say “I want to die”, it makes more sense to say “I want to be dead.”  If I had an “off” switch that could just be flipped, that might be the best thing.  But, of course, that’s not how biological organisms tend to operate, and the process of dying tends to be extremely unpleasant, for good, sound, biological reasons.

Sometimes I think if I could just get actual, restful sleep, that might be enough.  The last restful night of sleep I remember happened in the mid-1990s, and I remember it because it was such an outlier.  I was not used to waking up and feeling refreshed and rested and alive.  It was glorious.

Sleep clearly serves some important biological function; probably it serves more than one.  What it does is clearly complex, but I sometimes imagine it as a kind of automated pipe-scrubbing system in some intricate network of steam-punk machinery.  Every day, the system goes into idle, and the pipe-scrubbing/exhaust clearing system goes to work.  But my auto-maintenance, pipe-clearing system is faulty.  It doesn’t ever completely clear out the day’s accumulated debris and grime.

When the system is relatively new‒when one is young‒it’s possible for things to work relatively well, even if all the grime of a given day is never quite cleared away.  But the grime accumulates, the system accrues varying levels of obstruction, its auto-repair doesn’t work as well as it should, and gradually, over time, everything builds up, pipes get leaky, some junctions and connections get severely constricted and some fail altogether, and it gets harder and harder for the system to continue to function well.

People think I’m fairly smart; just imagine how clever I might be if I could just get a decent night’s sleep once in a while.

Probably the lack of sleep contributes to my chronic pain‒and then, of course, the chronic pain contributes to my sleep problems, which is not a paradox, but is actually an almost predictable occurrence in such spontaneously self-assembling, complex adaptive systems with all sorts of internal feedback systems and self interaction and all that.

“For want of a horseshoe nail, the kingdom was lost.”

“For want of the price of tea and a slice, the old man died.”

Oh, well.  Since I work tomorrow, I think I might try my walking home quest after work, then.  I have new socks that I ordered for just such a thing after Wednesday.  It would be cool if they help.  Perhaps I would sleep really well afterwards.  Or, hey, who knows, maybe I’ll get hit by a car (or other vehicle) on the way, and this will all be taken out of my hands.

There are worse things I can imagine.  One of them is simply my life continuing, as it currently is, indefinitely into the future.  The prospect of facing several thousand pounds of rapidly moving metal, perhaps steered by someone who has been drinking, seems much less unpleasant than that other, more banal and yet supposedly desirable alternative.